As stated by the ADB, the technical assistance (TA) aims to support the upstream technical due diligence, design, development, processing, and implementation of the ensuing project for Tajikistan programmed for 2026 with an estimated budget of $31 million. The TA will also provide technical advisory and capacity building support to enhance governance, regulatory, and planning capacity of the Ministry of Health and Social Protection of the Population (MOHSPP), Committee of Food Safety, and other concerned institutions. The TA is aligned with the Asian Development Bank's (ADB) Strategy 2030 Development Results. It also contributes to achieving the Sustainable Development Goal (SDG) targets for poverty reduction (SDG 1.1), improving health and well-being (SDG 3.1, 3.8, 3.c, and 3.d), and enhancing gender equity (SDG 5.6).

• Output 1: Gaps and weaknesses of health system assessed and sector capacity enhanced. The output will support (i) a gap analysis of border health with special focus on the capacity of CESS stations at land and air POEs across the country in accordance with relevant guidelines on vector surveillance and control, infectious prevention and control, and coordination with overall public health surveillance systems, etc.; (ii) developing POE-specific capacity improvement recommendations and investment requirements with costing in consideration of the epidemiological context, geographic features, status of utility supplies, transport and communication, connection, climate risk of each POE; (iii) an assessment of the capacity and utilization status of public health laboratories across identified project districts with recommendations on laboratory clustering and classification (district, regional, and apex). The recommendation should define number of human resources, types and capacity of laboratory testing, minimum infrastructure requirement, needs of laboratory information system, and laboratory transpiration and referral pathways at each level of laboratories; (iv) a costed investment plan for upgradation, co-location, and integration of identified laboratories for enabling smoot sample referral and laboratory clustering; (v) developing a business model for upskilling the human resource capacity, improving fiscal sustainability, and improving the testing capacity of National Laboratory of Public Health as the apex public health laboratory of Tajikistan. The business model should also allow it to accept samples from private laboratories to generate revenue through public-private partnerships; (vi) assessing and exploring available innovative digital solutions for information management, surveillance data analysis, and emergency response such as Artifactual Intelligence and machine learning; (vii) a gap analysis of PHC services in rural and broader districts with special focus on mental health, maternal and child health, palliative and rehabilitative care, community outreach services, and biomedical waste management capacity in consideration of gender equality, social inclusion, and youth and civil society engagement; (viii) provision of handholding policy advisory support to the government's ongoing PHC reforms with special focus on gender-responsiveness of health services, gender-based violence prevention and control, healthcare workforce upskilling, climate resilience of health infrastructure and service delivery, and community-based early warning of infectious diseases and climate threats; (ix) reviewing digital health interoperability standards and/or data governance protocols to ensure the compliance of digital health investments of the ensuing project; (x) providing capacity building, knowledge sharing, and training support to MOHSPP and local healthcare officials on subjects covered by the TA to ensure the adoption of knowledges and recommendations generated from above-mentioned TA-funded upstream analytical work; and (xi) providing short-term external expert support to other technical areas not covered by above activities but considered critical to the development of health sector.
  
  
• Output 2: Project processing and implementation support provided. The output will provide technical design, due diligence, and capacity building support to the processing and implementation of the ensuing Strengthening Regional Health Security and Primary Healthcare Services Project, including facilitating consultations with non-governmental organizations, civil society organizations, and communities on their possible role in the implementation of the project.

ADB Team Leader:

Dai-Ling Chen
Email: dchen@adb.org 

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