Hypertension is a major driver ofpre-mature death and disability in Tajikistan, a low-incomecountry in Central Asia. The high burden of disease alsoresults in significant health care expenditure and lostlabour productivity. Therefore, there is an urgent need tostrengthen service delivery systems through early detectionof high blood pressure, prompt diagnosis, sustainedtreatment maintenance, and the attainment of blood pressurecontrol. The Ministry of Health and Social Protection andthe World Bank undertook implementation research to identifyeffective and context-appropriate solutions for improvinghypertension services. The assessment used the cascadeframework to describe drop-offs along the continuum of care,collected patient and health care provider perspectives onthe causes of discontinuities, used routine data fromparticipating facilities in a Bank-supported operation, anddrew on the international literature on chronic careinterventions. The report presents feasible andcost-effective recommendations that, if adopted, canstrengthen current programs and policies to address thegrowing burden of hypertension in Tajikistan.