Current issues and what the World Food Programme is doing
What are the current issues in Tajikistan?
Tajikistan is a landlocked, lower-middle income, food deficit country with a population of approximately eight million, three quarters of whom live in rural areas. The mountainous landscape confines the arable area to just seven percent of the country’s surface and poses enormous challenges to food security during the winter period when poor weather conditions and natural disasters impede movement and routinely trigger energy and food shortages. According to the latest Tajikistan National Health Survey of 2012, 10 percent of children under five years are affected by acute malnutrition (wasting) and 26 percent from chronic malnutrition (stunting). The latest round of Food Security Monitoring System (FSMS) showed that despite improvement in food security in recent years, only 24 percent of Tajikistan’s rural population is food secure, with the remaining 76 percent: marginally food secure (50 percent), moderately (22 percent) or severely (5 percent) food insecure.
The country is the poorest in the Commonwealth of Independent States, with 47 percent of its population living on less than USD 1.33 a day and 17 percent subsisting on less than USD 0.85 a day. Tajikistan ranks 129 out of 188 countries on Human Development Index. The majority of the population spends between 70-80 percent of their income on food yet around one fifth of the population is affected by food insecurity. According to findings of the 2015 Global Hunger Index (GHI), Tajikistan tops malnutrition among the former Soviet republics. The 2015 GHI notes that 33.2 percent of Tajikistan’s population is suffering from undernourishment.
Remittances, mostly from migrants working in Russia, account for approximately 43 percent of the Tajikistan’s Gross Domestic Product (GDP). According to the National Bank, remittances dropped by 32 percent in first 6 months of 2015 and poverty rate reached 36.1 percent in rural areas. Tajikistan is one of the most remittance dependent countries in the world. Recent depreciation of the Russian Ruble impacted the Tajik economy, the crisis increased the volume and frequency of reduction in remittances, 80 percent of which are used by Tajik households to purchase food. An estimated 11 percent of the population (about 660,000 people) are in need of food assistance according to the recent Integrated Food Security Phase Classification (IPC) analysis (April 2015). This segment of population is marginally able to meet minimum food needs, and can only do so with the accelerated depletion of livelihood assets.
What is the World Food Programme is doing in Tajikistan
The World Food Programme is the United Nations agency in Tajikistan with the largest reach, currently extending its support to over 550,000 people through four field offices (in Khujand, Kurgan-Tyube, Gharm and Khorog) and a Country Office in Dushanbe.
WFP has been present in Tajikistan since 1993, when it launched an Emergency Operations to provide life-saving assistance during the Civil War. Moving away from crisis assistance, WFP’s strategy in Tajikistan has been increasingly emphasizing three longer term objectives:
1) Policy advocacy with the Government and partners to ensure food security and nutrition are prioritized in national strategies, policies and programmes;
2) Support to the Government and partners to enhance their capacity to implement and monitor sustainable hunger solutions, through social safety nets for the most vulnerable;
3) Direct support to communities to respond to crises and to improve their longer-term food security and resilience to shocks.
WFP is shifting its efforts from relief and recovery operations to long-term development, resilience and capacity building of local institutions. WFP’s Country Programme for 2016-2020 also emphasizes a gradual reduction in direct implementation of programmes leading to full ownership of most programmes. Under the new country programme Tajikistan 200813 (2016–2020), the food requirement is 64,624 mt at a cost of USD 39.0 million, at a total cost to WFP of USD 80.6 million.
■ School Feeding
WFP’s School Feeding Programme has played an important role for thousands of school children in Tajikistan since 1999 by increasing enrolment and attendance rates. Today, the School Feeding programme complements the government-owned social safety nets by providing daily school meals to over 370,000 schoolchildren in more than 2,000 schools (over 60 percent of the total schools) in rural areas.
Worldwide, WFP school meals are a major incentive for underprivileged families to send their children, particularly girls, to school. As a result, school enrollment and attendance rates are usually much higher in schools assisted by WFP than in non-assisted schools. In the aftermath of the Civil War that ended in 1998, the School Feeding Programme was one of the key factors to boost attendance rates from 60 to 90 percent in one year. Nowadays School Feeding plays an important role in keeping attendance rates for both boys and girls equally high.
Independent studies have shown that improved nutrition increases students’ attention span and alertness. Furthermore, it is also conducive to their mental and physical development. All of WFP’s food commodities are fortified with minerals and vitamins, thereby contributing to the prevention of micro-nutrient deficiencies.Every school day, schoolchildren from grades 1 to 4 in over 2,000 schools supported by WFP are served a hot nutritious meal consisting of soup and a piece traditional bread. The ingredients for the soup are comprised of pulses, enriched oil, iodized salt and vegetables. The latter are usually provided as in-kind contribution by the parents of the school through efforts coordinated by the Parents Teacher Associations (PTAs), promoting the participation and ownership by the targeted communities.
The cost of one daily hot nutritious meal is USD 38 per year - a small investment considering the significant long-term benefits of a better educated population. Moreover, parents can save on food expenditures as well. With an average of two children per family benefiting from WFP’s School Feeding, families can save up to USD 50 per year of households` food expenditures. School Feeding not only contributes to children’s education, it also improves their family’s livelihood and wellbeing.
■ Food for Assets
Food for Assets (FFA) is one of WFP’s key programmes for providing food assistance to the most vulnerable communities in Tajikistan. Using food, vouchers or cash transfers as an incentive, the communities participate in labour intensive activities to work on community assets such as irrigation systems, soil conservation and regeneration, drinking water supplies or construction of bridges. FFA activities can produce immediate advantageous results in terms of food security and nutrition. At the same time, these projects help build household and community assets that reduce exposure to and impact of shocks, strengthen resilience to natural disasters, and contribute to sustainable livelihoods while ensuring environmental benefits. WFP’s priority is to ensure that assistance is prioritized for the poorest and most food insecure households.
Recurrent natural disasters in Tajikistan are exposing low-income households in rural communities to chronic food insecurity. Vast swaths of agricultural land are being affected by wide-spread deforestation, soil erosion and droughts. Climate change is increasing overall temperatures, frequency of extreme droughts and floods, and erratic rainfall. It is also decreasing water availability for agriculture. As a result, Climate Change is exacerbating the impact of these natural disasters on food security and livelihoods. Disaster risk reduction (DRR) and climate change adaptation (CCA) therefore, have become increasingly important components of efforts to build community and household resilience to these shocks. WFP’s FFA is a practical programme to address these issues through building community infrastructure. It also supports natural resource management through trainings and restoration of agricultural and rural infrastructure. Through FFA, the poorest and most vulnerable segments of the population receive food or cash incentives for contributing to community-wide projects.
By the end of 2015, FFA projects resulted in a total of 33,500 m3 of check dams to protect arable land, 55,000 Ha of land benefited from rehabilitated irrigation systems, 2,400 Ha of land was regenerated through tree planting activities, 5,000 Ha of land was protected from erosion, 7,500 Ha of land protected from floods, 230 km of rural road, 528 classrooms and 29 bridges were constructed. In addition, a Food Security Monitoring System (FSMS) has also been established which provides a seasonal trend of food insecurity in rural Tajikistan by analyzing data from 1,300 rural households across 13 livelihood zones.
FFA is multipurpose programme and also lends itself as a short term social safety net by immediately improving the food security of households affected by sudden shocks, or of those who urgently require augmented access to food (or cash). Targeting of communities with short-term safety net FFA activities may be required anywhere in response to needs, depending upon the occurrence of shocks and severity of the impact on household food security. Most vulnerable food insecure beneficiaries are selected to rehabilitate damaged infrastructure through compensation in terms of food or cash according to the number of days worked on a given FFA project. The evaluation of the 2010-2015 PRRO has confirmed FFA to be an effective approach for producing and rehabilitating much needed community assets. Thus far, the projects have been coherent with community priorities and well maintained. FFA continues under the 2016-2020 Country Programme, planning to reach 100,000 beneficiaries.
As malnutrition impacts the lives and development of a vast number of children in Tajikistan, WFP in coordination with the Tajikistan’s Ministry of Health and Social Protection assists local health centres and parents to combat acute malnutrition. WFP’s nutrition activities contribute to the development and well-being of thousands of children every year. The programme is implemented in close cooperation with the United National Children’s Fund (UNICEF) and the World Health Organization (WHO).
Disparities between rural and urban areas are significant. WFP targets acutely malnourished children, mostly from poor households, in the rural areas. Khatlon has the highest rates of both wasting and stunting in the country. WFP assists 88 health care centres in the districts of Shaartuz and Kulyob to treat moderate acute malnutrition. Every year more than 5,000 children are enrolled in the health centre’s nutrition programmes and receive support from WFP. Enrolment in the programme usually lasts 8 to 10 weeks, during which weight, height and other growth indicators are closely monitored by the medical staff. After completion of the treatment, 98 percent of the treated children recover and no longer require WFP’s support.
The food modality used, Super Cereal Plus, is specifically developed for the treatment of children from 6-59 months. It is a fortified blended flour made of soya and corn that includes a comprehensive micronutrient vitamin and mineral mix. Additional milk powder, sugar and oil are also included. This blend of carbohydrates, fats, sugars, minerals and vitamins not only allows recipient children to quickly gain weight, but also prevents micro-nutrient deficiencies, detrimental to physical and mental development. The caregivers who attend the consultation with the children and the medical staff are trained on the preparation of the Super Cereal Plus porridge, which is fairly easy; only requires heating and adding water.
WFP nutrition activities are not only effective in the treatment of acute malnutrition but also have a positive impact on attendance at the health centres, vaccination, antenatal care and growth monitoring. The programme also provides an opportunity to increase the nutrition and health awareness of mothers through cooking demonstrations and preparation of appropriate foods. In 2015, targeted supplementary feeding programme was implemented in Kulyab and Shartuz districts of the Khatlon region, which has the highest global acute malnutrition levels in the country. WFP partners with NGO Mercy Corps to improve identification of malnourished children. While women are the primary caregivers of the children enrolled in the nutrition project, in the health centres both female and male caregivers receive counselling by the medical staff on how to improve the diet of the child as well as on good hygiene practices. This has had a positive impact on the seasonal peak in malnutrition at the end of the lean season, when nutrition is generally worse and when abundant rain allows diseases to spread quickly in unhygienic environments.
Funding remains a key challenge in addressing malnutrition in Tajikistan. In 2015, WFP was only able to procure limited quantities of Super Cereal Plus, and prevention component of the programme was not implemented and WFP focused its resources on moderate acute malnutrition treatment.
■ Support to TB patients and their families
WFP has been providing life-saving food assistance to tuberculosis (TB) patients and their family members since 2003, when it began a partnership with the NGO Project Hope to help 1,000 patients in and around the capital Dushanbe. The success of WFP’s assistance to the TB clinics treatment programme has led to the extension of the programme to all enrolled TB patients in Tajikistan.
In 2015, WFP provided food assistance to 25,405 beneficiaries which included TB patients and their families. According to the World Health Organization (WHO) the global mortality rate of TB is declining at last. Nonetheless, multidrug-resistant TB (MDR-TB) is still on the rise and now only AIDS surpasses the annual 1.3 million TB deaths. Tajikistan remains the poorest country in Europe and Central Asia (ECA) region. It also has the sixth highest incidence of TB in the ECA. According to WHO, the estimated incidence of TB was 91 cases per 100,000 people in 2014. In 2013, 81.7% of the TB cases reported had not been previously treated.
TB is a disease of poverty, and the burden of illness and death is experienced in Tajikistan’s food-insecure rural areas where households of TB patients are amongst the most destitute. TB patients are often the fathers, sons and brothers belonging to poor families who migrate to Russia or Kazakhstan to work and often live in substandard conditions where it is easy to contract TB. When they return home sick, they put new pressures on household spending and potentially spreading the disease to family members. According to the National Tuberculosis Center (NTBC), 55 percent of the new TB cases registered in 2014 were men. Above all, the disease primarily affects the most economically engaged segment of the population. WFP’s food is multi-purpose in the campaign to stop TB. First, patients are helped to gain weight and restore their nutritional levels in order to absorb the powerful drugs they have to take under the Directly Observed Treatment, Short Course (DOTS). Second, WFP’s food assistance provides a measure of financial security to families being deprived of their chief breadwinner. Third – and perhaps most important – the programme serves as a powerful incentive to the TB patient to continue the heavy DOTS treatment throughout the entire six-month regimen. Food commodities provided to outpatients affected by TB, comprise of fortified wheat flour, enriched vegetable oil, pulses and iodized salt. The patient and their family members receive a food ration on a bi-monthly basis contingent upon the patient’s compliance to the DOTS treatment program.
WFP’s yearly assistance to over 9,000 enrolled TB patients has ensured that the successful treatment rate of 87 percent in Tajikistan remained stable. Moreover, almost 16,000 TB affected household members benefitted from invaluable support from WFP as their loss of income, due to the illness of the breadwinner, was compensated through food rations. When patients interrupt their drug regimen, they easily develop the multi-drug resistant strain of TB (MDR-TB). The bacteria that cause TB can develop resistance to the antimicrobial drugs. As a result, MDR-TB strain does not respond to at least isoniazid and rifampicin, the two most efficient anti-TB drugs. The duration of the treatment course as well as the treatment costs are dramatically higher for MDR-TB juxtaposed to TB. Tajikistan has the third highest MDR-TB rates among previously treated patients in the world: 34.5 percent of the previously treated TB patients contract MDR-TB. For years, the WHO has classified Tajikistan as one of the 22 countries affected by a ‘high burden’ of MDR-TB prevalence. WHO estimates 8.1% of the new TB cases in Tajikistan diagnosed as MDR-TB in 2014. WFP’s programme provides important support to the prevention of MDR-TB since it incentivizes TB patients to finish the regimen.
WFP has provided assistance in 66 districts of the country and remains heavily dependent on external donors for financing TB control activities. WFP recently collected evidence and completed a study on the impact of food assistance on treatment adherence. The results justify the need to continue provision of food assistance, as it not only improves TB treatment outcomes, reduces side effects, but also increases endurance and nutritional status of the TB patients.
WFP partners in Tajikistan
WFP cannot fight global hunger and poverty alone. These are our partners in Tajikistan:
WFP activities are implemented in close partnership with UN agencies in particular Rome-based agencies and other UN agencies under the UNDAF framework, NGOs and various ministries in the Government of Tajikistan including:
Tajikistan’s Ministry of Health and Social Protection, Ministry of Trade and Economic Development, Ministry of Finance, Ministry of Labour, Ministry of Agriculture and Ministry of Education.
Tajikistan’s National Tuberculosis Centre
Social Industrial Food Services Institute (SIFI)
WFP Tajikistan’s activities have been supported by the Russian Federation, Japan and the UN Peacebuilding Fund.
Featured Tajikistan publications
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