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Ministry of Justice

Republic of Tajikistan

 On June 2, 2017 No. 37

CODE OF HEALTH CARE OF THE REPUBLIC OF TAJIKISTAN

of May 30, 2017 No. 1413

(as amended of the Law of the Republic of Tajikistan of 29.01.2021 No. 1762)

Accepted by the Resolution MH MOPT of March 15, 2017, No. 712

Approved by the Resolution MM MORT of May 18, 2017, No. 374

This Code governs the public relations in the field of health care and is directed to realization of constitutional rights of citizens and health protection.

Section 1. General part

Chapter 1. Basic provisions

Article 1. Basic concepts

In this Code the following basic concepts are used:

- accreditation in health sector, the procedure of recognition of competence of healthcare institutions for implementation of certain medical activities;

- sanitarno - epidemiological safety of the population - the state of health of the population and the habitat of people in case of which there are no harmful effects of factors of the habitat per capita and are provided favorable conditions for its activities;

- private medical practice - activities for delivery of health care by persons having secondary and higher professional medical education according to specialty based on the license granted in the procedure established by the legislation of the Republic of Tajikistan;

- employee assessment of health sector - process of determination of level of professionalism, professional competence, level of knowledge and practical skills of the worker;

- ionizing radiation - the radiation which appeared in case of radioactive decay, nuclear transformations, braking of charged particles in substance which in case of interaction with environment form ions of different signs;

- planning of family - capability of individuals and couples to provide and reach desirable number of children, with observance of interval between childbirth;

- conflict of interest - situation in which personal interest of health and pharmaceutical workers when implementing of labor activity by them for the purpose of profit earning by means of the pharmaceutical companies or through their representations, can become the reason of unfair execution of professional activity of specialists of health sector and contradict interests of the patient;

- medico-social resettlement - recovery of health of patients with complex use of medical, social and labor actions for involvement of patients to work, family and public life;

- narcological diseases - the violations of mental and somatic health caused by not medical consumption of drugs, the psychotropic and equated to them substances, alcoholic drinks which consequence forming of psychological dependence on the above-stated substances and social degradation is;

- infectious diseases - infectious diseases of the person which emergence and distribution is caused by impact per capita of biological factors of the habitat (causative agents of infectious diseases) and possibility of transfer of such diseases from the sick person and animal to the healthy person;

- mass noninfectious diseases - diseases of the person which emergence is caused by impact of physical, chemical, and (or) social factors of the habitat;

- occupational disease - the disease caused by impact on the worker of dangerous or harmful production factors;

- parasitic diseases - contamination condition protozoa or invazirovannost helminths as a result of which infectious processes of any type develop;

- tuberculosis - infectious disease which causative agent is the group of mikobakteriya of tuberculosis which is generally extending vozdushno - drop way;

- acquired immunodeficiency syndrome - the terminal (final) stage of infection caused by human immunodeficiency virus;

- infertility - inability to conception;

- fabrics - cellular connections and their derivatives (intercellular substances) united by structure community, functions and development (epitelialny, blood, lymph, actually connecting, cartilaginous, bone, muscular, nervous);

- human immunodeficiency virus - virus which causes immunodeficiency in human body;

- means of self-checking - the diagnostic test and devices providing possibility of independent determination of level of glucose in blood;

- contraceptive means - any method capable to prevent pregnancy;

- drugs - substances of synthetic or natural origin, their dosage forms, and also the plants classified in the corresponding international conventions and the National list of drugs, psychotropic substances and precursors (further - the National list);

- special national groups with the human immunodeficiency virus raised by risk of infection - persons who can have contact with source of human immunodeficiency virus and also play key role in development of epidemic, and in response measures, including the persons having same-sex sexual contacts and providing sexual services, and the faces using injecting drugs;

- the risk group - persons, the most subject to risk to get sick with tuberculosis, including: contact with TB patients, the labor migrants infected with human immunodeficiency virus, the women who are not observing intervals between childbirth, the children who did not undergo vaccination by Kalmette's bacillus - Zherena, prisoners sick with diabetes and chronic diseases of lungs;

- vulnerable national groups - national groups for which, in connection with influence of adverse family, economic, social, cultural and labor conditions, the risk of infection with human immunodeficiency virus, including labor migrants, prisoners, street children, youth with symptoms of infections, sexually transmitted, sexual partners of persons using injecting drugs increases;

- hygiene - the science studying influence of factors of external environment on human body for the purpose of optimization of favorable impact and prevention of adverse effect;

- food for babies - children's nutritious mix or other mix, suitable for feeding of babies, nutritious mix for children of more advanced chest age;

- additional food - the food suitable or represented as suitable as additional food to breast milk, to children's nutritious mix or mix for children of more advanced chest age;

- special food - food for newborns, feeding by which it is performed by means of small bottles (horns) for feeding, pacifiers, baby's dummy;

- children's nutritious mix - dairy food or similar to milk the product of animal or phytogenesis made on industrial basis according to the state or international standards of food, approved by International commission according to food standards for requirements satisfaction of babies in food during the period from the birth till first six months of their life;

- nutritious mixes for children of more advanced chest age - dairy food or similar to milk the product of animal or phytogenesis made on industrial basis according to the state or international standards of food, approved by International commission according to food standards, represented as suitable for feeding of babies are more senior than six months and children of younger age;

- natural feeding (breastfeeding) - natural feeding of babies (babies) and children of younger age;

- disinsection - destruction of arthropods of the pincers which are carriers of causative agents of infectious diseases, and also other insects having sanitarno - hygienic value, preventing work and rest of people;

- deratization - extermination of rodents - carriers of infectious diseases for the purpose of protection from them of harvest, food and property;

- disinfection - destruction of causative agents of infectious and parasitic diseases on environment objects;

- diabetes - the chronic disease which is characterized by the increased blood glucose level owing to lack of insulin;

- the blood donor - person, voluntarily last physical examination and taking blood test and its components;

- active blood donors - persons who addressed to organizations of service of blood it is also regular (at least 3 - x once a year) taking blood test and its components on paid basis or is non-paid (receiving monetary compensation instead of blood donation or not receiving instead of any material benefits);

- the donor - person who is voluntarily providing any body or fabric for change to other person (recipient);

- reserve blood donors - the persons involved in organized procedure in donorship or who are individually taking blood test and its components changeably, no more than 2 - x once a year (not receiving payment for the taken blood test);

- contractual blood donors - persons signing with organization of service of blood the agreement (contract) on blood donation and its components;

- toxicomania - the disease caused by chronic intoxication of organism owing to abuse of the medicines and other substances which are not relating to drugs and characterized by mental and physical dependence on them;

- substitute of breast milk - any baby food, is provided for realization or the breast milk provided in a different way, in parts or in full replacing;

- anatomic gift - donation of fabrics and bodies the citizen, by means of the will;

- quarantine - the administrative, medical and sanitary, veterinary and other measures directed to prevention of spread of infectious diseases and providing particular treatment economic and activities of other type, restriction of movement of the population, vehicles, freights, goods and animals;

- babies (babies) are children to 12 - ti months;

- children of younger age are children from 1 to 3 - x years;

- the child the disabled person - person aged up to 18 years who is the disabled person;

- medical care - measures for prevention and diagnosis of diseases, poisonings, injuries, treatment and rehabilitation of patients, pregnancy observation, acceptance of childbirth and observation of the postnatal period;

- palliative care - form of provision of medical care to persons with incurable diseases for the purpose of simplification of their state of health;

- primary health care - the level of medical attendance in case of which there is the first contact of healthy and sick citizens with doctors;

- mental health services - prevention of mental disturbances, inspection of mental health of citizens, dispensary control, diagnostics of mental violations, treatment, leaving, medical and social resettlement of persons suffering from mental diseases;

- antituberculous care - set social, medical, sanitarno - the hygienic and anti-epidemic actions directed to identification, inspection and treatment, including obligatory inspection and treatment, dispensary observation and rehabilitation of the TB patients who are carried out in the hospital and (or) out-patient procedure established by this Code and other regulatory legal acts of the Republic of Tajikistan;

- the narcological help - complex of the actions consisting of prevention, dispensary control, diagnostics, treatment, leaving, medical and social resettlement of narcological patients;

- state sanitarno - epidemiological rules and standard rates - the regulatory legal acts establishing sanitarno - epidemiological requirements (including, criteria of safety and (or) harmlessness of factors of the habitat for the person, hygienic and other standard rates) which non-compliance creates threat of human life, and also - threat of origin and spread of diseases;

- phytosanitary rules - set scientifically - the reasonable regulating documents establishing requirements to condition of lands, the woods and vegetation and also to the number of wreckers of plants, spread of disease of plants and availability of agrestal plants;

- fertility (fertility) - average of children who can be given birth by the woman during its reproductive age;

- authorized state body in health sector - the central executive body of the government realizing state policy in the field of health care and social protection of the population and exercising control and management of process of diagnostics, prevention and treatment in the organizations of health sector irrespective of patterns of ownership and departmental subordination;

- object of transplantation - the body or fabric used in case of transplantation;

- brain death - the complete and irreversible cessation of all functions of brain registered in case of the working heart and artificial ventilation of lungs;

- the disabled person - person having the violation of health with permanent disorder of functions of organism caused by the diseases, injuries, physical and intellectual defects which led to activity restriction, and needing social protection;

- disability - extent of restriction of activity of the person owing to violation of health with permanent disorder of functions of organism;

- confidentiality - preserving in secret the fact of visit of medical institution, about the state of health and the received information on the personality;

- consultation of doctors - meeting of group of doctors for discussion of condition of the heavy patient, refining of the diagnosis, determination of methods of treatment and the moment of death;

- alcoholism - the narcological disease which is characterized by long consumption of alcohol and proceeding with the phenomena of psychological and biological dependence on alcohol, changes from its influence, emergence and development of mental and somatic alcoholic degradation;

- the hygienic standard rate - the admissible maximum or minimum quantitative and (or) high-quality measure value established by researches, characterizing habitat factor from line items on safety and (or) harmlessness for the person;

- psychotropic substances - substances of synthetic or natural origin, their dosage forms classified in the corresponding international conventions and the National list;

- medical institution - the legal entity who irrespective of patterns of ownership in the procedure established by the legislation of the Republic of Tajikistan is engaged in prevention, diagnostics, treatment and recovery of population health;

- medicines of traditional medicine - the vegetable, animal, mineral and other means used for prevention, diagnostics, treatment and improvement which are entered in the special Section of the State medicinal register of the Republic of Tajikistan;

- turnover of baby food - activities of state bodies, and also companies, organizations and organizations, irrespective of the patterns of ownership and jurisdiction performing production, conversion, storage, transportation, transfer, sale, distribution, destruction, import and export of the designated product;

- the habitat of the person - set of objects, phenomena and factors surrounding (natural and artificial) environments, determining conditions of activity of the person;

- mental health facilities - lunatic and psychoneurological asylums, the psychiatric and psychoneurological centers, offices of the psychiatrist of the city and district centers of health where in close cooperation with network of organizations of primary health care and services of social protection, specialized medical care is provided to persons suffering from mental diseases;

- sanitary protection of the territory - complex of the actions directed to the prevention of drift and distribution of causative agents of quarantine and other infectious diseases on the territory of the country and performed by the border service, local healthcare institutions and sanitarno - epidemiological service;

- private medical institution - medical institution which property consists of the private property or property used based on the lease agreement;

- specialists of family medicine - the family doctor and the family medicine nurse;

- narcological organization - narcological hospitals the centers, rehabilitation departments or the centers for rendering medico-social resettlement by the narcological patient, offices of the narcologist in the city and district centers of health where specialized medical care is provided to persons having narcological diseases in close cooperation with services of primary health care;

- mental disturbances (diseases) - the violations of normal mental activities of the person which are expressed in decrease in mental capacities or the expressed change of thinking;

- the state supervision in health sector - complex of the actions directed to check of observance and execution of requirements of the legislation of the Republic of Tajikistan and also on the prevention, suppression and elimination of offenses in the field of health care;

- drug addiction - the disease caused by chronic intoxication of organism owing to abuse of drugs which are classified in the corresponding international conventions and the National list, and which is characterized by mental and physical dependence on them;

- habitat factors - biological (microorganisms, the elementary, bacterial, parasitic, mushroom, prions and virus), chemical and physical (noise, vibration, ultrasound, infrasound, the thermal, ionizing, not ionizing and other radiations), social (food, water supply, conditions of life, work, rest) and other factors of the habitat which make or can make impact per capita and (or) on the state of health of future generations;

- transplantation - organ transplantation or fabrics with their subsequent engraftment within one organism (autotransplantation) or from one organism to another (gomotransplantation), for the purpose of rescuing of human life or recovery of functions of its organism;

- prevention - complex of the medical and not medical actions directed to the prevention of emergence of diseases, progressing at early stages of disease and the including control of the developed complications, damages of bodies and fabrics;

- the recipient - person to whom replace any body or tissue of other person or organism (donor) in the medical purposes;

- health - condition of complete physical, mental and social wellbeing, absence of disease and physical defects;

- infection of human immunodeficiency virus - the chronic disease caused by human immunodeficiency virus;

- reproductive age - age of child-bearing (15 - 49 years);

- reproductive health - condition of complete physical, intellectual and social wellbeing in all questions concerning reproductive system, its functions and processes;

- subjects of private medical activities - the private medical organizations performing the private medical activities and physical persons practising private medicine;

- national calendar of inoculations - the act establishing terms and procedure for carrying out to citizens of preventive inoculations from infectious diseases;

- forced treatment - treatment which is carried out according to the petition of persons, labor collectives, the state and non-governmental organizations or at the initiative of law-enforcement bodies according to the requirement of this Code based on the conclusion of the commission of authorized bodies of health care, by a court decision in specialized departments of medical institutions with the set detention regime and work therapies;

- the family doctor - the specialist having the higher professional medical education or who completed retraining courses in the specialty, family medicine, the having supporting document (certificate);

- the folk healer - the person having the certificate of the folk healer and performing improvement of the population, prevention, diagnostics and treatment by methods and medicines of traditional medicine;

- health care - system of the measures of political, economic, legal, social, cultural and medical nature directed to the prevention and treatment of diseases, maintenance of public hygiene and sanitation, preserving and strengthening of physical and mental health of the person, maintenance of his active long life, provision to it medical care in case of loss of health;

- the antitubercular organizations - the medical organizations which are giving antituberculous care and performing prevention of tuberculosis, including specialized TB facilities, network of organizations of primary health care, medical TB facilities of system of corrective cases, medical educational institutions of average, the highest professional and post-qualifying education, having the relevant divisions, sanitarno - epidemiological and veterinary organizations;

- family medicine - the direction of primary health care on rendering the diversified paramount help to the population in urgent situations by specialists of family medicine, for the purpose of prevention and treatment of diseases;

- traditional medicine - the Section of health sector in which methods of improvement of the population, prevention of diseases, the diagnostics and treatments based on knowledge, skills and experience, acquired since ancient times and established by national traditions are used;

- body - the part of organism having certain structure and special purpose (heart, kidneys, liver, lungs, pancreas, bones, firm brain cover and cornea of eye);

- private medical activities - activities of physical persons and legal entities for rendering to the population medical care and services according to agreements, according to the procedure established by the legislation of the Republic of Tajikistan;

- medical attendance - the medical care provided by certain type of disease and in certain amount;

- donor blood - blood which undertakes at the donor for the purpose of use for treatment of patients, preparation of components of blood, production of their medicines which are used in scientifically - the research purposes;

- sanitarno - the epidemiological conclusion - the document certifying compliance (discrepancy) of factors of the habitat, economic and other activity, products, works and services, and also drafts of regulations, construction projects of objects, operational documentation to sanitary and hygienic rules.

- artificial insemination - fertilization of ovum out of organism and change of the crushed embryos in uterus cavity;

- the reproductive right - the right of citizens to protection of reproductive health and free decision making concerning the birth or refusal of the child's birth, and also on the public, information and advisory assistance in this sphere;

- sanitarno - anti-epidemic actions - organizational, administrative, inzhenerno - the technical, medical and sanitary, veterinary and other actions directed to elimination or reduction of harmful effects per capita of habitat factors, prevention of origin and spread of infectious and mass noninfectious diseases;

- active form of tuberculosis - tuberculosis form which signs of activity are established as a result of carrying out clinical, laboratory, radiological, genetic, bacteriological, cytologic, histologic, laparoscopic and bronchoscopic trials;

- infectious form of tuberculosis - the disease form dangerous to people around in connection with allocation to the external environment of mikobakteriya of tuberculosis;

- infected with human immunodeficiency virus - persons infected with human immunodeficiency virus (carriers of human immunodeficiency virus and patients with acquired immunodeficiency syndrome);

- patients with acquired immunodeficiency syndrome - persons with clinical displays of disease of which deep defeat of immune system human immunodeficiency virus is characteristic;

- favorable conditions for activity - condition of the habitat in which there are no harmful effects of factors of the habitat per capita (harmless conditions) and are available possibilities of recovery of the broken functions of human body;

- the certificate of the folk healer - the document on the education level, specialty and advanced training issued by organizations of medical education, and also the medical organizations in the field of health care;

- epidemic - the category of intensity of epidemic process reflecting the mass defeat of the population or its separate contingents infectious disease considerably exceeding the regular illness rate in this territory;

- preventive inoculations - introduction in human body of medical immunobiological supplies for the purpose of creation of specific immunity to infectious diseases;

- examination of quality of medical services - set of the organizational, analytical and practical actions performed for pronouncement of the conclusion of compliance of the quality level of the provided medical services to the standards approved in health sector;

- sanitarno - epidemiological examination - activities for establishment of compliance (discrepancy) of project and other documentation, objects of economic and other activity, products, works and services state sanitarno - to epidemiological rules and standard rates.

Article 2. Legislation of the Republic of Tajikistan on health care

The legislation of the Republic of Tajikistan on health care is based on the Constitution of the Republic of Tajikistan and consists of of this Code, other regulatory legal acts of the Republic of Tajikistan and the international legal acts recognized by Tajikistan.

Chapter 2. State regulation and management in the field of health care

Article 3. The principles of state policy in the field of health care

State policy in the field of health care is based on the following principles:

- ensuring equal rights of citizens on receipt of safe, effective and high-quality medical care;

- the joint liability of the state, employers and citizens for preserving and strengthening of individual and public health;

- providing the guaranteed amount of free medical care;

- protection of health of mother and child;

- priority of preventive orientation in activities of health care system;

- availability of medical care;

- systematic increase in level of medical care;

- providing sanitarno - epidemiological safety of the population;

- expansion of opportunities of society in questions of health protection;

- the sequence of organization activity of health care in case of delivery of health care;

- providing continuity and succession of medical and pharmaceutical education with use of modern technologies of training;

- the state support of domestic medical science, implementation of the advanced achievements of science, the equipment and international experience in the field of health care;

- encouragement of voluntary non-paid donorship;

- state support of domestic developments and development of competitive medical and pharmaceutical industry;

- participation of public associations in providing the rights of citizens to health protection;

- the social focus of health care directed to requirements satisfaction, needs of the population and improvement of quality of life;

- assistance in forming of healthy lifestyle and healthy food;

- interrelation of health of the population, safety, efficiency and quality of medicines with factors of ensuring national security.

Article 4. State regulation in the field of health care

1. State regulation in the field of health care is performed:

- Government of the Republic of Tajikistan;

- authorized state body in health sector;

- authorized body of the state supervision of medical activities;

- authorized body of the state supervision of pharmaceutical activities;

- authorized body state sanitarno - epidemiological surveillance;

- authorized state body of medico-social examination;

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