DEMOGRAPHICS MATERNAL AND NEWBORN HEALTH INTERVENTION COVERAGE FOR M OTHERS, NEWBORNS AND CHILDREN NUTRITION Exclusivebreastfeeding Percent infants < 6 months exclusively breastfed Total population (000) Total under-five population (000) Births (000) Birth registration (%) Under-five mortality rate (per 1000 live births) Infant mortality rate (per 1000 live births) Neonatal mortality rate (per 1000 live births) Total under-five deaths (000) Maternal mortality ratio (per 100,000 live births) Lifetime risk of maternal death (1 in N) Total maternal deaths Stuntingprevalence (moderate and severe, %) Wastingprevalence (moderate and severe, %) Complementa ry feeding rate (6-9 months, %) Low birthweight incidence (%) CHILD HEALTH Countdown to 2015 2008 Report Tajikistan Source :WHO,2006 Underweig ht prevalence Percent children < 5 years underweight for age* 33 9 *Base don 2006WHOreferenc epopulation 6,640 858 185 88 68 56 38 13 170 160 320 (2006) (2006) (2006) (2006) (2006) (2006) (2000) (2006) (2005) (2005) (2005) Causes of under-five deaths Globally more than one third of child deaths are attributable to undernutrition (2005) (2005) 15 10 (2005) (2005) Unmet need for family planning ( %) Antenatal visits for woman (4ormore visit s,%) Intermittent preventive treatment for malaria (%) C-section rate (total,urban, rural ;%) (Minimumtargetis5%and maximumtargetis15%) Early initiation of breastfeeding (with in1 hrofbirth,%) Postnatal visit for baby (with in2 daysforhomebirths,%) WATER AND SANITATION SYSTEMS POLICIES Financial Flows and Human Resources Tajikistan International Code of Marketing of Breastmilk Substitutes New ORS formula and zinc for management of diarrhoea Community treatment of pneumonia with antibiotics IMCI adapted to cover newborns 0-1 week of age Costed implementation plan(s) for maternal, newborn and child health available Midwives be authorised to administer a core set of life saving interventions Maternity protection in accordance with ILO Convention 183 Specific notification of maternal deaths No Yes No Yes Yes Yes Partial Yes Per capita total expenditure on health (US$) General government expenditure on health as % of total government expenditure (%) Out-of-pocket expenditure as % of total expenditure on health (%) Density of health workers (per 1000 population) Official Development Assistance to child health per child (US$) Official Development Assistance to maternal and neonatal health per live birth (US$) National availability of Emergency Obstetric Care services (% of recommended minimum) 54 5 76 7.2 5 5 86 (2007) (2007) (2007) (2003) (2005) (2005) (2005) Other 30% Malaria 1% Measles 0% Injuries 3% Diarrhoea 16% Pneumonia 20% Neonatal 30% Source:Lawn JE,Cousens SN forCHERG(Nov2006 ) Diarrhoea 2% Other 6% Congenital 11% Asphyxia 23% Infection 20% Preterm 34% Causes of neonatal deaths Coverage along the continuum of care Sourc e:DHS,MICS,OtherNS Pre-pregnancy Pregnancy Birth Neonatalperiod Infancy 0 20 40 60 80100 38 77 83 25 87 Measles Exclusive breastfeeding Skilledattendant at birth Antenatal visit (1 or more) Contraceptive prevalence rate *Postnatal care 1990 1995 2000 2005 2010 2015 30 0 60 90 120 150 P e r c e n t 20 0 40 60 80 100 Immunization Percent of children immunised against measles Percent of children immunised with 3 doses DPT Percent of children immunised with 3 doses Hib P e r c e n t 20 0 40 60 80 100 Source:UNICEF, 2006 Water Percent population using improved drinking water sources Sanitation Percent population using improved sanitation facilities Total Rural Urban Total Rura l Urba n Source: WHO/UNICEFJMP, 2006 Source: WHO/UNICEFJMP,2 006 P e r c e n t 20 0 40 60 80 100 2004 45 51 70 HIV/AIDS 0% 199 9 20 00 200 1 20 02 2003 200 4 2005 P e r c e n t 20 0 40 60 80 100 2005 MICS 1 1992 1997 2002 2006 Source:WHO/UNICEF 87 86 Skilled attendant at delivery Percent live births attended by skilled health personnel 2000 MICS 2005 MICS Antenatal care Percent women aged 15-49 years attended at least once by a skilled health provider during pregnancy 71 77 P e r c e n t 20 0 40 60 80 100 2005 MICS 14 Prevention of mother to child transmission of HIV Percent HIV+ pregnant women receiving ARVs for PMTCT Neonatal tetanus protection Percent of newborns protected against tetanus *SeeAnnex forindicator definition 2004 48 59 92 1996 OtherNS 2005 MICS 83 2000 MICS 71 79 Under-five mortality rate Deaths per 1000 live births 38 68 115 MDG Target P e r c e n t 20 0 40 60 80 100 2000 MICS 14 2005 MICS 25 At l eas t one dose Two dos es Vitamin A supplementatio n Percent children 6-59 months receiving vitamin Adoses 98 98 98 96 0 0 0 0 0 Source:UNICEF Diarrhoeal disease treatment Percent children < 5 years with diarrhoea receiving oral rehydration therapy or increased fluids, with continued feeding P e r c e n t 20 0 40 60 80 100 22 29 P e r c e n t 20 0 40 60 80 100 2005 MICS 2005 MICS 2000 MICS 2 Pneumonia treatment Percent children < 5 years with suspected pneumonia taken to appropriate health provider Percent children < 5 years with suspected pneumonia receiving antibiotics P e r c e n t 20 0 40 60 80 100 51 2000 MICS 64 2005 MICS 41 Poorest 2nd 3rd 4th Wealthiest P e r c e n t 20 0 40 60 80 100 EQUITY Coverage gap by wealth quintile Coverage gap (%) 2000 MICS 2005 MICS 37 1.4 12 31 1.4 10 Ratio poorest/wealthiest Difference poorest-wealth iest (%) P e r c e n t 20 0 40 60 80 100 P e r c e n t 20 0 40 60 80 100 P e r c e n t 20 0 40 60 80 100 --- --- --- ---, ---, --- 61 --- No data (2005) No data Causes of maternal deaths Regional estimates for Asia, 1997-2002 Sourc e:Khan,KhalidS.,etal, Lancet2006:3 67:1066 -74 Other causes 21% Anaemia 13% Haemorrhage 31% Abortion 6% Obstructed labor 9% Hypertensive disorders 9% Sepsis/Infections, including AIDS 12% Malaria prevention Percent children < 5 years sleeping under ITNs* Malaria treatment Percent febrile children < 5 years using antimalarials* *Sub-nationalrisk ofmalaria transmission *Sub-nationalrisk ofmalaria transmission