Transforming primary health care in Tajikistan: pilot of health financing reform in Sughd region

Launched on 1 January 2025 in the Republic of Tajikistan, the Sughd Pilot for Health Financing Reform aims to achieve universal health coverage by implementing planned health financing reforms, alongside crucial governance and service delivery transformations. To this end, it builds on the national Strategy on Health Care of the Population of the Republic of Tajikistan for the Period up to 2030. This pilot, conducted in five districts/cities of the Sughd region, seeks to address significant challenges such as high out-of-pocket expenditures, limited coverage for chronic conditions and unequal resource allocation. By rehearsing initial reform steps, expanding primary health care (PHC) access and building administrative capacity, the initiative intends to showcase PHC’s role in delivering high-quality, needs-based care efficiently. Key activities include regional health budget pooling, establishing a regional purchasing entity, introducing a new payment method, increasing facility autonomy and integrating vertical services into PHC.