Report prepared by Dr. Muhammad Akram Zaheer for the Islamabad Institute for Russia and Central Asia
Human development is defined as the process of enlarging people’s opportunities and improving their well-being. The concept of human development was developed by Mehboob ul Haq, a famous economist of Pakistan. He argued that the current measures for human progress have failed to account for the purpose of development to improve human lives. The basic capabilities valued virtually by everyone include good health, easy access to knowledge, and a decent standard of living, which many people believe are the basic blocks of well-being and opportunity. These core capabilities are largely valued around the globe.
According to the CIA World Factbook, Tajikistan is a landlocked state in Central Asia with an economy dependent on “mineral extraction, metal processing, agriculture”, and labor migrants. The positive dynamics of economic growth are fundamental to its socio-economic status. Its mid-term macroeconomic policy focused on reducing inflation and maintaining a decent living standard. In order to give impetus to economic growth and sustainable human development, the government of Tajikistan has consistently made efforts to organize sectorial and regional programs and then shape the National Development Strategy in 2015. In many respects, the people and the government of Tajikistan have attained remarkable achievement in meeting the challenges of human development.
A few decades ago, the people the Tajikistan were not only substantially less healthy but also less educated. The newly independent states of the region had blamed the USSR for the decline of health, education, nutrition, and jobs. The main growth of the economy is based on education, health, opportunities for the business, and quality labor provision. Research shows that the investment in human development programs is more effective for a country’s progress and prosperity. Therefore, the developing countries have to ensure that all children are nourishing better and are going to school to become a productive citizen in an increasingly competitive and integrative global economy. For this, Tajikistan also has made effort to alleviate the poverty rate from 80% to 30% of the population between 2000 to 2017. According to a report from the World Bank, seventeen percent of under-five children are stunted and only one in ten children aged three to six years benefits from a early learning program. Today, the human capital index of the World Bank shows that a child born in Tajikistan is expected to be 53% as productive as they are growing up with full health and complete education. The country manager of the World Bank for Tajikistan has said, “Improving school readiness, educational outcome and physical and mental health will lead to more productive and healthy adolescents and adults”. Further, he appreciated, “we are satisfied by Tajikistan’s effort to take a holistic approach to Early Childhood Development, benefitting today’s children and tomorrow’s workforce.”
According to a report from the World Health Organization, the pace of health reforms in many aspects of the health system of Tajikistan has been slow because the country has spent little expenditure per capita on health. The public financing depends upon local and regional establishments, thus the regional inequalities undermine the range of health system goals, financial protection, equity, efficiency and quality. Quality of care is another challenge, due to insufficient and inadequate training, lack of clinical guideline, under use of generic medicine, poor equipment and infrastructure and preserves financial encouragement for doctors in the form of pocket payment. The primary objective of health reforms is to strengthen the health care but it is suffering from low priority and underinvestment in Tajikistan. Although a package for primary healthcare has been introduced, it does not rollout all over the country. The National Health Strategy (2010-2020) envisages reforms in the health financing, capitation-based payment for primary health and doubling expenditure on health.
The strategy intended to facilitate and support the healthcare sector of Tajikistan. The government has begun modernizing its resources, financing system, and clinical base as well the organization of healthcare and services. Due to economic growth and constant attention of the government positive impact has been witnessed in the development of health sector. Therefore, the rate of maternal and child mortality has decreased since the last decade. The strategy and efforts for healthcare development resulted in a reduction of the rate of morbidity of communicable diseases, especially in the vaccine-preventable disease. The training of doctors and nurses has become a priority in the medical education. More effective measures have been taken to provide healthcare and services, facilities of network, and increasing of capacity of places and beds. The supervision of pharmaceutical and medical performance has been improved since the last decade. Today, provision of health facilities to the population has become a strategic turn towards a primary healthcare model.
The healthcare system of Tajikistan is influenced by the former Soviet legacy. Its rank is 129 as the human development index of 188 countries in 2016. In the post-Soviet regime, the healthcare facilities have decreased due to poor quality of nutrition, insufficient water supply, and a weak healthcare system. The healthcare system deteriorated badly due to insufficient funds, poor sanitation, and lack of water systems. The efficiency of the healthcare system and mechanisms are also weak. The reforms are made to strengthen the healthcare system but it is still running at a slow pace. In post-Soviet, life expectancy fell to 66 for men and 73 for women in Tajikistan. The fertility rate, which was 6.9 children per women during 1960-1980, now has decreased to 3.4 children per woman by 2016. The mortality rate in children is falling fast and significant improvement in nutrition of children is rising in Tajikistan and under-nutrition in health has become a challenge in rural and remote areas. Unbalanced nutrition leads to poor mental health. Poor maternal nutrition during pregnancy threatens the chance of safe delivery and healthy babies. Malnutrition, dietary factors, and lack of awareness about healthcare cause high prevalence of diseases and directly impact the economy of the country. The lack of healthcare of the masses is a key bottleneck on the way of a country’s development and progress.
According to a health survey from 2017, eighteen percent of under-five children are suffering from stunning and nutritional deprivation, six percent children are wasted, and more than eight percent children are underweight in Tajikistan. Children less than two years of age are lost in wasting and underweight while stunning is prevalent among children aged 24-35 months. Forty percent of children are anemic and only thirty-six percent mother breastfeed their babies for the first six month. That’s why 37 percent of children are suffering from Vitamin A deficiency and twelve percent are vitamin D deficient in Tajikistan.
According to a project report funded by the EU, the country has shown excitement to move towards the education space. Tajikistan’s institutional diversity along with several dimensions fuels the creation of new programs and reflects the needs of an emerging knowledge-based economy to meet market needs. The special focus given to structures of education in Tajikistan is initiated by a global program related to industries and technology. The government has set education as a tool for human capital formation to economic growth. The National Strategy for Education Development 2020 of Tajikistan aims at modernizing education with profession and skill to satisfy the needs of labor and to build the capacity of the country. The government has aimed at reforming educational standards with the curricula through modernization and with the participation of employers.
Since the post-disintegration of the USSR, de-urbanization and deindustrialization remained the key provisions of Tajikistan’s economy. The structural changes in the economy took place since 1991 and small industry lost its ground. Deindustrialization reduced the job opportunities and increased the unemployment rate particularly in rural areas. Today, the state has taken some measures to develop the economy but there are still many rooms for further improvement in the national strategy for economic development with maximum space capacity of productive employment. The low level of aluminum processing and agricultural production has hampered the growth of employment in these sectors. An ill-conceived privatization of certain industries and companies liquidated jobs. No comprehensive policy for labor productivity and security is present in the rural areas, which produce two-thirds of labor force of the country. According to a report by the World Bank, Women are least represented in the labor force and the trend is not encouraging. Employed women like to work in the public sector but are also involved in unpaid family business.
Another World Bank report said that although Tajikistan’s economy has not produced sufficient jobs for its rapid growing work force, particularly its burgeoning youth population, the government has set out new National Development Strategy. The strategy aims to create new jobs in the formal and private sectors, improving the quality of existing jobs, access to better opportunities, including low to higher quality jobs, with a focus on vulnerable workers. With the promotion of the private sector, and with the help of entrepreneurs and investment, new opportunities for business and sustainable jobs are expanding. According to The Diplomat, “Tajikistan is experiencing dynamic grassroots digital development”. The National Development Strategy of the country is also improving the productivity, earning, and access to formal jobs by strengthening local value, small producers, and rural SMEs. Therefore, Tajikistan can attract and connect people to jobs through empowering the population through a set of quality nutrition, good health, valuable education and trained and skilled labor. It seems that Tajikistan will soon overcome the challenges of human development and will create innovation through improvisation and will be a startup nation.