Quality of child health services in Tajikistan.

The Government of Tajikistan has identified Primary Heath Care (PHC) and Maternal and Child Health (MCH) as top priorities in its first Comprehensive National Health Sector Strategy (2010-2020). Poor child health outcomes in Tajikistan are related to systemic health sector issues including the financing and quality of health services as well as poverty rural residence and access to clean water. Tajikistan’s Millennium Development Goal (MDG) target for a two-thirds reduction in child mortality requires an infant mortality rate (IMR) of 29.6 and the under-five mortality rate (U5MR) of 39.3 by 2015. The most recent estimates place the IMR at 52 per 1000 live births and the U5MR at 61 per 1000 live births. To reduce its high infant and child mortality rates as well as develop PHC the Government of Tajikistan introduced the Family Medicine model of practice in 2001 and the Integrated Management of Childhood Diseases (IMCI) strategy in 2000. This World Bank study was undertaken in 2010 to assess the quality of outpatient health care services for sick children aged two months to five years at primary health care (PHC) facilities in Tajikistan. The specific focus of this study is on the quality of care delivered by PHC providers who were retrained over the last several years as Family Medicine practitioners. The team employed the standardized WHO/UNICEF IMCI survey methodology to evaluate the quality of care delivered to sick children attending outpatient facilities. The study was conducted in 19 districts in Khatlon region Sogd region the Rayons of Republican Subordination (RRP) and Dushanbe City. (excerpt)