Problem:

Reducing funding from international donors is a major challenge faced by many NGOs in Eastern Europe and Central Asia. Over the past years, the NGO sector has accumulated a huge potential for the effective implementation of HIV prevention and care services for different key groups involved in the HIV/AIDS epidemic. In the long term, it is necessary to ensure the sustainable implementation of programs/projects and the possibility of allocating funding directly to NGOs, through the mechanism of state social contracting.

Solution:

Work on the implementation of the state social contract system was started in Tajikistan in 2016. In 2018, a working group under the Ministry of Health and Social Protection of the Population of the Republic of Tajikistan developed a document “Specification and standards for categories of social services. Social services for people living with the human immunodeficiency virus and their environment.” This document was approved by order of the Ministry of Health and Social Protection of the Republic of Tajikistan No. 141, March 7, 2019. In 2019-2020, social services were defined taking into account the type, specification and standards of categories of social services for PLHIV. The timing of the time spent on social services and the timing of the social case have been determined. Regular working events were held with representatives of the Ministry of Health and Social Protection of the Republic of Tajikistan, with representatives of the Agency for Social Protection of the Population. There were consultations with representatives of the Alliance for Public Health on monitoring the results of ongoing activities. Technical assistance and support were provided by representatives of the Institute for Analytics and Advocacy.

Result:

All conducted budget advocacy activities contributed to the formation of a mechanism of state social contracting to provide assistance to people living with HIV who have found themselves in a difficult life situation in Tajikistan. In 2020, NGO “SPIN Plus” participated in the tender of the state social contracting and received the project “School of PLHIV Patients” for implementation. In 2021, the “Guide to the School of PLHIV Patients” was developed, approved for use and work in state social contracting, for the provision of social services in work with PLHIV. The guide is universal and applies to key populations in the penitentiary system and in public health. Within the framework of this project, 120 people living with HIV were covered by social services.

Further, the prospective expansion of the state social contracting is planned, as well as the participation of several organizations working in the field of providing services related to HIV/AIDS in a tender for receiving funding from the government. Expanding the sustainability of services is a strategic initiative for the effective use of public organizations resources (human one, work experience etc.).