Protocol №1

Meeting of the Intersectoral Coordination Council for the Scaling Up

Nutrition (SUN) in the Republic of Tajikistan
Chairman of the Council: Abdusamatzoda Z.M., Deputy Minister of Health and
Social Protection of the Population of the Republic of Tajikistan
Date: 24.05.2024, time: at 9:00 a.m.
Location: Assembly of the Ministry of Health and Social Protection of the
Republic of Tajikistan, 13th floor

08:30-09:00 Registration All participants

09:00-09:10 Opening remarks Abdusamatzoda Z.M.,
Deputy Minister of Health
and Social Protection of
the Republic of Tajikistan,
Chairman of the SUN
Coordination Council

09:10-09:30 Report of the Secretariat of the Scaling Up Hasanov M. Secretariat of

Nutrition (SUN) on the implementation of the the Scaling Up Nutrition
multi-sectoral plan for the improvement of (SUN)
nutrition in the Republic of Tajikistan in 2023
and plans for 2024
09:30-10:30 Implementation of the multi-sectoral plan for Ministries of education
the improvement of nutrition in the Republic and science, agriculture,
of Tajikistan in 2023 and plans in 2024 in economic development
ministries and departments and trade, industry and
new technologies,
standards agency and
other ministries and
agencies.
10:30-10:40 Development of the project Rahmatulloev Sh.
"Multidisciplinary plan for improving Secretariat of the Scaling
nutrition in the Republic of Tajikistan for Up Nutrition (SUN)
2026-2030"
10:40-11:30 The contribution of development partners in Representatives of
the implementation of the annual multi- development partners
sectoral plan for the improvement of nutrition (Representatives of
in the Republic of Tajikistan UNICEF, USAID, WHO,
GIZ, Aga Khan Fund)
11:30-12:00 Questions and answers
12:00-13:00 Lunch time All participants

Participants: 40 people

Nabiev Z.N - Head of the Department of Organization of Medical Services for

Mothers and Children and Family Regulation of the Ministry of Health and Social
Protection of the Population of the Republic of Tajikistan.
At the beginning of the working session, he welcomed the participants and
informed about the achievements and challenges associated with the
implementation of the “Multidisciplinary Plan to Improve Nutrition in the
Republic of Tajikistan for 2021-2025”, which demonstrates its central role in
achieving the Sustainable Development Goals:
• At least 12 of these Goals include indicators specifically related to nutrition.
The consequences of undernutrition can be irreversible: especially after the
first 1000 days, which includes a high risk of developing non-communicable
diseases in adulthood.
• Half-starvation has intergenerational implications: half-starved mothers
produce more underweight, malnourished children who are at higher risk of
illness, death and poor development.
• Binge eating, which characterizes overweight and obesity, is also considered
a major contributor to non-communicable diseases, stroke and type 2
diabetes.
• The problem of nutrition is not only in Tajikistan, but in all countries of the
world, it is considered an urgent problem. In some countries people suffer
from obesity, while in others they suffer from hunger and thinness. Until
recent decades, Tajikistan did not have problems with obesity, but in recent
years obesity has been increasing, among women of childbearing age it is
more than 38%, and overall it is 17%. Among children, this figure is 3% (p.
2017).
• The final malnutrition rate among children and women in 2017 showed
stunting at 18%, underweight at 8%, wasting at 6% and anemia at
42%.Preliminary results of the 2023 Demographic and Health Survey show
stunting dropped to 14%, underweight to 5%, thinness at the same level at
6%, and overweight increased from 3% to 5%. At the same time, the
percentage of pure breastfeeding in children under 6 months of age
increased from 34% to 41%.
 • Child mortality according to this study (since 2023) has a steady downward
trend: mortality of children under 5 years of age from 33.0 in 2017 to 24.0
per 1000 live births, mortality of children under 1 year from 27.0 in 2017 in
2017 to 20.0 per 1,000 live births, and the infant mortality rate from 13.0 in
2017 to 10.0 per 1,000 live births in 2023.
These achievements were achieved as a result of close cooperation between the
Government of the Republic of Tajikistan and development partners. “Food
security and healthy nutrition” is the 3rd strategic objective of the Government of
the Republic of Tajikistan, and given the importance of this issue, this issue is
included as a priority area of the “National Development Strategy of the Republic
of Tajikistan”. Tajikistan until 2030.” Since 2016, Tajikistan has been committed
to achieving the Sustainable Development Goals by 2030.
A number of regulatory documents have been adopted in this direction:
The National Development Strategy of the Republic of Tajikistan until 2030 and
on this basis two medium-term development programs for Tajikistan - one for
2016-2020 and the other for 2021-2025. - adopted by the Government of the
Republic of Tajikistan.
In this context, the Ministry of Health and Social Protection of the Population has
been working since 2016 to improve the level of nutrition “Strategy for the
development of school meals in the Republic of Tajikistan until 2027”,
“Multidisciplinary plan for improving nutrition”. in the Republic of Tajikistan for
2021-2025, “Program for the prevention of micronutrient deficiency and related
diseases among the population of the Republic of Tajikistan for 2022-2027”,
“National communication program for the first 1000 days of a child’s life in the
Republic of Tajikistan for 2020-2024”.
At the same time, they noted existing problems:
• insufficient funding of nutrition programs from the state budget,
• implementation of the programs “Prevention and treatment of acute and
moderate malnutrition” and “Changing social behavior of the population”.
• Anemia among children and women “Fortification of food products,
including fortification of wheat flour” is a shortage of personnel in the food
sector.
Hasanov M. A representative of the Secretariat of the Global Food Support
Movement (SUN) presented the Secretariat’s report on the implementation of an
intersectoral plan to improve nutrition in the Republic of Tajikistan in 2023 and
plans for 2024.
Representatives of ministries and departments:
Ministries of Finance, Economic Development and Trade, Industry and New
Technologies, Committee on Television and Radio under the Government of the
Republic of Tajikistan, Committee on Work with Women and Family under the
Government of the Republic of Tajikistan, Committee on Work with Youth and
Sports under the Government of the Republic of Tajikistan, Committee on
development of the region under the President of the Republic of Tajikistan, the
Committee on Food Safety under the Government of the Republic of Tajikistan,
the Chamber of Commerce and Industry of the Republic of Tajikistan, the State
Unitary Enterprise “Housing and Communal Services” of the Republic of
Tajikistan and others on the implementation of the “Multidisciplinary plan to
improve nutrition in the Republic of Tajikistan in 2023 and plans for 2024" in
ministries and departments.
Representatives of development partners (UNICEF, USAID, Aga Khan
Foundation) provided information on the contribution of development partners to
the implementation of the multi-sector annual plan to improve nutrition in the
Republic of Tajikistan.
A. Amonzoda, a representative of the Ministry of Finance of the Republic of
Tajikistan, noted that as part of the implementation of the “Multidisciplinary plan
to improve nutrition in the Republic of Tajikistan for 2021-2025”, reports will be
submitted on time and funding for programs will be allocated.
Rizvonova N., representative of television and radio under the Government of the
Republic of Tajikistan, noted:
• The institution operates 15 state television channels, which broadcast many
programs on healthy eating, including the programs “Madadi Sino” and
“Subhi Tojikiston”.
• Programs are presented twice a week with input from nutrition experts.
• The Safina TV channel broadcasts the “Laziz” program and two “Dar in
zamona” programs about the importance of healthy eating and a healthy
lifestyle.
• On Jahonnamo television, the programs “Tandurusti”, “Shifoi komil” on the
topics “Nutrition of pregnant women in the first 1000 days of life”, the
program “Ayonu bayon”, on monitoring compliance with sanitary and
hygienic rules in the public service, food and trade enterprises of the
Prevention of botulism, the “Kishovarz” program, the role of fruits and
vegetables in improving the nutrition of the residents of the republic”, the
“Sukhbati Ruz”, “Robita” programs and others.
• The Bahoriston TV channel developed and presented educational videos and
programs “Salomat boshed” etc. Similar programs are implemented on TV
“Science and Nature”, “Radio Tajikistan” and its networks.
 • Training for journalists on improving nutrition was proposed.

Amdamov I., representative of the Committee on Food Safety under the

Government of the Republic of Tajikistan, spoke about the work done:
• implementation of paragraph 1 of the “Multidisciplinary plan to improve
nutrition in the Republic of Tajikistan for 2021-2025”.
• The Committee approved the action plan by order dated February 2, 2022
№1/4-15.
• More than 1 million 17 thousand raids were carried out at all retail outlets,
more than 289 tons of products were confiscated.
• In the area of food safety, cultivation, transportation, storage and other areas,
they work with the Agency for Standardization, Metrology, Certification and
Trade Control under the Government of the Republic of Tajikistan. At the
same time, they noted the implementation of paragraphs 24, 27, 28, 52, 55,
56, 61 of the Plan.

Salimzoda Firuza, representative of the Committee on Work with Women and

Family under the Government of the Republic of Tajikistan on paragraphs 48 and
69 of the “Multidisciplinary plan to improve nutrition in the Republic of Tajikistan
for 2021-2025” noted that in order to improve the status of the family, expand the
culture of marriage, provide necessary conditions for the formation of a healthy
family, healthy nutrition, prevention of the birth of disabled children with
congenital malformations, the development of hereditary diseases, prevention of
obesity and infectious diseases, including HIV, tuberculosis, drug addiction,
working groups are being created among young people and women, as well as
among nationals of the country:
• Interviews and meetings are held regularly
• Awareness-raising events
• From May 13 to 24 of this year, meetings were held in rural communities of
Khatlon and Sughd regions with the participation of the deputy chairman of
the committee and representatives of relevant ministries and departments. At
the same time, a number of works have been completed in connection with
the water supply, sanitation and hygiene program aimed at nutrition.

Nushervoni Bilol, Deputy Director of the Republican Nutrition Center for training
specialists in the field of nutrition, noted that 1 specialist was trained at the
University of Postgraduate Education of Health Workers of the Republic of
Tajikistan, and 3 Center specialists were trained in the Russian Federation. The
support of development partners is needed in this regard.
They noted that the decline in national indicators depends on interdisciplinary
efforts.
H.O. Saidova, Director of the National Center for Reproductive Health, on the
importance of preventing diseases in women of childbearing age and pregnant
women, including anemia and others, noted the important role of micronutrient
supplements depending on the availability of folic acid and iron from Development
Partners. Clinical standards for the provision of these micronutrients have been
established.
In 66% of pregnant women, iron supplements are prescribed for prevention
purposes, and in 30% for treatment purposes.
Abdulloeva Zarina, a specialist in nutrition and health at the Center for
Entrepreneurship Development, said that the United Nations Children's Fund
(UNICEF) provided materials on folic acid in the amount of 350 thousand units
(each 100 tablets) and Sprinkles (1 million and 300 thousand units) are available
and will arrive at healthcare institutions in July-September.
The representative of the World Food Program in Tajikistan, M. Shabanova,
based on the results of the Demographic and Health Survey, mentioned the
following points:
 Although indicators are trending downward, they are still not at the required
level (for example, anemia remains at a high level).
 If 14% of children in absolute numbers, then this shows a large number of
children with stunted growth.
• About work at the community level, living conditions, proper provision of
micronutrients, obesity prevention
 Review of the Operational Guidelines for the Prevention and Treatment of
Children with Severe and Moderate Malnutrition.
 Introducing the topic of food safety and healthy nutrition into the programs
of institutes for advanced training of civil servants, it is necessary to
organize a round table on weight loss issues.
 In the absence of medicinal foods F-75, F-100, BPI-100 and others,
alternative methods of treatment should be considered.

Muhiddinov Maksud, a representative of the network of public organizations -

the Public Organization "Odam" noted that interdisciplinary coordination for the
implementation of the "Multidisciplinary plan to improve nutrition in the Republic
of Tajikistan for 2021-2025" has been established, but a permanent group is under
the Movement Secretariat. There is no wide area extension network (SAN).
It has been proposed:
• form a permanent group for monitoring and direct evaluation
• before the meetings of the Intersectoral Coordination Council will conduct
monitoring and analysis
• present information and proposals at Council meetings.
Ikromov T.Sh., Director of the Republican Scientific Clinical Center of Pediatrics
and Pediatric Surgery, spoke about the activities implemented, including staff
training in 7 pilot districts of the republic, but currently most of them are not
working (For example, from 50 trained employees in Shahin district only 23
people work, and in Faizabad district only 12 trained employees have no medical
personnel, it becomes difficult to control their use.
Khudoydodova F.A., Deputy Director of the Republican Educational and Clinical
Center for Family Medicine, noted that in the republic, with the support of the
United Nations Children's Fund (UNICEF), more than 400 specialists were trained
in 3 educational programs, but in fact, 3-4 months after the training, 20 -30% of
them are missing.
At the same time, with the support of UNICEF, they received 4 types of
breastfeeding banners and delivered them to hospitals and medical centers. It is
necessary to intensify work with society together with relevant ministries and
departments.
Saodaty Isaini, the representative of the Youth and Sports Committee under the
Government of the Republic of Tajikistan, noted:
 In "Multidisciplinary Plan for the Improvement of Nutrition in the Republic
of Tajikistan for 2021-2025" there are no separate items related to the
Committee, both in the direction of healthy nutrition, the Committee other
ministries and agencies have close cooperation.
 Over 10,000 booklets on this issue were distributed at various Committee
events.
 In carrying out actions among the population, especially young women,
related to marriage, healthy eating, disease prevention, etc., local
representatives should be present.
Muhammadzoda Rustam, Deputy Director of the State Institution “Republican
Center for Promotion of a Healthy Lifestyle” held events, reports and interviews on
the following topics: unhealthy diet, overeating, promoting the benefits of a
healthy lifestyle, especially sports and physical activity, principles of healthy
eating.
Together with the Committee on Television and Radio through television and radio
stations of the republic, including “Tajikistan”, “Safina”, “Jahonnamo”,
“Bakhoriston”, “Kino”, “Dushanbe”, “Khatlon”, “Penjikent”, “Kulyab”, radio
stations “Tajikiston”, “Farhang”, “Voice of Tajik”, “Sado Dushanbe”, “Khovar”,
“Vatan”, “Imruz” developed and presented 68 programs to viewers.
A representative of the United Nations Children's Fund (UNICEF) spoke about
accreditation standards in family medicine, technical groups, cooperation with
ministries and departments, promotion of healthy nutrition and other issues.
Rakhmatulloev Sh.R. - a representative of the Ministry of Health and Social
Protection of the Population spoke about the development of the project
“Multidisciplinary plan to improve nutrition in the Republic of Tajikistan for
2026-2030”.
He mentioned the following points:
• In most relevant ministries and departments, working groups on nutrition
have been created, but their activities are not at a sufficient level
• Аnnual work plans are not approved by ministers or heads of ministries and
departments, and if such plans exist, they are repeated every year and do not
indicate types of activities
• • There were 8 goals in the Millennium Development Goals and 17 in the
Sustainable Development Goals, 12 of which were nutrition related
• The Demographic and Health Survey (which was conducted three times, in
2012, 2017 and 2023) shows that the indicators are trending downwards.
Many programs lack funding, which leads to lack of sustainability
• It is expected to prepare a new multi-sectoral plan for improving nutrition in
the Republic of Tajikistan for 2026-2030 and a program for the first 1000
days of life, which is proposed by WHO representatives

Clifford Lubitz, USAID Country Director in Tajikistan

• A lot of work has been done in the field of healthy nutrition, including the
“Healthy Mother, Healthy Child” Project in 12 pilot districts of Khatlon
region, which operates, develops and approves materials at the national
level.
• The skills and knowledge of medical workers at the republican level are
being improved,
• Preparation of national methodological recommendations, together with the
Center for the Development of a Healthy Lifestyle and the Ministry of
Education and Science
 • Work is underway to change the behavior of health workers. population in
matters of nutrition.
Jabborova T. - representative of the “Healthy Mother, Healthy Child” Project
(USAID):
• The project operates in 12 districts of Khatlon region, and on issues of improving
nutrition and changing social behavior, activities are being carried out jointly with
the Ministry of Health and Social Protection of the Population,
• Center for the formation of a healthy lifestyle with the support of 850 local
medical teams.
• Educational centers have been created in pilot areas, educational programs at the
State Medical University and the Republican Medical College have been revised,
and additional hours on nutrition have been introduced.
• according to the results of the 2023 Demographic Health Survey, there are no
significant achievements, no analyzes, no prioritization of maternal and child
nutrition issues. A week before, we held a working meeting in the Kubodiansky
district, where the leadership of the executive bodies of local government was
ready to provide them with a list of underweight children and help these families,
which is considered a positive experience. However, they noted that trained
employees leave their jobs, which causes problems.
Representative of the Agakhan Foundation L. Qurbanmamadova noted the
reduction of stunting in GBAO through the use of ready-made medical food
“Achamam”
• positive experience was obtained in 2,300 children aged 6 to 59 months
• proposed to extend this experience to other regions of the republic.
• The issue of providing pregnant women with additional nutrition was
proposed.
Kamolzoda F.U., representative of the Local Development Committee under the
President of the Republic of Tajikistan, noted that every year the Committee
receives
• information from other ministries and departments on all social sectors,
including taxes, healthcare, electricity, etc.,
• the number of institutions and employees (from among doctors, paramedical
personnel, cleaners, hospitals and other medical institutions) are presented
and analyzed annually by the Committee's experts.
In 2023 (November 27, 2023 under №8362), the order was sent to ministries and
departments, all available data was analyzed and evaluated, and after
generalization, it was sent to the Administration of the President of the Republic of
Tajikistan.
Hasanov M. stated that, according to the “Guidelines for Partnership with
Society,” there are more than 850 local medical teams and they need to be
involved, and asked representatives of the committees for work with youth and
sports and work with women and families within the Government of the Republic
of Tajikistan to take part in more active implementation of the Guiding Principles.
Odinazoda M., representative of the Ministry of Economic Development and
Trade of the Republic of Tajikistan, noted the following:
 food security and healthy eating issues are addressed in local development
programs, and the Ministries of Economic Development and Trade provides
assistance to them.
• Medium-term programs at the national level should take into account
nutrition issues, and the executive authorities of the state are responsible for
this.
At the end of the meeting, Nabiev Z.N. once again thanked all participants and
expressed confidence that, together with ministries and departments, the activities
included in the “Multidisciplinary Plan for Improving Nutrition in the Republic of
Tajikistan for 2021-2025” have been implemented and correspond to the set goals
and sustainable development goals can be achieved with significant results.
The following decisions were taken on the above issues:
1. Report of the representative of the Secretariat of the Global Food Extension
Movement (SUN) Hasanov M. on the implementation of the multi-sectoral plan
related to the improvement of food in the Republic of Tajikistan in 2023 and
plans in 2024 should be taken into account.

2. In 2025, the project "Multi-sectoral plan for improving nutrition in the Republic
of Tajikistan for the years 2026-2030" will be developed by the Intersectoral
Coordination Council for the Global Movement of Food Expansion, in which the
cost of each event and the source of its funding will be determined. Term until the
end of 2024.
3. Instruct all ministries and departments to:
- submit the activity plan of their institutions for 2024, signed by the leader, to the
Secretariat of the Intersectoral Coordination Council of the Global Food Aid
Movement. Deadline – June 10, 2024.
- strengthen the activities of their infrastructures in cities and regions of the
republic to implement nutrition programs. The deadline is normal.
4. The SUN Secretariat is instructed to submit to the Ministry of Health and Social
Protection a list of candidate specialists to participate in the International
Conference in the state of Rwanda, which will be held in November 2024. Term 10
days.
5. The SUN Secretariat should be directed to apply for project funding, including
to the World Bank, for the implementation of wheat flour fortification, including
the establishment of a Revolving Fund and an implementation team for this Fund.
The deadline is normal.
6. Monitoring and evaluation of the “Multidisciplinary Plan for Improving
Nutrition in the Republic of Tajikistan for 2021-2025” should be regularly carried
out at the regional level in order to identify nutrition-related problems and
eliminate them.

Chairman of the Coordination Council

interdisciplinary on Scaling Up Nutrition (SUN): Abdusamatsoda Z.M.

Performer: Rakhmatulloeva S.I.