Improving social care in Tajikistan
The introduction of a model for service delivery monitoring and performance benchmarking has provided a framework for the more efficient and effective delivery of social care services across Tajikistan. We led this modernisation project, providing technical assistance to the Government of Tajikistan to strengthen a national social care system that meets the needs of the most vulnerable sectors of society. The lack of both technical capacity, basic data and robust planning and monitoring has constrained efforts to align social care service delivery with service-user needs to date. This project addressed these issues by working with key stakeholders to develop a standard approach to the development of social service specifications and operational standards against which to monitor service delivery. Innovative GIS mapping techniques were also used to help local stakeholders understand the nature and scale of current service provision and as an evidence base for prioritising and planning further service development. New social work and social care methodologies were piloted within existing social welfare institutions with a focus on strengthening person-centred care, tailored to service-user needs. Sustainability was a major theme of the project with a focus on building institutional capacity and developing the legal basis for key reforms that support the move towards a future deinstitutionalised, mixed market model of service provision.
The social care sector in Tajikistan has been constrained by limited capacity to identify demand and to plan and commission services on that basis. This has been compounded by a lack of baseline data and quality standards against which to measure performance and the absence of procedures allowing for the contracting of social services by non-state entities.
This project was established to address these issues by developing standards and guidelines to ensure the quality of service delivery backed by transparent coordination, monitoring and evaluation systems. It took place in the context of a shift in government policy thinking away from large-scale, centrally-controlled institutions and towards a model of mixed market provision with services better tailored to user need.
We led a team of specialist advisers working with the Government of Tajikistan to deliver a programme of technical assistance supporting the delivery of high-quality social care services to a wide range of vulnerable groups in Tajikistan. The multi-disciplinary project team provided support to officials within the Ministry of Labour and Social Protection of the Population (MLSPP) as well as social care services personnel working in a number of different settings. The project focused on improving the way services are delivered within the existing model as well as strengthening the overarching system for social care service management in Tajikistan to enable a shift towards community based service provision.
A key element of the project was the design and introduction of a basic standards-based model that could guide the design and monitoring of priority services and provide a solid basis for social services contracting and performance management. We also used an innovative GIS approach to mapping national service coverage to support the co-ordination and planning of social services at the national level and to raise awareness among social care professionals and (potential) service-users about the range and location of services currently available.
Specific areas of technical assistance provided by the team included:
- Comprehensive reviews of social care legislation, policies and institutions
- The development of specifications and operating standards for a range of social care services and the drafting of supporting legislation
- Support for the official introduction of new social care professions into the national legislative framework in line with international best practice
- The development of guidelines and resources to support person-centred approaches to social care delivery, including the introduction of social work case management and the establishment of pilot projects in a selected residential institutions
- Specialist support with budgeting for care services procurement
- The development of a National Qualifications Framework and framework for strategic social welfare workforce development
- Development of the website of the Ministry of Labour and Social Protection of the Population (MLSPP) to raise public awareness of social care services
Maximising the sustainability of reforms was also a key theme of the project. We supported the establishment of a national training and education centre (located at the Chorborg National Rehabilitation Centre) for mid-level social workers and social carers and delivered an extensive programme of capacity building including study visits, workshop and work-based training, seminars and conferences for social care personnel from across Tajikistan. Staff at the training and education centre, which includes an extensive resource library built up through the project, include former local project team members who are well placed to promote the retention and dissemination of knowledge and competencies developed over the project lifetime.
As a result of this project, the Government of Tajikistan has formally adopted specifications and operating standards for six service types, including day care services for children with disabilities and residential care for vulnerable elderly people. In addition, the legal basis for the development of social care services based on these standards and assessments of demand has been established through the adoption of secondary legislation.
The move towards an improved national social care service is being complemented by an increase in the understanding and use of person-centred approaches to social care and the introduction of new professional disciplines in social care (including occupational therapy and physiotherapy) as well as new levels of specialism in social work.
Overall, the project has created a framework for the more efficient and effective delivery of social care services across Tajikistan. The establishment of a national specialist training and education centre will support the promotion and dissemination of best practice across the country, aiding the sustainable roll-out of a new, improved national system of social care.