lntegrated Health and Habitat lmprovement in the Rasht Valley, Tajikistan


Through the project the population living in one of the poorest and fragile regions of Tajikistan (Rasht Valley) will gain access to basic social services (water and health). The interventions in the selected watersheds will empower the local communities enabling their active participation in decision-making and effective management of the resources. As a result, people in the project area will adopt healthier, more environmentally sustainable, and disaster-safer behaviours.

Country/region Topic Period Budget
Tajikistan
Water
Health
Climate change and environment
Water sanitation
Health systems strengthening
Environmental policy
01.01.2018 - 31.12.2021
CHF 7'050'000
Background Rasht Valley is located in the north-eastern part of Tajikistan - a region prone to disasters, which was afflicted by political instability and insecurity in the last decades.
Less than 45% of the local communities have access to safe drinking water; hygiene and sanitation conditions are below standards in most of the places.
With only 2% of GDP spent on healthcare the central government is not capable to provide good quality healthcare services in country's remote areas; in many places primary health care facilities are in poor condition or inexistent.
Poor management of natural resources, use of outdated agriculture/irrigation techniques, pressure by growing population, land degradation and deforestation are increasing natural risks, specifically those related to water.
Objectives People benefit from basic public services in a peaceful and equitable society allowing them to improve their quality of life.
Target groups The project will serve the development of the entire Rasht Valley (451 '400 people) with the project sites selected in all seven districts of the Valley (Fayzobod, Rogun, Nurobod, Rasht, Tojikobod, Lakhsh, and Sangvor). More than 120'000 people in 140 villages (14 target sub-watersheds) will directly benefit from safe drinking water supply, improved sanitation, health care, NRM/DRR projects, while investments in valley-wide health services will cover indirectly 322'000 people.
Medium-term outcomes
  • Communities, including women and youth, participate actively as stakeholders/actors in local development
  • The population has access to and uses vital public services
  • People in the target area adopt healthier, more environmentally-sustainable, and disaster-safer behaviours

 

Results

Expected results:  

  • 21 water supply systems established
  • 210 of private EcoSan or flush toilets constructed by the households as a result of project advocacy
  • 109 of youth- and women-focused income generating activities supported
  • 24 doctors and 120 nurses trained on family medicine specialty
  • Clinical Excellence Centre (CEC) established, 3 new Primary Health Centres (PHC) constructed and 10 PHC rehabilitated to ensure the quality of health service provision by the trained staff
  • 14 Watershed Management Plans (WMPs) developed and 111 DRR-driven NRM projects be implemented
  • 4 emergency communications systems and 7 safe havens/emergency shelters established


Results from previous phases:  

  • Over 62'000 people (or 12% of the Valley's population) got access to safe drinking water services and 2% of population improved their sanitation conditions by constructing project-promoted EcoSan latrines
  • Access to family medicine services expanded to reach 50% of the population of Rasht Valley; the under-five child mortality rate fell from 25.6 to 23.1 per 1'000 live births
  • 47% of population improved their livelihoods applying modern Natural Resource Management (NRM) techniques
  • 30% of communities are better protected from the impact of natural hazards (17% increase from 13% pre-project)
  • 61% of youth and 35% of women in the targeted communities participated in design and implementation of local development planning.


Directorate/federal office responsible SDC
Credit area Swiss cooperation with Eastern Europe
Project partners Contract partner
  • Agha Khan Foundation


Coordination with other projects and actors

At policy level, the project will contribute to overall health reform and water sector reform program in Tajikistan.

At operational level implementation will be coordinated with the main stakeholders through the national water and sanitation platform TajWSS (funded by SDC and implemented by Oxfam GB) and with other SDC-funded projects in health (Community Based Family Medicine Project, Enhancing Primary Health Care Services Project and Medical Education Project) and DRR fields (lntegrated Watershed Management).

Budget Current phase Swiss budget CHF   7'050'000 Swiss disbursement to date CHF   3'300'000
Project phases Phase 2 01.01.2018 - 31.12.2021   (Current phase) Phase 1 01.10.2012 - 31.12.2017   (Completed)