The Department of Organization of Medical Services for Maternal and Child Health and Family Planning of the MoHSPP of the Republic of Tajikistan is one of the key departments, and the interview with its head Nabiev Zoir Narzulloevich is hereby presented to readers:
Q: Indeed, maternal and child health is one of the most important areas of public health. In this regard what has been done by the Department of Organization of Medical Services for Maternal and Child Health and Family Planning of the MoHSPP during 2019 to improve timely, high-quality and targeted medical services for pregnant women, children with disabilities and sick children?
A: Maternal and child health is a priority for the Ministry of Health and Social Welfare. It is worth noting that only in the period of 2019 to increase the level of medical care for mothers and children with partners in the amount of 79 197 730.03 somoni, the country’s medical institutions received the necessary medical equipment and supplies.
An important achievement in the field of children’s health is the commissioning of a new modern building of the City Clinical Hospital for Infectious Diseases with 200 beds, in the opening ceremony of which the Founder of Peace and National Unity, the Leader of the Nation, the President of the Republic of Tajikistan, His Excellency Emomaly Rahmon took part. Such health facility services help children with infectious diseases and reduce child mortality.
As a result of the implementation of laws and strategies in the field of healthcare, growth delays, underweight and anemia among children and women of childbearing age this incators have decreased over the past 8 years, which shows the positive impact of effective government policies on maternal and child health. Deficiency of micronutrients (vitamins and minerals) is one of the main causes of morbidity and mortality. Nutrition is a priority in the National Development Strategy of the Republic of Tajikistan until 2030. Healthy nutrition is necessary from the first day up to the to the first two years of the child’s life, that is, 1000 days are needed. In this process, in order to reduce malnutrition among children and improve the quality of medical services for children, the centralized departments of pediatric hospitals in the cities and districts of the country were provided with 4340 F-100 medical nutrition at the amount of 277890,2 somoni, 5521 F-75 medical nutritionat the amount of 353509.63 somoni and 8970 Bi-Pi-100 at the amount of 178592.7 somoni from the UN Children’s Fund (UNICEF). At the same time, in order to improve opportunities for health and nutrition, raising and caring for young children, an interdisciplinary working group developed the project “National Communication 1000 Minutes of the First Days of a Child’s Life 2020-2024” and was submitted to the government for approval.
In accordance with a bilateral agreement, with the support of charity organizations of LDC (USA), medical and educational equipment (laryngoscope, Ambu bag, childbirth simulators and breastfeeding dummies) are provided annually, which significantly improves the quality of service. At the same time, in June 2019, training sessions were held on topics such as “Save the Children and Take Care of Them,” “Caring for Each Child,” and “Breathing Aid for Children,” and more than 106 people were trained, responsible for simulation rooms. During this process, 204 specialists were trained to regulate conditions for simulating childbirth and using dummies for the survival of newborns.
Q: We would like to take your opinion on the need to implement such a project to improve maternal and child health services in the Republic of Tajikistan.
A: The implementation of the project “Maternal and Child Health Integrated Care Project” in the Republic of Tajikistan is carried out in the Rasht and Fayzobod districts of the republic subordination and in Shamsiddin Shokhin of the Khatlon region. It should be noted that in these pilot areas all aspects of maternal and child health services will be improved, as a result of which a new model will be created for practice in other areas. It should be noted that one of the main goals of this project is to increase the capacity of medical personnel in pilot areas, in particular: pediatric doctors, obstetrician-gynecologists, neonatologists, pediatric surgeons and pediatricians. Improving infrastructure and healthcare facilities is critical to improving the quality of care for mothers and children.
Q: According to official statistics, maternal and child mortality rates in the Republic of Tajikistan are falling to the required level, what are the problems or shortcomings in the field or in ensuring adequate health care for mothers and children in the country??
A: Of course, there are problems and disadvantages. In the area of maternal and child health, the following issues can be mentioned:
Insufficient number of specialists in this field – pediatricians, obstetrician-gynecologists, neonatologists, and child psychologists;
Lack of material and technical facilities for children’s and maternity wards (provision of modern equipment, medicines, depreciation of water supply and sewage systems, repair of premises), primary health care facilities;
Close marriages between young people and the birth of children with disabilities;
Lack of funds to protect the health of mothers and children – for immunization, diagnosis and treatment of children (including hereditary diseases, congenital malformations, including cardiovascular diseases, etc.);
Problems of child and maternal nutrition – growth rates of children under 5 years old (2012 – 26%, medical and demographic study 2017-18%), wastewater (2012 – 10%, 2015) – 6%) , insufficient body weight (2012 – 12%, 2017 – 8%), anemia among women of reproductive age in 2017 – 41%, among children – 42%.
Q: What do you think are the main activities under this project to improve performance?
A: As is well-known, the “Maternal and Child Health Integrated Care Project” project consists of 3 components:
First – Improving the quality of integrated maternal and child health services in the pilot areas of the project:
Second – Improving and updating services in the field of maternal and child health in the pilot areas:
Third, raising awareness of maternal and child health and health-seeking behavior in the pilot areas of the project:
In this regard, an agreement was signed in October 2019 between the Ministry of Health and Social Protection of the Population of the Republic of Tajikistan and the United Nations Children’s Fund (UNICEF) on implementation of Output 1 and 3 of the Project.
Significant achievements of the project are improving maternal and child health indicators by reducing child and maternal mortality rates, improving the health indicators of women and children, as well as raising public awareness, especially of mothers, about their own health and children, disease prevention and proper nutrition. Reducing the number of children with severe and moderate malnutrition, increasing immunization, and expanding early intervention. Undoubtedly, the successful implementation of the “Maternal and Child Health Integrated Care Project” in Tajikistan can solve many existing problems.
I wish all the staff of the Project good luck and success.
Thank you for the very meaningful conversation!