Slight drop in infant mortality

Infant mortality has declined in Tajikistan, according to data from the health ministry, with only 273 deaths reported in the first six months of the year, down from 293 in the same period last year, an official said on Friday. "It's a good sign that the trend seems to be dropping, but I don't think that it is statistically very significant," a United Nations Children’s Fund (UNICEF) project officer, Dr Tarek Hussain, told IRIN from the capital, Dushanbe. High infant mortality rates had earlier been recorded in Tajikistan, with 89 of every 1,000 children dying at birth, or soon after, according to a report released in July by UNICEF. The report was based on comprehensive surveys conducted in 2000. According to UNICEF’s Social Monitor, an annual regional report examining the wellbeing of children in Central and Eastern Europe and the Commonwealth of Independent States, the infant death rate in the Caucasus and Central Asia is 12 times greater than in Western industrialised countries. The report compared official infant mortality data in eight countries of the Caucasus and Central Asia against information gathered in face-to-face interviews with women, revealing glaring discrepancies between government statistics and survey estimates. This anomaly is often the result of Soviet-era policies, which dictated the need to keep infant mortality low, forcing hospital staff to misreport the deaths of babies in their care for fear of stringent penalties. "Our research shows that infant mortality is a far greater problem in these countries than suggested in the official data. We have looked beyond the official statistics and talked to women in their own homes. And their stories reveal a child survival crisis," said UNICEF Executive Director Carol Bellamy in comments made to the Social Monitor. Sometimes, however, home births were not registered either, exacerbating the situation further, said Hussain, who works for UNICEF’s health and immunisation programme, a function which requires him to liaise closely with the government. "Home births are very high, and a lot of them are not registered, mostly because people cannot afford to shell out a two- or three-dollar fee for registration," he added. Diarrhoea is said to be the main cause of infant mortality in Tajikistan. Extreme poverty has left mothers unable to care properly for a sick infant. One example cited a woman who told researchers she had had to resort to a faith healer after visiting a paediatrician who prescribed medication she could not afford for her ailing son, the report said. The child’s condition worsened and he died soon after. The UNICEF report said most infant deaths in the countries under review were preventable, citing a mix of factors such as poverty, poor maternal health and nutrition, infections and poor medical care as reasons, all of which could be obviated. "What we have is two distinct problems. We have tens of thousands of infant deaths that could be prevented. And we have a systematic failure to properly count the lives being lost," Bellamy maintained. Getting the numbers right was an important issue, because it was a crucial first step towards saving young lives, she added. In the late 1980s, 40 of every 1,000 babies born in Tajikistan did not survive their first year of life. In the southern half of the country, the rate was more than 60 per 1,000. A 1989 census said the most frequent causes of deaths were infections and parasitic diseases, which accounted for roughly 78 percent of the nearly 33,000 deaths, including adults, that year. Today, the death of a baby may go unrecorded because of a difference in perception about the definition of a child being alive, the report said. According to a World Health Organisation (WHO) definition, an infant is "alive at birth if breathing or showing any signs of life, such as muscle movement and heartbeat". A Soviet-era definition, however, stipulates breathing as the "only criterion of life". "This year, we had a series of meetings with the government on the issue of the definition of live births. So, from this year, they will be following the same Live Birth Definition as other countries," Hussain said. Moreover, infants born before 28 weeks, weighing less than 1,000 g or measuring less than 35 cm in length are not counted as live births if they die within seven days, according to the Soviet-era definition, the report said. In Tajikistan, birth defects are also said to be on the high side due to environmental pollution, especially from agricultural chemicals used in cotton cultivation. Problems were further compounded in the 1990s when the country’s water supply was found to contain disease-causing organisms. Toxic chemicals from agricultural and industrial sources were also detected. "States have an obligation to give every child the best possible start in life," Bellamy said, pointing out that all the states in the region were signatories to the Convention for the Rights of the Child, as well as to the Millennium Development Goals and to the requirements of a World Fit for Children. "[These] goals can only be reached by tackling the issue of preventable infant death and its causes. It is time to give infant wellbeing the attention it deserves as a sign of national wellbeing, a sign that is every bit as important as economic growth and poverty reduction," she said.