Combating malnutrition among young children in Tajikistan amidst COVID-19

How UNICEF is supporting the Ministry of Health with the Integrated Management of Acute Malnutrition programme for children with severe acute malnutrition amidst the COVID-19 outbreak

Umeda Fazylova
A little girl looks into the camera in a city policlinic #9 in Dushanbe
UNICEF/Tajikistan/2021/U. Fazylova
17 January 2022

We met Shukrona, a 9 months old baby girl in the city policlinic #9 in Dushanbe. She held her mother's hand with her little fingers and smiled. You could tell by the protruding cheekbones and sunken eyes that Shukrona was in the -3Z zone, an indication for severe wasting. At the last examination by a pediatrician, she weighed only 5,300 grams, which is much less than the standard weight.

Little Shukrona is being checked on her weight by a doctor
UNICEF/Tajikistan/2021/U. Fazylova
Little Shukrona is being examined on her weight gain by pediatrician in a city policlinic #9 in Dushanbe.

Shukrona is the third child in the family, and her elder siblings were never very thin. Shukrona was also born healthy. But when she was 5 months old, she suffered severe diarrhea and lost almost a kilogram of her weight in a short time and could not regain it on her own. Shukrona is one of the many children in Tajikistan, whose families suffered the socio-economic impact of the COVID-19 pandemic, such as food insecurity and income loss.

Shukrona was diagnosed with severe wasting and was referred by a local family doctor to the city policlinic #9 for treatment. It’s been three weeks since Shukrona is receiving therapeutic BP-100 biscuits and recovering. As documented in her medical records, every week Shukrona gains additional 100-150 grams of her weight.

Shukrona’s mother is a very responsible parent and she always follows my instructions and prescriptions. I’m very happy that Shukrona never misses her routine health check up and her weight is steadily growing.

Dr. Zebunisso Kholova, a pediatrician from the polyclinic #9 in Dushanbe
Dr. Zebunisso Kholova, a pediatrician from the polyclinic #9 in Dushanbe showcases the BP-100 biscuits that are prescribed to children with diagnosed severe wasting.
UNICEF/Tajikistan/2021/U. Fazylova
Dr. Zebunisso Kholova, a pediatrician from the polyclinic #9 in Dushanbe showcases the BP-100 biscuits that are prescribed to children with diagnosed severe wasting.

Another girl who came for the routine health check-up is a 4-year-old Amina from Dushanbe. Shyly, she holds that "magic" BP-100 biscuit in her hand. For the past two months, these biscuits have become an essential part of treatment, along with other foods.

Nodira, the girl's mother, says that her daughter has always been thin, but just as active as her peers. She always ate little and was a very picky eater.

But after pneumonia two years ago, Amina began to literally “melt” before her mother’s eyes. In addition, two months ago Amina was diagnosed with anemia of the second degree and the doctor prescribed a comprehensive treatment. Now all the indicators of Amina’s health except her weight are normal. That is why Amina eats 12 BP-100 biscuits a day, adding 1,780 extra kilocalories to her diet.

Little Amina is eating her BP-100 biscuit to gain healthy weight
UNICEF/Tajikistan/2021/U. Fazylova
Amina, a 4 y.o girl and her mother came to the routine health check-up to the city policlinic #9, where she is getting her BP-100 treatment.

Amina started losing weight around the age of two, but it did not affect her activity in any way. She played alongside with other children, so we were not too worried. We tried to feed her at home, but she ate very little and continued to lose weight. The local family doctor referred us to our pediatrician, Dr. Zebunisso Kholova. We have been coming here for two months now and we are already observing positive changes. We hope that soon Aminа will recover fully.

Nodira, Amina's mother

Wasting among children continues to put children at increased risk of deaths around the world, including in Tajikistan. The Government of Tajikistan ensured that women and children could access essential nutrition services even during the COVID-19 outbreak.

Originally, the Integrated Management of Acute Malnutrition programme only covered hospitals in the country for inpatient care of severely wasted children with medical complications and/or no appetite. However, with indirect impact of the COVID-19 pandemic on children’s nutritional status, UNICEF, together with the Ministry of Health and Social Protection of Tajikistan, launched an outpatient treatment programme as part of the Integrated Management of Acute Malnutrition programme for children with severe acute malnutrition. Since September 2020, 109 polyclinics of Dushanbe and Khatlon received BP-100 biscuits, a ready to use therapeutic food for treatment of severe acute malnutrition. As a result, more than 5,000 children were able to re-gain their weight to normal.

The doctor is showing the weight measurement scale
UNICEF/Tajikistan/2021/U. Fazylova
Dr. Zebunisso Kholova was provided training by UNICEF and the Ministry of Health on how to prescribe BP-100 biscuits, monitor the recovery of severely wasted children and use the Z-scale measurement.

"During the year we examined 12,748 children. Among them we identified 228 children with the grade -1-2 Z and 21 children with the grade -3-4 Z of severe wasting. With the help of the programme, we will soon have all our children gaining the necessary weight."-shares Zebunisso Kholova, pediatrician at the city polyclinic #9.

UNICEF works together with the government and non-governmental partners to improve the situation of malnutrition among infants and young children and to address nutritional problems in Tajikistan by promoting a multi-sectoral approach that allows the application of integrated techniques and scaling up interventions related to health, agriculture, education, water, sanitation and hygiene, environment, social protection, and economy.