Tajikistan Women Health Information
Reported, January 5, 2012
In Tajikistan indicators such as infant and maternal mortality rates are among the highest of the former Soviet republics. In the post-Soviet era, life expectancy has decreased because of poor nutrition, polluted water supplies, and increased incidence of cholera, malaria, tuberculosis, and typhoid. The leading causes of death are cardiovascular diseases, respiratory disorders, and infectious and parasitic diseases. Because the health care system has deteriorated badly and receives insufficient funding and because sanitation and water supply systems are in declining condition, Tajikistan has a high risk of epidemic disease. Several typhoid epidemics have occurred since 1991. Many Russian doctors left Tajikistan after 1991, leaving the country with the lowest ratio of doctors to population in the former Soviet Union. The necessity of importing all pharmaceuticals has created an acute shortage of some critical items. The shortage of facilities, materials, and personnel is especially serious in rural areas. A presidential program doubled the wages of health workers in 2005. In 2003 a constitutional amendment eliminated the right to free health care for all citizens.
Since the late 1990s, the high volume of illegal narcotics trafficked through the country has caused a rapid increase in narcotics addiction, which has become a major health issue. In 2006 the number of addicts was estimated at between 60,000 and 100,000, two-thirds of whom are younger than 30 years of age. No substantial drug treatment programs are in place. Although reliable statistics are not available on the occurrence of human immunodeficiency virus (HIV), in 2005 the United Nations estimated Tajikistans figure at 5,000. Beginning in 2003, the incidence of new cases has increased more sharply each year. It is estimated that about 60 percent of HIV cases are drug-related. Since the late 1990s, HIV occurrence has increased rapidly in areas such as the autonomous province of Gorno-Badakhshan, where the flow of narcotics is heavy and poverty is endemic.
In June 2011, the United Nations Population Fund released a report on The State of the World’s Midwifery. It contained new data on the midwifery workforce and policies relating to newborn and maternal mortality for 58 countries. The 2010 maternal mortality rate per 100,000 births for Tajikistan is 64. This is compared with 45.6 in 2008 and 89.6 in 1990. The under 5 mortality rate, per 1,000 births is 64 and the neonatal mortality as a percentage of under 5’s mortality is 40. The aim of this report is to highlight ways in which the Millennium Development Goals can be achieved, particularly Goal 4 Reduce child mortality and Goal 5 improve maternal death. In Tajikistan the number of midwives per 1,000 live births is unavailable and 1 in 430 shows us the lifetime risk of death for pregnant women.
Tajikistan was the poorest of the Central Asian republics when it became independent in 1991. A long civil war led to the deterioration of economic and social development, which affected health outcomes. An estimated 22 percent of the population live in poverty. The total fertility rate remains high and contraceptive use is low. Yet, maternal health is making progress, with the halving of the maternal mortality ratio between 1990 and 2008. Midwives are unevenly distributed between urban and rural areas, and between primary care units and hospitals, with notable attrition in the remote postings. Out-of-pocket payments are frequent. Midwifery is taught by medical staff rather than by experienced midwives, and the latter often work as obstetricians assistants, rather than as autonomous professionals. In 2010, the Ministry of Health reviewed cases of maternal death in order to gain further evidence of key challenges that need to be addressed.
Resources:
http://www.unfpa.org/sowmy/resources/docs/country_info/
profile/en_Tajikistan_SoWMy_Profile.pdf
More Resources:
http://www.jica.go.jp/activities/issues/gender/pdf/08taj.pdf