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					Goal 1:         Between 1990 and the year 2000, reduction of infant and under-five
                mortality rate by one-third or to 50 and 70 per 1000 live births respectively,
                whichever is less.

Under-five mortality rate            Probability of dying between birth and exactly five years of age, per 1000 live births
                                     Total: 125, M: 125, F: 122 (MICS, 2000)


Infant mortality rate                Probability of dying between birth and exactly one year of age, per 1000 live births
                                     Total: 87, M: 91, F: 83 (MICS, 2000)



                            Infant Mortality Rate, Tajikistan 2000

   100
    90
    80
    70
    60                        45.9     48.7
    50     40.7     40.6                      40.6
    40                                                 30.6    29.1     27.6
                                                                                 23.4
    30                                                                                    17.8
    20
    10
     0
           1990     1991     1992    1993     1994    1995     1996     1997     1998     1999    2000

                                 IMR                 MICS 2000           Linear (IMR)


DATA Source: MICS 2000, State Statistical Agency

Data Quality:
The data from MICS uses the Q5 programme, following the United Nations Far East model.
The data from State Statistic Agency are based on the data of department of registration. The
meaning of infant mortality includes the childbirth in the period of less then 28 weeks of
pregnancy, where the result is the newborn with the weight of less then 1000 gr. and height less
then 35 sm, is considered as late miscarriage, except those cases when the child survives during 7
days.

The data point of MICS (87,0) indicates the period of 5-9 years before the survey.

The difference between state data and MICS data can be partly explained by different methods of
data collection and in difference of determination of indicator of infant mortality (IIM). Another
reason is that, there are a lot of unregistered newborns and a high rate of home delivery in the
republic of Tajikistan during the last five years.

Progress toward the goal:
According the Government data, the infant mortality rate has been decreased from 40.7 in 1990 to
19,4 in 1999 or approximately on half. However this data does not reflect the real situation
because of the above-mentioned reasons. According to the MICS data, the infant mortality rate
calculated by the methods of State Statistic Agency is about 37. This rate is higher then the rate of
infant mortality by the reported data, but less then the norm of 50 on 1000 alive newborn. The
rate of child mortality has been decreased from 61.5 in 1990 to 49.5 in 1995.


Goal 2:        Between 1990 and the year 2000, reduction of maternal mortality rate by
               half

Maternal mortality ratio            Annual number of deaths of women from pregnancy related causes, when pregnant or
                                    within 42 days of termination of pregnancy, per 100,000 live births

Women mortality ratio                   Annual number of deaths of women in the age of 15-49 on 1000 women of
                                    appropriate
in the age of 15-49age.             age


                                                 1990      1991       1992        1993       1994           1995
 Maternal mortality ratio                        41.8      53.2       69.6        73.9       87.5           58.2
 Women mortality ratio in the age of 15-49       1,4       1,39       1,48        1,99       1,89           1,83

Data sources: State Statistic Agency
Data of registration department.
                          1990   1991    1992      1993    1994     1995       1996        1997      1998     1999
 Maternal mortality       97,7   100,7   119,8     124,4   121,5    97,7       84,5        64,6      65,5     53,0
 ratio

Source: Ministry of Health
Data on pregnant women mortality according to the vital registration in Health centers of the
Ministry of Health.

Data quality: The data of the State Statistic Agency on women mortality is based on the
information from the department of registrations. The meaning of women mortality includes only
women mortality in a result of complication of pregnancy and delivery but not all pregnant
women. The data of Ministry of Health two times higher. It is connected with the fact that the
methods of Ministry of Health take into account mortality of pregnant women, who was
registered including mortality because of the reasons not connected with the pregnancy and child
delivery.

Progress towards the goal: According to the data of the State Statistic Agency and the Ministry
of Health the rate of mother mortality is very unstable in a last decade. However according to the
data of State Statistic Agency (SSA) there was not a big decrease of the indicators of mother
mortality and women mortality in the age of 15-49 years. So the rate of mother mortality has
grown from 41.8 in 1990 to 58.2 in 1995. The total mortality of women in the age of 15-49 has
also increased from 1,4 in 1990 to 1,83 in 1995. At the same time the data of the Ministry of
Health shows the decrease of mother mortality rate almost in two times from 97.7 in 1990 to 53
in 1999 and comparatively with the 1994 in 2.5 times.

Progress towards Goal: According to State Statistical Agency and Ministry of Health data
Maternal mortality rate is very variable. Ministry of Health data shows that Maternal Mortality
rate is increased almost two times, from 97,7 in 1990 to 53 in 1999.
Goal 3:       Between 1990 and the year 2000, reduction of severe and moderate
              malnutrition among under-five children by half

Underweight prevalence       Proportion of under-fives who fall below minus 2 and below minus 3 standard deviations
                             from median weight for age of NCHS/WHO reference population:
                             Below minus 2 SD: 27.5 %
                             Below minus 3 SD: 7.5 %
Stunting prevalence          Proportion of under-fives who fall below minus 2 and below minus 3 standard deviations
                             from median height for age of NCHS/WHO reference population
                             Below minus 2 SD: 34.4 %
                             Below minus 3 SD: 12.1 %
Wasting prevalence           Proportion of under-fives who fall below minus 2 and below minus 3 standard deviations
                             from median weight for height of NCHS/WHO reference population
                             Below minus 2 SD: 9.6 %
                             Below minus 3 SD: 1.9 %

Data Source:
National Nutritional Survey. Tajikistan. Action Against Hunger. September/October 1999.
Recalculated by UNICEF to eliminate inclusion of oedema, and to get a national average.

Data Quality:
This data is for children aged 6-59 months. Four separate 30 by 30 2-stage random clusters were
conducted, one for each of Dushanbe, Khatlon, Leninabad and the Rayons of Republican
Subordination. Two areas were excluded: GBAO for logistical reasons and because it only
represents four percent of the population, and the Karategin Valley because of security concerns
(approximately 5 percent of the population). As the Karategin Valley is one of the poorest in the
country, it is likely that its inclusion would have resulted in a greater percentage of malnourished
children.

Progress towards the goal:
There is no trend data, but it is almost certain that the rate of malnutrition has increased over the
decade. At any rate, these rates are high, and show a need for reduction.
Goal 4:       Universal access to safe drinking water

Use of improved drinking water   Proportion of population who use any of the following types of water supply for
sources                          drinking: (1) piped water to household; (2) public standpipe/tap;
                                 (3) borehole/pump; (4) protected well; (5) protected spring; (6) rainwater

piped water to household                                           38.2
public standpipe/tap                                                7.8

Borehole/pump                                                       6.1
protected well                                                      1.7
protected spring                                                    3.1
Rainwater                                                             0
Total with safe drinking water                                     56.9
 Total with safe drinking water – urban                              93
 Total with safe drinking water – rural                              47

Source: MICS, 2000.

                                                 1994                                1998
 Proportion of population who has                61                                  48
 access to piped water
 Proportion of drinking water which as           1989 – 15,3                         1999 – 27,4
 cleaned in cleaning equipment



Source: State Statistical Agency (report on the work of the pipe system). National Plan of actions
on hygiene of environment of the Republic of Tajikistan (Ministry of Health, Ministry of Nature
protection).

Data Quality:
The MICS is a nationally representative survey of 3720 households. The SSA data relies on the
report of the work of the water delivery system. According to this report the proportion of the
population using the piped water has been decreased from 61% in 1994 to 48% in 1998.
According to the MICS data this proportion is 46%. Taken together they suggest a rate of
coverage somewhere between 45 and 60 percent.

Progress towards the goal:
According to the SSA and MICS data the goal to the end of the decade has not been reached. In
fact there is a decrease of the proportion of the population using the drinking water from safe
sources. At the same time, during the 1999 only 27.3% of drinking water was delivered through
the cleaning system.

Disparity:
There is a big difference in this data in urban and rural areas. 46.9% percent of the population in
urban and 92.9 in rural areas. (SSA data 31% and 94.9% accordingly). The situation in GBAO is
considerably worse than in other regions; only 28 percent of the population in this region gets its
drinking water from a safe source, mainly the source of the drinking water is rivers.
Goal 5:        Universal access to sanitary means of excreta disposal

Use of improved sanitary means       Proportion of population who use any of the following types of sanitation
of excreta disposal                  facilities:(1) toilet connected to sewage system; (2) toilet connected to septic
                                     system (3) pour-flush latrine; (4) improved pit latrine; (5) traditional pit latrine

  toilet connected to sewage system/ septic system                               7.7
 pour-flush latrine                                                              1.2
 Improved pit latrine                                                            4.7
 traditional pit latrine                                                        76.2
 Total with sanitary means of disposal                                          89.9

Data Source: MICS 2000, UNICEF

                                          1990                                         1999
The proportion of areas
equipped with central                     23.3                                         13.2
canalization in % from the
total number (in sq. m.)

Data Source SSA, Report on the work of canalization.

Data Quality:
The MICS is a nationally representative survey of 3720 households. Information from SSA is
received according to the report on the work of canalization. There is no more detailed
information on providing to the population the safe, sanitary clean methods of sewage disposal
in statistical reports. According to the report on the work of canalization the proportion of
living spaces (in sq. m.), equipped with central canalization has been reduced from 23.3%
in 1990 to 13.2% in 1999. During the survey MICS took into account the population
using the central canalization, which proportion is 7.7%

Progress towards the goal: According to the MICS and SSA the goal at the end of decade has
not been achieved – 90% of the population of the republic is secured with safe by sanitary means
standpoint methods of sewage disposal.
Goal 6:        Universal access to basic education and achievement of primary education
               by at least 80 per cent of primary school-age children through formal
               schooling or non-formal education of comparable learning standard, with
               emphasis on reducing the current disparities between boys and girls

Children reaching grade 5          Proportion of children entering first grade of primary school who eventually reach grade
                                   5: 94 (MICS, 2000)

Net primary school                 Proportion of children of primary school age enrolled in primary school
enrolment ratio

Net primary school attendance rate Proportion of children of primary school age (7-11) attending primary school: 75.0
                                   Girls: 76.2, Boys: 73.9 (MICS, 2000)
                                   Proportion of children aged 8-10 attending primary school*: 93.0 Girls: 93.4, Boys:
                                   92.7 (MICS, 2000)

Gross primary school enrollment ratio proportion of children of primary school age, entered the primary school (without
                                  age limits) according to the age group of 7-11 years

* The survey was done in summer, parents were asked to say whether their child had attended school in the
last year. However, many of the seven year olds would have been six and thus too young for school in the
beginning of the last school year. Also, some of the 11 year olds would already have been in secondary
school, thus the attendance of 8-10 year olds is a more accurate measure of attendance.

Data source: MICS, Unicef. 2000.

Data quality: The MICS is a nationally representative survey of 3720 households, with 3555
children between 7 and 11 years of age, and 2187 between 8 and 10 years of age.

Progress towards the goal:
There is a growing problem of non-enrollment and non-attendance in the country. More than 80
percent of children who enter grade one complete grade five. There is no significant difference
between girls and boys attendance.
According to SSA data gross primary school enrollment ratio is decreased from 85,4% in 1995 to
80% in 1999.
Disparity:
There is no disparity in school enrollment between boys and girls. Dushanbe has the lowest
attendance rate at 68 percent, perhaps due to the presence of a large number of migrants.
Goal 7:         Reduction of the adult illiteracy rate (the appropriate age group to be
                determined in each country) to at least half its 1990 level, with emphasis on
                female literacy

Literacy rate                         Proportion of population aged 15 years and older who are able, with understanding, to
                                      both read and write a short simple statement on their everyday life: 95.3

                                                            1989*                                   2000**
Proportion of population aged 15 years of
age and older who are able, with                             97,5                                     95,3
understanding, to both read and write


Data source:
   * State Statistical Agency (1989 census)
   **MICS, UNICEF. 2000.

Data quality:
People were merely asked if they and their family members were literate, but were not asked to
demonstrate this. The MICS is a nationally representative survey of 3720 households, with 15088
people of 15 and more years of age.

Progress towards the goal:
Since the average literacy was already 97.5% in 1990, reduction of adult illiteracy by half did not
take place. Adult illiteracy is concentrated in people aged 55 and older. Younger adults have
literacy rates in the high 90s.The total literacy rate has decreased for about two percent.

Disparity:
There is some minor regional disparity, but the main disparity is between young and old,
particularly for women. Only 51 percent of women over 65 and 80 percent of men over 65 are
literate. The gap between male and female literacy starts at 55 years of age, but young women
and men have almost the same level of literacy. The total level of literacy among men is 97 % and
women is 93%.
Goal 8:          Provide improved protection of children in especially difficult circumstances
                 and tackle the root causes leading to such situations

Total child disability rate               Proportion of children aged less than 15 years with a registered physical or mental
                                          disability:

                                                                1990                                    1999
Total child disability rate (per 10 000                         26,6                                    60,2
children 0-15 years)


Data Source:
State Statistical Agency, Ministry of Social Protection.

Data Quality:
This indicator means all disabled children who receive social support from the government, and
includes children with chronic illnesses in the age of 0-15 years.

Progress towards the goal:
After the civil war, there were a large number of orphaned children, and efforts were made to
support them through the creation of more residential institutions. Due, however, to the poor
economic circumstances and lack of state resources, the institutions are in poor condition, and the
quality of life of many children living in them is poor.
Goal 9:       Special attention to the health and nutrition of the female child and to
pregnant and lactating women


Under-five mortality                Probability of dying between birth and exactly five years of age, per 1000 live births
rate – female/male                  – disaggregated by gender: M: 125, F: 122 (MICS, 2000)

Underweight prevalence-             Proportion of under-fives who fall below minus 2 standard deviations from median
female/male                         weight for age of NCHS/WHO reference population – disaggregated by gender

Underweight prevalence              Proportion of under-fives who fall below minus 2 and below minus 3 standard deviations
                                    from median weight for age of NCHS/WHO reference population:
                                    Below minus 2 SD: 27.5 % (total) F: 28.9 % M: 26.2 %
                                    Below minus 3 SD: 7.5 % (total) F: 8.7 % M: 9.0 %
                                    N. B. This data is for children aged 6-59 months.
Antenatal care                      Proportion of women aged 15-49 attended at least once during pregnancy by skilled
                                    health personnel: 71 percent (MICS, 2000)

HIV prevalence                      Proportion of population aged 15-49 who are HIV positive – disaggregated by gender and
                                    age: No data

Anemia                              Proportion of women aged 15-49 years with hemoglobin levels below 12 grams/100 ml
                                    blood for non-pregnant women, and below 11 grams/100 ml blood for pregnant women:
                                    no data is available


                                  1990          1999
 Under five mortality rate        61,5          49,5
 Male                             65,2          52,8
 Female                           56,5          45,0
 Antenatal care                   88,9          81,2
 Anemia                           29,6          57,0
Data source: State Statistical Agency


Data Quality:
The MICS is a nationally representative survey of 3720 households with 6282 women in the age
of 15-49 years.

Progress Towards the Goal:
There is no significant difference in the survival and nutrition of female and male infants. While
pregnant women are not well served by skilled medical personnel, a national programme
to fight anemia have been introduced since 1998, including iron supplementation and public
education.
Goal 10:         Access by all couples to information and services to prevent pregnancies that
                 are too early, too closely spaced, too late or too many

Contraceptive prevalence             Proportion of women aged 15-49 who are using (or whose partner is using) a
                                     contraceptive method (either modern or traditional): 33.9 (MICS, 2000)

                                     Modern method: 27.3 (IUD: 25.1, Injections: 0.9, Condom 0.4, Pill: 0.6, Female
                                     sterilization: 0.2, Male sterilization: 0.1) (MICS, 2000)

                                     Traditional method: 6.6 (Withdrawal: 3.0, Periodic abstinence: 2.5, LAM: 1.0, Other:
                                     0.1) (MICS, 2000)

Fertility rate for women
15 to 19                             Number of live births to women under 20 per 1000 women aged 15-19: 38 (SSA, 1995)

Total fertility rate                 Average number of live births per woman who has reached the end of her childbearing
                                     period:
                                     Average number of live births per woman: 4.3 (SSA, 1995)
                                     Mean number of children ever born, for women aged 45-49: 6.8 (MICS, 2000)

N.B. Data for Fertility Rate is for women under 20, not 15-19.
SSA Data for average number of live births is for all women, not those at end of childbearing years.

Data Source
Multiple Indicator Cluster Survey, Unicef. 2000. State Statistical Agency. Gender Statistics in the
Republic of Tajikistan, p. 29.

Data Quality:
The MICS is a nationally representative survey of 3720 households. Government data is collected
from routine health reporting.

Progress Towards the Goal:
The adolescent fertility rate is moderate, and the fertility rate is declining, but the contraceptive
prevalence rate is low. A significant percentage of couples do not have access to knowledge and
services related to contraception.

Disparity:
Contraceptive prevalence is highest in GBAO at 63 percent and Leninabad at 51 percent. Slightly
less than a quarter of married women in Khatlon and RRP use contraceptives. The use of
traditional methods is generally very low, except in Leninabad, where 18 percent of married
women report using them. Adolescents are far less likely to use contraception than older women.
Only about nine percent of married or in union women aged 15-19 currently use a method of
contraception compared to 18 percent of 20-24 year olds and 40 percent of older women.
Goal 11:          Access by all pregnant women to pre-natal care, trained attendants during
                  childbirth and referral facilities for high-risk pregnancies and obstetric
                  emergencies

Antenatal care                  Proportion of women aged 15-49 attended at least once during pregnancy by skilled
                                health personnel: 71 (MICS, 2000)

Childbirth care                 Proportion of births attended by skilled health personnel: 71 (MICS, 2000)

Obstetric care                  Number of facilities providing comprehensive essential obstetric care per 500,000
                                population. 3/500 000. (SSA 1999)

                                Number of facilities providing basic essential obstetric care per 500,000 population.
                                27/500 000. (SSA 1999)



Data Source
MICS 2000., SSA

Data Quality:
The MICS is a nationally representative survey of 3720 households with 6282 women in the age
of 15-49 years and older.

Progress Towards the Goal:
The goal has not been achieved. The proportion of women attended by skilled health personnel
(doctors, nurses and midwives) is low, and has declined over the decade, with more women being
attended by friends or traditional birth attendants during delivery.
Goal 12:       Reduction of the low birth weight (less than 2.5 kg) rate to less than 10 per
               cent

Birth weight below 2.5 kg     Proportion of live births that weigh below 2500 grams: 13.3
                              Proportion of births that were not weighed: 53.1
                              Proportion of birth weights that were listed as don’t know/missing: 39.7




Data Source:
Multiple Indicator Cluster Survey, Unicef. 2000

Data Quality:
The MICS is a nationally representative survey of 3720 households with 814 newborns under 1
year. There is no state data.


Progress Towards the Goal:
The goal has not been reached.
Goal 13: Reduction of iron deficiency anemia in women by one third of the 1990
          levels

Anemia                           Proportion of women aged 15-49 years with hemoglobin levels below 12 grams/100 ml
                                 blood for non-pregnant women, and below 11 grams/100 ml blood for pregnant women:
                                 This data is not collected.



Source: State statistic Agency



Progress towards the goal:
As there is no baseline or current data, it is impossible to state if anemia has been reduced. What
is known is that it is a serious health problem, based on tests of pregnant women, which showed
that 57 percent were anemic in comparison with 29.6 in 1990.




Goal 14:       Virtual elimination of iodine deficiency disorders

Iodized salt consumption         Proportion of households consuming adequately iodized salt: 20.2 (MICS, 2000)

Law potassium iodate                                     Proportion of population (school age children or
population in general) with the proportion in urine              proportion of potassium iodate in urine below 10
microgram on 100 ml of urine.

Data Source
Multiple Indicator Cluster Survey, Unicef. 2000

Data Quality:
The MICS is a nationally representative survey of 3720 households. T his is the first national
household survey to test salt, so there is no trend data.


Progress Towards the Goal:
Iodine deficiency disorders are common and increasing. In 1990, most salt was iodized, however
with the collapse of the Soviet Union, the import of salt was reduced, and local salt producers
emerged. While legislation was passed in 1997 to require the iodization of salt, it is still not
widely practiced.

Disparity:
The percentage of households with adequately iodized salt ranges from 52 percent in Leninabad
to thirty two percent in Dushanbe, and less than two percent in Khatlon, GBAO, RRP – 2.5 and
2.8 respectively.
Goal 15:    Virtual elimination of vitamin A deficiency and its consequences, including
            blindness

Progress towards the goal:
Vitamin A deficiency is not considered to be a public health problem, and vitamin A
supplementation is not carried out. Although no serum retinal survey has been carried out, there is
not a high prevalence of clinical signs of vitamin A deficiency.
Goal 16:       Empowerment of all women to breast-feed their children exclusively for four
               to six months and to continue breastfeeding, with complementary food, well
               into the second year

Exclusive breastfeeding        Proportion of infants less than 4 months (120 days) of age who are exclusively
rate                           breastfed: 19.4 (MICS, 2000)

Timely complementary           Proportion of infants 6-9 months (180-299 days) of age who are receiving
feeding rate                   breastmilk and complementary food: 34.5 (MICS, 2000)


Continued breastfeeding rate   Proportion of children 12-15 months of age who are breastfeeding: 75.2 (MICS, 2000)

                               Proportion of children 20-23 months of age who are breastfeeding: 35

Number of baby-friendly        Number of hospitals and maternity facilities which are designated as baby-friendly
facilities                     according to BFHI criteria: 4 (Unicef)

Data Source: MICS, Unicef. 2000.

Data Quality:
The MICS is a nationally representative survey of 3720 households. For each cohort (0-3 months,
6-9 months, 12-15 months, 20-23 months) there were between 226 and 281 babies. There is no
previous survey on breastfeeding.

Progress towards the goal:
Breastfeeding is widely practiced and the continued breastfeeding rate is high. The exclusive
breastfeeding rate is low, however, and mothers need more education about the merits of this
practice.
Goal 17:    Growth promotion and its regular monitoring to be institutionalized in all
            countries by the end of the 1990s

Progress towards the goal: The research was made in schools and preschools, taking into
account height and weight of the children. Because of the bad equipment and other facilities of
the medical units it is difficult to tend the data. There is no special monitoring of height of the
children of Tajikistan. In September-October of 1999 the Action Against Hunger NGO conducted
a survey on nutrition status of children in Tajikistan. The results of the survey are submitted in the
report.


Goal 18:    Dissemination of knowledge and supporting services to increase food production
            to ensure household food security

Progress towards the goal:
There is special services for monitoring of food quality. In 1999-2000 more than 75 thousand
hectares of land were distributed to families, for agriculture purpose.
Goal 19:       Global eradication of poliomyelitis by the year 2000

Polio cases                  Annual number of cases of polio: There have been no cases since 1996.


Data Source: State Statistical Agency, Ministry of Health

Progress towards the Goal:
The goal has been achieved, but WHO has not yet certified Tajikistan as polio-free, due to its
proximity to Afghanistan.



Goal 20:       Elimination of neonatal tetanus by 1995

Neonatal tetanus cases       Annual number of cases of neonatal tetanus: none in the decade


Sources of data:             Routine reporting by Ministry of Health

Progress towards the goal:
Since the introduction of the tetanus toxoid vaccination in 1960, there have been no cases of
neonatal tetanus.
Goal 21:        Reduction by 95 per cent in measles deaths and reduction by 90 per cent of
                measles cases compared to pre-immunization levels by 1995, as a major step
                to the global eradication of measles in the longer run

Under-five deaths from          Annual number of under-five deaths due to measles. Not reported
measles

Measles cases                   Annual number of cases of measles in children under five years of age: 2551(1997); 2080
                                (1998)




                1990     1991     1992     1993       1994       1995       1996        1997       1998       1999
Under- five     42       8        36       146        17         1          na          na         0          0
deaths from
measles
Measles cases                     1689     3672       310        41         33          2551       2080       62

Data Source: Ministry of Health

Data Quality:
The data on measles cases among children are submitted in the age group 0-5.

Progress towards the goal:

Introduction of measles immunization and good surveillance system has impact on
decreasing of deaths due to measles.
Goal 22:           Maintenance of a high level of immunization coverage (at least 90 per cent of
                   children under one year of age by the year 2000) against diphtheria,
                   pertussis, tetanus, measles, poliomyelitis, tuberculosis and against tetanus for
                   women of child-bearing age

DPT immunization                              Proportion of one year old children immunized against diphtheria, pertussis and
                                              coverage     tetanus (DPT): 75.6 (MICS, 2000)

Measles immunization                          Proportion of one year old children immunized against measles: 61.2 (MICS, 2000)
coverage

Polio immunization                            Proportion of one year old children immunized against poliomyelitis: 78.3 (MICS, 2000)
coverage

Tuberculosis                                  Proportion of one year old children immunized against tuberculosis: 88.7 (MICS, 2000)
immunization coverage

Children protected                 Proportion of one year old children protected against neonatal tetanus through
against neonatal tetanus           immunization of their mother:
This vaccination is not considered necessary, as neonatal tetanus is not a public health problem
                                                            Vaccine Coverage Rate,
                                                             Tajikistan 1994-1999
            97,9          97,3          99                   99                  98                  98        96
                                                                       95   95        95   94   94        95
   100             86,9                      89   91   90         92                                                89    88,7
                                 81,3                                                                                            78,3 75,6
    80
                                                                                                                                             61,2
    60
    40
    20
      0
                   1995                      1996                 1997                1998                1999                   MICS2
                                                                        BCG            OPV            DPT                MSL




Data Source
MICS2000, Ministry of Health.

Data Quality:
The MICS is a nationally representative survey of 3720 households. Ministry of Health data is
gathered from routine reporting, however, it is thought that are problems with the calculation of
the denominator, and that there are some mistakes in reporting.

Progress Towards the Goal:
According to the Ministry of Health data, the goal has been reached. According to MICS it was
only reached for tuberculosis.

Disparity:
Male and female children are vaccinated at roughly the same rate. Rural children are
more likely to be vaccinated than urban children, this could be explained by migration of
population from rural to urban areas, and consequent interruption of regular medical
visits.
Goal 23:       Reduction by 50 per cent in the deaths due to diarrhoea in children under
               the age of five years and 25 per cent reduction in the diarrhoea incidence
               rate

Under five deaths                 Annual number of under-five deaths due to diarrhoea: 2801 (1990); 1768 (1995)*
from diarrhoea

Diarrhoea cases                   Average annual number of episodes of diarrhoea per child under five years of age:
                                  0.02(1992); 0.05 (1999) *

ORT use                               Proportion of children 0-59 months of age who had diarrhoea in the last two weeks
                                      who
were treated with oral rehydration salts or an appropriate household solution   (ORT): 95.8 (MICS, 2000)

Home management of                Proportion of children 0-59 months of age who had diarrhoea in the last two weeks
diarrhoea                         received increased fluids and continued feeding during the episode: 19.9 (MICS, 2000)



Data Source
Multiple Indicator Cluster Survey, Unicef. 2000; * State Statistical Agency

Data Quality:
The MICS is a nationally representative survey of 3720 households.

Progress Towards the Goal:
Although there are some achievements on management of diarroeal disease, but diarrhoea still
one of leading causes of infant and child mortality.

Disparity:
Dushanbe was significantly below the national average on home management of diarrhea, with
only 3.8 percent practicing increased fluids and continued feeding, and RRP had higher
knowledge with 32.6 percent doing the correct practices.
Goal 24:        Reduction by one third in the deaths due to acute respiratory infections in
                children under five years

Care seeking for acute              Proportion of children 0-59 months of age who had ARI in the last two weeks and
respiratory infections              were taken to an appropriate health provider: 51 (MICS, 2000)

Under-five deaths from              Annual number of under-five deaths due to acute respiratory infections (ARI)
acute respiratory infections




                         Annual number of under-five deaths due to ARI

   8000
                  5307                                                    5750
   6000                                                                                       5212
                                    4638               4538
   4000
   2000
       0
                  1990              1991               1992               1993                1994


                                Annual number of under-one deaths due to ARI


   4000      3160        2946               2970
                                   2713                2739
   3000                                                          2211
   2000                                                                     1441
                                                                                       912           868
   1000
       0
             1990        1991      1992     1993       1994      1995       1996       1997      1998



Data Source:
MICS, Unicef. 2000
State Statistical Agency
Data Quality:
Data on U5 mortality was not collected after 1996. Data about the death cases of under 1 year
children is approximate and has to be reviewed. Also the data on children mortality not full
because of the high level of unregistered children.
Progress towards the goal:
It is difficult to say whether the goal was achieved, but the reduction of IMR due to ARI to almost
one quarter of 1990 levels by 1998 suggests that the number of under-five deaths due to ARI was
also reduced significantly.
Disparity:
The indicators of the children death cases from ARI is different by the regions. The lowest is in
Dushanbe – it is 4 times lower then in other regions of the country.
Goal 25:      Elimination of guinea-worm (dracunculiasis) by the year 2000

Dracunculiasis cases             Annual number of cases of dracunculiasis (guinea-worm) in the total population: 0


Progress towards the goal:
Guinea worm is not and never has been a health problem in Tajikistan.


Goal 26:      Expansion of early childhood development activities, including appropriate
              low-cost family and community-based interventions

Preschool development           Proportion of children aged 36-59 months who are attending some form of organized early
                                childhood education programme: 4 (MICS, 2000)

Underweight prevalence          Proportion of under-fives who fall below minus 2 standard deviations from median weight
                                for age of NCHS/WHO reference population: 27.5




                Proportion of children of pre-school age attending pre-
                                        school

      100                                                                                     Government
       80
       60
                                                                                              MICS
       40   15.2         10.5       9.4   6.9    6.3   6.3     6
       20                                                                   4
        0                                                                                     Linear
            1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000                            (Government)

  Data source:
  National Nutritional Survey. Tajikistan. Action Against Hunger. September/ October 1999.
  MICS, Unicef. 2000. (preschool)
  State Statistical Agency. (preschool)

  Data quality:
  The data for pre-school attendance uses very different sources – routine reporting and a
  household survey – but has similar results, which serves to validate the findings.

  Progress towards the goal:
  Tajikistan’s preschool system has been severely reduced over the decade, due to funding
  shortages.

  Disparity:
The percentage of boys and girls, attending children preschools is almost equal. There is a big
difference by regions. RRP – 2% attend preschools, Dushanbe 21%. In urban areas children
attend preschools 15 more then in rural areas.
Goal 27:        Increased acquisition by individuals and families of the knowledge, skills
and values required for better living, made available through all educational channels,
including the mass media, other forms of modern and traditional communication and
social action, with effectiveness measured in terms of behavioural change



Progress towards the goal:

Mass media has been used to promote breastfeeding, hygiene, prevent iodine deficiency
disorder and anemia, but no data is available as to behavioural change.
Additional indicators for monitoring children’s rights:

Birth registration          Proportion of children 0-59 months of age whose births are reported registered: 74.6
                            (MICS, 2000)

Children’s living           Proportion of children 0-14 years of age in households not living with biological
arrangements                parent: 1.0 (MICS, 2000)

Orphans in household        Proportion of children 0-14 years of age who are orphans living in households: 0.3 (both
                            parents) 4.9 (one parent) (MICS, 2000)

Child labour                Proportion of children 5-15 years of age who are currently working (paid or unpaid;
                            inside or outside home): 24.9 (MICS, 2000)


Data Source:
MICS, Unicef, 2000.

Disparity:
There is virtually no difference between boys and girls, although girls are more likely to do more
than four hours a day of domestic work 18.1% and 13.8 % respectively. Regionally, the
percentage of children working is lowest in GBAO at 2 percent, and only 12 and 13 percent
respectively in Dushanbe and Khatlon. In Leninabad, 13 percent of children 5-15 are currently
working, while in RRP, 48 percent of children are working. Rural children are far more likely to
work than urban children. (27 vs. 16 percent).




Additional indicators for monitoring the Integrated Management of Child Illness
(IMCI) and malaria:

Home management             Proportion of children 0-59 months of age reported ill during the last two weeks who
of illness                  received increased fluids and continued feeding: 19.1 (MICS, 2000)

Care seeking knowledge      Proportion of caretakers of children 0-59 months of age who know at least 2 of the
                            following signs for seeking care immediately: child not able to drink or breastfeed, child
                            becomes sicker, child develops a fever, child has fast breathing, child has difficulty
                            breastfeeding, child has blood in stools, child is drinking poorly: 90.1 (MICS, 2000)

Bednets                     Proportion of children 0-59 months of age who slept under and insecticide-impregnated
                            bednet during the previous night: 55.2 (MICS, 2000)

Malaria treatment           Proportion of children 0-59 months of age who were ill with fever (in malaria risk areas)
                            in the last two weeks who received anti-malarial drugs: 68.9 (MICS, 2000)


Data source:
MICS, Unicef. 2000.
Indicators for monitoring HIV/AIDS:


Knowledge of preventing     Proportion of women who correctly state the three main ways of avoiding HIV
HIV/AIDS                    infection: 4.2

Knowledge of                Proportion of women who correctly identify three misconceptions about HIV/AIDS: 3.8
misconceptions of
HIV/AIDS

Knowledge of mother to      Proportion of women who correctly identify means of transmission of HIV from
child transmission of HIV   mother to child: 8.1

Attitude to people with     Proportion of women expressing a discriminatory attitude towards people with
HIV/AIDS                    HIV/AIDS: 3.4

Women who know where        Proportion of women who know where to get a HIV test: 9.4
to be tested for HIV

Women who have been         Proportion of women who have been tested for HIV: 5.3
tested for HIV

Attitude toward condom      Proportion of women who state that it is acceptable for women in their areas to ask a
use                         man to use a condom: data not collected

Adolescent sexual           Median age of girls/women at first pregnancy: 1990- 22.3 1995 - 21.8
behaviour

Sources of data:
Multiple Indicator Cluster Survey, Unicef. 2000.
State Statistical Agency (Adolescent sexual behaviour)

Comment:
Only 19.8 percent of women have even heard of HIV-AIDS, which may explain the
extremely low knowledge, demonstrated. The fact that five percent of women have been
tested for HIV is due to the fact that mandatory testing of pregnant women is supposed to
take place, although in actually it is not carried out in many places due to lack of
supplies.

				
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