Aga Khan Foundation: Integrated Health and Habitat Improvement (IHHI) Rasht Valley

Project completed

Tajikistan is the poorest country of the former Soviet Union and is marked by a sluggish transition and fragility patterns. This project contributes to improving the Rasht Valley (the most neglected and fragile area of the country) population’s quality of life through better provision of and access to water and health services, as well as increased resilience against natural hazards. Moreover, it enhances professional skills and empowers the local population in planning and investing in its communities.

Country/region Topic Period Budget
Tajikistan
Climate change and environment
Water
Disaster risk reduction DRR
Environmental policy
Water resources conservation
Water sanitation
01.07.2013 - 31.12.2017
CHF  1’400’000
Background Rasht Valley is located in the north-eastern part of Tajikistan, a disaster prone region, which in the recent past has been afflicted by political instability and insecurity. Development perspectives will enhance stability in the area.
Tajikistan is currently in a process of transition from a Soviet-era health specialist based system to a more accessible one based on family medicine and primary health care. As a result of under financing (with only 2% of GDP spent on healthcare), the Central Government is not able to provide well-planned and organized health care services in geographically remote areas such as Rasht. In many places in the valley, primary health care facilities are not available or in poor condition. No more than 40% of Rasht Valley communities have access to piped water. In most cases water does not comply with adequate sanitation and hygiene requirements. The improper management of natural resources, use of outdated agriculture/irrigation techniques and deforestation are increasing natural risks, specifically those related to water.
Objectives The goal of the intervention is to contribute to improving the quality of life in Rasht Valley.
Target groups The project will serve the development of the entire Rasht Valley (400,600 people). Project sites will be selected in the seven districts of the Rasht Valley. A total of 480 villages will be covered with trained Community Health Promoters and 81 villages (more than 70,000 people) will benefit from a safe drinking water supply, improved sanitation, natural resource management and disaster risk reduction projects.
Medium-term outcomes
  1. Increased community capacity to plan and implement development projects together with local authorities, with the active participation of women and young people;
  2. Improved access to good quality health services;
  3. Improved access to drinking water and sanitation facilities combined with hygiene practices;
  4. Safer habitats through improved watershed management, efficient Natural Resource Management (NRM), and Disaster Risk Reduction (DRR).
Results

Expected results:  

Outputs for Outcome 1:

  • Civil society at community level is strengthened (Village Organisations, Water Users Associations) in its capacity to plan and take decision, to interact with local authorities, and to mobilize funds for development.

Outputs for Outcome 2: 

  • 800 Community Health Promoters are trained, integrated into Village Organizations, and brought into close cooperation with Primary Health Care staff;
  • 50 Primary Health Care facilities are renovated and provided with basic equipment;
  • 17 doctors and 118 nurses are trained in Family Medicine.

Outputs for Outcome 3:

  • 81 additional water supply systems are constructed and managed in a sustainable way;
  • 1300 adapted household and 52 community sanitation systems are installed.

Outputs for Outcome 4:

  • 52 plans and systems for watershed management, natural resource management, and land use are developed and implemented by communities.


Results from previous phases:  

SDC commissioned a formal Feasibility Study of the area, which identified the major needs of the population. The study results were validated through stakeholders’ meetings at the local, regional and national level, involving major development actors and donors, government officials, representatives of local NGOs and communities.

SDC also engaged with short term interventions in GBAO, Khatlon and Rasht Valley to improve access to basic health care by rehabilitating and equipping medical facilities. Drinking water provision and better sanitation and hygiene practices have also started.


Directorate/federal office responsible SDC
Credit area Humanitarian aid
Project partners Contract partner
International or foreign NGO
  • Agha Khan Foundation


Other partners
Village Organizations, Municipalities, Local Authorities in charge of water and health issues in the districts, Ministry of Health and Ministry of Land Reclamation and Water Resources.
Coordination with other projects and actors The project activities will be linked with the network in the drinking water supply and sanitation sector (implemented by Oxfam GB and funded by SDC), which includes all relevant stakeholders. It will cooperate with the other SDC funded health projects (Community Based Family Medicine Project, Enhancing Primary Health Care Services Project and Medical Education Project). At policy level, the project will contribute to overall health reform and drinking water reform in Tajikistan.
Budget Current phase Swiss budget CHF    1’400’000 Swiss disbursement to date CHF    1’400’000
Project phases Phase 2 01.01.2018 - 31.12.2021   (Completed)

Phase 1 01.07.2013 - 31.12.2017   (Completed)