Improving the quality of care for mothers, newborns, and children in ten hospitals of the Republic of Tajikistan
Yusupova S. Rasulova G. Zakirova F. Ibragimova Z. Abdulloeva Z. Shabanov R. Yunusova D. Aminov O. Gagua T. Lomauri K. Babaeva B. Jullien S. Kuzmenko O. Tilenbaeva N. Kuttumuratova A. Weber M.W. Alieva R. Kurbanova P. Rajabova S. Mirzabekova B. Isaeva M. Muzaffarrov S. Rustamova Z. Murodova J. Meniqulov A. Mirzoda I. Ishmirzoev J. Zubaidzoda S. Narzulloeva S. Safieva S. Khalilova R. Caraus T. Calancea T. Taratina M. Babich D. Gorina K. Nikonets A.
2026University of Edinburgh
Journal of Global Health
2026#16
Background Tajikistan has accomplished reductions in maternal, newborn, and child mortality over the past decades through targeted policies and interventions. Challenges remain in providing quality healthcare due to limited resources, geographic barriers, and inadequate infrastructure. We aimed to evaluate the impact of a quality improvement (QI) initiative implemented in ten district hospitals from 2021 to 2024 to improve maternal, newborn, and childcare to accelerate progress towards achieving the Sustainable Development Goals. Methods A baseline assessment was conducted in 2021, with an endline assessment in 2023, using updated WHO quality assessment tools. A multidisciplinary team of national and international experts evaluated hospital performance across three domains: support systems, clinical management, and organisation of care. Data was collected through observations, interviews, and medical record reviews. Project interventions included working with hospital-level Quality Improvement committees, capacity building in effective perinatal care, and the use of the WHO Pocketbook of Hospital Care for Children. Regular supportive supervision and half-yearly collaborative quality improvement meetings were held among the ten hospitals. We graphically displayed, analysed, and summed the assessment scores. Results We observed notable improvements in the quality of hospital care, with most facilities progressing from substandard to better-performing categories. Seven out of ten hospitals demonstrated advancements in their maternity and neonatal units, with improvements in clinical management and hospital support systems, including access to drugs and equipment. Challenges remained in paediatric care, with only two of ten hospitals showing improvements in infrastructure and laboratory services, and none improving drug availability. Improvements in infection prevention and control were minimal; however, four in ten hospitals managed to improve their practices despite challenges with resource availability, infrastructure, and current protocols. Conclusions Comprehensive QI interventions can raise standards of care in resource-limited settings like Tajikistan. Despite measurable progress, systemic barriers persist, with weak infrastructure, unstable workforce, and limited infection prevention and control, requiring targeted investment and political commitment. Sustained success depends on equitable resource allocation, robust monitoring systems, and the promotion of a non-punitive, systems-oriented culture. Scaling up this initiative nationwide is critical to achieving long-term improvements in health.
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World Health Organization Country Office of Tajikistan, Dushanbe, Tajikistan
Department of Pregnancy Pathology, National Research Centre for Obstetrics, Gynecology and Perinatology of the Republic of Tajikistan, Dushanbe, Tajikistan
Department of NICU, National Scientific and Research Centre for Obstetrics, Gynecology and Perinatology of the Republic of Tajikistan, Dushanbe, Tajikistan
The National Association of Midwives, Dushanbe, Tajikistan
Soghd Oblast Maternity, Khujand, Tajikistan
Mother and Child Department, Istiqlol Republican Clinical Centre, Dushanbe, Tajikistan
Department of Safe Motherhood and Family Planning, Ministry of Health and Social Protection, Dushanbe, Tajikistan
Department of Child and Adolescent Health and Parenting Skills, Ministry of Health and Social Protection, Dushanbe, Tajikistan
Davit Tvildiani Medical University, Tbilisi, Georgia
Department of Neonatology, Tbilisi, Georgia
National Centre of Medical Education, Astana, Kazakhstan
World Health Organization Regional Office for Europe, Division of Country Health Policies and Systems, Policy and Governance in Health Unit, Copenhagen, Denmark
World Health Organization Regional Office for Europe, Office for Quality of Care and Patient Safety, Athens, Greece
World Health Organization Regional Office for Europe, World Health Organization European Centre for Primary Health Care, Almaty, Kazakhstan
National Research Centre for Obstetrics, Gynecology, and Perinatology, Dushanbe, Tajikistan
Dushanbe Maternity, Tajikistan
Department of Obstetrics and Gynecology, National Research Centre for Obstetrics, Gynecology, and Perinatology, Dushanbe, Tajikistan
Dushanbe city Maternity, Tajikistan
Vahdat District Central Hospital, Tajikistan
Medical Centre Istiqlol, Tajikistan
Istiqlol Clinical Center, Dushanbe, Tajikistan
Shifobakhsh Clinical Center, Dushanbe, Tajikistan
Hissor Central Hospital, India
WHO, Switzerland
National Medical Research Center for Children’s Health, Moscow, Russian Federation
National Medical Research Center for Obstetrics, Gynecology and Perinatology, Moscow, Russian Federation
World Health Organization Country Office of Tajikistan
Department of Pregnancy Pathology
Department of NICU
The National Association of Midwives
Soghd Oblast Maternity
Mother and Child Department
Department of Safe Motherhood and Family Planning
Department of Child and Adolescent Health and Parenting Skills
Davit Tvildiani Medical University
Department of Neonatology
National Centre of Medical Education
World Health Organization Regional Office for Europe
World Health Organization Regional Office for Europe
World Health Organization Regional Office for Europe
National Research Centre for Obstetrics
Dushanbe Maternity
Department of Obstetrics and Gynecology
Dushanbe city Maternity
Vahdat District Central Hospital
Medical Centre Istiqlol
Istiqlol Clinical Center
Shifobakhsh Clinical Center
Hissor Central Hospital
WHO
National Medical Research Center for Children’s Health
National Medical Research Center for Obstetrics
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