Activities in Tajikistan

As part of 2007 to 2015 National Development Strategy (NDS), Tajikistan has set the goal of achieving the Millennium Development Goals in health and medical care. These 2015 goals include reducing infant mortality and improving maternal health to two-thirds and three-fourths of their respective 1990s rates. Two other goals are to control the spread of infectious disease such as HIV/AIDS and malaria, and to halve the number of people lacking safe drinking water.

Since gaining independence in 1991, Tajikistan experienced civil war from 1991 to 1997, followed by economic depression and severe damage to its socioeconomic infrastructure. According to NDS data for 2003, Tajikistan had an infant mortality rate of 89 for every thousand, an under-five mortality rate of 118 for every thousand and a maternal mortality rate of 120 for every 100 thousand. Furthermore, the number of HIV/AIDS patients was 506 in 2005, the inoculation rate for infants under one year old was 95 percent in 2003 and the regional availability of safe drinking water was 47 percent in 2004. Overall, the people of Tajikistan are living under harsh conditions, even compared to other Central Asian countries.

Infants in particular require early treatment for acute diseases. It is therefore imperative that child caregivers have a basic knowledge of health and illnesses. Unfortunately, despite specific requirements in Tajikistan’s education standards are met, there is poor health awareness at the local level, and the health care services provided by local government are frequently unreliable.

In response to this, Tajikistan launched its Integrated Management on Children Illness (IMCI) project in 2000. IMCI includes three programs: an 11-day training course for health and medical care workers, the procurement of basic medical supplies, and community-based health education. Spreading nationwide beginning in 2005, it is targeted to develop community-based health and medical care especially in rural areas.

Tajikistan’s health and medical care first received support in the form of the 2001 Project for Improving Maternal and Child Health Care in Tajikistan in cooperation with UNICEF. Since then, special training has been provided locally in maternal and child health administration, a general grant was given in 2005 to upgrade Diakov Hospital’s medical equipment, and trainings in Japan are being provided as part of the Maternal and Child Health Support Project in Tajikistan in two phases from 2005 to 2007 and 2008 to 2010.

This project supports the Tajikistan Ministry of Health’s policy of prioritizing the IMCI project in Khatlon Province, which faces severe child illness and mortality, as well as the districts in the Region of Republican Subordination (RRS) located near the national capital of Dushanbe, to supply basic medicines.

The small Tajikistani budgets for IMCI -- 7,250 Tajikistani somoni in 2005 and 10,500 in 2006 -- were entirely allocated to labor, management and communication expenses, inadequate to purchase essential drugs. Japan will provide funding to the RRS districts for five years that will cover about 90 percent of local infants in need of care.

In cooperation with UNICEF, JICA supplied six basic medicines and a range of supplies and devices for childhood illnesses required to establish and promote IMCI, the highest priority in maternal and child health care. They were provided in key areas between 2004 and 2008, the medicines including gentamicin, benzylpenicillin and paracetamol, and the other provisions including syringes, acute respiratory infection timers, oral rehydration salts and pediatric medical scales. From 2004 to 2007, the total annual amounts of these supplies were 18.8 million yen, 19.4 million yen, 13.8 million yen and 19.8 million yen, respectively.