WHO contributes to reduction of maternal morbidity and mortality in Tajikistan


Tajikistan, like other countries of the WHO European Region, has seen great progress towards improving maternal and perinatal health. However, the maternal morbidity and mortality rates remain unacceptably high.

Since 2008, Tajikistan, along with other countries in the Region, has begun implementation of the WHO methodology "Beyond the Numbers" (BTN). This approach aims to improve the quality of care for pregnant women, mothers and newborns in achievement of the Millennium Development Goal 5 to reduce maternal morbidity and mortality, and improve maternal health.

In 2008, with technical support from WHO and the United Nations Population Fund, the Ministry of Health and Social Protection of Population developed and approved a package of documents regulating the implementation of two approaches:

  • confidential enquiries into maternal deaths (CEMD) at the national level
  • near-miss case reviews (NMCRs) at the institutional level.

Responsibility for implementation of CEMD was assigned to the national Association of Obstetricians and Gynecologists, and the National Committee on CEMD was established.

Throughout 2008–2013, the Ministry, with support from WHO and partners, conducted numerous activities aimed at strengthening the implementation of these approaches. In 2013, due to personnel changes, the composition of the National Committee on CEMD was renewed. In addition, the CEMD questionnaire was revised and updated, and 20 regional coordinators were trained on the CEMD methodology. In 2014, data on 62 maternal death cases (officially registered in 2013) were collected. The National Committee on CEMD analysed the data, and with the support of WHO international experts, produced the first national CEMD report for 2013.

On 24 April 2015, a roundtable, organized with the support of WHO, gathered representatives of the Ministry, managers and staff of health institutions, development partners and members of the Association of Obstetricians and Gynecologists to present the first national CEMD report. The National Committee on CEMD presented the CEMD methodology, an analysis of the maternal death cases, including medical and nonmedical factors leading to adverse outcomes, and recommendations on improving the quality of services to pregnant women, mothers and newborns.

"Improving and strengthening the quality of services to pregnant women, mothers and newborns is one of the critical areas for improving sustainability of the health system in Tajikistan. WHO, in partnership with the Ministry and other development partners, will continue to work in this area within the health systems framework," said Dr Pavel Ursu, WHO Representative/Head of WHO Country Office in Tajikistan.