IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v65y2007i8p1720-1729.html
   My bibliography  Save this article

Implementing Family Health Nursing in Tajikistan: From policy to practice in primary health care reform

Author

Listed:
  • Parfitt, Barbara Ann
  • Cornish, Flora

Abstract

The health systems of former Soviet Union countries are undergoing reform away from the highly centralised, resource-intensive, specialised and hierarchical Soviet system, towards a more generalist, efficient health service with greater focus on primary health care. Family Health Nursing is a new model designed by WHO Europe in which skilled generalist community nurses deliver primary health care to local communities. This paper presents a qualitative evaluation of the implementation of Family Health Nursing in Tajikistan. Using Stufflebeam's 'Context, Input, Process, and Product' model, the paper aims to evaluate the progress of this reform, and to understand the factors that help or hinder its implementation. A four-phase research design investigates the development of the Family Health Nurse role over time. In 5 rural areas, 6 focus groups and 18 interviews with Family Health Nurses, 4 observations of their practice, 7 interviews with families and 9 interviews with physicians were carried out. Data were analysed according to the components of Stufflebeam's model. Although the legacy of the Soviet health system did not set a precedent for a nurse who is capable of decision-making and who works in partnership with the physician, Family Health Nurses were successfully implementing new practices. Crucial to their ability to do so were the co-operation of physicians and families. Physicians were impressed by the nurses' development of knowledge, and families were impressed that the nurses could offer real solutions to their problems. However, failure to pay the nurses regular salaries had led to serious attrition of the workforce. We conclude that the success of the Family Health Nurse role in other countries will depend upon its position in relation to the historical health care system.

Suggested Citation

  • Parfitt, Barbara Ann & Cornish, Flora, 2007. "Implementing Family Health Nursing in Tajikistan: From policy to practice in primary health care reform," Social Science & Medicine, Elsevier, vol. 65(8), pages 1720-1729, October.
    • Handle: RePEc:eee:socmed:v:65:y:2007:i:8:p:1720-1729
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277-9536(07)00340-1
    Download Restriction: Full text for ScienceDirect subscribers only
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Balabanova, Dina & McKee, Martin, 2004. "Reforming health care financing in Bulgaria: the population perspective," Social Science & Medicine, Elsevier, vol. 58(4), pages 753-765, February.
    2. repec:wbk:wbpubs:12425 is not listed on IDEAS
    3. World Bank, 2005. "World Development Indicators 2005," World Bank Publications - Books, The World Bank Group, number 12426.
    4. Falkingham, Jane, 2004. "Poverty, out-of-pocket payments and access to health care: evidence from Tajikistan," Social Science & Medicine, Elsevier, vol. 58(2), pages 247-258, January.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Nazim Habibov, 2011. "The inequity in out-of-pocket expenditures for healthcare in Tajikistan: evidence and implications from a nationally representative survey," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 56(4), pages 397-406, August.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Srivastava, Divya & McGuire, Alistair, 2015. "Patient access to health care and medicines across low-income countries," Social Science & Medicine, Elsevier, vol. 133(C), pages 21-27.
    2. Thomas L. Vollrath & Mark J. Gehlhar & Charles B. Hallahan, 2009. "Bilateral Import Protection, Free Trade Agreements, and Other Factors Influencing Trade Flows in Agriculture and Clothing," Journal of Agricultural Economics, Wiley Blackwell, vol. 60(2), pages 298-317, June.
    3. Simplice A. Asongu, 2014. "Knowledge Economy and Financial Sector Competition in African Countries," African Development Review, African Development Bank, vol. 26(2), pages 333-346, June.
    4. Sylvester Ngome Chisika & Chunho Yeom, 2021. "Enhancing Sustainable Management of Public Natural Forests Through Public Private Partnerships in Kenya," SAGE Open, , vol. 11(4), pages 21582440211, October.
    5. Ahmet Faruk AYSAN & Mustapha Kamel NABLI & Marie‐Ange VÉGANZONÈS‐VAROUDAKIS, 2007. "Governance Institutions And Private Investment: An Application To The Middle East And North Africa," The Developing Economies, Institute of Developing Economies, vol. 45(3), pages 339-377, September.
    6. SangHyun Cheon & Dong-Wook Song & Sungjin Park, 2018. "Does more competition result in better port performance?," Maritime Economics & Logistics, Palgrave Macmillan;International Association of Maritime Economists (IAME), vol. 20(3), pages 433-455, September.
    7. Fernández, Andrés & Martínez, Rodrigo, 2008. "The cost of hunger: Social and economic impact of child undernutrition in Central America and the Dominican Republic," Documentos de Proyectos 39315, Naciones Unidas Comisión Económica para América Latina y el Caribe (CEPAL).
    8. Busse, Matthias & Hefeker, Carsten, 2007. "Political risk, institutions and foreign direct investment," European Journal of Political Economy, Elsevier, vol. 23(2), pages 397-415, June.
    9. Walker, Douglas O., 2007. "Patterns of income distribution among world regions," Journal of Policy Modeling, Elsevier, vol. 29(4), pages 643-655.
    10. Kerekes, Carrie B. & Williamson, Claudia R., 2008. "Unveiling de Soto's mystery: property rights, capital formation, and development," Journal of Institutional Economics, Cambridge University Press, vol. 4(3), pages 299-325, December.
    11. Kai Carstensen & Erich Gundlach & Susanne Hartmann, 2009. "The Augmented Solow Model with Mincerian Schooling and Externalities," German Economic Review, Verein für Socialpolitik, vol. 10(4), pages 448-463, November.
    12. Montoya, Miguel A. & Trillas, Francesc, 2007. "The measurement of the independence of telecommunications regulatory agencies in Latin America and the Caribbean," Utilities Policy, Elsevier, vol. 15(3), pages 182-190, September.
    13. Marcus Noland, 2005. "Affinity and International Trade," Working Paper Series WP05-3, Peterson Institute for International Economics.
    14. Singh, Dharmendra P. & Biradar, Rajeshwari A. & Halli, Shiva S. & Dwivedi, Laxmi Kant, 2021. "Effect of maternal nutritional status on children nutritional status in India," Children and Youth Services Review, Elsevier, vol. 120(C).
    15. Christopher Edmonds & Sumner J. La Croix & Yao Li, 2006. "The China's Rise as an International Trading Power," Economics Study Area Working Papers 88, East-West Center, Economics Study Area.
    16. Francisco Rodríguez, 2006. "Openness and Growth: What Have We Learned?," Wesleyan Economics Working Papers 2006-011, Wesleyan University, Department of Economics.
    17. Shunichi Fukuhara & Chikao Yamazaki & Yasuaki Hayashino & Takahiro Higashi & Margaret Eichleay & Takashi Akiba & Tadao Akizawa & Akira Saito & Friedrich Port & Kiyoshi Kurokawa, 2007. "The organization and financing of end-stage renal disease treatment in Japan," International Journal of Health Economics and Management, Springer, vol. 7(2), pages 217-231, September.
    18. Raghav Gaiha & Katsushi Imai, 2006. "Agricultural growth, employment and wage rates in developing countries," Economics Discussion Paper Series 0621, Economics, The University of Manchester.
    19. Ilhom Abdulloev & Ira N. Gang & John Landon-Lane, 2011. "Migration as a Substitute for Informal Activities: Evidence from Tajikistan," Working Papers 311, Leibniz Institut für Ost- und Südosteuropaforschung (Institute for East and Southeast European Studies).
    20. Alberto Chong & Florencio Lopez-de-Silanes, 2006. "Corporate Governance and Firm Value in Mexico," Research Department Publications 4466, Inter-American Development Bank, Research Department.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:65:y:2007:i:8:p:1720-1729. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.