Tajikistan’s maternal mortality rate still high

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The Tajik government has taken steps to reduce maternal and infant mortality, but First Deputy Minister of Health Saida Jobirova said the problem is still significant.

In an interview with Central Asia Online, she noted that the government had adopted a number of acts on reproductive health, a national strategy on reproductive health, and family planning including the “Strategic Plan for Reproductive Health” and the “Safe Motherhood” program.

“Through the implementation of these acts we will achieve a 75 percent reduction in maternal mortality by 2015”, she said.

According to the World Health Organization (WHO), “The infant mortality in Tajikistan is high and the maternal mortality is the highest in the region”.

According to a WHO online database, in 2006 Tajikistan had the highest infant mortality in Central Asia, with 56 deaths per 1,000 live births. For the same year, Kazakhstan had the lowest infant mortality rate of 26 deaths per 1,000 live births.

The Ministry of Health reports that the maternal mortality rate in the country dropped from 40.8 women per 100,000 live births in 2008 to 30.8 per 100,000 live births in 2009. The WHO provided the same figures, but said the data varies depending on the region of the country.

Jobirova said the reasons for this are: ill-equipped maternity clinics; lack of necessary equipment; and shortages of obstetrical kits, mirrors and scalpels.

She also said many Tajik women die from not receiving obstetric care in a timely manner: “Women who live far from regional centres do not have the ability to seek out healthcare facilities”.

A UNICEF study found that in addition to high maternal mortality, infant mortality is also high during the first week and the second month of life. The study showed the infant mortality rate is higher in rural areas than in urban ones.

Among the causes of death are the combination of premature birth and low birth weight, improper management of maternal care, acute anaemia, diarrhea, malnutrition and infectious diseases.

UNICEF noted that in Tajikistan the per-capita number of health professionals is lower than in the other Central Asian countries.

“Health workers are one of the lowest-paid categories (of professionals). In 2003, their pay amounted to only half of the average salary and one-fifth of the salary for workers with the same level of qualifications in other industries. The lower remuneration has helped reduce the status of these workers and appealing to them to work on improving the quality of their services has proven a difficult challenge”, the report said.

Jobirova said the Ministry of Health offered training for medical staff. “We published a lot of literature that had been unavailable to health workers”.

She said the government should “work with women inside the family—with mothers and mothers-in-law—to increase every community member’s awareness of pregnancy danger signs in order to bring women to medical facilities on time so they can get medical help”.

Among the causes of death for pregnant women in Tajikistan, UNICEF cites malnutrition.

“Pregnant women should eat high-calorie foods, but, as a rule, it is not possible for them to have a normal diet”, Jobirova said. In order to improve the diets of pregnant women, the World Bank made a $4 million grant to buy groceries for 100,000 women in Khatlon Oblast and Sogdii Oblast.

“This is not a one-day issue. As our country develops economically, these problems will gradually outlive themselves”, Jobirova said.