Munosib Shohnazarov, 69, has been retired for almost six years. He is now engaged in gardening and farming in Derzud village of Rushan district in Gorno-Badakhshan Autonomous Oblast (GBAO). Although he is enjoying his retirement, after nearly 40 years working in the communications sector, he has started to feel pain in his knees and was recently diagnosed with knee osteochondrosis.
“I’d call it an occupational disease, as I spent most of my life working in extreme weather conditions. Rain, snowfall, avalanche, and other reasons were not an excuse to not provide people with stable communication. The broken pillars and disconnected communication transmission lines had to be replaced, regardless of the weather condition,” he recalls.
Munosib, a father of six children, receives TJS 530 (USD 52) monthly as a state pension, which he spends on his family’s necessities. Like many other households in GBAO, Munosib’s family is mostly dependent on remittances. His two sons working in Russia send money and medicines that are either not available in Tajikistan or too costly for Munosib.
To be able to cover some medical-related issues, Munosib and his wife joined the community-based health financing (CBHF) fund that was formed in his village in 2016. The fund’s participants put money together throughout the year with the aim of paying for any sudden medical problems of members in need. This assistance usually covers the costs of emergency medical care, transportation, medication, diagnostic testing, and other services as agreed upon by the members. Participation is voluntary, and all villagers are eligible for membership, helping them increase their access to health care while lowering their financial burden. Such a cushion against urgent cashflow needs can make the difference between poverty and good quality of life.
Since Thrive Tajikistan launched in 2018, it has provided continuous technical support through awareness raising, capacity building, and monitoring to this CBHF fund, along with 217 other existing CBHF funds in GBAO, and helped to form 60 more CBHF funds in both GBAO and Khatlon. Thrive Tajikistan: Partnership for Socio-Economic Development is a joint program of the United States Agency for International Development (USAID) and Aga Khan Foundation (AKF) with the aim to promote socio-economic development for people across Tajikistan.
In February 2022, Munosib was hospitalized at Aga Khan Medical Center (AKMC) in Khorog for his knee treatment. This was the moment when the Russian ruble started to lose value and the remittances Munosib received from his sons were insufficient to meet his family’s expenses, not to mention his treatment. As a result, the fund in which Munosib has been a member since its establishment in 2016 agreed to pay TJS 2,100 (USD 207) for his six-day treatment.
“By the time I was hospitalized, the payment had already been made to AKMC. People know the benefit of the funds and have the desire to join them. All my children, including those in Russia, have joined the fund and contribute their TJS 2 (USD 2) share every month.”
Due to the fast-growing membership and the motivation of members to pay their fees regularly every month, 44 funds in Rushan district, including the one which Munosib is a member, decided to join together to form a Union. Unions operate at the district level, and membership is voluntary. The Union leader is chosen through an election involving the CBHF fund leaders that are members of the Union.
“Coming together on a larger scale makes us able to handle more serious health-related problems. The CBHF Union serves as an important driving force towards this intention.”
In 2022 alone, the Rushan CBHF Union has managed to provide TJS 11,000 (USD 1,087) to help people hospitalized for different health-related issues. That offers peace of mind to families like Munosib’s across the entire district. Munosib is now feeling better and under the medical supervision of primary healthcare workers in Derzud village.
