Azerbaijan's Infant Mortality Crisis: Understanding The Factors

Azerbaijan has the highest infant mortality rate in Europe, with 18.386 deaths per 1000 live births in 2024. This figure has been steadily declining since 1991, when the rate was 93 deaths per 1000 live births. Despite this improvement, the country still faces challenges in addressing infant mortality, with recent reports indicating gaps in the healthcare system, including a lack of facilities, insufficient healthcare expenditures, shortages of trained healthcare workers, and inadequate data collection methods. These factors contribute to a high infant mortality rate, particularly in urban areas, and the government has implemented policies to address these issues.

Lack of facilities and equipment in hospitals

Azerbaijan has made significant progress in reducing its infant mortality rate since gaining independence in 1991, with the rate decreasing from 93 deaths per 1000 live births in 1991 to 28.2 deaths in 2015. However, recent reports indicate that Azerbaijan has the highest infant mortality rate in Europe, with 27.2 deaths per 1000 live births in 2018. This is a cause for concern and highlights the need for improved healthcare infrastructure and access in the country.

One of the main factors contributing to the high infant mortality rate in Azerbaijan is the lack of adequate facilities and equipment in hospitals. While the government has built new hospitals during the oil boom, these facilities often lack sufficient technologies, uninterrupted clean water, sanitation facilities, and electricity generators, especially in rural areas. This means that hospitals may not have the necessary resources and equipment to provide adequate care for newborns and pregnant women, increasing the risk of infant mortality.

The lack of essential drugs and medical equipment during birth and the first days and weeks of a newborn's life is also a critical issue. Access to basic and advanced medications and supplies is crucial for addressing infant mortality, and the unavailability of these resources can have detrimental effects.

To improve the situation, the Azerbaijani government should increase investments in healthcare infrastructure. This includes allocating more financial resources to procure essential drugs and medical equipment, improve clean water and sanitation facilities, and provide hospitals with electricity generators to address power shortages. Additionally, the government should focus on improving the quality and accessibility of healthcare services, especially in rural and remote areas, to ensure that all newborns and pregnant women have equal opportunities for a healthy start.

Furthermore, it is essential to address the underlying causes of the lack of facilities and equipment in hospitals. This may include increasing the healthcare budget, improving supply chain management, and fostering partnerships with international organizations and companies specializing in healthcare infrastructure development. By taking a comprehensive approach that addresses both the symptoms and root causes, Azerbaijan can make significant strides in reducing its infant mortality rate and providing better healthcare for its citizens.

Low healthcare expenditure

Azerbaijan's infant mortality rate is a cause for concern, with 18.386 deaths per 1,000 live births in 2024, the highest in Europe. While the country has made progress, with a 4.6% decrease in 2021, there are still significant challenges, particularly regarding low healthcare expenditure.

Azerbaijan's healthcare expenditure is notably low compared to other former Soviet countries. In 2018, healthcare expenditure was just 3.5% of the state budget, or 435.3 million USD. This is significantly lower than neighbouring countries such as Georgia (8.9% in 2016), Belarus (13.79% in 2015), and Russia (9.5% in 2015). The low budget allocation for healthcare is a pressing issue, as it directly impacts the availability and quality of healthcare services for infants and new mothers.

The budget for healthcare in Azerbaijan has been decreasing in recent years due to a drop in oil prices, which heavily influence the country's economy. In 2017, the budget allocation for health expenditure was 455.6 million USD, but this decreased to 435.3 million USD in 2018. The majority of the 2018 healthcare budget was allocated to maintenance and salaries, with only a small portion dedicated to research, infant and maternal mortality, and other essential services.

The low healthcare expenditure has direct implications for the availability and quality of healthcare facilities and services in Azerbaijan. There is a lack of essential drugs, medical equipment, and access to clean water and sanitation facilities in hospitals, particularly in rural areas. Additionally, there is a shortage of well-trained healthcare workers, nurses, and midwives, which is a critical factor in providing adequate care for pregnant women and newborns.

To address these challenges, the Azerbaijani government should consider increasing healthcare expenditure to improve the availability and quality of healthcare services. This includes allocating more financial resources to obtain essential drugs and medical equipment, improve infrastructure, and train and hire more healthcare professionals. By investing in the healthcare system and addressing the gaps in services, Azerbaijan can make significant strides in reducing its high infant mortality rate.

Shortage of trained healthcare workers

Azerbaijan has a high infant mortality rate, with 18.386 deaths per 1,000 live births in 2024. This is a decline from 2023, when the rate was 18.746 deaths per 1,000 live births. The rate has been steadily decreasing since 1991, when it was 93 deaths per 1,000 live births. Despite this improvement, Azerbaijan still has the highest infant mortality rate in Europe.

One of the main causes of this high rate is the shortage of trained healthcare workers, specifically nurses and midwives. This shortage has been exacerbated by the fact that many of those who are trained leave the country to practise elsewhere. For example, in 2012, only around 6% of midwife graduates remained in Azerbaijan to practise. This means that there are not enough healthcare workers to provide essential services to women during pregnancy, birth, and postnatal care. These services include antenatal care, micronutrient supplementation, delivery support, emergency obstetric care, and postnatal care.

To address this issue, the Azerbaijani government needs to increase its investment in healthcare and specifically in training and retaining healthcare workers. This could include improving the quality of midwifery education and increasing the number of midwifery education institutions. Additionally, the government could adopt policies that encourage hospitals to hire certified midwives from these institutions. Exchange programs could also be implemented to allow healthcare workers to gain expertise and knowledge from their counterparts in other countries.

By taking these steps, the Azerbaijani government can help to reduce the country's high infant mortality rate and ensure that women and infants have access to the essential healthcare services they need.

Lack of quality and awareness in healthcare services

Azerbaijan has made significant progress in reducing its infant mortality rate since gaining independence in 1991, with the rate decreasing from 93 deaths per 1,000 live births in 1991 to 28.2 deaths in 2015, and further down to 17.3 in 2020. However, according to a 2018 report by UNICEF, Azerbaijan still has the highest infant mortality rate in Europe, with a rate of 27.2 deaths per 1,000 live births. This is likely due to a lack of quality and awareness in healthcare services.

Additionally, there is a shortage of well-trained healthcare workers, nurses, and midwives in Azerbaijan. The number of nurses and midwives per 1,000 people has decreased significantly from 8.4 in 2009 to 6.8 in 2016. This shortage of skilled personnel directly impacts the quality of care provided to pregnant women and newborns, increasing the risk of infant mortality.

To address these issues, the Azerbaijani government should focus on implementing comprehensive educational programmes about pregnancy and reproductive health. These programmes should aim to empower young girls and women by providing information about proper nutrition during pregnancy, maintaining a healthy weight, and the benefits of regular check-ups and consultations. Involving civil society and the media in these educational initiatives can further enhance their reach and impact.

Furthermore, increasing investments in the healthcare sector, specifically in training and hiring more skilled midwives and nurses, is crucial. The government should also consider improving the midwifery education system, enhancing the technical capacity of existing institutions, and updating their curricula to meet current challenges. Additionally, adopting policies that prioritise the hiring of certified midwives from recognised institutions can help increase the demand for and improve the quality of midwifery services.

In conclusion, addressing the lack of quality and awareness in healthcare services is essential to reducing Azerbaijan's infant mortality rate. This can be achieved through targeted educational programmes, improving healthcare worker skills, and increasing investments in the healthcare sector, particularly in training and hiring skilled personnel. By implementing these measures, Azerbaijan can make significant strides towards lowering its infant mortality rate and ensuring better health outcomes for mothers and newborns.

Financial barriers to healthcare access

Azerbaijan has made significant progress in reducing its infant mortality rate since gaining independence in 1991, with the rate decreasing from 93 deaths per 1,000 live births in 1991 to 28.2 deaths in 2015. However, according to UNICEF and WHO reports, Azerbaijan still has the highest infant mortality rate in Europe, with 27.2 deaths per 1,000 live births as of 2018. This rate decreased to 18.386 deaths per 1,000 live births in 2024.

One of the main factors contributing to the high infant mortality rate in Azerbaijan is financial barriers to healthcare access. Citizens of Azerbaijan bear more than 78% of health expenditures out of pocket, creating a significant barrier for low-income families to access healthcare facilities. This often leads to home births, which can contribute to infant mortality, especially in cases of preterm, intrapartum, and congenital complications.

The government of Azerbaijan has a relatively low budget allocation for healthcare expenditures, with only 3.5% of the state budget, or 435.3 million USD, allocated for 2018. This is significantly lower than the healthcare expenditures of other former Soviet countries, such as Georgia (8.9% in 2016), Belarus (13.79% in 2015), and Russia (9.5% in 2015). The low budget allocation results in insufficient healthcare facilities, a lack of essential drugs and medical equipment, and inadequate sanitation and clean water facilities in hospitals, particularly in rural areas.

To address these financial barriers, the Azerbaijan government has implemented Compulsory Medical Insurance pilot projects in Yevlakh and Mingachevir cities, with plans to expand the system to more than 600 hospitals in 2019. Additionally, the government has adopted the "State Program to Improve Health of Mothers and Children," which aims to increase the quality of treatment and services provided to women and children and enhance their health. The program includes advancing the quality of medical services and staff training, improving the effectiveness of medical care for newborns, and adopting international standards to measure infant mortality rates.

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