Tajikistan’s health system faces a growing HIV/AIDS epidemic, high rates of tuberculosis (TB), and persistent challenges in maternal and child health. Its systemic problems are further enhanced by the insufficient number of healthcare workers able to provide much-needed care to the Tajik population. In addition to addressing these problems, USAID supports an inclusive society for individuals with disabilities. The recent COVID-19 pandemic affected progress across all health services, including the decrease in TB and HIV detection rates, as health care workers were reassigned to support COVID-related needs.
HIV/AIDS: Situated along the illicit drug transport corridor from Afghanistan, Tajikistan suffers from a growing HIV/AIDS epidemic, fueled largely by people who inject drugs and spread the disease to other intravenous drug users and their sexual partners.
USAID works closely with Tajikistan’s Ministry of Health to strengthen essential healthcare services. USAID programs expand access to comprehensive HIV/AIDS prevention, treatment, and care services for key populations and seek to reduce stigma and discrimination. USAID also focuses on strengthening the abilities of national and local institutions, non-governmental organizations, and individuals to more effectively lead the planning, delivery, and monitoring of the quality of services for key populations.
Tuberculosis: Tajikistan has one of the world’s highest rates of multidrug-resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB) fueled by a general lack of awareness of how TB spreads and that it can be cured. The stigma that accompanies a TB diagnosis is also a serious challenge. However, there is progress. The 2020 WHO Global TB Report places Tajikistan among 113 countries that made significant advances over the last five years, and achieved good testing coverage by the end of 2019.
USAID works with civilian and prison health officials to increase access to TB care and expand the use of patient-centered ambulatory treatment approaches. USAID also supports a rigorous program to build the skills and capacity of health providers, communities, and patients to understand and address treatment and care for TB and multidrug-resistant TB. Additionally, USAID is helping the Ministry of Health roll out treatment regimens for all types of DR-TB that reduce the treatment period from 24 to nine months, and new drugs capable of saving the lives of those with extensively drug-resistant TB.
In December 2017, the first cohort of XDR-TB patients completed the shorter treatment regimen, in which everyone fully recovered. The shorter regimen is now part of the national TB protocol.
Maternal and Child Health: Maternal and child mortality rates in Tajikistan are the highest in the region. Although the maternal mortality rate is steadily decreasing, Tajikistan is still a long way from reaching the desired level of child mortality of fewer than 25 deaths per 100,000 live births.
USAID works closely with Tajikistan’s Ministry of Health to prevent morbidity and mortality of mothers and children under two as well as improve the quality and availability of lifesaving, evidence-based health interventions for women and children. To achieve these goals, USAID supports the strengthening of all levels of Tajikistan’s health system and works to change the social and behavioral norms for nutrition and health care for mothers and children.
RESULTS:
USAID’s comprehensive maternal and child health education activities reached 67,203 pregnant women and 178,748 children younger than five years old.
USAID interventions helped increase the rate of women who made four or more antenatal visits during their last pregnancy significantly, from 56 percent in 2016 to 86 percent in 2019 in target areas.
USAID interventions in southern Tajikistan reduced in-home deliveries across the target districts, from 4.6 percent in 2016 to 1.7 percent in 2019, giving women and their children better access to health care when they need it most.
USAID helped to make many improvements in the mortality rates for mothers and children from 2016-2019, including maternal mortality that decreased from 20 to 17.5 deaths per 100,000 live births, perinatal mortality rates changing from 20.5 to 16 deaths per 1,000 births; and the mortality rate for children under-five that also decreased from 24.4 to 20.4 deaths per 1,000 live births.
USAID trained over 4,900 health care workers on a range of maternal and child health and nutrition issues to improve the quality and access to maternal and child health services.
USAID assisted in the adoption of new TB treatments and guidance that has led to achieving an 89 percent success rate for drug-sensitive TB cases to successfully complete their treatment, among new or relapsed TB cases.
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