Tajik Community Health Volunteers Improve Nutrition, Maternal Health, and Agriculture for Thousands

Thousands of people in Khatlon region now have greater access to health services and sanitation, thanks to the work of community health volunteers. Photo by Khosiyatkhon Komilova for IntraHealth International.

Thousands of people in Tajikistan's Khatlon region now have greater access to health services, nutrition, and sanitation, thanks to Feed the Future Tajikistan Health & Nutrition Activity (THNA), implemented by IntraHealth International.

In the twelve districts where IntraHealth conducts the USAID-funded work, in partnership with Abt Associates, widespread malnutrition leads to stunting, anemia, and poor maternal and child health, while infrastructure for proper sanitation and hygiene remains inadequate.

THNA recruited and trained 1,300 health volunteers and 500 agriculture volunteers.

To mitigate these issues, THNA recruited and trained 1,300 health volunteers and 500 agriculture volunteers who have given families access to health advice, agricultural skills, and necessary referrals.

These interventions mark a significant shift toward healthy behaviors in the communities supported by THNA. Since 2016:

  • The number of families that treat children with diarrhea by introducing more fluids has grown by from 33% to 80%.
  • 46% more families have soap present at a handwashing station.
  • The number of women who had four or more antenatal care visits went from 57% to 86%.
  • The percentage of non-breastfed children 6-23 months who receive a minimum acceptable diet has grown from 16% to 53%.

Volunteers work across maternal and child health, hygiene, agriculture, and advocacy:

  • Health volunteers regularly visit homes to check for new pregnancies, monitor the growth of young children, and provide counseling on antenatal care and breastfeeding. Volunteers made 420,217 home visits over the course of two years and referred 4,173 women for antenatal care in year four alone.
  • Volunteers conduct at least one cooking demonstration each month to teach the benefits of agricultural diversity and encourage healthy eating using local produce. In year four, volunteers held 3,895 demonstrations and distributed 4,500 project-developed recipe books to address malnutrition.
  • Health volunteers refer families to primary health centers and hospitals via a new referral system set up by the project.
  • Water, sanitation, and hygiene (WASH) volunteers work with village committees to provide guidance on proper garbage disposal, educate community members on disease prevention through handwashing with soap and the importance of hygiene and sanitation in child development, and address the need for ventilated improved pit latrines by training village masons to build concrete latrines at affordable prices. The project facilitated the installation of 1,749 latrines.
  • Agriculture volunteers train household members in home garden management, household budgeting and entrepreneurship, winter food storage, postharvest technologies, cheese-making, and poultry farming.

46% more families have soap present at a handwashing station.

In addition, new peer-support groups in each of the 500 project-supported communities bring together key groups, including:

  • Mothers-in-law, who influence how households are run and can encourage healthy habits at home.
  • Young mothers, who gain insight on antenatal and postnatal care and mother-and-child nutrition.
  • Men, the major decision-makers in households who have also been influential in the project’s agriculture and latrine-building initiatives.
  • School peer educators at 12 schools, who disseminate nutrition and agriculture information to their fellow students, which has increased yields and contributed to better food for schoolchildren.

Using these and other project results, THNA conducts quarterly meetings with the Khatlon Department of Health, district primary health center and hospital managers, and community volunteers to encourage data-driven decisions.  

The project team advocates for linking community volunteers with Centers for Healthy Lifestyles and government-led public health and health-promotion centers for community outreach in order to make them part of the formal health system and sustain these improvements.

IntraHealth International leads the USAID-funded Feed the Future Tajikistan Health & Nutrition Activity. With our partner Abt Associates, we are working to improve health and nutrition in Tajikistan, particularly among women and children in the Khatlon oblast. The activity integrates high-quality maternal, newborn, and child health care at the family, community, clinical, and national levels, with an emphasis on nutrition, sanitation, and hygiene.