Since the disintegration of the Soviet Union and its independence, the Republic of Tajikistan has been in a state of transition and struggled against economic decline. As a result, the health status of the population declined drastically: a low and rapidly deteriorating life expectancy rate, a high and increasing infant and maternal mortality rate, an alarming increase in the incidence of respiratory, digestive, infectious and parasitic diseases, and of tuberculosis rates. This severely affected the weaker members of the society, mainly women, children, elderly and the poor. The health care reflected the poor physical state of many facilities, the minimal availability and often lack of equipment and medical supplies, the level of financing as well as the low utilisation rates of facilities, and lack of well trained and motivated staff. Within the weak economic system much of the built-in support and impetus for providing effective health care was eliminated. In order to face these difficult circumstances, the Ministry took steps to improve the situation.
The overall project objective was to assist the Ministry of Health of the Republic of Tajikistan in its efforts to rebuild and reconstruct some of the polyclinics and district hospitals to provide adequate and efficient services addressing the emerging health needs of the population.
The Consultants met with responsible officers of the Ministry of Health and reviewed MoH plans and drawings for the requested district hospital and polyclinic sites. Several project sites were visited. After a careful analysis of the findings of the mission to Tajikistan, a bankable document - "Construction of polyclinics and district hospitals project - Tajikistan" including a proposal for the planning and implementation of the project (to be funded by the Islamic Development Bank) was prepared and submitted to the bank, containing detailed information on the respective project sites and providing cost estimates and an assessment of local capacity to carry out the envisaged construction works.