ORDER OF THE GOVERNMENT OF THE REPUBLIC OF TAJIKISTAN

of October 30, 2010 No. 560

About approval of the National program of forming of healthy lifestyle in the Republic of Tajikistan for 2011 - 2020

According to article 7 of the Law of the Republic of Tajikistan "About the state forecasts, concepts, strategy and programs of social and economic development of the Republic of Tajikistan" the Government of the Republic of Tajikistan decides:

To Approve 1):

a) The national program of forming of healthy lifestyle in the Republic of Tajikistan for 2011 - 2020 (is attached);

b) The plan of implementation of the National program of forming of healthy lifestyle in the Republic of Tajikistan for 2011 - 2020 (is attached).

2) to Heads of the ministries and departments, chairmen of the Gorno-Badakhshan Autonomous Region, areas, the city of Dushanbe, cities and areas within annually provided means of the Government budget to provide implementation of the National program of forming of healthy lifestyle in the Republic of Tajikistan for 2011 - 2020 and to annually provide information in the Government of the Republic of Tajikistan.

3) to the Ministry of Health of the Republic of Tajikistan, executive bodies of the government of the Gorno-Badakhshan Autonomous Region, areas, the city of Dushanbe, cities and areas for realization of the provided tasks to create Coordination council on accomplishment of this Program.

Approved by the Order of the Government of the Republic of Tajikistan of October 30, 2010 No. 560

The national program of forming of healthy lifestyle in the Republic of Tajikistan for 2011 - 2020

1. Determination of terms

Health is condition of complete physical, spiritual and social wellbeing.

Conduct of life - set of specific approaches of each person to use of the resources and opportunities represented to it by social conditions, traditions, education and the market relations.

Healthy lifestyle - the types, types, methods of life activity of the person, typical for this socioeconomic structure, strengthening the adaptive opportunities of its organism promoting full accomplishment of social functions by it and to achievement of active longevity.

Valueology - the field of preventive medicine studying the theory and practice on forming, preservation and promotion of health of the individual by means of expansion of its opportunities to adapt to the changing circle factors.

Personal and public hygiene - the most important component of general hygiene as it is turned literally to each collective and the certain person, depending on its age, sex, occupation, accommodation conditions. It promotes emergence of such stereotypes and forms of behavior which maintain equilibrium state between organism and the environment its natural social environment.

Public health care is science and art of prevention of diseases, continuations of life and ensuring health by means of organized efforts of society.

Stress - condition of the increased uneasiness resulting from excessive stressogenny situations.

Strengthening of health - capability of people to hold the factors influencing their health, and also capability in the hand to strengthen health.

Level of physical development is quantity characteristic of functioning and reserves of physiological, biological and mental systems, and also degrees of tension of the regulatory mechanisms raising organism homeostasis.

Risk factors - the factors of external internal environment of organism, behavioural features promoting increase in probability of development of diseases, their progressing and failure.

Physical activity - vigor, the strengthened activities, participation, in something.

Physical culture - part of general culture, one of spheres of social activities directed to strengthening of health, development of physical capabilities of the person.

Forming of ZOZh - complex problem, / requiring integrated approach to research of conduct of life and health of the population, and also attention of health workers, teachers, psychologists, also depends on specifics from macrosocial environment of the person, its labor, social and preventive activity.

PRIMARY MEDIKO - The SANITARY HELP - the primary health care (PHC) is the main link of health care system of any country, the main service of rendering the medical and sanitary help constructed by the principle "from the periphery to the center".

PHC - the integral component of social and economic development of this or that country.

Prevention of diseases - actions, directed not only on the prevention of disease, such as immunization, fight against carriers of diseases or company on fight against smoking, but also that to constrain its development and to reduce its effects after factual determination of disease.

Intersectoral actions - actions in case of which the cooperation of health care sector and the answering other sectors for achievement to common goal is performed, in case of exact approval of contribution of different sectors.

The migrant - person making the interlodged territorial movement (migration) for the purpose of change of the permanent residence, study, rest, etc., forever or for certain term (from 1 day to several years).

The hygienic culture - Hygienic culture of the individual represents the specific knowledge, abilities, skills, valuable orientations, views, opinions, beliefs, the behavior forms which are concerning health both being part of general culture of the personality and created in the course of educational educational impact.

2. Introduction

In paramount importance - protection and strengthenings of health - the leading role belongs to conduct of life of the person. Forming of healthy lifestyle and responsible attitude to the health, in many respects depends on the educational and cultural level of the population. In development of the majority of diseases the person, its low sanitary culture, unhealthy conduct of life and negative attitude to the health is considered guilty person.

Health of certain people or national groups is determined by influence of complex of the individual, social, economic and ecological factors interacting among themselves. Be healthy - shall be internal need of each person.

It should be noted that the state of health does not depend only on activities of health care sector, it is caused by interaction of complex, individual, social, economic, ecological factors, vital circumstances and the individual choice. Each person has right to be informed and shall own necessary knowledge of prevention of diseases, strengthening of health that is the basic principle to forming of healthy lifestyle.

In the strategic document of WHO "Health for all in the 21st century" - special attention is paid to questions of mobilization of communities in strengthening of health, by provision to people and communities of opportunity to increase control over the factors determining health. With respect thereto, in modern policy of forming of healthy lifestyle the important part is assigned to participation of communities in the solution of questions of health care sector. Only thanks to mobilization of efforts of different sectors and communities it is possible to provide healthy lifestyle and to create habitats, favorable for health.

Understanding of activities for strengthening of health are well reflected in the document of WHO "Ottawa Charter": "strengthening of health - as process which does people capable to strengthen control over the factors influencing health and to improve condition of own health".

Important point is forming of the steady integrated service of public health and health care relying on organizations of Primary health care and oriented to active involvement of the population which is specified in the Almaatinsky declaration on PHC (1978), it is reflected in the National strategy of health of the population of the Republic of Tajikistan for the period" 2011 - 2020 and is one of the fundamental principles for the country.

The most important strategy of primary and secondary prevention of diseases and strengthenings of health of the population shall become the updated policy of FZOZh oriented to overcomings the certain difficulties caused dominating physical, social, economic and cultural environment, effective multisectoral actions with sectoral responsibility development of access of the population to proper education and information in this sphere.

Active involvement of commercial and public organizations, local communities, mass media their understanding and support of processes in forming of the behavior models strengthening and keeping health.

It should be noted that success of the undertaken reform depends on awareness and activity of the population, and also knowledge of local communities of the carried-out transformations in health care sector. Besides, participation of communities in determination of the requirements is of great importance, but, unfortunately, now they do not take part in planning, realization and monitoring of health services.

In the long term it is necessary reorientation of scientific activities to requirements of public health, forming of healthy lifestyle, and also studying of the state of health of the population caused by influence of factors of the environment, possibility of scientific reasons for hygienic standard rates, working off and assessment of new technologies, and development of recommendations.

The international experience shows that one of low costly and most effective approaches on decrease in poverty of the population, at the same time and improvement of indicators of his health is forming of healthy lifestyle of people in this connection, this strategy in the Republic of Tajikistan relies on realistic and attractive perspective which people can use during the everyday life.

Due to the above there is need development of priority policy of FZOZh: development of national standards, implementation of the principles of ZOZh in educational institutions, involvement of media in informing the population and scientific maintenance of ZOZh that shall be aimed at the further development of tendencies of sustainable development of society, strengthening of health of the population of the country and cooperation with the international community in this area.

The Republic of Tajikistan - one of the Central Asian countries stretched from the West on the East on 700 km and from the North on the South on 350 km. More than 93% of the territory of the country occupy mountains. The population of the republic constitutes 7.2 million people. The annual surplus reaches 2%. More than 70% of the population live in the rural zone, the urban population constitutes 26.5%.

The general demographic situation is characteristic the high level of birth rate (28,0 for 1000 of the population) and rather low death rate of the population (4,7 for 1000 of the population), however the high nursery (14,2 for 1000 of the population) and maternal death rate (28 on 100 thousand live-birth), low urban saturation, high level of external labor migration. Natural increase of the population in 2009. to year constituted 23,3 for 1000 of the population and it was mutilated in comparison with 2008 (22,1 for 1000 us).

The overview of living standards in Tajikistan for 2003 demonstrates, that high rate of economic growth in recent years, positively affected reducing poverty in the country. According to recent changes according to new data in assessment of poverty of Tajikistan of the World Bank, all main indicators of poverty in 2009 constituted 53% which decreased in comparison with 2007 by 72%. On extremely measure if to estimate poverty ratio on the level of the income of the population, then it should be noted bystry rates of economic growth made notable impact on the level of the income of the population.

Increase in gap in the state of health between population socio-economic groups, being in more profitable and in less safe provision, that is poverty problems remains the main problem of health in the country. It is known that poverty is important determinant of deterioration in health in case of which the person loses opportunity to satisfy the basic needs and it promotes deterioration in demographic indicators and decrease in index of health of the population, growth of separate infectious and noninfectious diseases, easing of social unity. It is still aggravated with inadequate system of financing, disproportion between services of primary health care and the hospital sector, irrational use of resources (personnel, financial), deterioration in material and technical resources, growth of the level of unemployment, etc.

Economic growth is the main mechanism capable to provide the population with decent work and wellbeing. Such growth is provided by carrying out effective macroeconomic policy, restructuring of the companies, private sector development, agricultural industry, power, transport, telecommunication and information with employment. The analysis of development of economy in recent years states its stabilization and development.

However, despite it, in Tajikistan one of the main social and economic problems remains the high level of unemployment (to 46,8 of one thousand people) which promotes high migration of specialists from the country.

For the last 15 years since 1995, share of expenses on health care in Gross domestic product constantly decreased with 4, % (1991) to 1,3 (2006), but in 2009 it had positive effect and constituted % 1,9, however it is rather low interest.

Situation analysis shows that the system primary medical and sanitary, the help and public health care is poorly developed. Despite availability of large number of PHC organizations, efficiency of their use it is low because of lack of personnel, equipment the modern equipment, unsatisfactory physical condition of buildings and inefficient methods of treatment.

Availability of all types of disproportions in distribution of personnel is determined (by regions, by specialties, between organizations). All this is aggravated with their low categoriality in regions.

The indicator of infantile death rate remains rather high in the country and according to multiindikaterny cluster research of UNICEF, this indicator constituted 65 on 1000 live-birth. However, there is problem of unauthenticity of data connected with nedoregistration and therefore, according to MZ RT this indicator constituted all 14,1 for 1000 live-birth (2005). For many years, infectious and parasitic diseases, and also diseases of respiratory system were basic reasons of child mortality.

In recent years the main threat for health of the population of Tajikistan is posed by infectious diseases (typhoid - 17,1 malaria - 4,3 viral hepatitis - 106,6 on 100 000 us). Indicators of poliomyelitis of diseases, sexually transmitted are rather high (syphilis - 6.4 gonorrhea - 9,8 on 100 000 us). Sharp increase in number of HIV - infected in the country is noted. So, according to the Republican Center for prevention and fight against AIDS from 1991 to 2009 1853 cases of the HIV infected on the republic are officially registered.

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