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In under 5 mortality rate was recorded in the CEECIS region from 1990 to 2011.
National Survey to Lay Ground for Better Nutrition in Uzbekistan
It is a crisp autumn day in suburbs of Tashkent, Uzbek capital. Sherzod is almost running as he and his two companions make their way through the densely built-up neighborhood. "Hurry up, we have a dozen more houses to visit today," Sherzod says just before he stops at one of the houses and knocks on the door.
The door opens, and Dildora comes out to greet the visitors. "You must be the people doing the survey," she says "Please come in. I was told you would come."
After going through the traditional greetings and making themselves comfortable inside the house, the guests start asking questions - mostly on her family's eating habits and diet. Some of the questions make Dildora think harder, but she answers all of them happily. "I actually liked the idea of this study. I am intrigued to see the final results of this," she says at the end of the conversation.
Dildora, a school teacher and a mother of four, is among several thousands of people taking part in the nutritional status survey being carried out across Uzbekistan in October 2017.
The National Nutrition Survey, initiated by the Ministry of Health and UNICEF, is expected to gather much-needed data on malnourishment levels among women and children. The study seeks to shed more light on the scale of the micronutrient deficiencies, including iron and vitamin A deficiencies, which are often referred to as "hidden death" because of their latent nature and devastating impact they have on one's body.
The findings are going to be important for the government to come up with new targeted nutrition programs and adapt the existing ones. Saidakbar, father of 3-years-old Saidali who lives in the same neighbourhood as Dildora, hopes the survey will help the health authorities to make better-informed decisions. "It would be great to know the results. People do not go and complain about their nutrition problems. Such studies give decision makers the opportunity to address such concerns," he says.
The study will understand the nutrition status of children under 5, women of reproductive age (15-49) and pregnant women. In all, 4,200 randomly chosen households in rural and urban communities will be interviewed across the country.
The data collectors will also gather information on children's vaccination status.
Individual teams deployed in all 12 regions of the country as well as the autonomous Republic of Karakalpakstan and the city of Tashkent are conducting the survey.
Sherzod is leading the team in the central region of Tashkent, which also includes two interviewers, a nurse, a laboratory assistant and a driver.
"We received special training prior to the study. Team leaders, interviewers and medical workers were given detailed instructions, including on working with people and addressing problems that may arise during data collecting," he says.
Sherzod says that the team is working really hard to meet the deadlines. "People living in rural areas leave for work early in the morning and come back late in the evening. That is why we have been working from early morning till late night. There are some large families with up to 12 members, and we want to include every single family member," he says.
Apart from visiting households and interviewing people, the team collects blood and urine specimen from women, including the pregnant ones, at local clinics that also give a helping hand by providing facilities. Respondents are asked to visit the clinics to take weight and height measurements and also collect blood and urine specimens that are then sent to regional centers.
"People agree to answer the questions but some are hesitant when it comes to giving blood and urine specimen," says Bakhtigul, phlebotomist working alongside Sherzod. "We try to explain the benefits of the project for society and for them personally, which makes them more willing to cooperate," she says.
Team members visiting households take samples of flour and salt as well, which will be examined at a laboratory in capital Tashkent. Dildora also let the interviewers to take several spoonfuls of flour and salt from her kitchen. "They say the salt is iodized, but we cannot be sure. In general, I want better state control over food production because I am concerned about the health of my children and grandchildren," she says.
Dildora's worries seem well-grounded as previous studies suggest that the minerals and vitamins deficiency still persist in Uzbekistan despite the progress the country has made over the last two decades.
A 2008 survey, conducted by the Ministry of Health, showed that over 34 per cent of women of reproductive age were anemic, while nearly 30 per cent of women suffered from iron deficiency.
Despite the surveys on anemia and growth rates in certain regions, data on nutritional status of women and children remains scarce. There are no representative data on deficiency of iron, Vitamin A, folate and vitamin B12.
The National Nutrition Survey aims to fill this gap by providing the first ever region-specific figures on nutritional status. Having disaggregated and reliable data on critical indicators will help in planning and monitoring the State programmes for the wellbeing of women and children of Uzbekistan.