Maternal, Newborn and Child Health in Tajikistan
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Maternal, Newborn and Child Health in Tajikistan
- 1. Saving a Generation: Maternal, Newborn & Child Health in Tajikistan October 2013
- 2. Tajikistan and its Neighbours Tajik-Uzbek Border 1000km Tajik-Afghan Border 1200km Tajik-Chinese Border 400km Tajik-Kyrgyz Border 900km
- 3. 942,600 220,000 182,000 Khatlon 400,600 Afghan Badakhshan TotalRasht ValleyGBAO 140,000 AKF Health Program works in 3 regions/17 districts and covers 10% of Tajikistan’s population, plus programs in Afghanistan
- 4. To improve the health status of the target population, particularly women of reproductive age and children under five Goal of AKF –TJK Health Programme
- 5. • Mountainous and remote, landlocked • High unemployment rate • Little access to family medicine health services • High dependency on remittances from labour migrants, largely working in Russia Gorno-Badakhshan Autonomous Oblast
- 6. • Mountainous and remote, landlocked • High unemployment rate • Little access to family medicine health services • High dependency on remittances from labour migrants, largely working in Russia Gorno-Badakhshan Autonomous Oblast
- 7. • Mountainous and remote, landlocked • High unemployment rate • Little access to family medicine health services • High dependency on remittances from labour migrants, largely working in Russia Gorno-Badakhshan Autonomous Oblast
- 8. • Mountainous and remote, landlocked • High unemployment rate • Little access to family medicine health services • High dependency on remittances from labour migrants, largely working in Russia Gorno-Badakhshan Autonomous Oblast
- 9. 2 135 350 57 68 65 63 11 6 99 82 12 6 Health expenditure (as % of GDP) Health expenditure per capita ($) 4,500 Prevalence of Tuberculosis (per 100K) Rural population with access to clean water (%) Life expectancy (years) Maternal mortality (per 100K live births) <5 mortality (per 1000 live births) Canada Tajikistan Health indicators comparing Canada and Tajikistan - 2011
- 10. Tajikistan continues to operate health care similar to the Soviet era, but there are opportunities for positive growth Current challenges Top-down, hospital-based Limited focus on primary Very few GPs Unequal distribution of funds between hospitals (49%) and out-patient, primary care (14%) Opportunities Support the Government in implementing Health Reform according to the National Health Strategy (2010-2020) Increase the knowledge and ability of communities to protect and promote health by applying gender-based behavior-change interventions.
- 11. While Canada’s population is aging, Tajikistan’s is largely <35
- 12. AKDN enhances Mother, Neonatal and Child Health through community interventions: • Immunization campaigns • Nutrition education and access for mothers and their newborns • Antenatal, Delivery and Postnatal Care • Family Planning
- 13. 9 12 13 46 361993 2012 2011 2010 2003 Infant and child mortality rates are steadily declining 13 18 18 54 45 Infant mortality rate (1000 live births) < 5 mortality rate (1000 live births)
- 14. Photo Gallery Left: Family Medicine Nurses Right: Emergency Medical Care
- 15. Photo Gallery Above: Family Medicine Doctor Home visit Right: Child Growth Monitoring
- 16. THANK YOU PLEASE RAISE YOUR QUESTIONS Rudoba Rakhmatova Senior Health Programme Officer , AKF-TJ Dr. Rudoba Rakhmatova Senior Programme Officer Health AKF, Tjk
Editor's Notes
- 1.Tajikistan is one of the five countries in Central Asia; the others are Uzbekistan, Kazakstan, Turkmenistan and the Kyrgyz Republic. Ninety-three percent of Tajikistan country is mountainous and the country has some of the highest mountain peaks on earth, such as Ismoili Somoni, at 7495 m.
- In the Republic of Tajikistan, the AKF Health Programme works in three regions and 17 districts. In addition, the programme operates in three districts of Afghan Badakhshan, just across the Panj River from GBAO.
- In the 29 countries where AKDN is operating, the health programme has the following objectives: Develop, test and advance models of sustainable healthcare that protect and promote health, prevent disease and facilitate access to the effective management of illness. Support the provision of basic, essential health services, especially for mothers, newborns and young children Build the capacity of health professionals Contribute evidence to influence government policies on health.
- Poorest country in Central Asia Currently according to the http://www.tradingeconomics.com/tajikistan/unemployment-rate the unemployment rate is 2.50 in 2013. http://www.tradingeconomics.com/tajikistan/rural-population-percent-of-total-population-wb-data.html 93 % of Tajikistan is mountainous area and 74% of total population live in rural area 4. Out of 74% of population that live in rural area only 30% have access to Family medicine healthcare services 5. About 2 mln of Tajik population, mainly men aged 16- 49 are in Russia. Personal remittances, received in 2011 were 47% out of GDP. http://search.worldbank.org/quickview?name=Workers%27+%3Cem%3Eremittances%3C%2Fem%3E+and+compensation+of+employees%2C+received+%28%25+of+GDP%29&id=BX.TRF.PWKR.DT.GD.ZS&type=Indicators&cube_no=2&qterm=remittances+in+Tajikistan
- Poorest country in Central Asia Currently according to the http://www.tradingeconomics.com/tajikistan/unemployment-rate the unemployment rate is 2.50 in 2013. http://www.tradingeconomics.com/tajikistan/rural-population-percent-of-total-population-wb-data.html 93 % of Tajikistan is mountainous area and 74% of total population live in rural area 4. Out of 74% of population that live in rural area only 30% have access to Family medicine healthcare services 5. About 2 mln of Tajik population, mainly men aged 16- 49 are in Russia. Personal remittances, received in 2011 were 47% out of GDP. http://search.worldbank.org/quickview?name=Workers%27+%3Cem%3Eremittances%3C%2Fem%3E+and+compensation+of+employees%2C+received+%28%25+of+GDP%29&id=BX.TRF.PWKR.DT.GD.ZS&type=Indicators&cube_no=2&qterm=remittances+in+Tajikistan
- Poorest country in Central Asia Currently according to the http://www.tradingeconomics.com/tajikistan/unemployment-rate the unemployment rate is 2.50 in 2013. http://www.tradingeconomics.com/tajikistan/rural-population-percent-of-total-population-wb-data.html 93 % of Tajikistan is mountainous area and 74% of total population live in rural area 4. Out of 74% of population that live in rural area only 30% have access to Family medicine healthcare services 5. About 2 mln of Tajik population, mainly men aged 16- 49 are in Russia. Personal remittances, received in 2011 were 47% out of GDP. http://search.worldbank.org/quickview?name=Workers%27+%3Cem%3Eremittances%3C%2Fem%3E+and+compensation+of+employees%2C+received+%28%25+of+GDP%29&id=BX.TRF.PWKR.DT.GD.ZS&type=Indicators&cube_no=2&qterm=remittances+in+Tajikistan
- Poorest country in Central Asia Currently according to the http://www.tradingeconomics.com/tajikistan/unemployment-rate the unemployment rate is 2.50 in 2013. http://www.tradingeconomics.com/tajikistan/rural-population-percent-of-total-population-wb-data.html 93 % of Tajikistan is mountainous area and 74% of total population live in rural area 4. Out of 74% of population that live in rural area only 30% have access to Family medicine healthcare services 5. About 2 mln of Tajik population, mainly men aged 16- 49 are in Russia. Personal remittances, received in 2011 were 47% out of GDP. http://search.worldbank.org/quickview?name=Workers%27+%3Cem%3Eremittances%3C%2Fem%3E+and+compensation+of+employees%2C+received+%28%25+of+GDP%29&id=BX.TRF.PWKR.DT.GD.ZS&type=Indicators&cube_no=2&qterm=remittances+in+Tajikistan
- Challenges 1. Focus on curative, specialized care delivered through hospital. Moreover there is a huge number of health facilities. For example in GBAO there are only 200, 000 population and 225 Health facilities. 2. Centrally planned system with authority resident in hospitals 3. System does not have adequate funding for hospital or primary care. Moreover, communities still wedded to the idea that health is achieved through expensive hospital-based care. There is little focus on health promotion and disease prevention. 4. 70 % of all health expenditures in Tajikistan are out-of-pocket payments made by individuals and families; 15% is covered by the government and 15% is contributed by international donor agencies. Opportunities for Growth The key area of the National Health Strategy is PHC strengthening accomplished by implementation a Family Medicine Programme. According to the plan for the National FM Programme, 70% of PHCs to be converted to FM centers. In AKF targeted areas, 31% of GBAO population and 35% of Khatlon region (3 districts) have access to quality FM services. To support MoH to implement the National Health Strategy AKF health programme calls for following interventions: i) Rehabilitation of Health facilities; ii) Provision of basic, specialized diagnostic and medical equipment; iii) Training of PHC and hospital level health workers at 6 month FM courses and on- job short and long terms trainings through continuing medical education. iv) Capacity building of ministry of health in planning, management and monitoring. So far there are more 900 Community Health Promoters in both GBAO and Khatlon that conduct health sessions among community about prevention of most common inflectional diseases, safe motherhood, immunisation, ECD, hygiene and sanitation etc. Women of reproductive age and young mothers are one of the key targeted group. Health messages reach targeted community by: i) conducting health sessions among community; ii) distributing of Information, Education & Communication materials; iii) Broadcasting TV spots on the national TV
- Mother and Child Health is one of four key priorities of the National Health Strategy. Child survival remains the greatest challenge for the country’s fragile health system. Children under five comprise 37% of the general population and those under 15 comprise almost 50% of the general population. In short, the population of Tajikistan is very young when the population of Canada under 14 are only 17 %http://www12.statcan.ca/census-recensement/2011/as-sa/98-311-x/2011001/tbl/tbl2-eng.cfm
- To improve MNCH services the following interventions are being implemented by the Health programme: Rehabilitation of MNCH supported health facilities, including provision of MNCH supported equipment; Capacity building of MNCH supported health workers at Primary health care and Hospital level, including eHealth interventions; Provision of Sprinkles for children 6 month – 24 moths in targeted areas; Conduction of health sessions among new mothers, pregnant women and caregivers about safe motherhood, Benefits of life saving vaccination, Early Childhood Development Conducting immunization campaigns in Afghan Badakhshan.