Breaking Barriers For A Common Healthy Future
How UNICEF & USAID helped a rural doctor in Tajikistan provide breastfeeding and complementary feeding support to his community through training in Maternal, Infant and Young Child Feeding.
"Summers in my village can be very hot and dry, and I know that my three-month-old baby gets thirsty just like us adults, and I need to breastfeed her. The first milk that comes with each feed contains water, which quenches the baby’s thirst and protects her from infection,” - says Sangimohi Mahmadullo, a young mother to a three-month baby girl. “My doctor, Shoev Davron, has counselled me on the importance of breastfeeding and breast milk."
Dr Davron works at a local health center in the remote village of Nurobod in Muminobod district. Located away from the district’s center, Nurobod is a hard-to-reach village surrounded by many hills. It has a hot and dry summer and a wet, cold winter. In this remote village, counselling breastfeeding mothers is an important part of Dr Davron’s daily routine. He shares that breastfeeding practices and child nutrition in his district are not adequate and mentions common challenges faced by mothers.
In Tajikistan, only 36 per cent of mothers exclusively breastfeed their babies for the first six months, and only 9 per cent of young children aged 6-23 months receive optimal nutritious diets. Underlying these inadequate feeding patterns is a general lack of knowledge among mothers about adequate diets for themselves and feeding practices for their babies. Many mothers think, often mistakenly, their breastmilk supply is insufficient and start feeding their infants formula milk and other fluids.
What is more, breastfeeding mothers, especially those with large families, often lack sufficient time to sit down and breastfeed their babies properly due to work inside and outside their home. Consequently, they may only breastfeed for 10 minutes at a time, which leaves their babies feeling unsatisfied. Additionally, many mothers are unaware of when to start feeding their babies food alongside breastmilk and what to prepare.
In many communities, like the one Dr. Davron observes, mothers start giving food too early before 6 months and focus on preparing food from a single food group, mostly starchy food, neglecting others like protein rich food sources and vitamin A rich fruits and vegetables. Unfortunately, this practice can lead to different forms of malnutrition in young children, which can have a lifetime impact on their lives.
To help breastfeeding mothers Dr Davron started attending the Maternal, Infant and Young Child Feeding (MIYCF) training in Muminobod district of Khatlon region, organized by UNICEF with the financial support of USAID. During the training Davron and his fellow colleagues not only enhanced their knowledge on maternal nutrition, breastfeeding and complementary feeding but also their skills in providing interpersonal nutrition counselling that is tailored to specific needs of pregnant and breastfeeding mothers.
“I learnt a lot during the training, but the most striking for me was learning about the optimal recommended gap between the siblings, which is three years. This period allows parents to dedicate quality time, energy and attention to each child without feeling overwhelmed. Also, it can provide parents with time to recover from physical and emotional demands of pregnancy, childbirth, and early parenting,” – says Dr Davron.
After enhancing his knowledge during the six-day training, Dr Davron returns refreshed and full of energy to serve his community. Families with young children visit him every day and receive valuable advice and counselling on breastfeeding and complementary feeding.
“The new knowledge I have gained from the training will help me to counsel pregnant women and young mothers for the common future of the nation. People listen to us, and they follow our advice. A healthy child – a healthy nation!” – said Dr Davron.
Investing in healthcare workers’ continuous capacity strengthening can help improve the quality of nutrition service delivery and in turn ensure that pregnant and breastfeeding mothers receive the support they need to maintain their health and that of their children no matter where they live.
In Tajikistan, despite the steady progress in growing the economy and reducing poverty, malnutrition remains a critical public health concern, in all its forms, and in all segments of society. Stunting and wasting persists, while overweight and obesity rapidly increases. Levels of vitamins and mineral deficiencies are stagnating. When vulnerable children and women are malnourished during the critical moments in life, such as pregnancy and the first two years of a child’s life, not only is their health and well-being at stake, but also that of the next generation, compromising the nation.
To address these issues and support the Government of Tajikistan in tackling the triple burden of malnutrition, UNICEF launched a three-year programme (2023-2025) on scaling up maternal and child nutrition services and care for pregnant women, breastfeeding women, children under five years, caregivers and family members of pregnant women and young children in Khatlon and Dushanbe with financial contribution from USAID.
