DUSHANBE, November 26, 2013, Asia-Plus -- An article “Tajik Authorities Frown on Home Births” by Farangis Najibullah and Zarangez Navruzshoh Tajik Authorities Frown On Home Births that was posted on Radio Liberty’s website on November 25 notes that Tajikistan, which is suffering from the highest maternal mortality rate in Central Asia, has embarked on an ambitious plan to improve access to obstetric care.  But statistics on home births show the country has a long way to go.

A recent survey reportedly found that at least 44 percent of the women who gave birth in Khatlon province''s Yovon district over the past year delivered their babies at home.  In nearly half of those cases, the women gave birth without the assistance of a qualified midwife.

According to the article, Strategia Center, whose survey covered September 2012 to September 2013, earlier identified Khatlon province as having the highest rates of home births in the country, with about one out of every three women giving birth at home.  In the northern province of Sughd, the number stands at about 20 percent, and in the eastern Gorno Badakhshan Autonomous Region (GBAO) 10 percent.

The Tajik Health Ministry says that, nationwide, the vast majority of women choose to give birth in hospitals or other facilities, with only 10 percent of women opting for home births.  But it, too, notes that of the recorded home births, most take place without the presence of a qualified attendant.

The seriousness of the problem with home births is highlighted by the fact that for every 100,000 live births in Tajikistan, about 47 pregnant women die due to labor and delivery complications. The majority of the fatalities involve women who opted for home births.

The high maternal mortality rate has prompted Tajik health authorities to launch an initiative that intends to ensure every pregnant woman has access to obstetric care during pregnancy and childbirth by 2015.

Firouz Saidov, a member of the team who conducted the Strategia Center survey, says there are a variety of reasons why women don''t seek proper medical care during their pregnancies.  “Some of them live in remote villages and simply don''t have anyone at home to take them to hospitals,” he says.  “Some are not aware of the risks involved.”

Although Tajikistan''s maternal mortality rate remains the highest in Central Asia, there are signs of progress. Just five years ago (2008), the maternal mortality rate stood at 64 for every 100,000 live births.

There are no official statistics on how many infants in Tajikistan die or sustain injuries during home births.

Tajikistan has enlisted the help of international organizations such as the World Health Organization, the German Development Agency, and the UN Population Fund to make childbirth and pregnancy safer.  Emergency obstetric-care centers have been constructed, the training of qualified midwives and nurses ramped up, and a greater emphasis has been placed on health education.

However, the quality of medical services and public health facilities in rural areas remains questionable.  Hospitals and other clinics in villages often do not have modern sanitation facilities, and during the winter months they often have only a few hours of electricity per day.