Infant mortality on the rise in north

The infant mortality rate is going up in northern Tajikistan, health officials say, citing poor socioeconomic conditions in the country. Of the 48,997 births officially registered in the region in 2004, there were 1,037 deaths of infants under one. This means the province has an infant mortality rate of 21.2 per 1,000 live births. In 2003, the rate in the province of Sogd stood at 13.5 cases per 1,000 live births. And even these figures may underestimate the truth. Tajik health officials conceded that not all cases of deaths, especially of infant ones, were reported by local families. However, Safar Saifiddinov, head of the statistics department of Tajikistan's Ministry of Health (MoH), told IRIN in the Tajik capital, Dushanbe, that official data on infant mortality for 2004 would be available only by the end of February. Experts cite the deterioration of birth and death records, lack of telephone communication on the ground and home-based births in remote villages, where no registration is conducted, as the primary factors contributing to under-reporting of infant deaths in the former Soviet republic. Khusein Aminov, chief of the health ministry's maternal and child health department, admitted that official data did not reflect the real situation and differed from the results of surveys conducted by international NGOs. "The real numbers may exceed the official statistics by three or four times," he claimed. According to the United Nations Children's Fund (UNICEF), the under one infant mortality rate was 92 cases per 1,000 live births in 2003, while the US Agency for International Development (USAID) said in its recent report on health in Tajikistan that infant mortality rate in the country for 2004 was 112.1 cases per 1,000 live births. "The main factors fuelling infant mortality [in the country] are poor living standards, particularly in rural areas and consequently sick women," Khairiniso Zurkholova, head of the Neonatology Department of the Tajik Scientific Research Institute of Obstetrics, Gynecology and Pediatrics, said. "A sick mother delivers a sick and weak baby." Tajikistan is the most impoverished state among the former Soviet republics, with some 65 percent of the country's 6.4 million population living below the national poverty line. Observers also note that the difference between official statistics and international figures on infant mortality stems from different definitions of live births in the former Soviet republics and those used by the World Health Organization (WHO). According to the WHO definition, an infant is "alive at birth if breathing or showing any signs of life, such as muscle movement and heartbeat". The Soviet-era definition, however, stipulates breathing as the "only criterion of life". In an effort to get a clearer picture of infant mortality in the country, the WHO definition is being introduced in Tajikistan for registration of birth and death rates, Aminov added.