Tajikistan. Population and health

According to estimates from 2012, the population of Tajikistan is 7 807 212, with an expected growth rate of 1.9% and a migration rate of –1.21 per 1000. Just over a quarter live in urban areas (26.4%) with 704 000 residing in Dushanbe.

The male to female ratio is 49.5% to 50.5%. The total population fluctuates annually, in contrast to the steadily decreasing trend observed in neighbouring countries over the past decade, but data on population characteristics and health-related topics remain of questionable accuracy and consistency.

Table 1 summarizes these and other key indicators for Tajikistan compared to averages for central Asian countries of Kazakhstan, Kyrgyzstan and Uzbekistan and the Republic of Moldova and Ukraine.

Table 1. Selected demographic, health and lifestyle indicators, 2012 data (unless otherwise indicated)

a 2005 data.

b 2009 data.

c 2010 data.

d 2011 data.

e SDR = standardized death rate.

Source: WHO Regional Office for Europe

Average life expectancy at birth for people in Tajikistan (again, 2012 figures) is 68 years (67 for men and 69 for women), which is lower than that for the European Region (76 years) by eight years on average. Life expectancy at birth in Tajikistan, the European Region and globally is shown in Fig. 1.

Fig. 1. Life expectancy at birth (years) in Tajikistan, WHO European Region and globally

Source: WHO

The population is relatively young, with the proportion under 15 years much greater than that of people over 60 (35.9% and 4.8% respectively). This can be explained in part by the high birth rate, reported in 2012 as 3.8 children per woman, compared to the European Region average of 1.6. Maternal and under-5 mortality rates, however, remain high.

As shown in Table 2, maternal mortality is higher only in Kyrgyzstan and Turkmenistan and the infant mortality rate is among the highest relative to the central Asian republics and Kazakhstan.

Table 2. Maternal and infant mortality rates in Tajikistan, central Asian republics and Kazakhstan (2012)

a Per 100 000 live births (interagency estimates).

b Per 1000 live births, both sexes.

Source:WHO

Tajikistan now faces a double burden of communicable and noncommunicable diseases (NCDs), which account for 62% and 32% of disability-adjusted life-years respectively. Similar to trends elsewhere in the European Region, NCDs account for more than half (59%) of mortality, with the proportion of deaths caused by NCDs increasing with later life (Fig. 2).

Cardiovascular and circulatory diseases account for the greatest proportion (39%). These health trends reflect impoverishment of the population and deterioration of health services following the civil war and post-independence years, during which many previously eradicated diseases re-emerged due to poor public health services affecting water quality and health education. 

Fig. 6. Leading causes of death across the life course in Tajikistan (2010)

Source:Institute for Health Metrics and Evaluation. Reproduced with permission from the Institute for Health Metrics and Evaluation

Maternal and child health

Infant and under-5 mortality rates (34 per 1000 and 43 per 100 000 live births, respectively) are decreasing but remain higher than averages for the Region. The maternal mortality rate is also decreasing, from 65 deaths per 100 000 live births in 2010 to 37 in 2011, according to official data. National data indicate that over half of infant mortality (57%) occurs in the neonatal period, with leading causes of death beyond this stage including diarrhoea, lower respiratory-tract and other infectious diseases (see Fig. 2). Leading causes of maternal deaths nationally are nonpregnancy-related conditions, including hypertensive disorders (26%), hepatitis (13%) and cardiovascular conditions (8.4%).

In relation to child immunization against vaccine-preventable diseases, 88% of children aged 18–29 months in 2012 received all basic WHO-recommended vaccinations. Tajikistan demographic and health survey data also show the underweight trend remains high, with only a 1% decrease in children under 5 years whose weight is below two or three standard deviations for their age (from 17% in 2005 to 16% in 2012). In this context, the MoH continues to support women and children’s health through initiatives such as promoting the use of contraceptives (achieving 29% in 2012, up from 5% in 1991) and issuing a law on childhood immunization and the national programme for immunization for 2011–2015.

Fig. 3. Changes in the leading causes of death, 1990–2010

a Number in brackets represents the estimated deaths by cause, all ages, males and females in 1990 and 2010.

Source: Institute for Health Metrics and Evaluation. Reproduced with permission from the Institute for Health Metrics and Evaluation. 

Source: WHO