Dear colleagues,
Thank you for your interest in our work in Tajikistan.
*Why* children and pregnant women are unnecessarily hospitalized and *why*
misuse of antibiotics is so common were exactly some of our questions. We
reflect on the causes and impact within the health systems in the following
viewpoint:
*Wasting resources in health care - unnecessary hospitalisations and
over-medicalisation: The health workers' or the health systems' fault?
Evidence from Romania and Tajikistan and implications for global health* (
https://pubmed.ncbi.nlm.nih.gov/37141528/)
We are currently conducting qualitative research in Tajikistan (and
Kyrgyzstan, where these practices are also common) and aim to have a deeper
understanding from interviews with health care workers. We will be happy to
share our findings as soon as we have them.
To answer the questions that have been asked, PHC in Tajikistan is largely
undervalued and not trusted by the population. PHC is mainly run by family
doctors and nurses, while in the hospitals, children are mainly cared for
by paediatricians and family doctors. Most facilities at PHC level have
(very) limited equipment and capacity for basic testing. In addition,
informal payments are the norm, therefore, the intermediary step at PHC
before being transferred to the hospital is likely to only increase the
cost for the end users seeking care. Access to care largely differs between
the capital and the mountainous remote rural areas.
Best wishes,
Sophie Jullien
Consultant Child and Adolescent Health and Quality of care
World Health Organization Regional Office for Europe
> CHIFA Profile: Stefano del Torso is a Primary care Pediatrician at ChildCare Worldwide ( www.ccwwitalia.org) in Italy. Professional interests: International cooperation projects. Email deltorso AT gmail.com
