Nursing Personnel Convention, 1977 (No. 149) - Tajikistan (Ratification: 1993)

Direct Request (CEACR) - adopted 2024, published 113rd ILC session (2025)

Article 2 of the Convention. Formulation and implementation of a policy concerning nursing services and nursing personnel. The Government indicates that as of 1 January 2023, 61,383 specialists with secondary medical education were working in the healthcare system and that the number of healthcare professionals per 100,000 inhabitants was 617. The Government adds that the categorization of specialists with secondary medical education was 42.7 per cent and employment of health care professionals was 87.9 per cent. The Committee welcomes that the Government has communicated a copy of Ordinance No. 7 of 10 January 2000 establishing the national nursing care centre but observes that the information provided by the Government predates for the most part the reporting period under analysis. In view of the above, the Committee reiterates its request to the Government to provide updated, specific and detailed information on the impact of measures taken in the framework of its policy concerning specifically nursing services and nursing personnel which are aimed at attracting and retaining nursing personnel, including midwives, particularly in rural and remote areas of the country, as well as statistical information reflecting trends in this sector. The Committee also requests the Government to provide information regarding consultations held with the social partners with respect to the formulation and implementation of the policy, as required by Article 2 of the Convention. It further requests the Government to provide copies of any official texts adopted in the context of the implementation of its policy on nursing services and nursing personnel.

Articles 3 and 4. Basic requirements in relation to teaching and training.The right to exercise the profession. The Committee notes that, according to the Licence of the Supervisory Agency for Education and Science No. 0001325 of 2 August 2021, advanced training courses are held for nursing staff in order to enhance the knowledge level of nursing staff and professional competence, practical skills and abilities. There are currently 35 medical colleges in the country (16 public and 19 private) that train healthcare professionals in various specialities. The Association of Nurses of the Republic of Tajikistan, together with the National Nursing Care Centre, has developed a Code of Ethics for Nurses, the purpose of which is to provide nurses with the skills of a psychological and ethical approach and an appropriate level of knowledge in nursing care. The nursing personnel are hired in accordance with the Labour Code after graduating from a secondary medical school. The duration of a working day for nursing staff is 8–14 hours, while overtime work is unpaid and that weekly rest, annual paid leave, study leave, maternity leave, sick leave, and social security are also provided under the Labour Code. While taking due note of this information, the Committee once again reiterates its request to the Government to indicate the basic requirements in relation to the teaching and training of nursing personnel, and the conditions governing the right to practice nursing care and services. The Committee also requests once again the Government to provide a copy of any relevant law or regulation in this regard.

Article 5. Consultations with nursing personnel. The Committee notes that, during the period 2019–2023, the Government held different activities with the National Midwives Association, which included training courses, round tables, seminars and meetings in several cities and districts to attract midwives to the ranks of organization representatives. The Committee notes however that the report does not provide information on the consultations held with such personnel on decisions concerning them and on the application of the Ethical Code for Nurses. The Committee therefore urges the Government to provide further information on the measures taken to promote the participation of nursing personnel in the planning of nursing services. It also reiterates its requests to the Government to provide information on the consultations held with such personnel, including the Tajik Nursing Association and the Midwives Association of Tajikistan, on decisions concerning them, in a manner appropriate to national conditions. The Committee further reiterates its requests to the Government to provide additional information on the application of the Ethical Code for Nurses.

Article 6. Conditions of employment. The Committee notes that the General Agreement for 2021–2023 concluded between the Government, the Federation of Independent Trade Unions and the Association of Employers of the Republic of Tajikistan, provided for a study the ratification of the Maternity Protection Convention, 2000 (No. 183). The Committee notes the Government’s indication that the country’s trade union organizations are working on gender development issues within the social partnership framework. The Committee notes however that the Government’s report does not provide a response the various issues underlined in its previous direct request. The Committee therefore recalls once again the requirement set out by the Convention that nursing personnel shall enjoy conditions of employment at least equivalent to those of other workers, and urges the Government to indicate the provisions guaranteeing that nursing personnel enjoy conditions of employment and work at least equivalent to those of other workers in relation to hours of work, including regulation and compensation of overtime, inconvenient hours and shift work.

Direct Request (CEACR) - adopted 2022, published 111st ILC session (2023)

The Committee notes with deep concern that the Government’s report has not been received. It expects that the next report will contain full information on the matters raised in its previous comments. The Committee informs the Government that, if it has not supplied replies to the points raised by 1 September 2023, then it may proceed with the examination of the application of the Convention on the basis of the information at its disposal at its next session.

Repetition

Article 2 of the Convention. Formulation and implementation of a policy concerning nursing services and nursing personnel. In its previous comments, the Committee requested the Government to communicate copies of Ordinance No. 7 of 10 January 2000 establishing the national nursing care centre as well as any other official texts adopted in the context of the implementation of its policy on nursing services and nursing personnel. The Committee notes that the Government’s report does not provide this information. The Government refers to the establishment of the Tajik Nursing Association in 1997, indicating that the Association aims to bring together Tajikistan’s nurses and midwives, strengthen their role in maintaining public health care and enhance advocacy for nursing. The Government adds that the Midwives Association of Tajikistan was established on 16 October 2014, in order to enhance the prestige of midwives and develop their knowledge. The Committee notes that, according to a 2016 report of the European Observatory on Health Systems and Policies (the EO report) entitled Tajikistan: Health System Review, the number of nurses per 100,000 population in Tajikistan declined, from 597 in 1990 to 350 in 2004, before increasing again to 444 in 2013. Despite this more recent increase, the EO report indicates that the ratio of nurses in Tajikistan to population size remains one of the lowest in the region and that, in addition, Tajikistan’s health-care system suffers from pronounced regional imbalances, with health-care workers concentrated in urban areas, notably in Dushanbe, due to challenges in rural and remote areas that include low salaries, outdated medical equipment and the poor condition of health facilities. The EO report refers to incentives introduced by the Ministry of Health and Social Protection aimed at improving the distribution and motivation of health-care workers, to attract them to rural and remote areas.The Committee requests the Government to provide in its next regular report, due in 2018, detailed information on the impact of measures taken in the framework of its policy concerning nursing services and nursing personnel and which are aimed at attracting and retaining nursing personnel, including midwives, particularly in rural and remote areas of the country, as well as statistical information reflecting trends in this sector. It further requests the Government to provide information regarding the consultations held with the social partners with respect to the formulation and implementation of the policy, as called for under Article 2 of the Convention. The Committee once again requests the Government to provide a copy of Ordinance No. 7 of 10 January 2000 establishing the national nursing care centre and any other official texts adopted in the context of the implementation of its policy on nursing services and nursing personnel.

Articles 3 and 4. Basic requirements in relation to teaching and training. The right to exercise the profession. In its previous comments, the Committee requested the Government to indicate the basic requirements in relation to the teaching and training of nursing personnel, and the conditions governing the right to practice nursing care and services. The Government indicates that the national nursing centre and regional nursing centres in Sughd Region, Khatlon Region and the Gorno-Badakhshan Autonomous Region were set up as of 10 January 2000 in order to coordinate the development of nursing in Tajikistan, to develop educational policy at both the graduate and post-graduate levels and to review practice among intermediate medical staff. In accordance with Ministerial Order No. 877 of 17 October 2014, courses to enhance the qualifications of intermediate medical staff are being held at the national nursing centre to enhance the knowledge, professional competencies, practical skills and abilities of intermediate medical staff. The Government indicates that there are currently 23 medical colleges in Tajikistan (16 public and seven private) where training is provided for intermediate medical staff with various specialties. The Committee notes the indication in the EO report that nursing is still poorly developed and many nurses are underqualified. According to the EO report, reforming medical education has been one of the key directions of reform, with upgraded nursing training. The Committee further notes from the EO report that a nursing faculty has been established at the Postgraduate Medical Institute, and nurse training has been upgraded to a four-year course. Retraining is also provided through a six-month continuing medical education course for physicians and nurses who wish to retrain in the area of family medicine.The Committee once again requests the Government to indicate the basic requirements in relation to the teaching and training of nursing personnel, and the conditions governing the right to practice nursing care and services. It also once again requests the Government to provide a copy of any relevant law or regulation in this regard.

Article 5. Consultations with nursing personnel. The Government indicates that the Tajik Nursing Association was established under the auspices of the American International Healthcare Alliance in 1997 in order to bring together Tajikistan’s nurses and midwives, to strengthen their role in maintaining public health care and to enhance advocacy for nursing. The Tajik Nursing Association, together with the National Nursing Centre, drew up an Ethical Code for Nurses. The Midwives Association of Tajikistan was later established on 16 October 2014 with the aim of bringing together the country’s midwives, enhancing their prestige and their role in society and developing their knowledge.The Committee requests the Government to provide further information on the measures taken to promote the participation of nursing personnel in the planning of nursing services. It also requests the Government to provide information on the consultations held with such personnel, including the Tajik Nursing Association and the Midwives Association of Tajikistan, on decisions concerning them, in a manner appropriate to national conditions. The Committee further requests the Government to provide additional information on the application of the Ethical Code for Nurses.

Article 6. Conditions of employment. The Government indicates that intermediate medical staff are employed in accordance with the Labour Code. Government or sectoral awards are granted in accordance with length of service and particular merit. For intermediate medical staff, the working day lasts between eight and 14 hours. Overtime is not compensated. Weekly rest days, annual paid leave, study leave, pregnancy and maternity leave, sick leave and social security are also provided for under the Labour Code.Recalling the requirement set out by the Convention that nursing personnel shall enjoy conditions of employment at least equivalent to those of other workers, the Committee requests the Government to indicate the provisions guaranteeing that nursing personnel enjoy conditions of employment and work at least equivalent to those of other workers in relation to hours of work, including regulation and compensation of overtime, inconvenient hours and shift work.

Direct Request (CEACR) - adopted 2021, published 110th ILC session (2022)

The Committee notes with deep concern that the Government’s report has not been received. It expects that the next report will contain full information on the matters raised in its previous comments. The Committee informs the Government that, if it has not supplied replies to the points raised by 1 September 2022, then it may proceed with the examination of the application of the Convention on the basis of the information at its disposal at its next session.

Repetition

Article 2 of the Convention. Formulation and implementation of a policy concerning nursing services and nursing personnel. In its previous comments, the Committee requested the Government to communicate copies of Ordinance No. 7 of 10 January 2000 establishing the national nursing care centre as well as any other official texts adopted in the context of the implementation of its policy on nursing services and nursing personnel. The Committee notes that the Government’s report does not provide this information. The Government refers to the establishment of the Tajik Nursing Association in 1997, indicating that the Association aims to bring together Tajikistan’s nurses and midwives, strengthen their role in maintaining public health care and enhance advocacy for nursing. The Government adds that the Midwives Association of Tajikistan was established on 16 October 2014, in order to enhance the prestige of midwives and develop their knowledge. The Committee notes that, according to a 2016 report of the European Observatory on Health Systems and Policies (the EO report) entitled Tajikistan: Health System Review, the number of nurses per 100,000 population in Tajikistan declined, from 597 in 1990 to 350 in 2004, before increasing again to 444 in 2013. Despite this more recent increase, the EO report indicates that the ratio of nurses in Tajikistan to population size remains one of the lowest in the region and that, in addition, Tajikistan’s health-care system suffers from pronounced regional imbalances, with health-care workers concentrated in urban areas, notably in Dushanbe, due to challenges in rural and remote areas that include low salaries, outdated medical equipment and the poor condition of health facilities. The EO report refers to incentives introduced by the Ministry of Health and Social Protection aimed at improving the distribution and motivation of health-care workers, to attract them to rural and remote areas. The Committee requests the Government to provide in its next regular report, due in 2018, detailed information on the impact of measures taken in the framework of its policy concerning nursing services and nursing personnel and which are aimed at attracting and retaining nursing personnel, including midwives, particularly in rural and remote areas of the country, as well as statistical information reflecting trends in this sector. It further requests the Government to provide information regarding the consultations held with the social partners with respect to the formulation and implementation of the policy, as called for under Article 2 of the Convention. The Committee once again requests the Government to provide a copy of Ordinance No. 7 of 10 January 2000 establishing the national nursing care centre and any other official texts adopted in the context of the implementation of its policy on nursing services and nursing personnel.

Articles 3 and 4. Basic requirements in relation to teaching and training. The right to exercise the profession. In its previous comments, the Committee requested the Government to indicate the basic requirements in relation to the teaching and training of nursing personnel, and the conditions governing the right to practice nursing care and services. The Government indicates that the national nursing centre and regional nursing centres in Sughd Region, Khatlon Region and the Gorno-Badakhshan Autonomous Region were set up as of 10 January 2000 in order to coordinate the development of nursing in Tajikistan, to develop educational policy at both the graduate and post-graduate levels and to review practice among intermediate medical staff. In accordance with Ministerial Order No. 877 of 17 October 2014, courses to enhance the qualifications of intermediate medical staff are being held at the national nursing centre to enhance the knowledge, professional competencies, practical skills and abilities of intermediate medical staff. The Government indicates that there are currently 23 medical colleges in Tajikistan (16 public and seven private) where training is provided for intermediate medical staff with various specialties. The Committee notes the indication in the EO report that nursing is still poorly developed and many nurses are underqualified. According to the EO report, reforming medical education has been one of the key directions of reform, with upgraded nursing training. The Committee further notes from the EO report that a nursing faculty has been established at the Postgraduate Medical Institute, and nurse training has been upgraded to a four-year course. Retraining is also provided through a six-month continuing medical education course for physicians and nurses who wish to retrain in the area of family medicine. The Committee once again requests the Government to indicate the basic requirements in relation to the teaching and training of nursing personnel, and the conditions governing the right to practice nursing care and services. It also once again requests the Government to provide a copy of any relevant law or regulation in this regard.

Article 5. Consultations with nursing personnel. The Government indicates that the Tajik Nursing Association was established under the auspices of the American International Healthcare Alliance in 1997 in order to bring together Tajikistan’s nurses and midwives, to strengthen their role in maintaining public health care and to enhance advocacy for nursing. The Tajik Nursing Association, together with the National Nursing Centre, drew up an Ethical Code for Nurses. The Midwives Association of Tajikistan was later established on 16 October 2014 with the aim of bringing together the country’s midwives, enhancing their prestige and their role in society and developing their knowledge. The Committee requests the Government to provide further information on the measures taken to promote the participation of nursing personnel in the planning of nursing services. It also requests the Government to provide information on the consultations held with such personnel, including the Tajik Nursing Association and the Midwives Association of Tajikistan, on decisions concerning them, in a manner appropriate to national conditions. The Committee further requests the Government to provide additional information on the application of the Ethical Code for Nurses.

Article 6. Conditions of employment. The Government indicates that intermediate medical staff are employed in accordance with the Labour Code. Government or sectoral awards are granted in accordance with length of service and particular merit. For intermediate medical staff, the working day lasts between eight and 14 hours. Overtime is not compensated. Weekly rest days, annual paid leave, study leave, pregnancy and maternity leave, sick leave and social security are also provided for under the Labour Code. Recalling the requirement set out by the Convention that nursing personnel shall enjoy conditions of employment at least equivalent to those of other workers, the Committee requests the Government to indicate the provisions guaranteeing that nursing personnel enjoy conditions of employment and work at least equivalent to those of other workers in relation to hours of work, including regulation and compensation of overtime, inconvenient hours and shift work.

Direct Request (CEACR) - adopted 2020, published 109th ILC session (2021)

The Committee notes with concern that the Government’s report has not been received. It hopes that the next report will contain full information on the matters raised in its previous comments.

Repetition

Article 2 of the Convention. Formulation and implementation of a policy concerning nursing services and nursing personnel. In its previous comments, the Committee requested the Government to communicate copies of Ordinance No. 7 of 10 January 2000 establishing the national nursing care centre as well as any other official texts adopted in the context of the implementation of its policy on nursing services and nursing personnel. The Committee notes that the Government’s report does not provide this information. The Government refers to the establishment of the Tajik Nursing Association in 1997, indicating that the Association aims to bring together Tajikistan’s nurses and midwives, strengthen their role in maintaining public health care and enhance advocacy for nursing. The Government adds that the Midwives Association of Tajikistan was established on 16 October 2014, in order to enhance the prestige of midwives and develop their knowledge. The Committee notes that, according to a 2016 report of the European Observatory on Health Systems and Policies (the EO report) entitled Tajikistan: Health System Review, the number of nurses per 100,000 population in Tajikistan declined, from 597 in 1990 to 350 in 2004, before increasing again to 444 in 2013. Despite this more recent increase, the EO report indicates that the ratio of nurses in Tajikistan to population size remains one of the lowest in the region and that, in addition, Tajikistan’s health-care system suffers from pronounced regional imbalances, with health-care workers concentrated in urban areas, notably in Dushanbe, due to challenges in rural and remote areas that include low salaries, outdated medical equipment and the poor condition of health facilities. The EO report refers to incentives introduced by the Ministry of Health and Social Protection aimed at improving the distribution and motivation of health-care workers, to attract them to rural and remote areas. The Committee requests the Government to provide in its next regular report, due in 2018, detailed information on the impact of measures taken in the framework of its policy concerning nursing services and nursing personnel and which are aimed at attracting and retaining nursing personnel, including midwives, particularly in rural and remote areas of the country, as well as statistical information reflecting trends in this sector. It further requests the Government to provide information regarding the consultations held with the social partners with respect to the formulation and implementation of the policy, as called for under Article 2 of the Convention. The Committee once again requests the Government to provide a copy of Ordinance No. 7 of 10 January 2000 establishing the national nursing care centre and any other official texts adopted in the context of the implementation of its policy on nursing services and nursing personnel.

Articles 3 and 4. Basic requirements in relation to teaching and training. The right to exercise the profession. In its previous comments, the Committee requested the Government to indicate the basic requirements in relation to the teaching and training of nursing personnel, and the conditions governing the right to practice nursing care and services. The Government indicates that the national nursing centre and regional nursing centres in Sughd Region, Khatlon Region and the Gorno-Badakhshan Autonomous Region were set up as of 10 January 2000 in order to coordinate the development of nursing in Tajikistan, to develop educational policy at both the graduate and post-graduate levels and to review practice among intermediate medical staff. In accordance with Ministerial Order No. 877 of 17 October 2014, courses to enhance the qualifications of intermediate medical staff are being held at the national nursing centre to enhance the knowledge, professional competencies, practical skills and abilities of intermediate medical staff. The Government indicates that there are currently 23 medical colleges in Tajikistan (16 public and seven private) where training is provided for intermediate medical staff with various specialties. The Committee notes the indication in the EO report that nursing is still poorly developed and many nurses are underqualified. According to the EO report, reforming medical education has been one of the key directions of reform, with upgraded nursing training. The Committee further notes from the EO report that a nursing faculty has been established at the Postgraduate Medical Institute, and nurse training has been upgraded to a four-year course. Retraining is also provided through a six-month continuing medical education course for physicians and nurses who wish to retrain in the area of family medicine. The Committee once again requests the Government to indicate the basic requirements in relation to the teaching and training of nursing personnel, and the conditions governing the right to practice nursing care and services. It also once again requests the Government to provide a copy of any relevant law or regulation in this regard.

Article 5. Consultations with nursing personnel. The Government indicates that the Tajik Nursing Association was established under the auspices of the American International Healthcare Alliance in 1997 in order to bring together Tajikistan’s nurses and midwives, to strengthen their role in maintaining public health care and to enhance advocacy for nursing. The Tajik Nursing Association, together with the National Nursing Centre, drew up an Ethical Code for Nurses. The Midwives Association of Tajikistan was later established on 16 October 2014 with the aim of bringing together the country’s midwives, enhancing their prestige and their role in society and developing their knowledge. The Committee requests the Government to provide further information on the measures taken to promote the participation of nursing personnel in the planning of nursing services. It also requests the Government to provide information on the consultations held with such personnel, including the Tajik Nursing Association and the Midwives Association of Tajikistan, on decisions concerning them, in a manner appropriate to national conditions. The Committee further requests the Government to provide additional information on the application of the Ethical Code for Nurses.

Article 6. Conditions of employment. The Government indicates that intermediate medical staff are employed in accordance with the Labour Code. Government or sectoral awards are granted in accordance with length of service and particular merit. For intermediate medical staff, the working day lasts between eight and 14 hours. Overtime is not compensated. Weekly rest days, annual paid leave, study leave, pregnancy and maternity leave, sick leave and social security are also provided for under the Labour Code. Recalling the requirement set out by the Convention that nursing personnel shall enjoy conditions of employment at least equivalent to those of other workers, the Committee requests the Government to indicate the provisions guaranteeing that nursing personnel enjoy conditions of employment and work at least equivalent to those of other workers in relation to hours of work, including regulation and compensation of overtime, inconvenient hours and shift work.

Direct Request (CEACR) - adopted 2019, published 109th ILC session (2021)

The Committee notes with concern that the Government’s report has not been received. It expects that the next report will contain full information on the matters raised in its previous comments.

Repetition

Article 2 of the Convention. Formulation and implementation of a policy concerning nursing services and nursing personnel. In its previous comments, the Committee requested the Government to communicate copies of Ordinance No. 7 of 10 January 2000 establishing the national nursing care centre as well as any other official texts adopted in the context of the implementation of its policy on nursing services and nursing personnel. The Committee notes that the Government’s report does not provide this information. The Government refers to the establishment of the Tajik Nursing Association in 1997, indicating that the Association aims to bring together Tajikistan’s nurses and midwives, strengthen their role in maintaining public health care and enhance advocacy for nursing. The Government adds that the Midwives Association of Tajikistan was established on 16 October 2014, in order to enhance the prestige of midwives and develop their knowledge. The Committee notes that, according to a 2016 report of the European Observatory on Health Systems and Policies (the EO report) entitled Tajikistan: Health System Review, the number of nurses per 100,000 population in Tajikistan declined, from 597 in 1990 to 350 in 2004, before increasing again to 444 in 2013. Despite this more recent increase, the EO report indicates that the ratio of nurses in Tajikistan to population size remains one of the lowest in the region and that, in addition, Tajikistan’s health-care system suffers from pronounced regional imbalances, with health-care workers concentrated in urban areas, notably in Dushanbe, due to challenges in rural and remote areas that include low salaries, outdated medical equipment and the poor condition of health facilities. The EO report refers to incentives introduced by the Ministry of Health and Social Protection aimed at improving the distribution and motivation of health-care workers, to attract them to rural and remote areas. The Committee requests the Government to provide in its next regular report, due in 2018, detailed information on the impact of measures taken in the framework of its policy concerning nursing services and nursing personnel and which are aimed at attracting and retaining nursing personnel, including midwives, particularly in rural and remote areas of the country, as well as statistical information reflecting trends in this sector. It further requests the Government to provide information regarding the consultations held with the social partners with respect to the formulation and implementation of the policy, as called for under Article 2 of the Convention. The Committee once again requests the Government to provide a copy of Ordinance No. 7 of 10 January 2000 establishing the national nursing care centre and any other official texts adopted in the context of the implementation of its policy on nursing services and nursing personnel.

Articles 3 and 4. Basic requirements in relation to teaching and training. The right to exercise the profession. In its previous comments, the Committee requested the Government to indicate the basic requirements in relation to the teaching and training of nursing personnel, and the conditions governing the right to practice nursing care and services. The Government indicates that the national nursing centre and regional nursing centres in Sughd Region, Khatlon Region and the Gorno-Badakhshan Autonomous Region were set up as of 10 January 2000 in order to coordinate the development of nursing in Tajikistan, to develop educational policy at both the graduate and post-graduate levels and to review practice among intermediate medical staff. In accordance with Ministerial Order No. 877 of 17 October 2014, courses to enhance the qualifications of intermediate medical staff are being held at the national nursing centre to enhance the knowledge, professional competencies, practical skills and abilities of intermediate medical staff. The Government indicates that there are currently 23 medical colleges in Tajikistan (16 public and seven private) where training is provided for intermediate medical staff with various specialties. The Committee notes the indication in the EO report that nursing is still poorly developed and many nurses are underqualified. According to the EO report, reforming medical education has been one of the key directions of reform, with upgraded nursing training. The Committee further notes from the EO report that a nursing faculty has been established at the Postgraduate Medical Institute, and nurse training has been upgraded to a four-year course. Retraining is also provided through a six-month continuing medical education course for physicians and nurses who wish to retrain in the area of family medicine. The Committee once again requests the Government to indicate the basic requirements in relation to the teaching and training of nursing personnel, and the conditions governing the right to practice nursing care and services. It also once again requests the Government to provide a copy of any relevant law or regulation in this regard.

Article 5. Consultations with nursing personnel. The Government indicates that the Tajik Nursing Association was established under the auspices of the American International Healthcare Alliance in 1997 in order to bring together Tajikistan’s nurses and midwives, to strengthen their role in maintaining public health care and to enhance advocacy for nursing. The Tajik Nursing Association, together with the National Nursing Centre, drew up an Ethical Code for Nurses. The Midwives Association of Tajikistan was later established on 16 October 2014 with the aim of bringing together the country’s midwives, enhancing their prestige and their role in society and developing their knowledge. The Committee requests the Government to provide further information on the measures taken to promote the participation of nursing personnel in the planning of nursing services. It also requests the Government to provide information on the consultations held with such personnel, including the Tajik Nursing Association and the Midwives Association of Tajikistan, on decisions concerning them, in a manner appropriate to national conditions. The Committee further requests the Government to provide additional information on the application of the Ethical Code for Nurses.

Article 6. Conditions of employment. The Government indicates that intermediate medical staff are employed in accordance with the Labour Code. Government or sectoral awards are granted in accordance with length of service and particular merit. For intermediate medical staff, the working day lasts between eight and 14 hours. Overtime is not compensated. Weekly rest days, annual paid leave, study leave, pregnancy and maternity leave, sick leave and social security are also provided for under the Labour Code. Recalling the requirement set out by the Convention that nursing personnel shall enjoy conditions of employment at least equivalent to those of other workers, the Committee requests the Government to indicate the provisions guaranteeing that nursing personnel enjoy conditions of employment and work at least equivalent to those of other workers in relation to hours of work, including regulation and compensation of overtime, inconvenient hours and shift work.

Direct Request (CEACR) - adopted 2018, published 108th ILC session (2019)

The Committee notes that the Government’s report has not been received. It hopes that the next report will contain full information on the matters raised in its previous comments initially made in 2017.

Repetition

Article 2 of the Convention. Formulation and implementation of a policy concerning nursing services and nursing personnel. In its previous comments, the Committee requested the Government to communicate copies of Ordinance No. 7 of 10 January 2000 establishing the national nursing care centre as well as any other official texts adopted in the context of the implementation of its policy on nursing services and nursing personnel. The Committee notes that the Government’s report does not provide this information. The Government refers to the establishment of the Tajik Nursing Association in 1997, indicating that the Association aims to bring together Tajikistan’s nurses and midwives, strengthen their role in maintaining public health care and enhance advocacy for nursing. The Government adds that the Midwives Association of Tajikistan was established on 16 October 2014, in order to enhance the prestige of midwives and develop their knowledge. The Committee notes that, according to a 2016 report of the European Observatory on Health Systems and Policies (the EO report) entitled Tajikistan: Health System Review, the number of nurses per 100,000 population in Tajikistan declined, from 597 in 1990 to 350 in 2004, before increasing again to 444 in 2013. Despite this more recent increase, the EO report indicates that the ratio of nurses in Tajikistan to population size remains one of the lowest in the region and that, in addition, Tajikistan’s health-care system suffers from pronounced regional imbalances, with health-care workers concentrated in urban areas, notably in Dushanbe, due to challenges in rural and remote areas that include low salaries, outdated medical equipment and the poor condition of health facilities. The EO report refers to incentives introduced by the Ministry of Health and Social Protection aimed at improving the distribution and motivation of health-care workers, to attract them to rural and remote areas. The Committee requests the Government to provide in its next regular report, due in 2018, detailed information on the impact of measures taken in the framework of its policy concerning nursing services and nursing personnel and which are aimed at attracting and retaining nursing personnel, including midwives, particularly in rural and remote areas of the country, as well as statistical information reflecting trends in this sector. It further requests the Government to provide information regarding the consultations held with the social partners with respect to the formulation and implementation of the policy, as called for under Article 2 of the Convention. The Committee once again requests the Government to provide a copy of Ordinance No. 7 of 10 January 2000 establishing the national nursing care centre and any other official texts adopted in the context of the implementation of its policy on nursing services and nursing personnel.

Articles 3 and 4. Basic requirements in relation to teaching and training. The right to exercise the profession. In its previous comments, the Committee requested the Government to indicate the basic requirements in relation to the teaching and training of nursing personnel, and the conditions governing the right to practice nursing care and services. The Government indicates that the national nursing centre and regional nursing centres in Sughd Region, Khatlon Region and the Gorno-Badakhshan Autonomous Region were set up as of 10 January 2000 in order to coordinate the development of nursing in Tajikistan, to develop educational policy at both the graduate and post-graduate levels and to review practice among intermediate medical staff. In accordance with Ministerial Order No. 877 of 17 October 2014, courses to enhance the qualifications of intermediate medical staff are being held at the national nursing centre to enhance the knowledge, professional competencies, practical skills and abilities of intermediate medical staff. The Government indicates that there are currently 23 medical colleges in Tajikistan (16 public and seven private) where training is provided for intermediate medical staff with various specialties. The Committee notes the indication in the EO report that nursing is still poorly developed and many nurses are underqualified. According to the EO report, reforming medical education has been one of the key directions of reform, with upgraded nursing training. The Committee further notes from the EO report that a nursing faculty has been established at the Postgraduate Medical Institute, and nurse training has been upgraded to a four-year course. Retraining is also provided through a six-month continuing medical education course for physicians and nurses who wish to retrain in the area of family medicine. The Committee once again requests the Government to indicate the basic requirements in relation to the teaching and training of nursing personnel, and the conditions governing the right to practice nursing care and services. It also once again requests the Government to provide a copy of any relevant law or regulation in this regard.

Article 5. Consultations with nursing personnel. The Government indicates that the Tajik Nursing Association was established under the auspices of the American International Healthcare Alliance in 1997 in order to bring together Tajikistan’s nurses and midwives, to strengthen their role in maintaining public health care and to enhance advocacy for nursing. The Tajik Nursing Association, together with the National Nursing Centre, drew up an Ethical Code for Nurses. The Midwives Association of Tajikistan was later established on 16 October 2014 with the aim of bringing together the country’s midwives, enhancing their prestige and their role in society and developing their knowledge. The Committee requests the Government to provide further information on the measures taken to promote the participation of nursing personnel in the planning of nursing services. It also requests the Government to provide information on the consultations held with such personnel, including the Tajik Nursing Association and the Midwives Association of Tajikistan, on decisions concerning them, in a manner appropriate to national conditions. The Committee further requests the Government to provide additional information on the application of the Ethical Code for Nurses.

Article 6. Conditions of employment. The Government indicates that intermediate medical staff are employed in accordance with the Labour Code. Government or sectoral awards are granted in accordance with length of service and particular merit. For intermediate medical staff, the working day lasts between eight and 14 hours. Overtime is not compensated. Weekly rest days, annual paid leave, study leave, pregnancy and maternity leave, sick leave and social security are also provided for under the Labour Code. Recalling the requirement set out by the Convention that nursing personnel shall enjoy conditions of employment at least equivalent to those of other workers, the Committee requests the Government to indicate the provisions guaranteeing that nursing personnel enjoy conditions of employment and work at least equivalent to those of other workers in relation to hours of work, including regulation and compensation of overtime, inconvenient hours and shift work.

Direct Request (CEACR) - adopted 2017, published 107th ILC session (2018)

Article 2 of the Convention. Formulation and implementation of a policy concerning nursing services and nursing personnel. In its previous comments, the Committee requested the Government to communicate copies of Ordinance No. 7 of 10 January 2000 establishing the national nursing care centre as well as any other official texts adopted in the context of the implementation of its policy on nursing services and nursing personnel. The Committee notes that the Government’s report does not provide this information. The Government refers to the establishment of the Tajik Nursing Association in 1997, indicating that the Association aims to bring together Tajikistan’s nurses and midwives, strengthen their role in maintaining public health care and enhance advocacy for nursing. The Government adds that the Midwives Association of Tajikistan was established on 16 October 2014, in order to enhance the prestige of midwives and develop their knowledge. The Committee notes that, according to a 2016 report of the European Observatory on Health Systems and Policies (the EO report) entitled Tajikistan: Health System Review, the number of nurses per 100,000 population in Tajikistan declined, from 597 in 1990 to 350 in 2004, before increasing again to 444 in 2013. Despite this more recent increase, the EO report indicates that the ratio of nurses in Tajikistan to population size remains one of the lowest in the region and that, in addition, Tajikistan’s health-care system suffers from pronounced regional imbalances, with health-care workers concentrated in urban areas, notably in Dushanbe, due to challenges in rural and remote areas that include low salaries, outdated medical equipment and the poor condition of health facilities. The EO report refers to incentives introduced by the Ministry of Health and Social Protection aimed at improving the distribution and motivation of health-care workers, to attract them to rural and remote areas. The Committee requests the Government to provide in its next regular report, due in 2018, detailed information on the impact of measures taken in the framework of its policy concerning nursing services and nursing personnel and which are aimed at attracting and retaining nursing personnel, including midwives, particularly in rural and remote areas of the country, as well as statistical information reflecting trends in this sector. It further requests the Government to provide information regarding the consultations held with the social partners with respect to the formulation and implementation of the policy, as called for under Article 2 of the Convention. The Committee once again requests the Government to provide a copy of Ordinance No. 7 of 10 January 2000 establishing the national nursing care centre and any other official texts adopted in the context of the implementation of its policy on nursing services and nursing personnel.

Articles 3 and 4. Basic requirements in relation to teaching and training. The right to exercise the profession. In its previous comments, the Committee requested the Government to indicate the basic requirements in relation to the teaching and training of nursing personnel, and the conditions governing the right to practice nursing care and services. The Government indicates that the national nursing centre and regional nursing centres in Sughd Region, Khatlon Region and the Gorno-Badakhshan Autonomous Region were set up as of 10 January 2000 in order to coordinate the development of nursing in Tajikistan, to develop educational policy at both the graduate and post-graduate levels and to review practice among intermediate medical staff. In accordance with Ministerial Order No. 877 of 17 October 2014, courses to enhance the qualifications of intermediate medical staff are being held at the national nursing centre to enhance the knowledge, professional competencies, practical skills and abilities of intermediate medical staff. The Government indicates that there are currently 23 medical colleges in Tajikistan (16 public and seven private) where training is provided for intermediate medical staff with various specialties. The Committee notes the indication in the EO report that nursing is still poorly developed and many nurses are underqualified. According to the EO report, reforming medical education has been one of the key directions of reform, with upgraded nursing training. The Committee further notes from the EO report that a nursing faculty has been established at the Postgraduate Medical Institute, and nurse training has been upgraded to a four-year course. Retraining is also provided through a six-month continuing medical education course for physicians and nurses who wish to retrain in the area of family medicine. The Committee once again requests the Government to indicate the basic requirements in relation to the teaching and training of nursing personnel, and the conditions governing the right to practice nursing care and services. It also once again requests the Government to provide a copy of any relevant law or regulation in this regard.

Article 5. Consultations with nursing personnel. The Government indicates that the Tajik Nursing Association was established under the auspices of the American International Healthcare Alliance in 1997 in order to bring together Tajikistan’s nurses and midwives, to strengthen their role in maintaining public health care and to enhance advocacy for nursing. The Tajik Nursing Association, together with the National Nursing Centre, drew up an Ethical Code for Nurses. The Midwives Association of Tajikistan was later established on 16 October 2014 with the aim of bringing together the country’s midwives, enhancing their prestige and their role in society and developing their knowledge. The Committee requests the Government to provide further information on the measures taken to promote the participation of nursing personnel in the planning of nursing services. It also requests the Government to provide information on the consultations held with such personnel, including the Tajik Nursing Association and the Midwives Association of Tajikistan, on decisions concerning them, in a manner appropriate to national conditions. The Committee further requests the Government to provide additional information on the application of the Ethical Code for Nurses.

Article 6. Conditions of employment. The Government indicates that intermediate medical staff are employed in accordance with the Labour Code. Government or sectoral awards are granted in accordance with length of service and particular merit. For intermediate medical staff, the working day lasts between eight and 14 hours. Overtime is not compensated. Weekly rest days, annual paid leave, study leave, pregnancy and maternity leave, sick leave and social security are also provided for under the Labour Code. Recalling the requirement set out by the Convention that nursing personnel shall enjoy conditions of employment at least equivalent to those of other workers, the Committee requests the Government to indicate the provisions guaranteeing that nursing personnel enjoy conditions of employment and work at least equivalent to those of other workers in relation to hours of work, including regulation and compensation of overtime, inconvenient hours and shift work.

Direct Request (CEACR) - adopted 2014, published 104th ILC session (2015)

The Committee notes with regret that the Government’s report has not been received. It hopes that a report will be supplied for examination by the Committee at its next session and that it will contain full information on the matters raised in its previous comments.

Repetition

Article 2(1) of the Convention. Development and implementation of a policy concerning nursing services and nursing personnel. The Committee notes the Government’s report, particularly the establishment in the Ministry of Health of the National Nursing Care Centre by Ordinance No. 7 of 10 January 2000. The Government indicates that the Centre has been established with a view to: (i) coordinating the development of nursing care and health care activities; (ii) establishing the policy and strategy for activities relating to nursing care; (iii) creating a basis for cooperation with different organizations; (iv) promoting the conditions to change social and vocational status; and (v) increasing the role of professional nursing personnel in the care provided to the population. The Government adds that the Centre has already undertaken several activities relating to nursing personnel, namely: (i) a programme for the registration of nursing personnel; (ii) a code of conduct; (iii) a document on the activities of nursing care and the participation of nursing personnel in the work process; and (iv) a document on the mandate of nursing personnel in paediatrics. The Committee requests the Government to provide a copy of Ordnance No. 7 of 10 January 2000 establishing the National Nursing Care Centre, and the Code of Conduct, the registration programme and any other official text adopted in the context of the implementation of a policy on nursing services and nursing personnel. The Committee also requests the Government to continue to provide information on the work of the National Nursing Care Centre.

The Committee also notes that, according to the statistics provided by the Government, 29,437 nurses were recorded in 2006, representing 83.3 per cent of the needs for nursing personnel. However, the Committee understands that, in view of the migration that occurred during and after the civil war, the country is suffering from a shortage of trained and experienced personnel in the health field. According to a study published by the WHO in 2000, the number of nurses per 1,000 inhabitants fell by 26 per cent between 1990 and 1997. The Committee therefore requests the Government to provide detailed information on trends in the situation of nursing personnel and, where appropriate, on the additional measures adopted or envisaged to contain the phenomenon of the migration abroad of skilled nursing personnel.

Articles 3 and 4. Basic requirements in relation to teaching and training. The right to exercise the profession. The Committee requests the Government to indicate in its next report the basic requirements in relation to the teaching and training of nursing personnel, and the conditions governing the right to practice nursing care and services. It also requests the Government to provide a copy of any relevant law or regulation.

Article 6. Conditions of employment. Recalling the requirement set out by the Convention that nursing personnel shall enjoy conditions of employment at least equivalent to those of other workers, the Committee requests the Government to indicate the provisions guaranteeing that nursing personnel enjoy conditions of employment and work at least equivalent to those of other workers in the following fields: (a) hours of work, including regulation and compensation of overtime, inconvenient hours and shift work; (b) weekly rest; (c) paid annual holidays; (d) educational leave; (e) maternity leave; (f) sick leave; and (g) social security.

Direct Request (CEACR) - adopted 2013, published 103rd ILC session (2014)

The Committee notes that the Government’s report has not been received. It hopes that a report will be supplied for examination by the Committee at its next session and that it will contain full information on the matters raised in its previous direct request, which read as follows:

Repetition

Article 2(1) of the Convention. Development and implementation of a policy concerning nursing services and nursing personnel. The Committee notes the Government’s report, particularly the establishment in the Ministry of Health of the National Nursing Care Centre by Ordinance No. 7 of 10 January 2000. The Government indicates that the Centre has been established with a view to: (i) coordinating the development of nursing care and health care activities; (ii) establishing the policy and strategy for activities relating to nursing care; (iii) creating a basis for cooperation with different organizations; (iv) promoting the conditions to change social and vocational status; and (v) increasing the role of professional nursing personnel in the care provided to the population. The Government adds that the Centre has already undertaken several activities relating to nursing personnel, namely: (i) a programme for the registration of nursing personnel; (ii) a code of conduct; (iii) a document on the activities of nursing care and the participation of nursing personnel in the work process; and (iv) a document on the mandate of nursing personnel in paediatrics. The Committee requests the Government to provide a copy of Ordnance No. 7 of 10 January 2000 establishing the National Nursing Care Centre, and the Code of Conduct, the registration programme and any other official text adopted in the context of the implementation of a policy on nursing services and nursing personnel. The Committee also requests the Government to continue to provide information on the work of the National Nursing Care Centre.

The Committee also notes that, according to the statistics provided by the Government, 29,437 nurses were recorded in 2006, representing 83.3 per cent of the needs for nursing personnel. However, the Committee understands that, in view of the migration that occurred during and after the civil war, the country is suffering from a shortage of trained and experienced personnel in the health field. According to a study published by the WHO in 2000, the number of nurses per 1,000 inhabitants fell by 26 per cent between 1990 and 1997. The Committee therefore requests the Government to provide detailed information on trends in the situation of nursing personnel and, where appropriate, on the additional measures adopted or envisaged to contain the phenomenon of the migration abroad of skilled nursing personnel.

Articles 3 and 4. Basic requirements in relation to teaching and training. The right to exercise the profession. The Committee requests the Government to indicate in its next report the basic requirements in relation to the teaching and training of nursing personnel, and the conditions governing the right to practice nursing care and services. It also requests the Government to provide a copy of any relevant law or regulation.

Article 6. Conditions of employment. Recalling the requirement set out by the Convention that nursing personnel shall enjoy conditions of employment at least equivalent to those of other workers, the Committee requests the Government to indicate the provisions guaranteeing that nursing personnel enjoy conditions of employment and work at least equivalent to those of other workers in the following fields: (a) hours of work, including regulation and compensation of overtime, inconvenient hours and shift work; (b) weekly rest; (c) paid annual holidays; (d) educational leave; (e) maternity leave; (f) sick leave; and (g) social security.

Direct Request (CEACR) - adopted 2010, published 100th ILC session (2011)

Article 2(1) of the Convention. Development and implementation of a policy concerning nursing services and nursing personnel. The Committee notes the Government’s report, particularly the establishment in the Ministry of Health of the National Nursing Care Centre by Ordnance No. 7 of 10 January 2000. The Government indicates that the Centre has been established with a view to: (i) coordinating the development of nursing care and health care activities; (ii) establishing the policy and strategy for activities relating to nursing care; (iii) creating a basis for cooperation with different organizations; (iv) promoting the conditions to change social and vocational status; and (v) increasing the role of professional nursing personnel in the care provided to the population. The Government adds that the Centre has already undertaken several activities relating to nursing personnel, namely: (i) a programme for the registration of nursing personnel; (ii) a code of conduct; (iii) a document on the activities of nursing care and the participation of nursing personnel in the work process; and (iv) a document on the mandate of nursing personnel in paediatrics. The Committee requests the Government to provide a copy of Ordnance No. 7 of 10 January 2000 establishing the National Nursing Care Centre, and the Code of Conduct, the registration programme and any other official text adopted in the context of the implementation of a policy on nursing services and nursing personnel. The Committee also requests the Government to continue to provide information on the work of the National Nursing Care Centre.

The Committee also notes that, according to the statistics provided by the Government, 29,437 nurses were recorded in 2006, representing 83.3 per cent of the needs for nursing personnel. However, the Committee understands that, in view of the migration that occurred during and after the civil war, the country is suffering from a shortage of trained and experienced personnel in the health field. According to a study published by the WHO in 2000, the number of nurses per 1,000 inhabitants fell by 26 per cent between 1990 and 1997. The Committee therefore requests the Government to provide detailed information on trends in the situation of nursing personnel and, where appropriate, on the additional measures adopted or envisaged to contain the phenomenon of the migration abroad of skilled nursing personnel.

Articles 3 and 4. Basic requirements in relation to teaching and training. The right to exercise the profession. The Committee requests the Government to indicate in its next report the basic requirements in relation to the teaching and training of nursing personnel, and the conditions governing the right to practice nursing care and services. It also requests the Government to provide a copy of any relevant law or regulation.

Article 6. Conditions of employment. Recalling the requirement set out by the Convention that nursing personnel shall enjoy conditions of employment at least equivalent to those of other workers, the Committee requests the Government to indicate the provisions guaranteeing that nursing personnel enjoy conditions of employment and work at least equivalent to those of other workers in the following fields: (a) hours of work, including regulation and compensation of overtime, inconvenient hours and shift work; (b) weekly rest; (c) paid annual holidays; (d) educational leave; (e) maternity leave; (f) sick leave; and (g) social security.

Part V of the report form. Application in practice. The Committee would be grateful if the Government would provide general information on the manner in which the Convention is applied in practice, including, for example, updated statistics on the numbers of nursing personnel, disaggregated where possible by level of training and function, sex and age, their relation to the population, the numbers of persons entering and leaving the profession each year, copies of official reports or studies on nursing personnel, and information relating to any practical difficulties encountered in the implementation of the Convention.