Integrated Health and Habitat Improvement in the Rasht Valley, Tajikistan

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
Climate change and environment
Drinking water and basic sanitation (WASH) (til 2016)
Primary health care
Disaster risk reduction DRR
01.10.2012 - 31.12.2017
CHF 9'140'000

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 The improper management of natural resources, use of outdated agriculture/irrigation techniques and deforestation are increasing natural risks, specifically those related to water.


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
  • Increased community capacity to plan and implement development projects together with local authorities, with the active participation of women and young people
  • Improved access to good quality health services
  • Safer habitats through Improved access to drinking water and sanitation facilities combined with hygiene practices
  • Improved watershed management, efficient Natural Resource Management (NRM), and Disaster Risk Reduction (DRR)

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 Swiss cooperation with Eastern Europe
Project partners Contract partner
International or foreign NGO
Private sector
  • Agha Khan Foundation
  • Foreign private sector North

Budget Current phase Swiss budget CHF   9'140'000 Swiss disbursement to date CHF   8'486'870
Project phases Phase 2 01.01.2018 - 31.12.2021   (Current phase)

Phase 1 01.10.2012 - 31.12.2017   (Completed)