Medical Education Reform in Tajikistan

Project completed

Tajikistan is the poorest among the former Soviet Union countries with a Gross Domestic Product per capita of US $ 820 in 2010. Its health care system undergoes a difficult process of profound reforms endeavouring to adjust scarce financing allocated to the health sector with the obligation to improve the quality and accessibility of the poor population to basic health services. Establishment of a well functioning family medicine of a good quality is an effective way to decrease the morbidity and mortality rates which are currently the highest in the region. To reach this aim in the long-term, SDC supports the reform of medical education.

Country/region Topic Period Budget
Tajikistan
Health
Education
Primary health care
Health systems strengthening
Tertiary education
01.09.2012 - 30.09.2015
CHF 3'050'000
Background

Tajikistan is currently in the process of changing its health system from a Soviet-era specialist based system to a primary health care system based on family medicine. This requires important changes related to medical education. Up to now the family medicine practitioners are prepared by internationally supported projects through retraining activities at postgraduate level. The training capacity of this post-graduate approach is 70 doctors per year while the need for family doctors is substantially higher (Since 2000 only 3040 out of needed 5833 family doctors have been trained). In consequence, without a strong involvement of the Tajik State Medical University (TSMU), the only university preparing medical doctors for the country at the undergraduate level and investing in Post University Specialty training for family medicine, it will still take decades to roll out the family medicine model nation-wide.

Objectives

The overall goal of the project is that the population of Tajikistan is benefiting from the improved quality of health care services, especially at primary health care level, through improved medical education.

Target groups
  • Staff of the Tajik State Medical University (TSMU), Post Graduate Medical Institute and two medical colleges in charge of nurse training
  • 5000 students from the TSMU and 1000 students from the medical colleges, family medicine doctors and nurses in 6 districts of Tajikistan
  • Policy makers from the Ministries of Health and Education

The whole population of Tajikistan (7.8 mio) will benefit from the improved health care services provided by retrained family doctors and nurses, and better trained graduates from medical university.

Medium-term outcomes
  • Students at TSMU in year 1 and 2 (undergraduate level) have improved their knowledge and practices through a new curriculum and better teaching approach
  • Family Medicine interns have improved their knowledge and practices through the implementation of Post University Speciality Training program and a functioning mentoring system
  • Family doctors and nurses have improved their knowledge and practices through a functioning continuing medical education and learning system that is steered and managed by Tajik institutions
  • Roles and responsibilities of different institutions as well as the financing of medical education are clarified through policy dialogue

 

Results

Results from previous phases:  

Within the first project’s phase, the national standards for medical education were renewed; the curriculum of medical education at the TSMU was updated to the needs of the health care sector; 66 teachers of TSMU improved their teaching capacities; a clinical skills laboratory was established allowing students of courses 2 and 5 (overall 1200) to develop practical skills. The external evaluation of 2011 assessed the phase 1 of the project positively underlining its substantial potential to improve health outcomes. The experts recommended continuing the project enlarging its scope so as to address problems related to post university specialty of doctors and nurses. The integration into the MEP of the medical education components of the Tajik-Swiss Health Care Reform and Family Medicine Project (SINO project) was recommended to increase the development of a holistic approach for medical education at all levels.


Directorate/federal office responsible SDC
Credit area Swiss cooperation with Eastern Europe
Project partners Contract partner
Private sector
Swiss Academic and Research Institution
  • Foreign private sector North
  • Swiss Tropical and Public Health Institute


Budget Current phase Swiss budget CHF   3'050'000 Swiss disbursement to date CHF   2'959'150
Project phases Phase 3 01.10.2015 - 30.09.2019   (Current phase)

Phase 2 01.09.2012 - 30.09.2015   (Completed)