More than 20 percent of children underthe age of 5 in Tajikistan are stunted. A large literaturefinds that stunting and undernutrition in early childhoodare commonly the result of several contributingenvironmental, food, hygiene, and health-related factors.However, quantifying these interactions is usually notpossible due to the difficulty of collecting sufficient dataon each dimension in a single survey. To address this issue,we integrated the samples of two separate nationallyrepresentative surveys conducted simultaneously inTajikistan in late 2016. This design allows analysis of thedeterminants of undernutrition in a unified framework. Theresults show strong associations between undernutrition andthe number of food calories consumed, food diversity, accessto water, sanitation and hygiene (WASH) services, access tohealth services, and care practices. Consistent withprevious studies, the results also show that overlappingadequacies are associated with much reduced stunting risk.The findings suggest that: i) nutritioninterventionsaddressing multiple risk factors may promote better outcomesthan focusingon any single deprivation, ii) there is needfor programs addressing food inadequacy, bothin the form ofthe number of calories consumed and the diversity of foodconsumed, iii)promoting food adequacy alone is likely notsufficient to generate large reductions inmalnutrition, andiv) interventions should predominantly focus on rural areaswhere risksof malnutrition are substantially higher.
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