Tajikistan

Summary

Tajikistan, in Central Asia, gained its independence in 1991, with the breakup of the Soviet Union. There followed a period of civil war, 1992–97. In 2003, 64% of Tajikistan's population was poor, which was defined as living on less than US$2.15 per day at purchasing power parity by the UN Appeal for Tajikistan (2006). The Tajik healthcare budget appropriations decreased from 4.5% of gross domestic product in 1991 to 1.3% in 2005. The average annual rate of population growth is 2.19%. The estimated 7 320 815 population of the country is mainly rural (73.5%) and about 38% of the country's population is under the age of 14. Life expectancy at birth is 62 years for males and 68 years for females. The infant mortality rate is 106.49 deaths per 1000 live births.

Tajikistan has a state-regulated system of healthcare which increasingly depends on unofficial private payments for medical services (70% of total spending in recent years). In 2005, Tajikistan presented its draft National Development Strategy with three fundamental priorities: public administration reform, private sector development, and development of human potential. The main priorities for development of the healthcare system in Tajikistan are:

• reform of the healthcare system, including development of the private sector and attraction of investment

• improvement of maternal and child health

• a significant slow-down in the spread of HIV/AIDS, a reduction in infectious diseases and the eradication of certain infections that can be controlled by vaccination

• improved availability, quality and effectiveness of medical services (National Development Strategy, 2006).

Mental health policy and legislation

The legal framework for public health-related activities is the Law of the Republic of Tajikistan ‘On Protection of Health of the Population’, of 15 May 1997. It contains, inter alia, some provisions dealing with mental health. According to article 53 of this law, people with mental illnesses are categorised as those who ‘pose a threat to surrounding people’, along with people with tuberculosis, sexually transmitted diseases, leprosy, AIDS and other infections.

Activities in the field of mental healthcare provision have not been specifically regulated up to 2002 from the legal point of view.