Abstract
The United States Agency for International Development Central Asia (USAID/CA)-funded Tajikistan Health and Nutrition Activity (THNA) is a five-year project designed to improve the health and nutrition status of women and children in 12 southwestern districts of the Khatlon region of Tajikistan. THNA is seeking to achieve this goal through implementing a range of interventions and strategies that focus on the 1,000-day window of opportunity?between conception and a child?s second birthday?to make a lasting impact on the child?s growth, learning, and future productivity. This performance evaluation was commissioned to determine THNA?s results achieved to date and identify lessons learned and best practices and make recommendations for future USAID maternal, newborn, and child health (MNCH) and nutrition programs. The Evaluation Team (ET) conducted desk review of materials, interviews with key stakeholders, focus group discussions with direct beneficiaries, client exit interviews with women that use the health facilities (HFs) supported by THNA, and a survey of health workers (HWs). The ET found that THNA?s interventions have: 1) improved MNCH and nutritional status; 2) developed national capacity to assess, plan, train, provide supportive supervision, and monitor programs; and 3) provide a package of health, hygiene, and nutrition Social and Behavior Change Communication interventions at the household level linking communities to improved MNCH and nutrition health services. The ET recommends supporting increased access to MNCH services in rural communities, expanding quality improvement to neonatal and child health programs, increasing attention to maternal nutrition and anemia, and developing a Community Health Worker program.