Provision of primary health care has become a priority under the Health Sector Reform initiative of the Government of Tajikistan. The Aga Khan Health Services (AKHS) established the Family Medicine and Clinical Excellence projects in GBAO in order to improve the quality of health care, increase the use of primary healthcare services and establish a culture of professional development.
The Family Medicine component of the project, which was initiated in 2008, involves the rehabilitation of healthcare facilities, training of family medicine health professionals and awareness-raising programs. Family Medicine Centers serve as gatekeepers for secondary care institutions and reduce the cost of healthcare services. In partnership with the Tajikistan Department of Health, AKHS established the Khorog Family Medicine Training Center to provide continuous training for family medicine doctors and nurses. AKHS also conducts workshops for Department of Health staff members and other health professionals on a variety of healthcare topics, such as family medicine, health promotion and disease prevention, and how to address medical emergencies. As of early 2010, the Family Medicine project has trained 19 doctors and 23 nurses, and rehabilitated 14 health facilities. The Clinical Excellence component of the project aims to establish quality assurance processes in order to ensure the provision of high quality health care. AKHS facilitates clinical audits, promotes continuing professional development through monthly presentations, and releases health updates and holds training sessions at its Clinical Excellence Centers. In the past, AKHS also focussed on improving the formal education of nurses in Tajikistan. In partnership with the World Health Organization, AKHS developed and implemented a nursing curriculum in all medical colleges in Tajikistan. The curriculum encompassed a range of disciplines such as sociology, psychology, research methods, nursing management, family health, communication, health promotion and safe motherhood. AKHS has also partnered with institutions such as the Aga Khan University’s School of Nursing in Karachi, Pakistan and the Tajik Postgraduate Medical Institute to provide nurses with the opportunity to enroll in short courses.