Tajikistan

Government Decree 600 sets out the types of health services which ought to be provided free of charge, and those that require full or co-payments. Since 2007 a basic benefits package has also been piloted in some districts, providing all citizens with access to basic primary care and emergency services at no or very low cost, as well as some specialist health services for more vulnerable groups. The package was gradually scaled up to cover 31 of the country’s 65 districts by 2022, but in May 2023 it was withdrawn and a new version has not yet been launched.

 In accordance with the Law “on health protection” of 1997 (No. 421), the executive authorities of the state are responsible for the protection of the health of the population. Although the national Ministry of Health and Social Protection formulates health policy, it is mostly local level administrations that deliver health services. 

 Government revenue is derived from the collection of national (republican) and local taxes. National health funding is allocated by the Ministry of Finance, but a sizeable amount of health financing comes from local resources. There are notable regional inequalities correlating to wealth and health care infrastructure, with the poorest regions spending the least on health per person. Public spending on health per capita is low in absolute terms and private out-of-pocket payments make up a large share of health spending.

 The provision of health services in Tajikistan is organized according to the country’s administrative tiers and differs in urban and rural areas. In rural areas, primary care is delivered through health houses, rural health centres and rural hospitals. In urban areas, primary and secondary care is delivered by rayon and city health centres (replacing the former polyclinics), basic secondary care by central rayon or city hospitals, specialized secondary care by oblast hospitals, and more complex care in national hospitals.