Understanding the health needs of Tajikistan
New data has been made available regarding health hazards in Tajikistan thanks to 3 WHO surveys conducted in the past year: the FeedCities survey, an ongoing multicountry study, which describes the urban food environments of cities in central Asia, the Caucasus and south-eastern Europe; the WHO STEPwise approach to Surveillance (STEPS) survey, a simple, standardized method for collecting, analysing and disseminating data on noncommunicable disease (NCD) risk factors; and the WHO European Childhood Obesity Surveillance Initiative (COSI) survey.
Overall, the main findings of the surveys are quite optimistic, although some alarming tendencies have been observed. Preliminary results regarding the prevalence of obesity and overweight in children received through the COSI survey are impressive. Tajikistan showed the lowest levels in both categories among all surveyed countries of the WHO European Region: only 9% of boys and 5% of girls were overweight, while only 2% of boys and 1% of girls were obese. The prevalence of obesity and overweight did not depend on the parents’ working status and levels of education. However, undernutrition might be a problem: a significant proportion of 7-year-olds surveyed were found to be thin (4%), stunted (10%) and underweight (8%).
The analysis of street food in Dushanbe, Tajikistan, during the FEEDCities survey showed mixed results. Fresh fruits, a very important element of a healthy diet, are widely available, helping to ensure that urban residents have easy access to this type of food. However, the type and composition of the other foods and drinks on offer could be improved. This study found high levels of salt and trans fatty acids in both industrially produced and homemade, commonly consumed food items.
The results of the STEPS survey are rather positive with regards to the prevalence of NCD risk factors, compared to other eastern European and central Asian countries. Most probably due to cultural and religious factors, the rates of alcohol consumption are very low, although men are disproportionately more affected by it. Consumption of tobacco, especially its smokeless forms, is moderate to high among men and very low in women. The smokeless forms of tobacco appear to be the main area of concern in the Tajikistan, which requires attention. On average, the respondents seemed to be consuming a fair amount of fresh fruits and vegetables a week, they were aware of the dangers of salt consumption, and a fair proportion of the population seems to be taking measures to lower salt intake. However, the levels of medical health care and screening are alarmingly low. The majority of respondents have never been tested for raised blood pressure, sugar levels and cholesterol, and only 8% of women have ever been tested for cervical cancer. Around 10% of the participants aged 40 years and over had a cardiometabolic scoring higher or equal to 30%, meaning they were at high risk of having a cardiovascular disease event in the next 10 years.
These results were made available during a recent joint Nutrition and NCDs Mission to Tajikistan organized by the WHO European Office for the Prevention and Control of Noncommunicable Diseases (NCD Office) on 18–20 April 2018. The launch of the results of these 3 main surveys provides vital evidence for informed policies related to NCD prevention and control. Member States, which did not previously have their own NCD risk factor data, are now making significant progress in the Region.
The WHO STEPS survey is a tool initially developed by WHO globally. With the support of the WHO/Europe surveillance team, the WHO Country Office and the Ministry of Health and Social Protection conducted the survey in Tajikistan. Alongside the STEPS survey, FEEDCities and COSI (2 surveys developed by WHO/Europe) were also conducted to provide a more comprehensive picture of the current state of affairs regarding NCD risk factors. This provides an example of all 3 levels of WHO working with the Member State to address an important public health issue. Recommendations based on the results of all 3 surveys were presented during the intersectoral roundtable.
Relevant stakeholders, including a representative of the Russian Federation Ministry of Health, the United Nations Resident Coordinator, and representatives of the United Nations and other international organizations were present at the event. The WHO NCD Office was represented by Dr João Breda, Dr Enrique Loyola and Dr Kremlin Wickramasinghe.