PERSPECTIVE article
Front. Health Serv.
Sec. Health Policy and Management
Volume 5 - 2025 | doi: 10.3389/frhs.2025.1617679
This article is part of the Research TopicPublic Health Outcomes: The Role of Social Security Systems in Improving Residents' Health WelfareView all 85 articles
Health care benefits design to improve outcomes in resource-constrained settings: Suggestions for Tajikistan
Provisionally accepted
- 1Lund University, Lund, Sweden
- 2WHO Country Office, Dushanbe, Tajikistan
- 3World Health Organization Barcelona Office for Health Systems Financing (Spain), Barcelona, Balearic Islands, Spain
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The Tajik health system is characterized by improving health outcomes over the last 20 years, but also major inefficiencies in health care delivery and large difficulties for people to access affordable essential health care. The benefits package (BP) is an important prioritization tool in allocating the state budget to the health interventions that most purposefully raise health system performance.This article suggests directions for the new BP, which is envisioned in currently ongoing reforms. A universal health coverage framework is used to describe how the public budget is prioritized in the current BP and the main performance challenges targeted in the Government's current health reform efforts are investigated from a BP perspective. Criteria for a new BP are presented and suggestions for their application are provided.The article explains how BP design can improve health system performance in a budget constrained setting by focusing on primary health care interventions, and abolishing user-fees for child-and maternal services without additional budget resources. The main strength of the current BP is free-of-charge family doctor and nurse consultations for all. However, the BP does not support effective management of highly prevalent chronic non-communicable diseases and efficient use of public resources, due to the narrow scope and high user-fees for essential interventions. The user-fee exemptions for vulnerable population groups are neither rational in design, nor possible to evaluate due to absence of data.
Keywords: Benefits package, prioritization, Universal Health Coverage, Effective Primary Health Care, Budget resources
Received: 21 May 2025; Accepted: 18 Aug 2025.
Copyright: © 2025 Wilkens, Goroshko, Khakimova, Egamov, Habicht and Dastan. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Jens Wilkens, Lund University, Lund, Sweden
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