Tajikistan’s fragile health system is faced with a number of significant challenges. The country has one of the highest rates of tuberculosis (TB) in Central Asia. Located along the illicit drug transport corridor from Afghanistan, Tajikistan is also faced with a growing HIV/AIDS epidemic, which is fueled largely by people who inject drugs, but which is also spreading through sexual transmission from intravenous drug users to their sexual partners.

Maternal and child mortality rates are the highest in the Central Asian region.  Only about 33 percent of women of reproductive age use modern contraceptive methods, and nearly one in five home deliveries are not attended by a skilled birth attendant. Over 40 percent of the population does not have access to clean water, and only 20 percent consume water from a central water supply system. Up to 60 percent of intestinal diseases in Tajikistan are water-borne, which accounts for 16 percent of deaths in children under 5 years of age. In 2010, Tajikistan experienced the first wild polio outbreak since 2002.

USAID responded the to the polio outbreak in 2010 by assisting in vaccinating 95 percent of the population under age 5.

Mercy Corps

USAID partners with the Ministry of Health to strengthen essential health care services. For example, USAID works with civilian and prison health officials to increase access to TB care and expand the use of patient-centered outpatient treatment approaches. USAID also supports a rigorous program to build the skills and capacities of health providers, communities, and patients to understand and address the treatment and care of TB and multidrug-resistant TB. In HIV, USAID programs expand access to comprehensive HIV/AIDS prevention, treatment and care services for most-at-risk populations and seek to reduce stigma and discrimination. USAID also focuses on strengthening the capacities of national and local institutions, non-governmental organizations and individuals to more effectively lead the planning, delivery and monitoring of quality services for the most-at-risk populations.

Results:

• USAID-supported community health educators conducted more than 10,000 home visits. About 43,000 people participated in almost 5,000 USAID educational sessions about prenatal care and infant health in the last quarter of 2012. A midterm evaluation for the Maternal and Child Health project showed that 80 percent of mothers can indicate more than two signs of severe diarrhea compared with 20 percent at the start of the project. The percentage of mothers who exclusively breastfed their babies increased from 37 percent to 85 percent.
• A USAID-supported video on the topic of personal hygiene” and “keep the water sources clean” was broadcast and reached a viewing population of more than 3 million people—roughly one-third of the country’s population—with multiple behavior change messages. Children living in the program areas who reported washing their hands with soap after using the bathroom increased by 64 percent.
• USAID programs helped provider teams practice life-saving skills, such as newborn resuscitation and active management of the third stage of labor, on an ongoing basis. National trainers conducted courses on antenatal care for over 100 providers and established birth preparedness schools in five facilities, which provide classes for about 2,000 pregnant women.