Nutrition
UNICEF is working to improve infant and young child nutrition, helping to ensure that every child has the best possible start in life
Challenges
In Tajikistan, despite falling child mortality rates and significant improvement in the overall nutritional status of children, undernutrition remains a critical public health concern – particularly in remote regions and rural areas. Stunting, wasting, vitamin and mineral deficiencies all affect children’s health and wellbeing in Tajikistan.
Stunting, wasting, vitamin and mineral deficiencies are major issues affecting the health and wellbeing of children in Tajikistan.
The Demographic Health Survey 2017 established that 18 per cent of under-five children suffer from stunting, an irreversible result of chronic nutritional deprivation. More than 8 per cent of children in Tajikistan are underweight and 6 per cent are wasted. Wasting and underweight are more prevalent among children under two years, while stunting is prevalent among children aged 24-35 months. Three per cent of children were overweight or obese.
In Tajikistan, more than 4 in 10 children are anaemic. Only 36 per cent of mothers in Tajikistan breastfeed their children exclusively for the first six months. Almost half start giving their children complementary food between four and six months, and every tenth mother does so even earlier. Thirty-seven per cent of children suffer Vitamin A deficiency and 12 per cent vitamin D deficiency.
Only 40 per cent of children aged 6-23 months receive the optimal food diversity and meal frequency.
Undernutrition also contribute to poor maternal health. Forty-one per cent of women of childbearing age are anaemic. Poor maternal nutrition before conception and during pregnancy and the first two years of life threatens the chances of safe delivery and healthy babies, and can cause developmental delays that undermine children’s potential.
Despite high prevalence of diseases caused by malnutrition amd dietary preferences, there is an alarming lack of awareness of the potential health effects of nutrient deficiencies - including iron-deficiency anaemia – and the danger of birth defects. Additionally, lack of appropriate parental knowledge and skills to manage common childhood illnesses, child feeding practices and seeking timely medical attention critically affect child malnutrition. These factors, coupled with sub-optimal knowledge and skills among health professionals at primary healthcare level for management of malnutrition, result in poor nutrition outcomes for children and women and result in micronutrient deficiencies, underweight and stunting.
Furthermore, the lack of financing for sustainable inter-sectoral approaches to address malnutrition is a key bottleneck. This causes lack of capacity in all building blocks of food systems and nutrition governance; including human resource, the evidence-base, programming and integration of nutrition in primary health care.
The solution
UNICEF is working with the Government and non-governmental partners to tackle infant and young child malnutrition and address Tajikistan’s nutrition concerns by promoting a multi-sectoral approach to enable a holistic approach and scale up interventions that link with health; agriculture; education; water, sanitation and hygiene; the environment; social protection; and the economy.
As the Scaling Up Nutrition (SUN) movement country facilitator since 2013, UNICEF is supporting Tajikistan to improve coordination mechanisms, by building technical capacity to monitor, analyse, plan and develop sustainable mechanisms for nutrition interventions from national to regional levels.
UNICEF has collaborated with the World Food Programme and the World Health Organization to assist the Ministry of Health and Social Protection of the Population (MoHSPP) to implement the national Integrated Management of Acute Malnutrition (IMAM) Protocol to increase children’s access to treatment for severe acute malnutrition and ultimately further reduce wasting. This collaboration is accompanied by capacity building for partners across the country.
UNICEF and other development partners ensure the availability of vitamin A, iron, folic acid, sprinkles and therapeutic food at health facilities.
To sustain gains made towards universal salt iodization in Tajikistan and address challenges including sub-optimal iodization of salt, UNICEF has supported the Government to establish a strong supervision and enforcement mechanism. In addition, with UNICEF support the government’s inspection agencies have assisted major salt producers to establish a rigorous internal quality control and assurance system and to externally audit this system.
To create value around the critical window of the first 1,000 days of a child’s life and its long-lasting implications across a child's lifecycle, UNICEF is supporting the MoHSPP to initiate the development of a National First 1,000 Golden Days Communication Strategy and Plan. It is envisaged that a steering committee will guide the process and facilitate multisectoral inputs and buy-in. The Communication Strategy and Plan will guide age-appropriate and action-oriented communication for behavioral change, demand generation and monitoring of families’ and caregivers’ child care and feeding behaviour and practices.
Implementation of the First 1000 Golden Days Strategy will provide an entry point for promoting nurturing care and optimal infant and young child feeding practices as core components of early childhood development.
