Leveraging Telehealth for Improved Healthcare Access in Remote Tajikistan: Feasibility and Impact in Sughd Oblast Pilot Districts

Ilker Dastan, Malika Khakimova, Farrukh Egamov, Maruf Abdurahmonov

Keywords: Telehealth, remote populations, health financing reform, quality of care, digital health, Tajikistan, primary health care

Background:

Telehealth has gained prominence as an innovative solution for overcoming healthcare access barriers, particularly in underserved and geographically remote regions. During the COVID-19 pandemic, its importance became evident in Tajikistan, prompting efforts to strengthen primary health care (PHC) infrastructure and capacity. Sughd Oblast, a pilot region for health financing reforms emphasizing output-based financing, provides a unique setting to assess telehealth integration within PHC systems to enhance access and quality of care.

Research questions:

1. What are the technical and operational feasibility aspects of telehealth in Sughd Oblast?
2. How can telehealth address healthcare gaps, particularly for remote populations?
3. What challenges hinder the consistent and effective use of telehealth in PHC?

Method:

A mixed-methods approach was used to evaluate telehealth feasibility. Quantitative data on health system performance and population demographics were analyzed alongside qualitative insights from interviews with healthcare providers, patients, and policymakers. Key areas of focus included infrastructure readiness, workforce capacity, regulatory framework, and community acceptance. Household surveys highlighted unmet healthcare needs linked to workforce shortages and facility limitations.

Results:

Preliminary findings suggest telehealth is technically feasible in pilot districts due to existing telecommunication infrastructure and the organization of PHC. Telehealth has the potential to bridge geographic and service delivery gaps, enabling remote consultations with specialized centers. However, challenges such as limited digital literacy, cultural hesitancy, and costly internet connectivity persist. Patients expressed enthusiasm for telehealth, emphasizing its cost and time-saving benefits. Policymakers noted its utility for managing non-communicable diseases and maternal health.

Conclusions:

Telehealth offers significant potential to transform healthcare access in Sughd Oblast, particularly in rural areas. While health financing reforms provide a strong foundation, addressing barriers like digital literacy and internet affordability is critical. Investments in PHC infrastructure, workforce development, and public engagement are essential for scaling telehealth and improving health outcomes in Tajikistan.

Points for discussion:

Strategies for enhancing digital literacy among healthcare providers and patients.

Policy frameworks to ensure equitable access to telehealth services.

Overcoming financial and cultural barriers to telehealth adoption in remote areas.

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