Interview with N.Jafarov

Dear Mr. Deputy Minister, 

You are the key person in the Ministry of Health and Social Protection of Population for the issues of electronic systems in the healthcare and in particular for the EU funded project "Technical Assistance to Support the Strengthening of the Health Information System in Tajikistan". Could you please say several words of your role and main tasks? 

The project assisted us a lot and contributed greatly in the development of the Health Information System in Tajikistan designed to meet our requirements and needs.  Up till nowadays we used paper based information collection means for our reporting needs and now we are at the transition stage from paper to computer and digital versions of documents. In other words, now for sending information from the remote district to the centre only one thing is necessary,  to have the connection to the information system DHIS2 and access to internet, and information becomes instantly available online for the decision makers and healthcare managers.


The value of the new system is to provide a possibility to have the information available for the decision makers not only after the end of the reporting period but ensures on-going access in the real time.

This process needs to be controlled and even not so much controlled but coordinated. Mainly it is coordination of activities within the healthcare system, development and introduction of information materials, reporting and accounting records. I was given the responsibility as the Deputy Minister to coordinate all the activities that are included in the development and introduction of information systems as well as efficiency analysis of measures and decisions taken to respond to the figures and information that we have. Information system includes demographic data such as births and deaths.  At the moment the CRO offices are making the registration but as the next stage it is possible to develop the national register system. Then it would be possible to register new-borns in hospitals, i.e. when parents come to get their new-born registered he or she would be already in the information system.

The project activities and activities of the project's partners, in particular of the Republican Centre of Medical Statistics and Information, are targeted at the timely collection and analysis of information. Nowadays we rather frequently face the situation when districts have a great challenge collecting the required information, as all the information is paper-based. We hope that after the introduction of the information system in the healthcare we will timely get all the information from all the districts and this would create a possibility to analyse the information on a timely basis and to take needed decisions at the local, regional and central levels on the improvement of management of the health system, introduction of national or sectorial programmes, for example aimed at the reduction of any varying incidence or introduction of prevention programmes.

As much as I understood from the Project team this year is a year of change – the decision has been taken to finalise the use of the previous version of the statistical programme MEDSTAT and from the beginning of 2015 the new information system DHIS2 should be in place and start being operational.  Do you see any challengers in this process and how the project might help in the transition period?     

The main issue that is always arisen when the new projects are being introduced is qualified staff.  All the new programmes provide educational trainings for the specialists working at the field but then sometimes we do not find trained people – people change jobs or move to other places. 

Social-economic factors influence brain drain and sometimes it happens that a specialist is leaving the country.   Training of specialists at all levels, staring from the primary level is of an extreme importance. We think that it would be advisable to introduce the training course on the basics of information system in the Medical University curriculum or in Medical Colleges. This would help to educate graduates of Medical University or Medical Colleges on how to work with the information system and desirably teach them some skills.    

Using this opportunity I would like to express my suggestion to the project, after the system introduction and evaluation of its sustainability proving its efficiency, we would like together with the project to suggest the introduction of the information system training programme into the curriculum of Medical University and Medical Colleges.   

Another challenge that I see in the development of the information technologies on the district level is the access of remote districts to the telephone connection: telephone lines or Internet.

We know from the several presentations of the President that the population of the Republic of Tajikistan is a little more then 8 million but the number of sim cards sold to the population exceeds 10 million.  It proves that availability of mobile connection is getting higher. With this said I want to hope that availability and access to Internet connection would be getting higher in future. So far mobile communication is cheaper in Tajikistan compared to other countries and it is possible to consider using flash-modems to get Internet access in case there is a mobile coverage.

Another issue is the use of landlines. It would good if our partners – Tajiktelecom works with Governmental agencies with understanding and in particular with healthcare system and helps to information transfer in the healthcare system.  I would give an example coming from the sector I am responsible for – sanitation and epidemiology, if within 6 - 24 hours we are not getting any information about the most dangerous infection happened somewhere in a remote area, it is not possible for us to control the situation or to take any measures. It would be good if socially significant projects find a solid support of our partners. Pricing policy of the landline communication is so far acceptable and it is a safe, reliable communication and we hope for the further cooperation. 

The next questions follows from all the mentioned above – the issue of budget allocation.  It would be good if every district allocated not less then 5% out of the total district budget. At the moment we know that not all the districts can afford to cover the Internet connection from their budget. This is one more challenge that might influence the information system introduction plans that we set for the next year.    

What do you think that the health system of Tajikistan and the health specialists are ready to move to the new and modern information system? 

You know, we got many responses from the regions and people treat with enthusiasm everything that comes new.  And enthusiasm as such helps our health professionals to introduce new technologies and to overcome challengers. The National Health Strategy of the Republic of Tajikistan for 2010-2020 is targeted on the promotion of the medical services to the remote areas and this makes us to think that slowly the newest medical technologies would be available for the population in the remote areas. The information system plays here an important role, not only in information exchange but also the equal importance lays in the fact that medical facility would be obliged to have access to Internet. This fact changes traditions and prepares situation for other coming technologies.  The most important is to start.  And speaking about our project it is worth saying that the start has been already launched and nowadays the project progress is on-going and stable: the specialists are trained, equipment in the needed numbers is in the field and is already used appropriately in the pilot mode.       

I hope that the change of statistical programmes generations would go successfully and very soon we will be using all the advantages of the new information system for the Tajik population benefits.  



Thank you!