Tajikistan
GaneshAID supported Tajikistan in zero-dose child identification and Gavi application development — Central Asia's most mountainous country, where high-altitude geography, rural isolation and economic constraints limit equitable access to immunisation.
Key Immunisation and Health System Challenges
Tajikistan is one of Central Asia's poorest and most mountainous countries. High-altitude terrain and seasonally inaccessible valleys create severe logistical barriers to cold chain continuity and outreach. Rural communities in remote districts may be cut off for months during winter, making consistent immunisation delivery extremely difficult to maintain.
Economic constraints further compound geographic barriers: health workers often lack transport and resources for regular outreach, and families in remote communities may have limited awareness of or access to immunisation services. GaneshAID's technical assistance supported Tajikistan's Ministry of Health in systematically mapping where zero-dose children are concentrated and what drives the gaps, building the analytical foundation for Gavi investment.
Tajikistan's mountainous terrain creates seasonal inaccessibility and cold chain continuity challenges that require specifically designed supply chain and outreach strategies — particularly for the Pamir and remote district populations.
GaneshAID Support in Tajikistan
Zero-dose child identification and barrier analysis
Primary and secondary analysis responding to all key analytical questions from Gavi's Zero-Dose Analysis Cards ("identify" section). Additional qualitative data collection conducted where the country context required it. Analysis covered geographic coverage gaps, demand-side barriers, supply-side constraints and systemic factors — differentiated by community typology (conflict zones, rural, urban informal, mobile populations).
HCD ideation sessions for tailored solutions
Interactive ideation sessions facilitated in-person and/or remotely using Human Centred Design methodology. Sessions brought together Ministry of Health staff, EPI teams, NGOs, local CSOs and humanitarian actors to co-design new, tailored and sustainable solutions directly addressing identified barriers to reaching zero-dose children. Documentation of minutes, action items and follow-up assurance throughout.
Gavi funding application development
Development of a complete set of prioritised, sustainable programmatic interventions reflected in: (1) Theory of Change for Gavi investments; (2) the supporting country application narrative; and (3) the submitted work plan, budget and Monitoring & Learning Plan. All applications developed under Ministry of Health leadership with full EPI stakeholder engagement.
Operational Contributions and System Improvements
As part of an eight-country zero-dose programme, applications were developed successfully under the leadership of the Ministry of Health, with full engagement of EPI stakeholders including NGOs, local CSOs and humanitarian actors. The participatory approach built national analytical capacity beyond the immediate application cycle.
Ministry-led applications
All applications developed under Ministry of Health ownership — national propositions, not donor-driven products.
Differentiated barrier analysis
Zero-dose typologies and barriers identified by context: conflict zones, rural areas, urban settlements and mobile populations.
HCD-validated solutions
Tailored programmatic interventions co-designed with national stakeholders and validated through participatory ideation.
Partners and Ecosystem in Tajikistan
Part of an eight-country zero-dose programme
This engagement is one of eight countries where GaneshAID provided participatory technical assistance for Gavi funding applications. The multi-country programme covered EAF, HSS, CCEOP and FPP funding streams, building a replicable model for equity-focused zero-dose programme design across fragile and low-resource contexts.