6 Improve maternal health

Where we are?

  Improve maternal health
©UNICEF Tajikistan/2012/Zohidov

According to official statistics of the Ministry of Health, maternal mortality has decreased almost twofold between 1990 and 2005 (from 97.7 to 33.2 per 100,000 live births). In 2009, the figure was 46.2 per 100,000 live births. Current problems in the registration of maternal mortality, the high incidence of unsafe home births (40-60%) suggest that this official figure is understated.

In 2009 still 30 – 40% of pregnant women were not actually covered by any antenatal care services and remained without a minimum set of services and medical examinations.

A major problem in improving maternal health is still the high prevalence of home deliveries in some regions of the country. Home births are often carried out in unsafe conditions, without providing adequate medical assistance by medical staff. 60% of women do not receive postnatal care and assistance in the first six weeks after birth.

Despite the wide-ranging measures to improve reproductive health, the majority of parturient leave maternal hospitals, without having high-quality contraceptive services.

The most important risk is the acute shortage of qualified medical personnel as a result of foreign labour migration (the availability of obstetricians-gynecologists in the country is 1.9 per 10,000 population) and deteriorating infrastructure.

Tajikistan has made considerable progress in delivery management by trained personnel, although the gains vary from region to region. Further reduction of maternal mortality is complicated by low quality and effectiveness of prenatal preventive interventions and emergency care, and to a large extent, by still high poverty rates, malnutrition (widespread iodine deficiency and anemia) and the general poor state of maternal health.

Targets for MDG 5
  1. Reduce by three quarters the maternal mortality ratio
    • Most maternal deaths could be avoided
    • Giving birth is especially risky in Southern Asia and sub-Saharan Africa, where most women deliver without skilled care
    • The rural-urban gap in skilled care during childbirth has narrowed
  2. Achieve universal access to reproductive health & inadequate funding for family planning is a major failure in fulfilling commitments to improving women’s reproductive health
    • More women are receiving antenatal care
    • Inequalities in care during pregnancy are striking
    • Only one in three rural women in developing regions receive the recommended care during pregnancy
    • Progress has stalled in reducing the number of teenage pregnancies, putting more young mothers at risk
    • Poverty and lack of education perpetuate high adolescent birth rates
    • Progress in expanding the use of contraceptives by women has slowed & use of contraception is lowest among the poorest women and those with no education