Azerbaijan

Azerbaijan is located on the edge of eastern Europe, with its eastern border on the Caspian Sea. Russia and Georgia border on the north, Armenia on the west, and Iran on the south. From 1920 to 1991, Azerbaijan was part of the Soviet Union. Its population is about 8 million people. Almost 60 percent of the population live below the poverty level. Azerbaijan's healthcare system was poor during the Soviet years, and faltered more after independence. Today, the government spends $7 per capita on healthcare. Medical personnel are only paid about $10 per month; physicians earn less than $100 a month. Equipment is outmoded and many medical procedures are outdated.

Life expectancy at birth is low by regional standards. The average Azerbaijani man lives to be about 60, the average woman to about 69. The World Health Organization estimates healthy life expectancy at 59 years for women and 56 years for men. The rate of cardiovascular disease is high among men, many of whom smoke and have elevated cholesterol levels.

Maternal mortality is high compared to nearby Europe, with 37 maternal deaths for every 100,000 live births. Women marry young and begin having children immediately, increasing the likelihood of high-risk pregnancies. About 40 percent of childbearing women are anemic. Access to contraceptives is limited; in one survey, 57 percent of women said their last pregnancy was unintended. For many women, abortion is the only method of fertility control, and even in the cities, contraception is limited to condoms or intrauterine devices.

Azerbaijan also has some of the highest infant and child mortality rates in Europe. Infant mortality is about 69 deaths per 1,000 live births. Immunization rates are high, so most of these children die not from major infectious diseases such as diphtheria or measles, but from respiratory or diarrheal illnesses. A 2000 survey found that 20 percent of Azerbaijani children under 5 showed stunted growth, a key indicator of malnutrition. A 2001 study found that 32 percent of children under 5 were anemic. Chronic malnutrition and anemia together lower children's resistance to illness.

Sanitation is limited outside the cities, making waterborne illnesses a problem in most of the country. Hepatitis A and B are common, as is typhoid fever. Malaria is prevalent in the central part of the country, and not uncommon in other regions outside the mountains. In spring 2006, at least five people in Azerbaijan died of the H5N1 avian flu.

There are two major medical schools within the country: the Azerbaijan Medical Institute in Baku and the Institute for Advanced Training for Physicians. A network of 700 hospitals and clinics serves all but the most rural populations. Visits to state-run hospitals and clinics are free to citizens, but an increasing number of Azerbaijanis have begun to favor private clinics. Although private healthcare can be expensive, private clinics tend to have newer equipment and bet-ter-trained staff than state hospitals. A private-clinic doctor can expect to earn $500 a month, rather than $80 offered by the state. By 2005, there were 400 clinics employing more than 5,000 people.

...