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Tajikistan, a mountainous, landlocked country in central Asia, is a former republic of the Soviet Union. It became independent in 1991, and experienced civil war from 1992 to 1997. Although currently at peace, it remains one of the poorest countries among the former Soviet Republics: nearly half the labor force works abroad, and remittances are an import source of income. The Gross Domestic Product (GDP) per capita was $2,100 in 2008, with moderate inequality: the Gini index is 32.6 with the lowest decile earning 3.3 percent of the income, while the highest decile earns 25.6 percent.

Population in 2009 was estimated at 7.4 million, with a predominantly young population, as is typical of developing nations. The median age of the population is 21.9 years; 34.3 percent of the populace are aged 14 years or younger, while only 3.6 percent are 65 years or older. The population growth rate is 1.9 percent, with a birth rate of 27.2 per 1,000 (the highest among eastern European and former Soviet countries), and a total fertility rate (an estimate of the number of children born per woman) of 2.9. The sex ratio is almost even at 0.99 males per female, with women predominating in the 65-and-over age group (0.74 males per female). Life expectancy at birth is 62.3 years for males and 68.5 years for females. The populace is primarily Tajik (79.9 percent) and Uzbek (15.3 percent), and association by religious sect is Sunni Muslim (85 percent) or Shia Muslim (5 percent). Literacy is almost universal at 99.7 percent for men and 99.2 percent for women.

Poverty and Health Services

Due to the country's poverty and devastation suffered during the civil war, the quality of health services in Tajikistan is low. There are also difficulties in interpreting data supplied by the national government, as they often differ sharply from calculations by the World Health Organization (WHO), due primarily to under-registration of infant and child mortality attributable to the poor national infrastructure and predominantly rural population.

For instance, in 2000, Tajikistan reported an infant mortality rate of 15.5 per 1,000 live births, while the WHO estimates 51 per 1,000; this underreporting also acts to inflate life expectancy at birth. Similarly, in 2000, Tajikistan reported maternal mortality of 48.4 per 100,000 live births and under-5 mortality of 21 per 1,000 live births, while the WHO estimates are 100 per 100,000 and 188 per 1,000, respectively.

Save the Children, an international organization devoted to improving maternal and child health, places Tajikistan in its Tier II or less developed countries, where it ranks 45th out of 66 countries on the Women's Index (taking into account factors such as life expectancy, maternal mortality, availability of modern contraception, and maternity leave benefits) and 49th out of 66 countries on the Mothers' Index (taking into account additional factors related to children's health and well-being, such as the under-5 mortality rate and gender parity in primary school enrollment).

Sarah E.BoslaughWashington University School of Medicine

Bibliography

Save the Children. “State of the

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