SWAP in Tajikistan
In Tajikistan efforts are ongoing for the development of a sector wide approach (SWAP) in health.
Ministry of Health (MoH) and Development Partners (DPs) initiated this process in recognition of the genuine challenge for the MoH to deal with 53 partners funding and implementing 97 projects (WHO 2006: Externally Financed Projects in Tajikistan mapping).
In 2008 facilitated by WHO MoH and all DPs agreed a “Letter of Intent” outlining six key steps towards development of a SWAP:
- MoH and DPs work together on the development of a new comprehensive health sector strategy supported by all significant partner/funding agencies
- Work together on the development of a medium term expenditure framework or budget which supports this strategy/policy
- Government leadership in a sustained partnership in the sector
- Work together to develop a set of mechanisms and working arrangements that enable structured dialogue and consensus building around managing the sector strategy and work program
- Work together to develop a set of common review mechanisms to evaluate health sector progress and commitment to the strategic plan
- Commitment over time to move to a greater reliance on Government financial management and accountability systems.
The first step agreed towards development of a SWAP was to develop a new comprehensive health sector strategy expected to be completed first part of 2010. The WHO-supported Health Policy Analysis Unit (HPAU) assisted the Ministry of Health in developing a roadmap for the strategy development process subsequently agreed by all partners in November 2008. All main partners in the sector work together and have contributed resources to the process. A Steering Committee led by the Minister of Health oversees the process.
Thematically the content of the strategy is organized according to the four health system functions (service delivery, financing, resource generation and stewardship) each supported by a core team led by a senior Ministry official supported by a local and international adviser. Partners organize their support in line with their comparative expertise each focusing on a particular part of the process with WHO providing technical advice to the area of governance and resource generation (Human Resource, infrastructure, pharmaceuticals) in addition to overall coordination support. The strategy is expected to be finalized in first part of 2010. Government and partners are considering conducting a Joint Assessment of the National Strategy (JANS) aiming to increase buy in and alignment of all partners around the new strategy.
