IMPLEMENTATION OF YOUTH HEALTH DEVELOPMENT PROGRAMME IN THE REPUBLIC OF TAJIKISTAN FOR 2006-2010: ACHIEVEMENTS, PROBLEMS AND PERSPECTIVE
TABLE OF CONTENTS
1. PREFACE.. 4
2. ACHIEVEMENTS TOWARDS REALIZATION OF YOUTH HEALTH DEVELOPMENT PROGRAMME IN THE REPUBLIC OF TAJIKISTAN FOR 2006-2010. 6
3. CHALLENGES RELATED TO EFFECTIVE REALIZATION OF YOUTH HEALTH DEVELOPMENT PROGRAMME IN THE REPUBLIC OF TAJIKISTAN FOR 2006-2010. 17
4. PERSPECTIVE RELATED TO IMPROVING HEATH CONDITION OF YOUTH.. 20
Contribution of international organizations that have direct cooperation, like United Nations Development Programme, the Global Fund to Fight AIDS, Tuberculosis and Malaria, the World Bank, CARE Tajikistan, United Nations Children Fund, United Nations Population Fund and the World Health Organization is unprecedented in effective realization of youth health development in the Republic of Tajikistan for 2006-2010.
In this direction, we – young people of Tajikistan express gratitude to the responsible persons of the above-mentioned organizations and completely believe that henceforward, activities of these organizations and other concerned foundations will get more and improve in the way to refine the health condition of new generation and youth to ensure that near future of Tajikistan derives benefit from this initiatives.
Person responsible for the development:
MIRALIEV K.A. – Head of Social Policy Department of Committee of youth sport and tourism under the Government of the Republic of Tajikistan, Coordinator of youth health development Programme in the Republic of Tajikistan, Candidate of Political Sciences
JURAEV K.K. – first depute Chairman of Committee of youth sport and tourism under the Government of the Republic of Tajikistan
MUINOVA M.M. – depute Chairman of Committee of youth sport and tourism under the Government of the Republic of Tajikistan
MIRZOEV I., FAKIROV A., ODINAEV K., NURIDINOVA P. – Project Coordinators of “Prevention of HIV/AIDS among youth rural”
Health creates a favourable condition for all kinds of operations in the realm of improving economic situation and human development. Therefore, healthy lifestyle development perspective is the most important speeding factor for stable development, reducting poverty level and improving population’s living standards.
Social development tendency of Tajik youth is taking place in a difficult social and economic condition, transition period and civil war, during the break-up of past time values and new social relations development, that broke constant ties between generations and made the course of proper development even more difficult.
The established situation didn’t retain itself from exerting influence on living skills development and youth health improvement.
Therefore, it’s not possible to successfully evaluate youth health condition without looking at achieved successes. During recent 15 years, stable growth of unfavourable phenomena is observed like earlier pregnance, abortion, pread of drug addiction, sexually transmitted diseases, Human Immunodeficiency Virus (hereinafter referred to as HIV)/Acquired immunodeficiency syndrome (hereinafter referred to as AIDS).
It’s necessary to note that over 42 million peoples are spreaders and sufferers of HIV/AIDS throughout the world, out of which 3,2 million of them are children aged up to 15 years old. Majority of them do not realize that they spread the virus. Earlier sexual activization tendency of teenagers is onserved that facilitates in spreading the infectious disease. Lack of knowlesge and or insufficient knowledge about sexual education leads to wider spread of diseases and makes the healthy and complete lifestyle impossible.
During transition period in XXI century it became clear that several difficulties of preserving population’s health could be resettled only through behavioral change and developing living skills in health realm. If these interventions are applied firstly among youth, who are standing in initial phase of personality development, it will give effective results and also ensures their participation in implementation course. Additionally, provision of health services for youth should be rational, their interest and needs should be considered based on good deeds towards them. Because servicing mode facilitates in finding proper and timely information, complete list of available, acceptable, quality and confidential servicing by professional employees, who were trained in issues related to health, principles of well-wishing servicing to youth and most important, it provides participation of youth themselves through realizing educational programmes “Peer to peer”.
Experience and conducted analyses show that, one of the most important factors that bar the way to youth’s living skills in health realm are the followings:
— low quality of well-wishing servicing in the direction of youth health;
— low level of youth participation, particularly vulnerable groups in development and realizing of preventive actions;
— ineffective use of capacities and possibilities of educational system in teenagers’ living skills development in health realm;
— low level of communications strategy in teenagers’ living skills development in health realm;
— imperfection of social cooperation between different sectors of civil society and world community in the course of preventive actions development;
Youth health development programme in the Republic of Tajikistan for 2006-2010 (hereinafter referred to as Programme) includes contribution of government structures, non-governmental and international organizations in the way to achieve Millenium Development Goals that facilitates in resolving the above-mentioned problem.
From this viewpoint, Decision of Government of the Republic of Tajikistan as of 3 March 2007 under No 107, “Youth health development programme in the Republic of Tajikistan for 2006-2010” has been approved with the aim to support and create favourable condition for youth health development.
Basic aim of the Programme is to improve youth health through reducing risky behaviour including accidental sexual intercourse, drug addiction, sexually transmitted diseases and HIV/AIDS.
prevent and reduce the influence of risky behaviour related to issues of accidental sexual intercourse, drug addiction, secually transmitted diseases and HIV/AIDS through betterment of condition for providing access to information, education and living skills development in health realm;
facilitate in protecting youth rights, including vulnerable groups regarding social and legal support, gender equality and youth participation in purposeful programmes directed at health development;
activate participation and improve sense of responsibility among youth in purposeful programmes directed at health development;
improve youth conditions concerning ensuring available quality and well-wishing servicing in social institutions;
improving society’s role in the way to establish well-wishing environment for youth health development.
The difference of this Programme with the other programme is that it is inter-agency and several ministries and agencies are assigned as responsible for realization of established tasks, also, this Programme has its special action strategy, which is directed at designing and developing youth friendly servicing system. Namely, all activities implemented within the framework of the Programme are based on complex well-wishing servicing.
Chairman of Committee of youth sport and
tourism under the Government of the Republic of Tajikistan
2. ACHIEVEMENTS TOWARDS REALIZATION OF YOUTH HEALTH DEVELOPMENT PROGRAMME IN THE REPUBLIC OF TAJIKISTAN FOR 2006-2010
Achievements for the realization of youth health development Programme in the Republic of Tajikistan for 2006-2010 (hereinafter referred to as Programme) is concretely stipulated below, that they were compiled based on information received from concerned ministries and agencies, international and public organizations.
According to the point 12 of the Youth Health Development Programme in the Republic of Tajikistan for 2006-2010 “Executors and facilitating structure, which are directly involved into Programme realization submit reports addressed to Interministerial coordinating commission on improving youth friendly servicing not lesser that one time during a year”, every concerned structure, including relevant international organization, regardless of preliminary warning, at the end year, should deliver information addressed to Youth, Sport, and Tourism Committee at the Government of the Republic of Tajikistan regarding achievements made towards realization of youth health development Programme in the Republic of Tajikistan for 2006-2010. However, unfortunately, this mechanism didn’t fully comply with and it’s natural that in this case, this guidance reflects the real situation of participation and operation level of concerned (responsible) organizations. According to the limit, the received information is equal to 60% of events that were really carried out.
As majorities are aware, youth health development Programme in the Republic of Tajikistan for 2006-2010 consists of six priority directions and realization of each of them bear specific characteristics. Therefore, achievements are given below according to these priotiries.
Develop and apply youth friendly servicing policy
Realization of this priority, which is directed at providing Programmatic policy, usually covers developing and realizing theoretical measures.
According to the regulated sequence, the Programme, which is governed by state and has national specifics, is adopted at the level of all republican cities and districts dependent on local conditions and possibilities for the period of 2006-2010.
According to realization of Article 7 of the Programme, an Interministerial coordinating Commission on improving youth friendly servicing (hereinafter referred to as the Commission) was established on account of health, education, labour and population’s social protection specialists, international organizations, including CARE Tajikistan United Nations Chindren Fund and public associations. Working schedule and staff of the Commission was approved based on the resolution of Committee’s Board of Advisors as of 22 June 2006 under No.3.2. Thus, until present time, Commission summed several meetings to resolve existing challenges that arose in the course of Programme implementation and relevant decisions were adopted.
Aimed at effective implementation of the Programme, draft mechanism of realizing youth health development Programme in the Republic of Tajikistan for 2006-2010 was developed and approved based on Commission’s decision. This mechanism has strategic specificity and concretely covers all Programmatic actions through determining tasks and influencing steps.
According to the Programme’s requirement, Ministry of Education, Ministry of labour and population’s social protection, Committee for women and family affairs, Television and Radio Committee regularly (annually) developed and realized specialized measures within the frames of possibilities and their taken actions will be detailed below.
Upon suggestion made by United Nations Population Fund, draft educational Programme for youth based on “Peer to peer” education (standardization of action) was discussed and approved by the Commission. This Programme allows to standardize all activities performed by concerned organizations, including public associations, towards conducting educational measures based on “Peer to peer” principles. The necessity of adopting this standard, first, is based on globalization of action and regulating, ensuring quality in modern society conditions.
One of the Programme’s innovations is providing anonymous servicing to youth, that in this context, aimed at regulating and developing “Hotline for teenagers and youth” services, draft Regulations and methodological operations manual for sector specialists were developed and approved through Commission’s decision. Methodological manual could be used as guidance in the course of establishing hotlines in different country areas and for preparing sector specialists through organizing educational workshops.
With the aim of regulating and developing the activities of Centers for well-wishing education and information to youth, special activities’ Regulations was developed by specifically established Task Force and approved through Commission’s decision. Additionally, aimed at sustainability of activitied perfrmed by Centers for well-wishing education and information to youth, the above-mentioned manual was ratified with the coverage of Centers’ priority directions, being under use as operations guidance.
Aimed at effective implementation of health related priorities of the Programme, Board for implementation of “Youth health development Programme in the Republic of Tajikistan for 2006-2010” was established at the Ministry of Health of the Republic of Tajikistan comprised of members from among health specialists, specialists of youth affairs, public associations and international organizations. This Board organizes regular sectoral meetings and is taking a set of measures aimed at improved application of activities towards youth health development.
In the direction of learning practical experiences of foreign countries, regular study tours of specialists from ministries, agencies and public and international organizations were organized, including to the Islamic Republic of Iran for participation in the International Conference to prevent HIV/AIDS, to Saint-Petersburg of the Russian Federation to participate in the International Conference “Friendly services for youth”, to Kiev city of Ukraine for learning their experience in complex and intersectoral well-wishing servicing to youth, also, similar visits were organized on the same problems to Macedonia, Kazakhstan, Kyrgyzstan and other countries.
Over four methodological-practical guidances were development for young volunteers within the frames of realizing the Project “HIV/AIDS prevention among rural youth”.
With the aim of improving leval foundation of possibilities to organize and render humane assistance to teenagers and youth, a research entitled “Provision and access of teenagers and youth to medical-social services with due consideration of observing human rights” was commissioned during 2009-2010 with the help and support from the World Health Organization.
The Ministry of Health with the support rendered from the United Nations Children Fund and in cooperation with the Ministry of Finance established a Task Force that aimed at investigating the costs of well-wishing services to teenagers and youth. The purpose of the Task Force is to commission a pilot and indirect financing of medical services to teenagers and youth and with this mean, in a one-day seminar was organized in February 2009 with the participation of representatives from concerned organizations and an international consultant. At the same time, Ministry of Health selected 8 cities and districts to investigate the costs of well-wishing services for teenagers and youth: Dushanbe, Khujand, Kurghonteppa, Kulob, Khorog, Tursunzoda, Isfara and Vahdat. All eight medical-counselling Departments of well-wishing relations to teenagers and youth are provided with contraceptive agents and drugs to treat syndrome were provided by CARE Tajikistan and the utilization term of these drugs were determined until 20102.
The referral system exists between well-wishing information and education Centers for youth and medical-counseling Departments for teenagers and youth. This mechanism is being regularly activated.
With the aim to improve knowledge and skills of medium health personnel, upon decision of the Ministry of Health, 140 specialists in Vahdat town and Yovon district were trained on reproductive health problems of teenagers and youth in February 2009 with the financial support rendered from CARE Tajikistan.
Education living skills in health
Within this priority realm, more activities are directed at education and it’s actual that namely thorugh raising educational level of youth, protecting and reducing the growth level of extremely threatening diseases, including AIDS, has a close probability.
2.1. In cooperation with United Nations Children Fund and the Global Fund, the Ministry of Education accomplished a set of events and undertakings among schoolchildren, students and teachers and arranged a basis for publishing methodical guidances, textbooks, journals and newspapers, discs and information and propaganda posters against drug-addiction, smoking, alcoholism, HIV and AIDS.
2.2. In 2006, with the support rendered from the United Nations Children Fund, a sociologic research “Perception and world vision of children about healthy lifestyle” was commissioned among 11 thousand children aged 13-15 years old. This survey showed that, the perception level of children aged 13-15 is very high and they are not indifferent about events and incidents that take place. The results of this survey and cross-questions were discussed at the level of Government of the Republic of Tajikistan and Ministry of Education. Namely, it was made clear, that children aged 13-15 years old of our country have information abour the use of alcohol, ciragette, intoxicating agents, drugs and a little part of them have used these substances hiddenly or through curiosity. This study established a basis for institutionalizing “Healthy lifestule” through educational lessons and out-of-class and out-of-school lessons. Namely, order of the Minister of Education was signed on 3 March 2007, under No. 86 in this background and this kind of education was applied through educational lessons. Instruction of this subject covered human health in its very detailed description and attractive and comprehensive topics were placed in upper classes aimed at preventing drug-addition, alcoholism, smoking and other unfavourable habits.
2.3. In order to deeply acquaint teachers with health issues and training “Healthy lifestyle”, the Ministry of Education published a journal with the title of “Education and AIDS” with the number of 6 thousand printed copies and made it available to schools. Principle problematic subject of youth suffering from HIV and AIDS is designed in this journal.
2.4. In 2007, concerned specialists of relevant ministries and agencies went to study tour to the Ukraine with the purpose of learning progressive experience, ways of developing educational materials, conducting educational trainings and seminars for parents on healthy lifestyle. As the result of cooperation with Ukrainian specialists, and educational manual of “Healthy lifestyle” for schoolchildren of 7-9 Forms and methodical guidance for teachers were developed. The use of these manuals was operationalized according to the decision of advisory board of the Ministry of Education as of 11 July 2008 under No. 1089. This book was published in amount of 60 thousand print copies and delivered to 200 pilot schools.
2.5. In view of realizing the above-mentioned programme, 84 education specialists underwent educational courses in 2008, and received a certificate as specialist to teach this subject. Besides, according to order of the Minister of Education of the Republic of Tajikistan as of 1 July to 1 September 2009, pilot schools’ teachers were involved into refresher courses and learned active training methods to train “Healthy lifestyle”.
2.6. In addition, training “Healthy lifestyle” Programme was arranged in summer and recreational camps for children and leaders were prepared from among them. These schoolchildren hold regular explanatory activities in their own schools about the damaging consequences of drugs, tobacco, alcoholism and other unfavourable habits while used the “Peer to peer” method.
2.7. In cooperation with Youth, Sport and Tourism Committee at the Government of the Republic of Tajikistan, the Ministry of Education arranged trainings on prevention from drug-addiction and other unfavourable habits among students of professional secondary education institutions and higher schools.
2.8. Besides, in cooperation with United Nations Children Fund and other international organizations, the Ministry of Education organized numerous seminars and events in institutes and advanced training centers for teachers and aimed at acquainting teachers with this problem in extension courses applied five-hour lessons to teach all subjects. In addition, more than ten different awareness-raising guidances from the threat of HIV/AIDS, tuberculosis, fever, drug-addiction and smoking were published and provided to educational institutions.
2.9. Presently, Ministry of Education decided to develop educational manuals of “Healthy lifestyle” also to schoolchildren of 1-6 and 10-11 Forms and thus inform them about all unfavourable habits that cause children’s inclination to these diseases or their moral degradation. In this direction, Ministry of Education has regular cooperation with the National Coordination Committee, Healthy Lifestyle Center of the Ministry of Health, State Drug Control Agency at the President of the Republic of Tajikistan, Youth, Sport and Tourism Committee at the Government of the Republic of Tajikistan, Committee for Women and Family Affairs at the Government of the Republic of Tajikistan and international organizations and cooperation has been recently initiated to develop mentioned books and manuals.
2.10. In lower classes, according to the educational programme, schoolchildren are informed about the infection ways of microbes that causes children’s illness, washing hands, cleanness, not chewing gums, not chewing nails, having cautious treatment with domestic animals (particularly, dogs and cats). In upper classes, schoolchildren get acquaintance with the problems like HIV/AIDS, tuberculosis, drug-addiction and diseases transmitted through blood.
Facilitation to protect the rights of extremely vulnerable youth groups
3.1. Engagement of vulnerable groups of youth into accessible health service is one of the priority problems in modern society. Therefore, still in the course of developing this Programme, pilot project of organizing friendly services to Dushanbe youth by State Unitary Enterprise “Republican Center for information and inclination of youth” and public association “Nasli Navras”, “Khonai Javonon”, public association “Ghamkhor” in Kurghonteppa and public association “Dina” in Khujand, Support project for vulnerable group of youth was developed towards prevention from infectious diseases and HIV/AIDS. Nowadays, the above-mentioned organizations has hundreds of young wanderers and homelesses voluntarily involved and conduct awareness-raising campaigns about healthy lifestyle, including prevention from HIV/AIDS.
3.2. Starting from March 2005, within the frames of youth health development Programme, “Youth hotline” services was established under the Committee targeting vulnerable groups of youth. Activities of this Service are in place in cooperation with psychologists, medical and law specialists, also specialists engaged with youth affairs. Usually, youth appealed to this Service with their life-bound difficulties, most important of which is lack of good relations with parents, quarrels with one’s beloved and sexually transmitted diseases. Similar “Youth hotline” service was also established based on public organization “Zuhro” whose specialists are engaged into both phone and oral counseling to youth in need.
3.3. In cooperation with concerned organizations and institutions involved into healthy lifestyle, including prevention of suicide, intention for suicide, cleanness and gender issues, Ministry of Culture undertook certain measures. Regular events were organized by Ministry’s structures, including “Woman is source of life”, “Kindness bearer”, “Who is the best”, “Why women commit suicide?”, “The damage of burning oneself” and others.
3.4. With the purpose of promoting healthy lifestyle, moral education of youth, including, vulnerable youth and prevention of family quarrels well made works of Tajik play writers are being regularly written and performed in country’s theatres scenes. Similar newly written performances include “Obi Jonbakhsh” written by H.Mirzosharif, “Afsonai besha” libretto and “Tavhid” written by S.Umar.
3.5. One of the day’s pressing problems is women’s endless attention, including attention of girls from country’s several areas, like Isfara, is to the concocted consequences of Islamic religion (namely, in fact they are behaviours against Islam), that has nothing but negative influence. Pursuant to this problem, majority of girls wear paranja and are unaware about modern requirements and it’s real that due to shortage of education and limitation of possibilities often fall into different physical and mental diseases. In this context, the Committee for women and family affairs at the Government of the Republic of Tajikistan organize regular events through local structures aimed at preventing sexually transmitted diseases, reproductive health development and family regulation. Similar events were organized in cities and districts of Mastchoh, J.Rasulov, Khujand, Qayroqqum and other regions of the country under the slogan “Mother is propagandist of healthy lifestyle”, “We are against drug addiction”, “Educated woman is support to healthy society”, “Woman is health guide” and others.
3.6. Certain layer of vulnerable youth is consisted of drug-addicted group, whose birthplace is originally in major bordering cities and districts of the republic.
Against this background and aimed at carrying out the Protocol of Coordination council meeting to prevent excessive use of narcotics as of 21 December 2009, during the first quarter of 2010, activities of bordering districts of Khatlon province were examined. In Mir Said Alii Hamadoni district, in connection with Programme implementation, the activities of youth, sport and tourism department of Mir Said Alii Hamadoni district are weakly arranged towards organizing information and awareness-raising campaigns in district communities and rural locations. This is in case, when the Committee developed methodical-practical guidance regarding realization of social policy of Tajik youth and dispatched to all local structures for realization.
Besides, activities of youth, sport and tourism department of Kulob city was targeted for examination. Within the frames of this programme, series of cultural and sport events including city youth action against drug-addiction diseases, counseling seminar, competition of “Guldukhtaron”, competition of best pictures, sports competition “Ofarin” were organized among schoolchildren of general secondary education schools, national wrestling, table tennis, chess and football among organizations and institutions.
Undertakings in this direction are weakly organized in Vose’ district. Youth, sport and tourism Department needs to reinforce its activities in this direction, carry out regular actions, meetings and counseling seminars, and consequently submit information to the Committee regarding results achieved while performing activities.
According to the examination schedule, activities of youth, sport and tourism Department of Shahritus and Jaloliddini Rumi districts deserves pride and appreciation. Based on the Programme and action plan of Coordination council to prevent excessive use of narcotics, events and meetings were arranged with farms named after A.Dustov, N.Begov, T.Esanqulov, S.Khumaev, settlements of Guliston, Kalinin and jointly with public organizations of “Akhtari Bakht”, “Hiloli Ahmar”, “AIDS Centers” of the district and also among district’s general secondary schools competitions of “Young writers”, “Best essay dedicated to drug-addiction” and “The best work of literature” were implemented, in which area observers and head of primary youth organizations has taken part. This decision rests under control, awareness-raising campaigns are in place regarding prevention of excessive use of narcotics among youth residing in district communities, settlements and villages.
Administration of youth, sport and tourism of Khatlon province and local structures accomplished series of events in cities and districts of the region pursuant to implementing the order of Committee’s chairman as of 20 January 2009 under No. 6 “In the direction of realizing single purposeful state Programme regarding prevention of drug-addiction and countering illegal circulation of narcotics in the Republic of Tajikistan for 2008-2012”. In bordering districts of Hamadoni, Farkhor and Shuroobod, the administration organized meetings in communities, settlements and villages with participation of representative from internal affairs’ department, women affairs, muezzin of five-time mosque, and jamoat chairmen with youth dedicated to the subject of drug-addiction and ways of its prevention. Besides, departments of youth, sport and tourism of Kulob city, and Shuroobod, Baljuvon, Yovon, Qumsangir, Abdurahmoni Jomi and Farkhor districts covering subjects of “Youth against narcotics”, “Narcotics and its harm”, “Prevention of drug-addiction and narcotics trafficking” organized seminars and meetings in settlements, cities and districts. Local structures of the Administration organized over 150 different educational and awareness-raising events towards prevention of drug-addiction through involvement of youth volunteers’ circle members and thus, over 15 thousand young people were covered in these events.
Members of examination group recommended youth, sport and tourism Departments to reinforce propaganda and awareness-raising activities to combat this unfavourable phenomenon, take practical measures to prevent the use and sale of narcotics. Administration and Departments of youth, sport and tourism were assigned to organize regular propaganda and awareness-raising events in general secondary education schools, district colleges and among population through holding thematic lessons on drug-addiction and its consequences. Authorities need to make narcotics related informational documents available and add them to working packages for execution.
3.7. Through close cooperation between several organizations, including the Ministry of Health, public organizations “Zuhro”, “Youth of XXI century” and “Supporting youth rights”, “Mehrubon” and “MOST” with the financial support rendered from the United Nations Population Fund trust points were established for vulnerable youth in several selected districts and are currently active.
3.8. With direct initiative of the Ministry of Health, through the financial support of the World Health Organization and United Nations Children Fund, International seminar with the subject “Vulnerable youth’s access to well-wishing health services” was organized on 17-10 June. Representatives of concerned ministries, agencies and international and public organizations from Russia, Kazakhstan, Kyrgyzstan, Tajikistan, Ukraine and Uzbekistan took part in it. In the course of this event, participants were acquainted with Tajikistan’s achievements towards youth health in targeted areas.
Youth participation in programmes directed at youth health development, reproductive health, prevention of sexually transmitted diseases, HIV/AIDS and drug-addiction
4.1. Aimed at participation in developing and realizing programmes that facilitate youth health development, representatives of the Committee and other concerned ministries and agencies are joining the National Committee to fight AIDS, tuberculosis and malaria at the Government of the Republic of Tajikistan and other Task Forces and keep regular activities related to youth health challenges.
4.2. Active youth from among volunteering youths filled the rows of the Interministerial coordination council of the youth health development Programme in the Republic of Tajikistan for 2006-2010, who have equal voices on a par with adult groups and effective use them.
4.3. Through youth’s initiatives in Tajikistan, including within youth health development Programme in the Republic of Tajikistan for 2006-2010, from 2002 henceforward National Strategy “Youth Friendly Initiatives” (YFI) was developed that provides accessible, voluntary, confidential and trusted services to young individuals.
4.4. One of the priority directions of YFI Strategy is to involve international organizations and activization of public organizations concerning implementation of youth health initiatives.
Against this background, in cooperaion with CARE International within the frames of sexual and reproductive health of teenagers and youth project and Ministry of Health 30 well-wishing informational and educational centers for youth and 8 well-wishing medical-counseling centers for youth were established in Dushanbe, Vahdat and Yovon district, with this centers’ personnel mainly composed of young volunteers from among, schoolchildren, students and unemployed. Among their peers, they undertake different regular educational and informational events on healthy lifestyle, prevention of unfavourable factors and work to spiritually and morally educate youth.
Funding of the above-mentioned Project has been completely realized in June 2009 by CARE International and further management of centers, including, well-wishing educational and informational Centers was relayed under the responsibility of Youth, Sport and Tourism Committee and well-wishing medical-counseling Departmenets for youth was assigned to the Ministry of Health.
A total of 1,2 million US dollars were allocated in realizing this Project.
In today’s condition of international funding this is considered as the best way of providing desired sustainability of grant project. Because, today’s world community directs all efforts in using internal forces, namely, local specialists and developing possibilities of management, authority and patronage of state in relation to funded projects. Every state that has independent possibility and from the viewpoint of involving work force, possesses the ability in efficient use of any international funding, namely this group of states are included in stable and capable group of states. Namely, favorable environment of involving foreign investment is developed in these states, and its security provision is protected.
4.5. With the aim of raising the awareness level of youth on reproductive health issues and sexually transmitted diseases, specialists of National reproductive health Center organized 25 meetings in Information Centers located in Dushanbe, Vahdat and Yovon district that was attended by 278 volunteers and received information about the above noted issues.
4.6. Targeting the matters of development and broadcasting specialized programmes on reproductive health issues among teenagers and youth, during this year, specialists of National reproductive health Center and Republican healthy lifestyle development Center, jointly with the Committee of television and radio at the Government of the Republic of Tajikistan broadcasted series of TV and radio programmes, including radio quizzes, live talks, show programmes that were directly attended by youth themselves and broadcasting of similar programmes is continued.
Medical-counseling Departments with well-wishing servicing functions provided made the following equipments available to teenagers and youth.
Ultrasound apparatus — 4 pieces
Gynecological table – 8 pieces
Bookcase – 12 pieces
Microscope — 8 pieces
Table – 24 pieces
Chairs -144 pieces
Computer with printer – 8 pieces
Air conditioner – 8 pieces
Height meter – 8 pieces
Weighting machine – 8 pieces
Centimeter scale – 8 pieces
Stethoscope – 8 pieces
Case sterilized with steam – 8 pieces
Vacuum- aspiration apparatus – 8 pieces
Case for medicaments – 8 pieces
In addition to this, the above-mentioned departments were provided with eight kinds of medicaments for the treatment of sexually transmitted diseases and five kinds of contraceptive agents.
These departments regularly provide medical and counseling services to teenagers and youth.
With the help and financial support from CARE Tajikistan contraceptive agents were made available with the total budget of 227389,1 US dollars, including vaginal means 5976 pieces, hormonal tablets – 41139 convolutes, Depo-Provera injections 882 bottles, farmatex 47100 pieces and condoms 109 071 pieces.
4.7. 70,4% youth live in rural locations and namely, this layer of youth encounter different infectious diseases due to lack of knowledge. From this viewpoint, aiming at prevention from HIV/AIDS and other unfavourable factors among rural youth, in cooperation with and financial assistance from United Nations Development Programme through the Global Fund to Fight AIDS, tuberculosis and malaria, the project of prevention from HIV/AIDS among rural youth is being implemented in Tajikistan since 2007. Basic objective behind the Project is to reduce the infection threat of HIV/AIDS and sexually transmitted diseases among rural youth through developing modern ways of action, widening cooperation in arranging informational and educational events, improving the level of awareness, knowledge and changing youth behaviour. Project’s priorities include organizing young volunteers’ clubs (YUC), strengthening cooperation with concerned organizations, facilitating youth’s access to vitally important information on health and systematic control and evaluation and exerting impact through project realization.
The project has preventive characteristics and is implemented among rural youth and is based on youth health development Programme in the Republic of Tajikistan for 2006-2010. Within the framework of the Project, in 50 selected cities and districts and 8 jamoats of Vahdat city, youth volunteers’ club consisting of 1500 volunteers and 150 trainers were prepared who are regularly leading awareness raising campaigns among rural youth on prevention of HIV/AIDS and developing healthy lifestyle based on the principle of “Peer to peer”.
Within project’s frames, educational and informational, cultural-entertainment, sport, training activities are held through sharing experience and through the mass media.
Direct participation of youth is provided while organizing events, namely, these events are arranged according to the principle of “peer to peer”.
Specialists from the United Nations Population Fund regularly train project volunteers and trainers. Besides, within the framework of cooperation with United Nations Population Fund regular foreign and domestic study tours of Project volunteers are arranged according to the principle of “peer to peer”, radio, TV programmes and theatre performance are organized.
For example, we can bring here Project’s one-year coverage for 2008-2009, that includes the following achievements:
— Educational activities, seminars — 2365 local training seminars were organized with participation of over 46657 young people.
— Educational-cultural events, competitions — in 2020 local and regional events 70685 young people were directly covered and 222359 different information materials were distributed amongst youth during organization of events.
— Sports events — 3772 sports and mass events like football, volleyball, chess, draughts, table tennis and basketball were organized and covered 93033 young people. 264627 citizens of selected districts participated as spectator in those events that had mass characteristics.
— Meetings — 48747 individual events and 5346 group events were organized and covered 160462 young people.
— Events dedicated to historical dates — 2821 events were organized and covered 104603 young people. 261256 different information materials were distributed to youth while organizing those events.
— Events arranged through the mass media — 1251 undertakings, including publication of articles in periodical newspapers and magazines and programmes broadcased in radio and TV networks, approximately 20% of target group, namely rural youth, was covered through providing necessary information.
In general, within the Project’s frame, during the reporting period, 475384 teenagers and youth were covered during organization of events through awareness raising campaigns on healthy lifestyle, including drug-addiction. Besides, during organization of events in the republic, local structure of the Committee directly allocated 63972 somonis of additional funding and realized it that deserve thanks.
Over 4 million somonis were allocated in realization of Project on prevention from HIV/AIDS among rural youth for 2007-2010 that provides effective youth health development Programme in the Republic of Tajikistan for 2006-2010. Namely this Project provides basic principles for the realization of Strategy “Well-wishing initiatives for youth”.
Development of communications strategy
5.1. In cooperation with international organizations and public associations, regular different educational and awareness-raising campaigns are developed and organizated by youth affairs’ bodies with the wider participation of youth and dedicated to historical dates, Children’s protection day – 1 June, International day to fight narcotics – 26 June, International AIDS day – 1 December and others. As the result of these events, thousands of young people were informed with necessary information abour prevention of AIDS, drugs diseases and sexually transmitted diseases.
5.2. Besides, local structure of youth, sport and tourism Committee directly organizes regular “Cheerful and witty” Club among students and “Quick Wits” Club among rural youth on an annual basis, that fills in the rows of thousands of participants and participants organize these competitions with great enthusiasm and willingness. This includes organization of events within the Project “Prevention of HIV/AIDS among rural youth” that was dedicated to the 1150th Anniversary of Rudaki and the Year of Tajik language (2008), the Year of Imami A’zam’s glorification (2009) and the year of technical culture and education (2010) being organized on a high organizational level through “Quick Wits” Club under the title of “Health is our protector”.
5.3. Project volunteers actively participated in the monthly Action under the title of “We, youth, advocate for healthy lifestyle” and republican Marathon under the title of “Only together we can succeed over AIDS”. With their initiative, annual drawing, essay competitions and sports competitions like volleyball and chess are widely organized at the city and district level.
5.4. Similar actions are regularly organized through concerned ministries, agencies, international and public organizations with the coverage of thousand young people.
5.5. Aimed at teenagers’ moral education in 21st century, theatrical performances from M.Mahmoudov Youth Theatre under the themes of “War of crave” and “Healthy lifestyle” were shown to teenagers in different cities and districts of the country. It’s noteworthy that theatrical group consisting of 12 professional teenagers attracted spectators’ attention. Similar kinds of events are purposeful and they concentrate youth more on learning good deeds from the other and changing their own behaviour towards healthy lifestyle development.
5.6. Upon initiatives made by international and public organizations, regular informational and discussion events are organized in radio and TV networks that exert positive influence on raising awareness and improving knowledge.
Monitoring and evaluation
According to the actions of youth health development Programme in the Republic of Tajikistan for 2006-2010, the following measures were realized in relation to monitoring activities.
1.1. Information fund of the Project of prevention of HIV/AIDS among rural youth. This Fund is considered to be one of the most important Programme achievements and is directed at regulation, coordination and development of possibilities for the Project of prevention of HIV/AIDS among rural youth and youth health development Programme in the Republic of Tajikistan for 2006-2010 and covers 51 republican cities and districts.
1.2. With the financial support rendered from the United Nations Children Fund, sociologic research “Perception and world vision of children towards healthy lifestyle” was commissioned in 2006 covering 11 thousand schoolchildren aged 13-15 years old. This survey showed that, the perception level of children aged 13-15 is very high and they are not indifferent about events and incidents that take place. The results of this survey and cross-questions were discussed at the level of Government of the Republic of Tajikistan and Ministry of Education. Namely, it was made clear, that children aged 13-15 years old of our country have information abour the use of alcohol, ciragette, intoxicating agents, drugs and a little part of them have used these substances hiddenly or through curiosity. This study established a basis for institutionalizing “Healthy lifestule” through educational lessons and out-of-class and out-of-school lessons. Namely, order of the Minister of Education was signed on 3 March 2007, under No. 86 in this background and this kind of education was applied through educational lessons. Instruction of this subject covered human health in its very detailed description and attractive and comprehensive topics were placed in upper classes aimed at preventing drug-addition, alcoholism, smoking and other unfavourable habits.
Contribution of international organizations that have direct cooperation, including United Nations Development Programme, Global Fund to Fight AIDS, tuberculosis and malaria, the World Bank, CARE Tajikistan, United Nations Children Fund, United Nations Population Fund and World Health Organization is unprecedented in effective realization of youth health development Programme in the Republic of Tajikistan for 2006-2010 amd deserve gratitude!
3. CHALLENGES RELATED TO EFFECTIVE REALIZATION OF YOUTH HEALTH DEVELOPMENT PROGRAMME IN THE REPUBLIC OF TAJIKISTAN FOR 2006-2010
As it was stated earlier, youth health development Programme in the Republic of Tajikistan for 2006-2010 has intersectoral specifics and along with Youth, Sport and Tourism Committee, direct implementers are Ministry of Health, Ministry of Labour and Social Protection and Women and Family Affairs’ Committee and other agencies. Namely, realization of youth health development Programme in the Republic of Tajikistan for 2006-2010 should encompass joint and direct cooperation of the above-mentioned ministries and agencies. However, unfortunately, in general, a set of the following challenges exists, that impedes Programme realization at the needed level.
Timely submission of annual reports by concerned ministries and agencies.
Weakness in the activities of concerned ministries and agencies towards realization of concerned priority directions of the Programme.
Lack of public organizations’ attention to Programme priorities and their weak cooperation with concerned ministries and agencies.
Poor action of international organization towards realization of priority 1 “Develop and apply well-wishing servicing policy for youth”.
Poor action of international and domestic public organizations concerning applying activities in country’s rural areas.
Poor action and lack of local executive bodies of the state government’s attention to Programmatic undertakings.
Actions not performed within youth health development Programme in the Republic of Tajikistan for 2006-2010 in relation to priorities are as follows.
Develop and apply well-wishing servicing policy for youth
Development and approval of documents that provide confidential services to teenagers aged 10 to 16 years old, was not carried out. This problem created numerous difficulties for youth and it was necessary to implement them at a necessary level, including at the level of Ministries of Health and Justice.
Development and realization of documents related to voluntary counseling, confidential diagnostics and treatment of sexually transmitted diseases, HIV/AIDS, and drug-addition in compliance with international standards. These documents, including Regulations and standard operations of well-wishing informational and educational Centers for youth and Hotline services for teenagers were approved, but series of documents fell out of sight that their necessary implementation was desirable.
Reducing distribution of responsibilities in counseling, voluntary diagnostics, examination and treatment of sexually transmitted diseases, HIV/AIDS was not completely performed, as it was important to approve necessary normative acts to realize this initiative.
Development of certification mechanism for well-wishing services targeting youth. This objective was not carried out, as it was necessary to regulate and coordinate activities of concerned youth organizations.
Establishment of regional training centers for preparing cadre potential in delivering well-wishing services to youth. This objective wasn’t carried out, despite several efforts that eventually came forward to establish similar center at the national level.
Development and adoption of certification mechanism for service-providers within well-wishing services for youth. This objective wasn’t performed owing to the lack of normative and legal background.
Applying the concept of well-wishing service for youth within the frames of secondary and high educational institutions’ programme wasn’t performed, but similar mechanism in the form of educational programmes “Healthy lifestyle” were improved for teachers and schoolchildren of 7-9 Forms.
Education living skills in health
Analysis of existing educational programmes, training-methodical aids, suggestions concerning training life skills in health through targeting secondary and high educational institutions. This action was not completely carried out, including actions related to special and high educational institutions.
Development and introduction of suggestions concerning applying life skills educational programme in health in general educational institutions, post-diploma preparation institutes and nongovernmental organizations, as an addition to the State Programme “Development of educational sector for 2003-2010” wasn’t completely accomplished, including, action related to amending tendencies in State Programme “Development of educational sector for 2003-2010” concrete measure was not taken.
Preparing human resources from among teachers, youth and their certification in formal and informal educational structures wasn’t completely carried out, as special certification mechanism doesn’t exist in the country.
Involvement and raising the knowledge level of public representatives and religious leaders for propagating learning living skills in health wasn’t performed.
Facilitation to protect the rights of extremely vulnerable youth groups
Organization and realization of educational events based on the principle of promoting the interests of extremely vulnerable groups of youth. This task was partially performed, but not with complete coverage of all layers of vulnerable youth.
2. Development of mechanism to widen the well-wishing services’ network for youth with accessible possibilities to extremely vulnerable groups of youth wasn’t performed.
3. Development of educational and informational programmes for extremely vulnerable groups of youth wasn’t carried out.
4. Organization and implementation of educational events aimed at applying substitute treatment for drug-addicted persons through injections wasn’t completely implemented, though certain measures were taken.
5. Development of cadre potential in providing well-wishing services to youth from among vunerable youth and applying the training principle of “Peer to peer”. The Committee and Ministry of Health and some public associations held some actions, but the system is still imperfect.
Youth participation in programmes directed at youth health development, reproductive health, prevention of sexually transmitted diseases, HIV/AIDS and drug-addiction
1. Development of volunteers’ certification mechanism wasn’t carried out, as out-of-school/information education system doesn’t exist in the country.
Development of communications strategy
Develoment and implementation of communications strategy concerning changing and reducing risks of sexually transmitted diseases, HIV/AIDS, drug-addiction and absentmindedness. This task was partially carried out, that covers issues related to prevention of sexually transmitted diseases and HIV/AIDS.
Arranging permanent radio and TV programmes, newspapers and magazines with participation of youth. This task was partially carried out, as it requires huge financial costs.
Youth training to work with state-of-the-art information technology wasn’t carried out.
Regulating activities of disco clubs and rest and entertainment places for youth was partially carried out (through educational and informational events), as relevant normative and legal background doesn’t exist in the country.
Monitoring and evaluation
Development and adoption of monitoring and evaluation indicators from the course of Programme implementation was partially carried out and within the possibilities of Youth, Sport and Tourism Committee
Establishment of electronic informational intersectoral source on youth issues was partially carried out and within the possibilities of Youth, Sport and Tourism Committee
Improving the experience of regular surveys for identifying social and economic requirements of teenagers and youth wasn’t carried out.
Conducting periodic researched and situation analysis wasn’t carried out
Periodic publication of information bulletins on youth issues wasn’t carried out
4. PERSPECTIVE RELATED TO IMPROVING HEATH CONDITION OF YOUTH
It’s realistic that any government initiative has regular specifics, as society is evolving and relatively challenges under discussion also has its transition time and requires change in society’s modernity.
Youth health development programme in the Republic of Tajikistan for 2006-2010 is also one of similar initiatives that require regular modernization. Particularly, it is important in this case as main Programme priority, namely sexually transmitted diseases, HIV/AIDS and drug-addiction is growing daily, specifically among youth, who is considered as future of the society. Namely, basic Programme objective is to facilitate in preserving future health condition as of today. Consequently, if we inclined in preserving and keeping healthy generation, if we need to have healthy and complete society (which is as it is), we should regularly pay particular attention to application, development and completeness of youth health development Programme in the Republic of Tajikistan.
From the initial periods of youth health development Programme in the Republic of Tajikistan for 2006-2010 that originally didn’t have budget financing, with the allocation of non-budget funding in amount of over 5 million US dollars or its equivalent of 22,5 million somoni we achieved numerous successes.
Shortcomings also existed along with achievements, the most important of which are the following factors:
Lack of funding of youth health development programme in the Republic of Tajikistan for 2006-2010 on account of state budget.
In modern world, state financing determines the indicator of Programme’s importance at the national level. Namely, lack of securing state investment represents Programme being as not one of the state’s priority directions.
If we discuss this situation in relation to investment policy of Government of the Republic of Tajikistan, than according to the international standards, those programmes are accepted that are selected with due consideration of state priorities and (state) financial investment and those that have national specifics. Namely, allocating state investment contribution increases the probability of involving non-budget investments.
Against this background, new edition of youth health development Programme in the Republic of Tajikistan for 2011-2013 with due consideration of funding from the state budget will be developed and submitted to Government of the Republic of Tajikistan.
Incomplete realization of predefined tasks of the Programme
Out of 52 tasks related to youth health development Programme in the Republic of Tajikistan for 2006-2010, a total of 26 tasks are realized and that’s all that makes up only 50%. The remaining tasks, namely 50% of tasks were not carried out die to wider scope of their requirements and inactiveness of concerned ministries and agencies, relevant public associations and international organizations, also with the reason of weak cooperation among state offices and civil society.
From this viewpoint, while developing a new edition of youth health development Programme in the Republic of Tajikistan for 2011-2013, first, unfinished tasks of the first period will be discussed and included. Besides, a part of tasks that weren’t completed, but have reinforcing characteristics, will be considered.
One of the important problems that were partially covered through realizing youth health development Programme in the Republic of Tajikistan for 2006-2010 is facilitation to development of intellectual and technical opportunities of sport services and physical training in the country.
3.1. Nowadays, there is a possibility to implement physical training subjects at the necessary level in all educational institutions, as schedules hours are reduced and or doesn’t possess needed training and educational equipments.
3.2. Besides, sports stadiums turned into enterprises, organizations and or residential houses. Concerned situation in rural areas, in major parts of population points sport stadium doesn’t exist at all and youth urge to use free areas (in many cases, cotton fields and or ploughed lands) to play football, volleyball and other games.
3.3. In relation to health improvement of population and youth, currently, sports and health improving and entertainment areas are not functional in front of many multi-storied buildings that causes physical inactiveness of children and teenagers, that also becomes the reason for increasing unfavourable factors among them.
3.4. According to the established order, it is necessary that all educational institutions have specialized sport stadium, but unfortunately, not all school are provided with these conditions. At the same time, schools possessing sport and health improvement possibilities, close their gates after classes and ban entrance to school territory.
Major schoold that more often has similar possibilities, close their gates, sport stadiums are turned into areas of enterprises and houses, them where do young people go. Namely, suchlike relations causes increase in unfavourable factors among youth and physical ailment of youth generation.
From this viewpoint, during the next phase of the Programme targeting issues of development and improving massive sport opportunities and physical training of teenagers and youth through restoring sport and health improvement services, including sport stadiums, access to schools’ possibilities and other issues will be discussed and implemented.
Concerning technical development opportunities and modern world communications, mechanism of distributing and sharing information through mobile networks would be desirable. Because, today we have around 2-3 mobile phones in every family, this means that distribution channels of designated information is compliance with society’s progress and makes activities more effective.
Regarding developing the next edition of the Programme, issues related to propagating healthy lifestyle through mobile networks will be elaborated and carried out.
Thus, objectives of the nest phase of Youth Health Development Programme in the Republic of Tajikistan for 2010-2013 will be designed with due consideration of above priorities and those tasks that were not carried out in Programme’s first phase.