[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-detail-108466-en":3,"doc-seo-108466-105":31,"detail-sidebar-cat-0-en-105":92},{"code":4,"msg":5,"data":6},0,"success",{"doc_id":7,"user_id":8,"nickname":9,"user_avatar":10,"doc_module":4,"category_id":11,"category_name":12,"doc_title":13,"doc_description":14,"doc_content":15,"file_id":16,"file_url":17,"file_type":18,"file_size":19,"view_count":20,"is_deleted":4,"is_public":21,"is_downloadable":21,"audit_status":21,"page_count":22,"language":23,"language_code":24,"site_id":25,"html_lang":24,"table_of_contents":26,"faqs":27,"seo_title":28,"seo_description":14,"update_tm":29,"read_time":30},108466,4398048950312,"Violet","https://ap-avatar.wpscdn.com/avatar/400002538284de19e3c?_k=1778320343897328908",8,"Research & Report","Tajikistan - Policy Note on Mandatory Health Insurance - Executive Summary","Tajikistan’s government seeks progress toward Universal Health Coverage (UHC) through policy documents, yet key health financing reforms have lagged, as highlighted by the COVID-19 pandemic’s economic and human costs. The Ministry of Health and Social Protection requested technical support from the World Bank to review the Mandatory Health Insurance (MHI) Law adopted in 2008. The policy note assesses legislative inconsistencies, missing elements, and proposes five strategic directions and an MHI roadmap with phased implementation steps.","Public Disclosure Authorized Public Disclosure Authorized  \nTajikistan:  \nPolicy Note on Mandatory Health Insurance  \nMoulay Driss Zine Eddine El Idrissi, Lead Economist &  \nMirja Sjoblom, Senior Economist  \nWorld Bank  \nExecutive Summary  \nSince the second half of the 2000s, the government of Tajikistan has confirmed its commitment to move toward Universal Health Coverage (UHC) through various policy documents. However, implementation of key health financing reform has lagged behind.  \nThe COVID-19 pandemic has demonstrated the consequences of underinvesting in the health sector, both in terms of economic impact and human suffering. This has galvanized support both from domestic and international stakeholders in Tajikistan to advance on the implementation of critical health financing and health service delivery reforms.  \nTo seize this window of opportunity and advance on Tajikistan’s path toward UHC, the Ministry of Health and Social Protection (MoHSP) sought technical advice from the World Bank to review the Mandatory Health Insurance (MHI) Law. In response to this request, this Policy Note has been prepared with the objectives to:  \n(i) Review the existing law on MHI and provide the World Bank’s technical opinion on the legislation.  \n(ii) Provide concrete recommendations for how Tajikistan can advance with the implementation of MHI legislation toward UHC.  \nThe detailed review of the MHI Law, presented in this Policy Note, shows that there is room for improvement of the law, which was adopted in 2008 (14 years ago) , as there are several inconsistencies in the legislation, as well as gaps and important elements that are missing.  \nTo advance on implementing UHC in Tajikistan, the World Bank proposes five strategic directions:  \n1. Enlarge the fiscal space for health to raise more resources for MHI with a first step to develop a medium/long-term resource mobilization strategy.  \n2. Carefully consider ifa contributory health insurance scheme financed through payroll taxes (proposed in the law) is the best way forward, as a noncontributory scheme financed through general taxation seems more appropriate for the Tajikistan context.  \n3. Make the scheme truly universal by developing one state-guaranteed benefit package for the entire population that can start small and expand over time as more funds become available.  \n4. Introduce strategic purchasing, starting with primary healthcare, to increase value for money in health spending.  \n5. Introduce cost containment measures from the outset to make the scheme financially sustainable.  \nBased on these strategic directions, a Roadmap for MHI with key actions is proposed for the next years with the following steps:  \n1. Launch critical studies to inform decision-making, including a detailed financial analysis.  \n2. Improve the design of the MHI scheme and update and revise the legislation to current context.  \n3. Phase in the new design of the MHI model in one region and gradually scale up.  \n4. Continue to make critical investments on the supply side.  \n5. Create an intra-ministerial working group that can spearhead the implementation of the action plan.  \n6. Draw from international experiences but build an MHI model specifically tailored for Tajikistan.  \n1. Introduction  \nSince the second half of the 2000s, the government of Tajikistan has confirmed its commitment to move toward Universal Health Coverage (UHC) through various policy documents. In 2005, the 2005-2015 Health Financing Strategy was developed with a focus on:(i) better pooling of resources; (ii) developing strategic purchasing (single payer, provider payment mechanisms, etc.); (iii) combating informal payments; (iv) improving public sector wage; and (v) improving international partners ’ aid coordination. Three years later in 2008, the government approved a law on Mandatory Health Insurance (MHI) . Thereafter, the 2010-2020 National Health Strategy was adopted, which reconfirmed the government ’s desire to make the ","cbCair9g0Zw2Mxe7","https://ap.wps.com/l/cbCair9g0Zw2Mxe7","pdf",374621,4,1,25,"English","en",105,"# Executive Summary\n## Policy objectives and MHI law review\n## Strategic directions toward UHC\n## Roadmap steps for implementation","[{\"question\":\"Why was this Policy Note prepared for Tajikistan’s Mandatory Health Insurance Law?\",\"answer\":\"The Ministry of Health and Social Protection requested World Bank technical advice to review the MHI Law and provide concrete recommendations to advance implementation toward UHC.\"},{\"question\":\"What weaknesses does the Policy Note identify in the 2008 MHI legislation?\",\"answer\":\"The review finds room for improvement due to inconsistencies in the legislation, as well as gaps and important elements that are missing.\"},{\"question\":\"What five strategic directions does the World Bank propose to advance MHI toward UHC?\",\"answer\":\"Enlarge fiscal space for health, assess whether a payroll-tax contributory scheme is appropriate, make benefits universal via a state-guaranteed package, introduce strategic purchasing (starting with primary care), and implement cost containment to ensure financial sustainability.\"}]","Tajikistan - Policy Note on Mandatory Health Insurance - Executive Summary | PDF",1784471422,63,{"code":4,"msg":32,"data":33},"ok",{"site_id":25,"language":24,"slug":34,"title":13,"keywords":35,"description":14,"schema_data":36,"social_meta":87,"head_meta":89,"extra_data":91,"updated_unix":29},"tajikistan-policy-note-on-mandatory-health-insurance-executive-summary","",{"@graph":37,"@context":86},[38,54,69],{"@type":39,"itemListElement":40},"BreadcrumbList",[41,45,49,52],{"item":42,"name":43,"@type":44,"position":21},"https://docshare.wps.com","Home","ListItem",{"item":46,"name":47,"@type":44,"position":48},"https://docshare.wps.com/document/","Document",2,{"item":50,"name":12,"@type":44,"position":51},"https://docshare.wps.com/document/research-report/",3,{"item":53,"name":13,"@type":44,"position":20},"https://docshare.wps.com/document/tajikistan-policy-note-on-mandatory-health-insurance-executive-summary/108466/",{"url":53,"name":13,"@type":55,"author":56,"headline":13,"publisher":58,"fileFormat":61,"inLanguage":24,"description":14,"dateModified":62,"datePublished":63,"encodingFormat":61,"isAccessibleForFree":64,"interactionStatistic":65},"DigitalDocument",{"name":9,"@type":57},"Person",{"url":42,"name":59,"@type":60},"DocShare","Organization","application/pdf","2026-07-29","2026-07-19",true,{"@type":66,"interactionType":67,"userInteractionCount":20},"InteractionCounter",{"@type":68},"ViewAction",{"@type":70,"mainEntity":71},"FAQPage",[72,78,82],{"name":73,"@type":74,"acceptedAnswer":75},"Why was this Policy Note prepared for Tajikistan’s Mandatory Health Insurance Law?","Question",{"text":76,"@type":77},"The Ministry of Health and Social Protection requested World Bank technical advice to review the MHI Law and provide concrete recommendations to advance implementation toward UHC.","Answer",{"name":79,"@type":74,"acceptedAnswer":80},"What weaknesses does the Policy Note identify in the 2008 MHI legislation?",{"text":81,"@type":77},"The review finds room for improvement due to inconsistencies in the legislation, as well as gaps and important elements that are missing.",{"name":83,"@type":74,"acceptedAnswer":84},"What five strategic directions does the World Bank propose to advance MHI toward UHC?",{"text":85,"@type":77},"Enlarge fiscal space for health, assess whether a payroll-tax contributory scheme is appropriate, make benefits universal via a state-guaranteed package, introduce strategic purchasing (starting with primary care), and implement cost containment to ensure financial sustainability.","https://schema.org",{"og:url":53,"og:type":88,"og:title":13,"og:site_name":59,"og:description":14},"article",{"robots":90,"canonical":53},"index,follow",{"doc_id":7,"site_id":25},{"code":4,"msg":5,"data":93},[94,98,102,106,111,116,121,124,129,132,136],{"id":21,"doc_module":4,"doc_module_name":47,"category_name":95,"show_sort_weight":96,"slug":97},"Story & Novel",90,"story-novel",{"id":48,"doc_module":4,"doc_module_name":47,"category_name":99,"show_sort_weight":100,"slug":101},"Literature",80,"literature",{"id":20,"doc_module":4,"doc_module_name":47,"category_name":103,"show_sort_weight":104,"slug":105},"Exam",70,"exam",{"id":107,"doc_module":4,"doc_module_name":47,"category_name":108,"show_sort_weight":109,"slug":110},5,"Comic",60,"comic",{"id":112,"doc_module":4,"doc_module_name":47,"category_name":113,"show_sort_weight":114,"slug":115},6,"Technology",50,"technology",{"id":117,"doc_module":4,"doc_module_name":47,"category_name":118,"show_sort_weight":119,"slug":120},7,"Healthcare",40,"healthcare",{"id":11,"doc_module":4,"doc_module_name":47,"category_name":12,"show_sort_weight":122,"slug":123},30,"research-report",{"id":125,"doc_module":4,"doc_module_name":47,"category_name":126,"show_sort_weight":127,"slug":128},9,"Religion & Spirituality",20,"religion-spirituality",{"id":127,"doc_module":4,"doc_module_name":47,"category_name":130,"show_sort_weight":127,"slug":131},"World Cup","world-cup",{"id":133,"doc_module":4,"doc_module_name":47,"category_name":134,"show_sort_weight":133,"slug":135},10,"Lifestyle","lifestyle",{"id":137,"doc_module":4,"doc_module_name":47,"category_name":138,"show_sort_weight":107,"slug":139},19,"General","general"]