In Tajikistan, the poorest country in Central Asia, up to 35% of women of reproductive age are anemic. About 70% are deficient in folic acid. 

These deficiencies lead to serious problems in pregnancy and delivery, and if they are not addressed, an estimated $878 million will be lost over ten years in added health care costs and reduced economic productivity.

We're supporting a major undertaking for the country: the production of micronutrient supplements in Tajikistan.

Iodine deficiency is another problem. Over 53% of children under five in Tajikistan are deficient, and there is unequivocal evidence that severe iodine deficiency in pregnancy impairs brain development in the child. Expectant mothers must have iodine in their diets in order for the brains of their children to grow properly. 

These are only a few of the serious nutrition problems Tajikistan faces, but there are some simple solutions available. IntraHealth International’s Feed the Future Tajikistan Health and Nutrition Activity (THNA) is working with Tajikistan’s Ministry of Health to identify them.

Flour fortification, for example, will solve the anemia and folic acid problems at a cost of only 15 cents per 50 kilograms, an increase of about 0.8% in the retail price of flour. And iodized salt is an easy and common method of getting iodine into the mother's diet (though only about 39% of households use adequately iodized salt, according to Tajikistan's 2012 Demographic and Health Survey).

IntraHealth is now supporting a major undertaking for the country: the production of micronutrient supplements in Tajikistan. Currently all supplements are imported. The project is preparing a study to assess the feasibility of beginning local production of at least some of 17 elements recommended for child supplements.

And THNA nutrition experts are working with the Ministry of Health on several "схема"—concise, action-oriented documents that apply global best practices in antenatal care and nutrition to the local context. On nutrition, the схема lay out the elements of a healthy diet using locally available food products in targeted messages on the nutrition needs of pregnant women, teenaged girls, women after delivery, and children under two. 

In Tajikistan, 27% of children are stunted.

The схема for antenatal care list and describe each of the seven recommended antenatal visits and their purposes (due to the general level of health of women in Tajikistan, seven rather than four antenatal visits are recommended). All of the схема are produced in common language for distribution in the villages.

In addition, another team of experts is working on a national nutrition curriculum, as courses in nutrition exist but need revision. The new material will form the basis for a revitalization of the Center for Nutrition in the ministry and also for an undergraduate specialization in nutrition at the Tajik State Medical University.

Of 1,000 live births, 77 children in Tajikistan die before their fifth birthday, and 27% of children are stunted. Health care for pregnant women, mothers, and newborns is inadequate. These small changes could have lasting effects for generations to come. 

IntraHealth's work in Tajikistan is funded by the US Agency for International Development.