The Republic of Tajikistan is a country located in Central Asia. In 1991, when Tajikistan became independent it was the most poverty-stricken country of the Central Asia republics. A civil war hurt Tajikistan’s economic and social growth, which led to a decline in overall health in the region. One of these health issues is that Tajikistan has had a very high maternal mortality rate. However, in the last decade progress has been made and maternal mortality rates for women in Tajikistan are dropping.
Tajikistan currently has a rate of 32 maternal deaths for every 100,000 live births. This number has significantly decreased since 1990 when the rate was 107. There are multiple factors that are responsible for the decline in maternal mortality rates. One of the dangers had been the fact that many women have their babies at home. In fact, at least 15 percent of women still give birth without a doctor or midwife present.
Hospitals and Healthcare Facilities
A project by the name of Feed the Future Tajikistan Health and Nutrition Activity (THNA) is spreading information about the dangers of giving birth at home. They also teach women in the country about the benefits of delivering in a hospital or other health care setting. Funded by USAID, THNA is working alongside hospitals and healthcare centers in different locations throughout the country to talk about the three main factors that lead to increased chances of maternal mortality, also known as the three delays:
- Seeking maternity care
- Reaching a healthcare facility
- Receiving high-quality care once at a healthcare facility
In 2016, THNA partnered with the Ministry of Health and Social Protection of the Population to further understand the problem. The duo conducted 14 in-depth assessments of hospitals in the region. They found out that many healthcare facilities did not have proper medical supplies, lacked adequate equipment and were understaffed. The duo worked together and provided the healthcare centers with new equipment and supplies.
The partnership also taught more than 1,400 people in the community to be health educators. The health educators, in turn, taught women about prenatal care and when they should go to a hospital. These changes are a major reason why maternal mortality rates in Tajikistan are declining.
Families in Tajikistan who cannot afford healthcare facilities often turn to alternatives such as midwifery. It is challenging to find a good midwifery service in the country. However, the United Nations Population Fund (UNFPA) is working with the Ministry of Health to increase the quality of midwives in the region. They supply midwives with education, capacity building and medical equipment. Furthermore, the UNFPA trains midwives on effective perinatal care.
UNFPA also provides technical help in improving training curriculums at schools throughout the country. Nargis Rakhimova, the UNFPA National Program Analyst on Reproductive Health in Tajikistan said, “This initiative is considered a breakthrough as it raises educational programmes to the level of internationally agreed standards.” Improved midwifery services are another factor why maternal mortality rates for women in Tajikistan are dropping.
Even though it is easy to recruit young women into midwife training programmes, it is not easy to keep them in the profession. Midwives do not make a lot of money and there is no official certification for midwifery, which may lower the standards of services in the region. Rakhimova said, “Though the midwifery situation in Tajikistan is improving, midwifery needs to be developed as a separate profession complementary to medicine.” Improving compensation for midwives will help continue to lower maternal mortality rates in Tajikistan.
Continuing to Improve
The poverty Tajikistan faced when it gained its independence led to a number of health crises in the region. Maternal mortality rates are one of these issues. Even though the country still faces problems with maternal mortality, the conditions are improving. The combination of advancements in healthcare facilities and midwifery services are a big reason for the improvements. These are the two main contributors as to why maternal mortality rates for women in Tajikistan are dropping.