The challenges are profound and include a limited resource base, the fact that the country is prone to natural disasters, gender inequalities, and institutional weaknesses. These combine to threaten the sustainability of reforms and development achievements.
Tajikistan is the poorest country in the region, with a 2007 gross national income of $460 per capita. Between 2000 and 2007, the gross domestic product (GDP) grew annually by an average of 7.7 percent. Over one third of the labour force works abroad, and its 2008 remittances accounted for over half of GDP. The current global financial and economic crisis threatens not only these remittances but also economic growth and investment in children and women.
Roughly half of the population still lives in poverty, which is more prevalent in the south and east of the country. Recent price inflation exacerbated food insecurity, which affected 13 per cent of the population in the first half of 2008. Social assistance benefits for children do not reach all those below the poverty line. Social sector budgets remain low and are barely adequate to maintain existing systems: Tajikistan spends 3.8 per cent of its GDP on education, and 1.6 per cent on health. Tajikistan regularly experiences natural disasters, which include earthquakes, floods and harsh winters, and has weak institutional capacities to deal with environmental shocks and challenges such as availability of clean water. Together these constitute a continuing development emergency.
In spite of such challenges, Tajikistan succeeded in decreasing sharply the infant mortality rate from 75 deaths per 1,000 live births in 2000 to 56 in 2006; and the child mortality rate from 93 deaths per 1,000 live births in 2000 to 67 in 2006. Coverage of vitamin A supplementation increased from a negligible amount in 2004 to 65 per cent in 2007, and iodized salt consumption grew from 20 per cent in 2000 to 49 per cent in 2007. Full immunization coverage rose from 71 per cent in 2004 to 85 per cent in 2007. Moreover, the Government is introducing financing reforms in health (Basic Benefits Package) and education (per capita financing) and is improving the child protection system by including a social-work approach to case management and community-based family support/substitution services. Tajikistan is engaged in a Poverty Reduction Strategy Paper (PRSP) process, addressing social and economic reforms. A Joint Country Support Strategy will contribute to a more effective and efficient use of aid.
Tajikistan can achieve Millennium Development Goal 4 “Reduce child mortality”, provided it focuses more strategically on the main causes of death. More than 40 per cent of infant deaths occur in the first week, despite the fact that 62 per cent of births take place in institutions and 83 per cent are accompanied by a skilled attendant. In the postnatal period, malnutrition, diarrhoeal diseases and acute respiratory infections are the major causes of death. Only one third of the population receives its water from unimproved sources, and water quality in general is a concern. The maternal mortality ratio (MMR) is higher than the region’s average, largely because of inadequate peri-natal care, and therefore Goal 5 will be difficult to achieve.
Family knowledge and care practices are inadequate. Roughly one third of children aged 6-59 months are stunted. Only 6 per cent of children with diarrhoea receive increased fluids and continued feeding, and only 3 per cent of women know the two danger signs of pneumonia. This situation is compounded by chronic food insecurity and vulnerability to increases in food and energy prices. The Millennium Development Goal target on child malnutrition could be met with great difficulty.
Three quarters of children enter grade 1 without pre-school experience, since access to pre-school education remains unaffordable for many, especially vulnerable, children. Fewer than 10 per cent of children attend State pre-schools, whereas 15 per cent are in private kindergartens for which data on the quality of the programmes are not available. There is a lack of family knowledge on child development: as many as 60 per cent of children lack support for early learning at home.
Enrolment and attendance rates at primary school (grades 1-4) are very high for both sexes, but by grade 9, roughly one fourth of girls no longer attend school. As this situation has persisted for several years, the country is beginning to experience the challenge of children being born to mothers with incomplete basic education. Household work or school-related expenses are cited by girls 60 per cent of the time as the reason for not attending school. Teachers are in short supply; 16 per cent of them do not have the required level of pre-service training; and their in-service training is sporadic. For these and other reasons, the country may not achieve Goals 2 and 3.
There is a rapidly increasing HIV/AIDS epidemic, centred on a widespread availability of cheap drugs for intravenous use, commercial sex work, and population migration. The 2007 HIV prevalence rate was 19 per cent among intravenous drug users and 1.8 per cent among commercial sex workers. The Joint United Nations Programme on HIV/AIDS (UNAIDS) estimates there are 10,000 people (15-49 years) living with HIV/AIDS. Groups at risk are difficult to reach because of their engagement in marginalized and illegal activities; constraints on access and use of services for under-age groups; and stigma and discrimination in health services. Goal 6, therefore, is unlikely to be met.
Around 200,000 children aged 5-14 are engaged in some form of child labour (excluding non-intensive household chores) and 65,000 children aged 5-14 are engaged in paid work, according to the Multiple Indicator Cluster Survey (MICS) in 2005. Child abuse and neglect is a challenge, and children are commonly exposed to physical and psychological punishment. According to MICS 2005, among children 2-14 years, 76.7 per cent of boys and 71.8 per cent of girls experienced some forms of punishment. Severe physical punishment was applied to 18 per cent of boys and 14.2 per cent of girls in the same age group. In 2005, about 12,900 children lived in residential care institutions; nearly 80 per cent of them had at least a biological parent alive. The reform of the child protection system is hindered by the lack of alternative services and monitoring systems.
In 2005, there were 255 children in prison and 327 in open rehabilitation institutions. The juvenile justice system needs its own legislation, procedures, authorities, and sentencing guidelines and practices. Children under the age of 14 years still face arrest, pre-hearing detention and extended deprivation of liberty, often for minor offences.
The observations of the Committee on the Rights of the Child date from 2000, but many remain relevant: gender discrimination, the lack of access to family support services for children with disabilities, the deterioration in the quality of education and health services, additional household costs of school attendance, and the lack of a well-administered juvenile justice system.
Women and girls face great challenges. For instance, only 1 in 10 Parliamentarians is a woman, and 1 woman in 6 marries before age 18. The United Nations Special Rapporteur on Violence against Women noted in her concluding statement of May 2008 that while gender equality is promoted in law, in practice the situation of women has regressed in the past 15 years.
Facts about children in Tajikistan
(i)The 2005 estimate developed by WHO/UNICEF/UNFPA and the World Bank, adjusted for underreporting and misclassification of maternal deaths, is 170 deaths per 100,000 live births (childinfo.org).