Tajikistan
Understanding age-old tradition to end malnutrition
How might we empower caregivers to reduce stunting in their families?
At a Glance
In Tajikistan, one in five children under the age of five is stunted – the highest rate in Europe and Central Asia. We partnered with Tajikistan’s Ministry of Health and UNICEF to explore a critical question: how might we empower caregivers to reduce stunting in their families?
The Context
With a quarter of Tajikistan’s men working abroad, the women who remain at home shoulder the majority of family responsibilities, including childcare. While grandparents, or older siblings who step in, offer a mother valuable support and help ease workload, it often results in an unintended consequence – missed nutritional and health milestones during a baby’s crucial first 1,000 days of life.
More than 20% of children under five in Tajikistan are stunted, the highest rate in Europe and Central Asia.
Traditional customs offered to newborns at 40 days can interfere with exclusive breastfeeding.
1 in 4 families has at
least 1 male working
abroad in Russia.
Takijistani women take on more family
responsibilities, which puts added
pressure on new mothers.
Only 9% of children under two years old in Tajikistan have a healthy diet.
What We Heard
To get a fuller picture of the lives of mothers and families in rural Tajikistan, we followed the footsteps of mothers who used local health services. What are their barriers? What are their opportunities? Our team listened to rural mothers and their families, collected video diaries, and plunged into a broad range of data from food security, economics, nutrition, anthropology and health.
Our exploration shed light on why babies were missing crucial nutritional milestones when supportive caregivers stepped in to ease the mother’s workload. We learned that when grandmothers become the primary caretakers of young children, they often rely on traditional knowledge, recipes and practices to care for children. While many of these are beneficial, food production and distribution systems have changed significantly in recent decades. Grandparents were not making use of available resources – like household vegetable gardens – and existing health and nutrition services are also not set up to make good nutrition easy to practice.
Our Solution
In collaboration with Tajikistan’s Ministry of Health and UNICEF, we identified five key moments across the first 1000 days of a child’s life that could help reverse the rate of stunted growth amongst Tajikistani children. While they are distilled from complex public health strategies, we worked hard to make healthy behaviour during these five moments simple and doable.
Co-created through a number of collaborative experiences, our strategy and an accompanying field guide for practitioners supports Tajikistani mothers and their wide circle of friends, family and providers who assist them in raising their children. Our strategy bolstered carers’ skills, self-confidence, and offered greater access to services, people and new ideas. The end result: healthier, happier babies and children who maintain their powerful traditions, while growing into more productive adults.
- Childhood stunting in Tajikistan: quantifying the association with wash food security health and care practices World Bank Group, 2017.
- Migration and Development in Tajikistan
- Tajikistan Demographics and Health Survey, 2017.
- Tajikistan Demographics and Health Survey, 2012.