Breaking Down Barriers to Breastfeeding: How Tajikistan’s Religious Leaders are Improving Maternal and Child Health by Engaging Fathers

USAID developed Breastfeeding Beyond the first 40 Days to encourage breastfeeding in Khatlon region and throughout Tajikistan. The intervention uses a community-tested social behavior change communication strategy to tackle major cultural barriers, including the religious community to find innovative ways to encourage breastfeeding.

To encourage more women in Tajikistan to breastfeed, educating the father is just as important as the mother, according to Domullo Shermuhamad Qaraev, a religious leader in Tajikistan.

“In Tajik families, the main decisions lay on the man’s shoulders,” said Domullo Shermuhamad, who lives in the Khroson district of Khatlon region with his wife and four children.

“Often men worry about their babies’ diseases quietly and deeply and sometimes don’t know what to do to prevent these diseases.”

USAID supports the Government of Tajikistan in improving the health and nutrition of women and children in the 12 western districts of the Khatlon region, which borders Afghanistan. Through the Healthy Mother, Healthy Baby program, USAID helps families adopt better maternal, newborn, and child health and nutrition practices during the first 1,000 days of a child’s life, such as breastfeeding.

Breast milk provides ideal nutrition for infants, supports optimal cognitive and physical development, and reduces the risk of deadly diseases like diarrhea and respiratory infections. For nursing women, breastfeeding improves birth spacing, and reduces the risk of breast and ovarian cancers and chronic diseases like type 2 diabetes and heart disease.

“The first time when we were trained by the USAID Healthy Mother, Healthy Baby activity, I realized how important is my role and responsibility in my community,” 

Domullo Shermuhamad

“According to Islam and the Holy Book Quran, breast milk is considered to be a compulsory food for children under 2 years old, and the importance of this message is that the father of the child is more responsible in this matter than his mother.”

USAID promotes breastfeeding within minutes of a baby being born, exclusive breastfeeding for the first six months, and continued breastfeeding along with a diverse, complementary diet for two years or more.

Exclusive breastfeeding–when an infant receives only breast milk without any additional food or drink–is one of the best ways to provide infants with the essential nutrients during the first six months. Globally, 44% of infants are exclusively breastfed before reaching six months. In Tajikistan, an even smaller percentage of babies under six months — 36% — are exclusively breastfed.

In Tajikistan, where nearly 70,000 pregnant women received nutrition support through USAID programs in 2023, most mothers initiate breastfeeding after birth and continue to exclusively breastfeed for at least one month.

However, gender imbalances in Tajikistan often hinder women’s participation in family decision-making processes, impeding access to vital health care services, especially pre- and postnatal care visits and breastfeeding support.

In 2023, USAID developed and launched a social behavior change campaign called Breastfeeding Beyond the first 40 Days to tackle major cultural barriers and social norms to encourage women throughout Tajikistan to breastfeed for longer. One of these social behavior change activities includes training imams to educate men in their communities about the importance of breastfeeding.

Domullo Shermuhamad is one of 300 imams trained by USAID in 2023. The imams gave educational sessions to more than 500,000 men before or after Friday prayers at 78 public mosques in the Khatlon region. Topics included the benefits of breastfeeding, how to support lactating women, maternal and child health, girls’ education, women’s rights, domestic violence, and equity.

“I am a Community Health Team member of my village,” Domullo Shermuhamad explained, “and when we organized an informational session for women, I wondered how I may do this between the males. I hurried to share the knowledge among the males of my village about breastfeeding because I got to know that breast milk is most important in the first days after giving birth both for babies and moms.”

Jamila Yuldosheva, a community health facilitator, said that Domullo Shermuhamad helped her a lot with promoting breastfeeding. She explained that men started to come with their spouses to the N. Asadullo village health facility to get information about the benefits of breastfeeding.

“Domullo Shermuhamad tells prayers about how the Holy Quran regards breastfeeding as a sign of love between the mother and child,” she said.