COMCEC

Malnutrition in the OIC Member

Countries: A Trap for Poverty

diseases. It is hypothesised that in adults, deficiencies of folate may increase the risk of heart

disease and existing zinc deficiency may increase the severity of diabetes (Eckhardt 2006).

Fruit and vegetable consumption in particular, are considered especially important given the

variety of micronutrients and other essential dietary components they contain. The World

Health Organization lists low fruit and vegetable intake as the

thgreatest risk factor for global

mortality (Eckhardt 2006). Within the context of high food prices, low levels of dietary

diversity, and a high reliance on refined wheat in the diet, it is likely that micronutrient

deficiencies may also be contributing to obesity.

Stunting and micronutrient deficiencies remain major nutritional challenges in Tajikistan, due

to low dietary diversity, a high reliance on nutrient-poor food (such as wheat) and high levels

of food insecurity.

Health, Water and Sanitation

Tajikistan has a good coverage of improved sanitation (95%; and open defecation is negligible)

but access to improved drinking water sources remains a challenge (74% in 2015). This

increases only slowly, as it was 70% in 2010 and 65% in 2005. Many stakeholders interviewed

highlighted sanitation and prevalence of waterborne diseases, and resulting gastrointestinal

tack damage, as a key major cause of poor nutrition in the country (Interview USAID, WHO,

Medical Science Academy).

The country has a better than average presence of skilled health professionals: the country had

1.9 doctors per 1,000 people in 2015 (the average in the world was 1.6), but this figure was

down from 2.7 per 1,000 in 1989. The country also had 5 nurses per 1,000 people in 2015,

which is twice as high as the global median. In terms of availability of hospital beds, Tajikistan

is on a downward trend. Whereas the country had about 10 beds per 1,000 in 1989 (in the top

5% in the world), it only had 5.5 in 2011 (which is still twice as high as the global median).

Tajikistan is also close to the global median in terms of maternal health: the lifetime risk of

maternal death was 0.12% in 2015, slightly better than the global median of 0.17% and

significantly better than the global average of

%. Antenatal care coverage is, however,

limited. Only 79% of pregnant women received such care in 2015, whereas the global median

is 95%. And little progress has been made since the early 2000s (75% in 2001).

There is a marked gap in terms of health outcomes between the rich and poor, with the poor

experiencing much worse health outcomes, and higher rate of morbidity and mortality

compared to rich households. The majority of healthcare funding come from out-of-pocket

spending, adding an addition layer of challenge for the poor in accessing health care (European

Union 2014). Geography also presents a challenge in terms of health care provision, with 10%

of health care facilities located in rural areas, despite the majority of the population (about

70%) living in rural areas. There are few distribution channels to supply health facilities in

rural areas, meaning that facilities often lack basic medicine and supplies. The country has a

better than average presence of skilled health professionals: the country had 1.9 doctors per

1.000 people in 2015 (the average in the world was 1.6), but this figure was down from 2.7 per

1.000 in 1989. However, low wages mean that health facilities have trouble attracting and

retaining health workers, who often migrate to countries with higher wages. (European Union

2014). There are also broader quality concerns about the health system which related to

insufficient training, a lack of evidence based guidelines and an underinvestment in primary

care (Khodjamurodov et al. 2016).

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