Tajikistan’s authorities claim that services in maternity hospitals are completely free of charge, but citizens report being charged a fee for giving birth and discharging their newborns from the maternity hospital.
Ozodamoh, a resident of Dushanbe, gave birth a few months ago in one of the capital’s maternity hospitals and stayed there for five days. She claims hospital personnel required money from the minute she passed the doorstep until the day she was discharged.
On the first day, as soon as Ozodamoh was admitted to the emergency room, her blood pressure was first checked and she was told to pay 10 somonis (about one US dollar).
«After giving birth, you will pay everyone who was present in the birthing suite during your childbirth, from doctors and midwives to nurses and cleaners. After transfer to the ward, you will also be charged for each service,» said Ozodamoh.
During your stay in the maternity ward, you pay 10-20 somonis (1-2 USD) per day to doctors who monitor the health of the mother and baby. The biggest expense is on the day of discharge from the hospital, beginning with charges for the baby’s medical records and progressing up to honorariums for doctors, nurses and ward maids.
During the five days in the maternity hospital she spent about 3,000 somonis (about US$300), Ozodamoh noted. Meanwhile, the average wage in Tajikistan last year was about 1,650 somoni (about US$160).
Quasi-Free Care
At the end of July 2022, the country’s population reached 10 million. According to the UN, Tajikistan has the highest population growth rate of any country in the region. According to Health Minister Jamoliddin Abdullozoda, between 80 and 130 babies are born every day in Dushanbe alone.
Authorities claim that all services in maternity hospitals are free of charge. Minister of Health and Social Protection Jamoliddin Abdullozoda told a press conference in July 2022 that childbirth is completely free in Tajikistan.
“Childbirth in Tajikistan is free of charge. We have to understand that when there is some violation of the law or any kind of rude attitude, it is on the conscience of that staff member or person. Services in the country’s maternity hospitals are completely free,” said Jamoliddin Abdullozoda.
Emomali Mirzoev, the spokesperson for the Ministry of Health and Social Protection of Tajikistan, also told CABAR.asia that services in maternity hospitals are completely free.
“The Ministry of Health’s hotline number is posted in every hospital where citizens can report cases of corruption,” he said.
However, sources claim that, contrary to official statements, women in labour are systematically being extorted for money.
Mamlakat, yet another resident of Dushanbe, who gave birth four months ago, said doctors never asked her for money afterwards, but she had to pay anyway.
“They said the delivery was completely free, just give as much money as you want, and they will divide it among themselves. My husband paid 500 somonis (about 50 USD) to the doctor, 100 somonis (about 10 USD) to the midwife and 50 somonis to the ward maid (5 USD). Those who were in the same room with me said they gave 250 somonis (about US$25) to each of the hospital personnel”, she said.
On the day she was discharged from the maternity hospital, they demanded another 200 somonis (about US$20) from her, claiming that Mamlakat should also pay for the maternity hospital staff caring for her and her baby for three days.
“They kindly told us several times that the service was free, but one should pay the doctors, cleaners and nurses who took care of me for three days. I told them that we would pay if they show us a receipt. As a result, we didn’t pay them the 200 somonis that they demanded from us. In general, there is no one in the maternity hospital who does not pay them money, it has become a tradition. Everyone pays them money on the day of the baby’s birth, and on the day of discharge, too. It’s tradition to pay. But we have refused,” she said.
CABAR.asia’s interlocutors from Sughd and Khatlon reported that each district has a specific “rate”.
According to sources, in one district of Sughd, it costs more to give birth to a boy than to a girl. Among other costs, a boy’s birth costs 600 somonis (about US $60), while a girl’s birth costs 500 somonis (about US $50). None of the doctors was able to explain why giving birth to boys is more expensive. It is likely to be linked to the patriarchal culture, which traditionally welcomes the birth of sons, who are seen as the successor of the paternal family.
Doctors’ salaries are low
Experts believe that the reason why doctors in maternity hospitals are demanding money is due to the same problem of low wages for medical professionals.
Abdullo Davlatov, a Tajik doctor living in Russia, said doctors need to be paid a decent wage so they can perform their duties professionally and not pick the pockets of mothers and newborn babies.
“Naturally, if we want to have a healthy and successful society, we have to support pregnant women and mothers with infants in normal physical and mental condition. So, I think that the Ministry of Health and other relevant structures should as soon as possible put an end to this cruel practice (of extorting money from birthing mothers – ed. note), which is equivalent to a crime,” he said.
In his view, a thorough reform of the industry is needed.
“Punishing a few workers in the industry won’t solve the problem,” Davlatov added.