INVESTING IN SUSTAINABLE DEVELOPMENT: MILLENNIUM DEVELOPMENT GOALS NEEDS ASSESSMENT Full Report TAJIKISTAN INVESTING IN SUSTAINABLE DEVELOPMENT: MILLENNIUM DEVELOPMENT GOALS NEEDS ASSESSMENT Full Report TAJIKISTAN Dushanbe May 2005 MILLENNIUM DEVELOPMENT GOALS NEEDS ASSESSMENT TAJIK ISTAN © MDG Need Assessment, UNDP, Tajikistan 1 INVESTING IN SUSTAINABLE DEVELOPMENT: MILLENNIUM DEVELOPMENT GOALS NEEDS ASSESSMENT TAJIKISTAN Full Report The Government Working Groups on the Millennium Development Goals (MDGs) and the United Nations (UN) MDG Needs Assessment Team extend their deepest gratitude to the President of the Republic of Tajikistan, Emomali Rakhmonov, for his commitment to reduc- ing poverty and fostering economic, social, and human development in the country through realization of the MDGs. The President’s invaluable and continued support was crucial to the success of the MDG Needs Assessment in Tajikistan. The MDG Needs Assessment Team would also like to express their gratitude to Fayzullo Kholboboyev, Economic Advisor to the President, for his effective coordination of the MDG Working Groups. The Working Groups were led by Vice-Prime Ministers of the Republic of Tajikistan, whose close collaboration and support are highly appreciated. We thank the Focal Points in the Ministry of Agriculture, the Ministry of Education, the Ministry of Health, the State Committee on Women’s and Family Affairs, and the Ministry of Melioration and Water Services, for leading the sectoral needs assessments. We gratefully acknowledge the close collaboration of the Ministry of Finance, the Ministry of Economy, the State Environmental Agency, the State Statistical Committee, the Poverty Reduction Strategy Paper (PRSP) Monitoring Unit, and the Aid Coordination Unit of the President’s Office. The MDG Needs Assessment Team is very grateful to the UN Resident Coordinator and UNDP Resident Representative, William Paton, and to UNDP Deputy Resident Representa- tive Igor Bosc, for their effective leadership of the MDG Needs Assessment work in Tajiki- stan. The MDG Needs Assessment Team gratefully acknowledges the invaluable technical support and close collaboration of the Millennium Project, headed by Prof. Jeffrey D. Sachs. More than 100 other organizations and individuals that have contributed to the MDG needs assessment process are named in the Acknowledgements section at the end of this report. MILLENNIUM DEVELOPMENT GOALS NEEDS ASSESSMENT TAJIK ISTAN 2 The MDG Needs Assessment Team: Temur Basilia, Team Leader Tuya Altangerel, Focal Point Oliver Babson, Consultant Firuz Shukurov, Financial and Macroeconomic Analyst Usmon Rakhmonov, Policy Advisor Nino Nadiradze, Advisor on Environmental Sustainability Tanzila Ergasheva, Food Security and Rural Development Advisor Sabrina Hacene-Lhadj-Pirova, Gender Advisor Firuz Bakiev, Health Advisor Ibaidullo Safarov, Education Advisor Kamoliddin Sirojiddinov, Water Advisor Bobokhon Ismoilov, PRSP Advisor Makhvash Khamrayeva, Administrative and Research Assistant Rustam Karimov, IT Specialist Prepared by: Design: Tuya Altangerel Mikhail Romanyuk Oliver Babson Temur Basilia Printed by: Mir Polygrafii, Dushanbe Editor: Tuya Altangerel Photo Credits: UNICEF/Tajikistan/Pirozzi Tuya Altangerel, UNDP Jean-Luc Ray, AKF 3 TABLE OF CONTENT 1. Introduction .......................................................................................................... 7 2. MDG Needs Assessment Process in Tajikistan ................................................ 9 UN Country Team ........................................................................................................................... 10 UN Millennium Project ................................................................................................................... 10 Needs Assessment Report ............................................................................................................ 10 3. Key Institutional and Structural Reforms ......................................................... 11 Macroeconomic Environment ....................................................................................................... 11 Good Governance and Public Administration Reform ........................................................... 12 Tax and Customs Administration Reform ................................................................................. 14 Privatization and Private Sector Development ......................................................................... 15 Public Utilities Reform .................................................................................................................... 17 4. Methodology for MDG Needs Assessment ....................................................... 19 5. MDG 1: Combating Poverty and Hunger .......................................................... 25 Income poverty ................................................................................................................................. 25 Recommendations ............................................................................................................................ 26 Food Security (Nutrition and Rural Development) ................................................................. 28 Nutrition ............................................................................................................................................. 29 Agricultural Productivity ................................................................................................................ 35 Reform in the Cotton Sector ........................................................................................................ 38 Land Reform ...................................................................................................................................... 43 Agricultural Infrastructure ............................................................................................................. 45 Financial Estimations for reducing poverty and hunger .......................................................... 47 Financial Profitability of Small Farmers ....................................................................................... 48 6. MDG 2: Achieve universal primary education .................................................. 52 Overview ............................................................................................................................................ 52 Government Measures .................................................................................................................. 59 Recommendations ............................................................................................................................ 62 Financial Estimations for Education .............................................................................................. 62 Total costs for general secondary education ............................................................................ 70 Conclusion ......................................................................................................................................... 72 7. MDG 3: Achieving Gender Equality ................................................................... 74 Overview ............................................................................................................................................ 74 Government Measures .................................................................................................................... 78 Recommendations ............................................................................................................................ 79 Financial estimations for Promoting Gender Equality ............................................................. 80 Conclusion ......................................................................................................................................... 82 8. Health MDGs (4, 5 and 6): Lowering child (MDG 4) and maternal (MDG 5) mortality rates, and combating the spread of infectious diseases (MDG 6) ................................................................................ 83 Overview ............................................................................................................................................ 83 Government Measures .................................................................................................................... 87 Goal 4: Reduce child mortality ..................................................................................................... 88 Goal 5: Improve maternal health .................................................................................................. 89 MILLENNIUM DEVELOPMENT GOALS NEEDS ASSESSMENT TAJIK ISTAN 4 Government measures on maternal and child health care .................................................... 91 Recommendations for improving maternal health care and RH .......................................... 92 Financial estimations for MDG 4 and 5 ....................................................................................... 94 Goal 6: Combat HIV/AIDS, malaria and other diseases ......................................................... 103 Combating Malaria ........................................................................................................................... 104 Financial estimations for combating the spread of malaria .................................................... 108 Parasitical