Combating malnutrition among young children in Tajikistan amidst COVID-19

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.

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.

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.

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.

"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.