“Then you raise them with Shirchoy or cookies”: Understanding influences on delayed dietary diversity among children in Tajikistan

Abstract

Dietary diversity is a key component of infant and young child feeding (IYCF) as well as adult health. In Tajikistan, a predominantly rural, former Soviet country in Central Asia, we conducted formative research to identify barriers to dietary diversity and strategies for nutrition behaviour change. In Spring, 2016, mixed-methods data collection took place across 13 villages in all five regions, collecting collaborative mapping; structured assessments of stores and markets; home visits for dietary recalls; food storage, preparation, and meal observations; focus groups with pregnant women, mothers of young children, fathers, and mothers-in-law; and in-depth expert interviews with local nutrition and health influentials. Overall, maternal diet was adequate in terms of diversity (only 13% reported <5/10 food groups in the past 24 hr); however, only 42% of index children 6-24 months met WHO guidelines for diversity, and only 34% met minimum acceptable diet criteria. In addition to issues of poverty and food scarcity, qualitative data reveal many behavioural barriers to timely introduction of diverse complementary foods. Women's strategies focused on gradual introduction of household diet components, without regard for diversity or nutrition. Foods such as meat were seen as costly and thus inappropriate for IYCF, and food taboos (i.e., fresh vegetables) further reduced diversity. Infant food preparation methods such as grinding were seen as impractical, and many foods were withheld until children develop teeth. Possible nutrition education strategies include point-of-purchase campaigns to improve availability and appeal of IYCF-friendly foods, as well as influencing other key household members through mosques, schools, and health care providers.

Maternal diets matter for children's dietary quality: Seasonal dietary diversity and animal‐source foods consumption in rural Timor‐Leste

“…and 2016 DHS Timor-Leste data found that mothers' achievement of MDD was lower than for young children when using the seven-food group indicator (University Research Co., 2018). In contrast, in rural Tajikistan, MDD-W was largely achieved by mothers while less than half of children 6-23 months met MDD, despite child and maternal DDS were positively associated (Klassen et al, 2019), analogous to our findings. Research among U.K. dyads concluded that the quality of mothers' diets was the leading explanatory factor informing children's dietary quality (Fisk et al, 2011), highlighting that shared family patterns are also expressed in resource-abundant settings.…”

Nutritional status of Tajik children and women: Transition towards a double burden of malnutrition

“…The national MDD score was adequate with 80.7% of women consuming at least five out of 10 food groups over 24 hr prior to the interview. This was comparable with another study conducted in spring 2016 in Tajikistan, showing similar values for women (87%) but reporting a serious problem in the diversity of children' diet, with only 42% of children aged 6–24 months meeting the WHO guidelines for MDD (Klassen et al, ). Unfortunately, children' dietary diversity data are missing in the current study.…”

“…Klassen et al, 2019). Unfortunately, children' dietary diversity data are missing in the current study.…”

Viewpoint: Agri-nutrition research: Revisiting the contribution of maize and wheat to human nutrition and health

“…For vulnerable populations, increasing consumption of ‘nutrient-rich foods’ can be achieved through multiple strategies, including own-food production among the rural poor, better incomes, and enhanced market availability and access for all consumers. Nevertheless, we are also learning more about specific barriers to adoption of better diets, for example, the complexity of linkages between agroecological, economic and social systems and education, and cultural barriers including food taboos on maternal behaviour patterns and infant and young child feeding practices ( Klassen et al, 2019 , Chegere and Stage, 2020 ).…”