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Situational Analysis: State of Rehabilitation in Tajikistan

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Situational Analysis: State of Rehabilitation in Tajikistan MINISTRY OF HEALTH AND SOCIAL PROTECTION OF THE POPULATION REPUBLIC OF TAJIKISTAN Mobility and Function for all Disability and Rehabilitation Programme - Breaking Barriers to Include All MINISTRY OF HEALTH AND SOCIAL PROTECTION OF THE POPULATION REPUBLIC OF TAJIKISTAN SITUATIONAL ANALYSIS State of rehabilitation in Tajikistan Disability and Rehabilitation Programme Breaking Barriers to Include All Abstract This publication summarizes the current gap, need and opportunities for intervention in the field rehabilitation for persons with disabilities in Tajikistan. The situational analysis process was conducted by an intersectoral working group consisting of members from different ministries under the leadership of the Ministry of Health and Social Protection, Republic of Tajikistan and with technical support from the WHO Country Office, Tajikistan. It was undertaken in collaboration with different disability and development related stakeholders and adopted a realist synthesis approach, being responsive to the unique social, cultural, economical and political circumstances in the country. The evaluation focuses on rehabilitation policy and governance, service provisions and its impact on persons with disabilities in development of an inclusive, rights-based society with equal opportunity for all in Tajikistan. Keywords Situational Analysis: State of Rehabilitation in Tajikistan. 1. Persons with disabilities - statistics and numerical data. 2. Persons with disabilities – rehabilitation. 3. Delivery of health care. 4. Children with disabilities. 5. Education. 6. Employment. 7. Person with disabilities – Policy and services. I. World Health Organization. Address requests about publications of the WHO Regional Office for Europe to: Publications WHO Regional Office for Europe UN City, Marmorvej 51 DK-2100 Copenhagen Ø, Denmark Alternatively, complete an online request form for documentation, health information, or for permission to quote or translate, on the Regional Office website (http://www.euro.who.int/pubrequest). ISBN 978 92 890 5075 3 © World Health Organization 2015 All rights reserved. The Regional Office for Europe of the World Health Organization welcomes requests for permission to reproduce or translate its publications, in part or in full. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. All reasonable precautions have been taken by the World Health Organization to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either express or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall the World Health Organization be liable for damages arising from its use. The views expressed by authors, editors, or expert groups do not necessarily represent the decisions or the stated policy of the World Health Organization. Illustrations provided by Aziza Khojaeva, Rustam Dustov and Satish Mishra Contents Contributors ...................................................................................................................... iv Abbreviations .................................................................................................................... vi Executive summary ........................................................................................................... vii Introduction......................................................................................................................... 1 General information about Tajikistan.................................................................................... 1 Methodology ........................................................................................................................ 2 Concepts and definitions ..................................................................................................... 5 Data-gathering and limitations ............................................................................................. 7 Legislation and services relevant to persons with disabilities ..................................... 9 Legislative framework relating to disability .......................................................................... 9 Overview of health-care, education, labour and social protection systems ......................... 12 Health care .......................................................................................................................... 12 Education ............................................................................................................................ 16 Livelihoods ........................................................................................................................... 18 Social protection system ...................................................................................................... 20 Social assistance for persons with disabilities ..................................................................... 21 Rehabilitation ..................................................................................................................... 26 Prevalence of disability........................................................................................................ 26 Mapping of rehabilitation service providers ......................................................................... 30 Supply of and demand for rehabilitation services ............................................................... 36 Medical rehabilitation techniques and practices .................................................................. 39 Community-based rehabilitation .......................................................................................... 43 Human resources for rehabilitation ................................................................................ 44 Training and education of rehabilitation professionals ........................................................ 44 Availability of rehabilitation professionals ............................................................................ 47 The cost of exclusion ........................................................................................................ 48 Conclusions and recommendations ................................................................................ 49 Strengthening existing services ........................................................................................... 50 Improving human resource capacity .................................................................................... 51 Improving identification of disabilities .................................................................................. 52 Extending services to all....................................................................................................... 52 Disability-inclusive health .................................................................................................... 52 Improving the legislative framework relating to disability ..................................................... 53 Changing societal attitudes ................................................................................................. 53 Improving accessibility of facilities ...................................................................................... 54 Improving data collection .................................................................................................... 55 References ......................................................................................................................... 55 Annex 1. Terminology of rehabilitation……………………………………………………...... 59 Annex 2. Review and analysis of existing legislation……………………........................ 67 Annex 3. Structure of the Ministry of Health and Social Protection……………………… 71 Annex 4. Structure of the State Agency on Social Protection of the Population……… 72 Annex 5. Rehabilitation services for adults with disabilities in Tajikistan……………. 73 Annex 6. Rehabilitation services for children with disabilities in Tajikistan………….. 74 Annex 7. Service providers included in the mapping………………………………………. 75 iii Contributors Editors Satish Mishra and Sherali Rahmatulloev Authors Goibov Amonullo, Lola Bobohojieva, Albert-Philip Burger D'Haem; Safo Kalandarov, Aziza Khojaeva, Zamira Kоmilova, Kudratullo Kurbonov, Satish Mishra, Hamza Navruzov, Sherali Rahmatulloev, Abdulkarim Shekhov Peer contributors (individuals and organizations) Agency for Medical and Social Examination; Agency on Social Insurance and Pensions; Agency on Social Protection; Association for Aid and Relief, Japan; Association of Parents with Children with Disabilities, Dushanbe; Association of Parents with Children with Disabilities “Gamkhori”; Association of Parents with
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