Tajikistan embraces a new way to fight child malnutrition

Qualitative global nutrition indicator helps Tajikistan monitor household diets and improve national nutrition.

Key facts

While progress has recently been made in reducing unemployment and poverty in Tajikistan, malnutrition is still widespread.  Half of all children under the age of five suffer from iodine deficiency, and a quarter suffer from stunting, putting their futures at risk.  In addition, obesity and diet-related diseases such as, heart disease and hypertension are  rising.  In response, the Government has joined the Scaling Up Nutrition (SUN) movement, committing to improve nutrition in the country. With FAO’s technical support, members of the Agency of Statistics in the region of Khatlon were trained in the collection and analysis of WDDS data, and assisted in conducting a local pilot survey. The WDDS, or  Women’s Dietary Diversity Score, is a qualitative global nutrition indicator which counts the number of food groups consumed by a person over the 24 hours preceding the test.  The objective is to integrate a nutrition element into the annual Household Budget Survey (HBS).  Given the response of the training, the Government has decided to integrate the WDDS data into the HBS, and FAO has been asked to assist in training the remaining regions of the country.


Tajikistan is a country with a young population.  Seven out of ten of its people are under the age of 30, and the country views this young and growing generation as an important asset to invest in for the future.  In recent years, they have achieved significant progress in reducing unemployment and fighting poverty, and now they are turning their focus on nutrition.

Malnutrition is widespread in Tajikistan.  Current diets are high in sugars and saturated fats, and poor in mineral-rich fruits and vegetables, resulting in a prevalence of diet-related problems such as obesity, hypertension, heart disease, and persistent under-nutrition.  These problems particularly affect the younger population, with half of all children under five years of age suffering from iodine deficiency, and a quarter suffering from stunting.

Scaling Up Nutrition
In response, the Government of Tajikistan joined the Scaling Up Nutrition (SUN) movement in September 2013, committing to improve nutrition for all. With malnutrition problems in the country being primarily related to poor diets, the first priority was to set up an adequate information system to understand and monitor the quality and diversity of people’s diets.  This would allow national authorities to plan and design appropriate programmes to address effectively and sustainably the root causes of malnutrition in the country.

What have you eaten in the last 24 hours?
With FAO’s technical support (and funding from the European Union), Tajikistan’s Agency of Statistics and Ministry of Health implemented a dietary assessment pilot survey in the Khatlon region, under the project “Strengthening of the National food security information system in Tajikistan”. The objective was to produce data informing the Agency on the variety and quality of local diets, with respect to World Health Organization recommendations.  The main focus of the project is the introduction of the Women’s Dietary Diversity Score, a simple qualitative global nutrition indicator which counts the number of food groups consumed by a person within a period of 24 hours.

The indicator focuses on women because, given their special nutritional needs (in particular mothers and would-be mothers) and special role in family nutrition (women statistically prioritize the food needs of their family members before satisfying their own), if women’s high nutritional needs are met, it implies with a high degree of certainty that the nutritional needs of the other family members are also satisfied. The idea behind this data collection is that it would show what foods people are eating more of, and which are being consumed less.  The objective of the exercise is to integrate a nutrition component into the annual Household Budget Survey.

“I think this dietary diversity study will help us understand issues at household level,” said Professor Azonov, at the Nutrition Institute of Tajikistan.  “It will contribute to further prevention of malnutrition, and to the improvement of the nutrition situation in Tajikistan.”

Developing local capacities
In May 2014, employees of the Agency of Statistics were invited to a 6-day training workshop.  Four days of the workshop were devoted to lectures, group exercises, focus group discussion, and role playing.  The lectures covered the basic concepts of food and nutrition security assessment, the different types of food-based indicators and how to incorporate WDDS data into assessments.  The final two days were devoted to field trips with hands-on experience on how to conduct WDDS data from members of local families and communities.

“This workshop and the food group adaptation process were very useful,” said Abdugaffor Sultonov, Agency of Statistics Chief Specialist in Kurgan Tyube.  “We improved our knowledge of common food items and meals, and included these into our tools to monitor diets.”

Easy and reliable
The WDDS is an easy and reliable methodology.  It provides data that helps the government of Tajikistan monitor the progress in improving diets and nutrition, and devise and implement strong policies and programmes.  So far, response to the workshop and support for the programme has been strongly positive.

The results of the data collection and analysis were presented to the Government in October 2014.  Given the success of nutrition data collection in the pilot phase, FAO has been requested by the Agency of Statistics to provide further assistance in training up locals in the remaining districts of the country.

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