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The purpose of this paper is to provide an up‐to‐date overview of Tajikistan's health system, focusing on the main factors affecting health systems development. The wider…
The purpose of this paper is to provide an up‐to‐date overview of Tajikistan's health system, focusing on the main factors affecting health systems development. The wider contextual environment is to be explored, focusing on political, social and economic issues. Different elements of the health system including health policy, governance, service delivery, human resources and health financing are reviewed in the light of their development over the past decade.
The paper shows that the Republic of Tajikistan is in transition. Formerly one of the most neglected republics within the USSR, the country became independent in 1990 and faced the civil conflict shortly thereafter. In the last few years there have been major public sector reforms with health reforms formally launched in the late 1990s. Little information about current Tajikistan is widely available.
The paper finds that the progress of health reforms in Tajikistan has been relatively slow compared with neighbouring Kazakhstan and Kyrgyzstan. This is largely due to the effects of civil war in the mid‐1990s and significant out‐migration of qualified experts, but it can also be attributed to an inability of central government to adequately adapt to the requirements of transition.
The paper shows that many problems are still to be overcome by the health system, ranging from operational issues related to service delivery to strategic issues such as formulating an explicit privatisation policy, reducing fragmentation of, and aligning, external aid. However, some recent developments, such as adoption of a country health reform conception, a health financing strategy, and willingness of central government to improve coordination, suggest that improvements are possible.
The purpose of this paper is to quantify the impact of socio‐economic characteristics on out‐of pocket expenditures for prescribed medications in Tajikistan and provide…
The purpose of this paper is to quantify the impact of socio‐economic characteristics on out‐of pocket expenditures for prescribed medications in Tajikistan and provide recommendations for healthcare sector reform. The research question in this paper is: what household, personal, economic, and health factors help explain expenditures on medications? From a theoretical perspective, this paper contributes to the on‐going discussion of out‐of‐pocket expenditures in Tajikistan. From a practical perspective, in line with this recent development in the Tajikistan healthcare sector, it helps to develop evidence‐based decision‐making by answering practical questions: what factors affect pattern of out‐of‐pocket expenditures for prescribed medication? Which groups of the population should be granted a discount or fee‐waiver when buying them?
Based on micro‐file data from the most recent cross‐sectional nationally‐representative survey of Tajik households, this paper develops and tests a multivariate model of identifying determinants of out‐of‐pocket expenditures on prescribed medications in Tajikistan.
The paper finds that economic status, chronic illness, disability, number of small children, short supply of necessary drugs, and cardiac and acute illnesses are the strongest determinants of spending for prescribed medications in the country.
This paper demonstrates that to ensure accessibility to and affordability of prescribed medications, discounts or fee‐waivers should be granted to specific categories of households, those in poverty, with chronically ill members and with small children. These discounts or fee‐waivers should cover prescribed medications for children, long‐standing illness as well as for cardiac and acute infectious diseases. Administrative and economic measures should be taken to reduce the extra costs incurred due to the shortage of prescribed medications. Hence, these findings can be used in developing and designing reforms in the Tajikistan healthcare sector.
How is migration related to informal activities? They may be complementary since new migrants may have difficulty finding employment in formal work, so many of them end up…
How is migration related to informal activities? They may be complementary since new migrants may have difficulty finding employment in formal work, so many of them end up informally employed. Alternatively, migration and informality may be substitutes since migrants’ incomes in their new locations and income earned in the home informal economy (without migration) are an imperfect trade-off. Tajikistan possesses both a very large informal sector and extensive international emigration. Using the gap between household expenditure and income as an indicator of informal activity, we find negative significant correlations between informal activities and migration: the gap between expenditure and income falls in the presence of migration. Furthermore, Tajikistan's professional workers’ ability to engage in informal activities enables them to forgo migration, while low-skilled nonprofessionals without postsecondary education choose to migrate instead of working in the informal sector. Our empirical evidence suggests migration and informality substitute for one another.
Related literature finds that human capital proxied by cognitive abilities is an important antecedent of numerous specific life outcomes. The purpose of this study is to…
Related literature finds that human capital proxied by cognitive abilities is an important antecedent of numerous specific life outcomes. The purpose of this study is to extend existing evidence by investigating the link between cognitive skills and income in Tajikistan. Tajikistan is a landlocked low-income country situated in Central Asia. Its population is 9.1 million people and gross domestic product per capita of US$822. According to the World Bank, Tajikistan has made significant progress in decreasing poverty levels from 83% in 2000 to 29.5% in 2017.
The data for this study comes from the 2013 Jobs, Skills and Migration Survey conducted by the World Bank and the German Society for International Cooperation. The main explanatory variable of the study is the cognitive abilities index of the respondents. The survey used item response theory (IRT) approach to estimate the ability of respondents. IRT is a method or a set of statistical frameworks, used to explore assessment item data, such as cognitive abilities assessment data. The wage function was estimated using the ordinary least squares method because the results are easier to interpret (Jencks, 1979; Bowles et al., 2001; Groves, 2006).
The baseline results are reported in Table 2. The results in Column 1 demonstrated the link between cognitive abilities and income without control variables (unconditional model). As expected, cognitive abilities are positively and significantly related to income (a1 = 0.0715, p < 0.01). The results from the unconditional model suggest that one standard deviation increase in cognitive abilities is associated with a nearly 17% increase in income.
However, the study has a number of limitations. First, the dependent variable measures the overall income of the respondent, which includes the profit from other businesses. The survey does not provide data on monthly wages of respondents. Second, the sample may not perfectly represent the overall population of Tajikistan. To partially resolve this issue, this paper re-estimated out results for various sub-samples. Another important limitation of this study is the lack of respondent’s family background, which is an important correlate of human capital and income.
The results in the study offer preliminary evidence on the link between cognitive abilities and income in Tajikistan. However, the results of the study also suggest that both measures of human capital are positively related to income. Therefore, policymakers in Tajikistan should invest greater resources to health care, education and training programs as cognitive skills can be built in particular in the early stages of the life cycle. Indeed, Tajikistan has a significant potential for economic growth model driven by human capital. According to the World Bank, the adult literacy rate in Tajikistan is 100%, which is significantly above of what is observed in other developing countries. This may imply that the human potential in this country is considerable, and further investment in soft and hard skills would have a positive impact on economic growth.
This paper offers new evidence on the link between cognitive abilities and income, using data from Tajikistan. First, this paper finds that cognitive abilities are positively and significantly correlated with income. Second, this paper finds that this link remains robust even when this paper control for a large set of personal and job-related characteristics. The results from the unconditional model suggest that one standard deviation increase in cognitive abilities is associated with nearly a 17% increase in income.
In 1996, capital was raised to launch a Pepsi‐Cola production line in war‐torn Tajikistan. Production capacity was 6,000 bottles per hour, in a country experiencing a painful transition to a market economy.
Central Asia's currency problems.
UZBEKISTAN/TAJIKISTAN: Goodwill expands regional trade
This chapter analyzes and discusses the food insecurity and malnutrition situation in Europe and Central Asia (ECA), with a strong focus on the Caucasus and Central Asian…
This chapter analyzes and discusses the food insecurity and malnutrition situation in Europe and Central Asia (ECA), with a strong focus on the Caucasus and Central Asian countries.
Authors use descriptive statistics to examine macro-level, sectoral-level, and household-level data from national and international sources to review production, trade, and consumption of food and agricultural products in the selected countries. Overall trends in economic growth and poverty reduction, constraints and bottlenecks in agricultural productivity growth, as well as policies that shape food security in the ECA region are analyzed.
While the countries that constitute the focus of this chapter have shown significant progress in alleviating food insecurity and extreme poverty, many risk factors remain, such as inadequate micronutrient intake, sub-optimal quality diets, growing obesity rates, and high dependence on food imports in a number of the ECA countries.
Based on the assessment of the food security situation in the ECA countries, the authors discuss government actions, including those emanating from various global initiatives, being implemented to reduce food insecurity and malnutrition.
Tajikistan's search for loans.