Trend’s interview with Dr. Farid Babayev, Assistant Representative of UNFPA Azerbaijan Country Office

Question: The UN previously stated that Azerbaijan’s population is expected to hit 10.68 million people by 2030 and 11.03 million people by 2050. In terms of economic reasons, what are the key factors favoring steady population growth in Azerbaijan?

Answer: Azerbaijan is the most dynamic nation in the South Caucasus in terms of demographic development with a population twice that of Georgia and three times that of Armenia. One of the most important characteristics features of Azerbaijan’s demographic situation is the relative rate of increase of the population number that depends on the fertility and mortality rates, balance of the external migration and the peculiarities of the population structure by sex and age.

In the next three decades Azerbaijan’s population is projected to grow by over half a million people per decade. It is expected that during the 21st century the population of Azerbaijan is likely to increase by over 3 million people and 70 percent growth will occur in the first half of the century. So, Azerbaijan will certainly retain its position of the demographic leader in the South Caucasus throughout the century.

Population growth in Azerbaijan was and continues to be ensured mainly (and almost exclusively) by the excess of the number of births over the number of deaths; while the impact of external migration on the change in the population size in Azerbaijan is insignificant.

The dynamics and the peculiarities of economic and social development in any country largely depend on the characteristics of the age structure of the population. The proportion of children, youth and people of retirement age are key factors of the structure of social expenditure on public health, education and pensions. Finally, the working age structure of the population is an important factor determining the state of the labor market.

Azerbaijan’s working age population has been growing rapidly over the past few decades. According to the UN medium projections , this growth will continue until 2018, with the number of females aged 20-59 and males aged 20-63 expected to reach six million (an almost 68% increase).

Azerbaijan will experience a big increase in the labor force during the first half of the 21st century when the population group aged 18-20 enter the labor market. Azerbaijan’s 18-20 population age group alternates every 10 years or so. The highest risk for youth unemployment took place between 2009-2011 when the number of 18-20 year olds was more than 550,000. This eventuality may occur again in the mid-2030s when this age group is again expected to number 500,000, despite the anticipated decrease in number to 330,000 in the early 2020s. Hence, the problem of youth employment in Azerbaijan will remain a development agenda priority in the decades to come, despite the stabilization of the size of the working-age population.

Q.: What is your assessment of the current state of reproductive health and family planning in Azerbaijan, what major milestones could you outline in particular?

The protection of reproductive health, including the health of mother and newborns, is under close attention of the state. The Constitution of the Republic of Azerbaijan, the Law of the Republic of Azerbaijan "On protection of public health" and other normative legal acts arising from this law are the guarantee of protection of public health, including maternal and children's health. The obstetrics and perinatal care are organized according to the three-level principle within the framework of the regionalization of perinatal care. To this end, seven perinatal centers have been established in the country: six in the regions and one in Baku (the Republican Perinatal Center).

National clinical protocols and standards based on the principles of evidence-based medicine for the provision of services during pregnancy, childbirth, postpartum period and care of newborns have been developed; regular monitoring are carried out on the quality of services (antenatal, midwifery and neonatal care) in the regions by the staff of the Research Institute of Obstetrics and Gynecology and the Center for Public Health and Reform. Since January 2017, the pilot implementation of compulsory health insurance has been launched in two regions. Since 2018-2019 years it is planned to introduce compulsory health insurance in the whole country. The basic package of compulsory health insurance includes services on reproductive health, including antenatal care and obstetrics, perinatal care.

The global challenges facing all workers of maternal and child healthcare services are the reduction of maternal and child mortality, improvement of the quality of medical care for newborns, reduction of the morbidity and mortality, and protection of health of adolescents and young people.

The early antenatal coverage of pregnant women, that is, registration before 12 weeks, makes up 74.1 percent according to data for 2015. The country lacks effective incentives for pregnant women to promote their early registration at antenatal care services. Due to a shortage of staff in remote regions of the Republic, difficulties arise with the involvement of specialists of various profiles in the pre-divisional preparation for the family, especially women with extragenital diseases. Azerbaijan needs to adopt a state program to provide women with iron, folic acid medicaments, and enriched flour during pregnancy and in the post-natal period.

The analysis of the number of premature births reveals a general rising tendency of this indicator. In 2005-2014, the figure gradually increased from 1.8 to 2.7 percent, and the increase in the indicator in 2015 to 3.7 percent is due to the transition on new criteria of live birth.

At the same time, there is a decrease in the level of home births in the republic, whereas in 2008 the share of giving births at home was 2.5 percent, in 2015 it is 0.9 percent. The cases of home births are recorded mainly in remote villages, and there is a positive trend towards a decrease in this indicator.

To get a clearer and more detailed picture of the preventable causes of maternal mortality in Azerbaijan, it is necessary to improve the collection of information and implement the WHO methodology for the analysis of critical cases in obstetrics.

Geographical location of remote regions of the Republic, especially in the winter season, creates certain problems in transportation, as well as in providing timely emergency assistance to pregnant women, parturients, mothers and newborns. In the same localities, there are difficulties in collecting statistical data, analyzing and reporting on reproductive health.

Q.: What are some examples of organizational or governmental efforts that you can point to as best-practice cases that have been particularly successful in Azerbaijan to ensure stable population growth?

A.: Following the adoption of the Cairo Programme of Action in 1994, Azerbaijan began implementing a number of comprehensive population development measures. The Cairo Conference provided a new impetus to policy-makers to seek solutions to the population and development challenges in the country. By adopting the Programme of Action the national government recognized that investing into human capital, broadening people’s choices and creating opportunities to realize their capabilities were fundamental for sustained economic growth and sustainable development. Since the Cairo Conference Azerbaijan has continued to pursue a comprehensive approach to mainstreaming population issues into national development policies and strategies.

The principal objective of the national policy for demographic development is to ensure quantitative and qualitative population growth by curbing negative demographic trends, consistent with the long-term national development strategy. This priority is also duly stipulated in the development concept ‘Azerbaijan - 2020: The Vision of the Future’ as well as the draft State Programme on Population Development and Demography of the Republic of Azerbaijan (2017-2030) was prepared with the technical support of UNFPA Country Office in Azerbaijan. The development of this Programme draft has been acknowledged the milestone achievement reflected the Government’s efforts and commitment to better address population and development issues in the country.

UNFPA pays continuous attention and renders substantive support to the activities aimed at raising critical awareness and drawing public attention on broad range of population issues among wide public circles of Azerbaijan at national and regional level. One of the major UNFPA interventions in the area of Population and Development is to institutionalize inclusion of population issues and concerns in development policy dialogue, and to integrate population factors into development strategies that are people-centered and recognize that demographic, social, economic and environmental factors are interrelated.

Q.: Can you please provide an update on the prospects of UNFPA’s cooperation with Azerbaijan, in particular future projects planned for implementation with the country?

A.: The UNFPA plays a unique role within the United Nations system by addressing population and development issues in partnership with national governments and other agencies, and emphasizing reproductive health and gender equality. In Azerbaijan, our mission is particularly focused on issues related to reproductive health and rights, gender equality and women empowerment and population dynamics.

Our office supports the government of the Republic of Azerbaijan in the integration of population and reproductive health issues into policies.

The United Nations Population Fund has closely cooperated with the World Health Organization in the development of the second cycle of "National Strategy on Reproductive Health and Family Planning", which is expected to continue from 2017 until 2025. The new cycle is expected to enable health providers to identify and focus on the following national priorities aspects of health care: safe care for mothers and newborn babies, family planning, control and prevention of Sexually Transmitted Diseases and developing an adequate response to gender based violence and so on.

Responding to violence against women in development and humanitarian settings is a strategic priority for UNFPA. This includes eliminating harmful practices such as child marriage and others. The Fund also collects data to accurately document incidents of violence, and helps to develop, enforce and reform national laws and policies on gender-based violence. In Azerbaijan, UNFPA owns the USAID-funded project striving to eliminate gender-based violence through conduction of systematic and standardized collection of quantitative and qualitative data on GBV as well as development of inter-agency GBV database that will not only elaborately collect data on GBV incidents throughout the country, but also facilitate evidence based decision making.

UNFPA is one of the world’s largest supporters of population data collection. In addition to supporting censuses and surveys, UNFPA works with policymakers, civil society, health-care providers and educators at all levels to promote sexual and reproductive health and rights – including voluntary family planning. One of the major UNFPA interventions in the area of Population and Development in Azerbaijan is to institutionalize inclusion of population issues and concerns in development policy dialogue, and to integrate population factors into development strategies that are people-centered and recognize that demographic, social, economic and environmental factors are interrelated.

Supporting the government, at its request, in integration of population and reproductive health issues into its planning and policy making has been one of the key strategic direction of UNFPA activities since its establishment in Azerbaijan. A special emphasis was made to strengthen national capacity in collection, analysis, dissemination and utilization of reliable and gender-sensitive population, demographic and health, including reproductive health data, as it plays a fundamental role for policymaking and generation the political will to appropriately address both current and future needs.

The support was provided to the Government with the development of the population projection by economic regions of Azerbaijan for 2016-2050. The development of the State Program on Population Development and Demography (2017-2030) has been acknowledged the milestone achievement reflected the Government’s efforts and commitment to better address population and development issues in the country.

UNFPA pays continuous attention and renders substantive support to the activities aimed at raising critical awareness and drawing public attention on broad range of population issues among wide public circles of Azerbaijan at national and regional level.