Using behavioural science to address maternal and infant malnutrition in Tajikistan

Breastfeeding within an hour of birth, eating nutritious meals during pregnancy and lactation, and feeding children over six months a diverse, nutrient-rich diet are globally recommended practices for supporting maternal and child health.

However, in Tajikistan, many mothers face significant barriers to following this guidance. As a result, the country has one of the highest malnutrition rates in Central Asia. Structural issues, such as food insecurity and lack of clean water, fuel this problem. But the everyday decisions of mothers and families also play an important role.

From 2023 to 2025, we partnered with UNICEF Tajikistan to develop a social and behaviour change strategy for improving maternal and child nutrition. Using a behavioural science lens, we identified what behaviours needed to change and explored why they weren’t happening, uncovering barriers like low awareness, limited self-confidence, and restrictive social norms.

Drawing on these insights, we co-designed solutions tailored to local contexts. These included interventions and targeted messaging that addressed behavioural drivers and supported mothers in making healthier choices.

Developing a social behaviour change strategy

A social and behaviour change strategy aims to lower structural and psychological barriers that hinder people from adopting positive practices. It blends scientific knowledge with community insights to create an environment where people have more control over the decisions that matter most, leading to greater social impact.

We worked with UNICEF Tajikistan to identify five behaviours around healthy eating and breastfeeding to target. We then conducted research to understand the barriers and enablers of each of these behaviours. Working with Hayot Dar Oila (HDO), a local NGO who helped collect the data, we:

• Reviewed the latest behavioural science literature on these topics
• Equipped HDO to interview Tajik mothers, healthcare workers and community members

• Led co-design workshops for government stakeholders, development partners and donors to help shape solutions

We used these insights to recommend four approaches to encourage healthy eating and breastfeeding for new mothers: a public health campaign, recipe books, behaviourally-informed counseling and breastfeeding/nutrition support groups. 

Using behaviourally-informed messaging

We designed a series of targeted messages to be delivered through our intervention channels. Each is tailored to a specific audience – mothers, family members and healthcare workers – and aims to address key behavioural barriers preventing mothers from following healthy practices.

Target behaviour: Women who give birth in hospital put newborn on breast within an hour of birth

Barriers: 

• Mother lacks knowledge on breastfeeding within an hour of birth and its benefits
• Mother lacks confidence in herself to breastfeed

Message:

The example image above shows messaging for mothers. But in our exploratory research, we found that not only mothers are involved in a baby’s nutrition.

Fathers and mothers-in-law can help – or hinder – a mother from breastfeeding or eating healthy. In response, our messaging framework is designed to be adaptable across audience groups, while preserving the behavioural insights embedded in the content. For instance, the message directed at fathers reads:

“Give your child the best start to life: support your wife to breastfeed within the first hour of birth – it will boost your child’s immune system.”

This message uses several behavioural principles:

• Partnership and support framing: Frames breastfeeding as a shared effort between the mother and healthcare professional, and mother and father.
• Call to action: Provides a clear, actionable step for mothers and fathers to take control.
• Emotional anchoring: Emphasises health benefits for the baby and mother and taps into emotions, making the message meaningful and motivating.

Target behaviour: Pregnant and lactating women eat less fried, salty, and sweet food and drink

Barriers: 

• Lack of knowledge around harms of unhealthy eating
• Lack of social support from family, friends or health professionals to maintain dietary changes

Message: 

Behavioural principles this message uses:

• Messenger effect: People are more likely to trust and act on suggestions delivered from perceived experts, such as health professionals.
  
• Clear call to action with a substitute: The message offers a straightforward action to replace sweets with fresh fruits. Traditional healthy eating messaging simply tells people what to eat or not. By offering substitute foods, our messaging makes the desired behaviour even easier to act on.

With a comprehensive and practical social behaviour change (SBC) strategy in place – rooted in behavioural expertise, local insights and evidence-based messaging – UNICEF Tajikistan is poised to drive meaningful progress for child nutrition.

As efforts are made to improve national food security, evaluating and refining these messages will be essential. That way, those with the greatest potential for positive behaviour and social change can be scaled widely.

Talk to us about your social behaviour change strategy

At BIT, we work with partners around the world to address complex issues like malnutrition, vaccination, and preventing infectious disease, including in low-income countries. Get in touch to talk about the challenges you’re looking to address and how we can work with you.