National Nutrition Program

Programme overview Malnutrition is one of the major public health problems in Pakistan. Malnutrition occurs throughout the lifecycle resulting in low birth weight, wasting and stunting. National Nutritional Survey 2001-2002 shows the alarming situation of Pakistan. Micronutrient deficiency in Pakistan is widespread and reflects a combination of dietary deficiency, poor maternal health and nutrition, high burden of morbidity and low micronutrient content of the soil especially for iodine and zinc. Most of these micronutrients have profound effects on immunity, growth and mental development and may underlie the high burden of morbidity and mortality among women and children in Pakistan. Nutritional Indicators The following comparative nutritional status indicators are available to the National Nutrition Program in targeting specific population groups and prioritizing its related activities: Sr. 1. 2. 3. 4. 5 6. 7. 8. 9. 10. Indicator Low Birth Weight %(Less than 2500gm) Wasting % (Low Weight for Height) Stunting%(low Height for Age) Under Weight%(Low Weight for Age) Anemia (Children) Anemia (Women) Iron Deficiency Anemia (Children) Iron Deficiency Anemia (Women) Vitamin A Def (Children)(Serum Retinol Level) Vitamin A Def (Mothers)(Serum Retinol Level) Human PC-1/ NNS Condition NNS 85-87 2001-02 Report 02 25% 15.3% 46.3% 51.5% 42% 45% 30% 11.7% 61.9% 44.6% 42% 60% 11.6% 31.% 41.5% 50.9% 29.4% 35.6% 25.5% 12.5% 5.9%

Project Objectives The Primary objective is to improve the nutritional status of the people of Pakistan in general, with special emphasis on certain sub-groups: women of child bearing age,

adolescence girls and children.

Reduce Low Birth Weight Babies % from 25 to 20 Reduce malnutrition % (preschool) o Moderate 38 to 30 o Severe 13 to 5 Iron Deficiency Anemia (Hb Level) (%) o Mothers from 25 to 15 o Children < 5 years from 35 to 20 Increase Mass Awareness for: o Mothers exclusively Breastfeeding (six months) (%) from 59 to 75 o Introducing complementary foods at 6 months (%) from 62 to 80 Maternal nutritional status: o Under weight mothers (non-pregnant) (%) 12 to 8 o Underweight mothers (lactating) (%) 13 to 9 Household consumption of Iodized salt (%)25 to 50 Mothers getting calories less than recommended allowance (%) 5 to 30 Vitamin A deficiency in (%) o Women 6 to 4 o Children 12 to 4

Strategies

To carry out situational analysis of the nutrition programmes under implementation in the past under various auspices and important lessons learnt for future interventions To enlist core issues and develop strategic options for action within the health sector, especially with a district focus on interventions within vulnerable groups especially mothers and children. These strategic options must be culturally acceptable and sustainable. To develop a cross sectoral strategy for promotion of nutrition improvement programs by linkages and delineation of roles and responsibilities of major partners and stakeholders from the public and private sectors. To build and strengthen the relevant infrastructure, management and implementation capacity at national, provincial and district levels for resource allocation/utilization and human resource development.

Way Forward Based on the strategy the major five targeted interventions need to focus on the needs of the population at-large target. The interventions need to target:

Maternal Health and Nutrition (including the newborn)

Infant and Child Health and Nutrition Adolescent Health and Nutrition Adult Health and Nutrition Nutrition and Health of the ElderlyThese specific programs are then supported by the four cross-cutting intervention strategies targeting specific nutrition and health issues: Behavior Change Communication Strategies Fortification Strategies and Programs( for vitamin A,iodine,iron/folate and other micronutrients) Food Safety and regulatory Issues Institutionalization of Nutrition and Management Strategies

Major Achievements

The National Plan of Action on Micronutrient Control has been launch and approved by the Ministry of Health. The Nutritional Strategic Plan of Action has been approved by the Nutrition Technical Committee. Initiation of adaptation of Global Strategy on Infant and Young Child in Pakistan Iron Wheat Flour Fortification - GAIN Project implementation Unit started in Nutrition Wing, Ministry of Health. The National TB Control Programme, Ministry of Health required micronutrient supplementation for the TB patients. Purchase of drugs & medicine for the 40,000 T.B patients (combination two micronutrient i.e. Tab Supradyn and Stress Tab 600(a combination of B-Complex, Zinc, Vitamin C, Folic Acid) that can delay absorption of over dosage and toxic effects of ionized, was procured . 63 districts are using 60% iodized salt. Wheat flour fortification is successfully done in 50 flour mills in the country.

Programme contact details Deputy Director General (Nutrition Wing) Ministry of Health 1st Floor, Taimur Chambers 10-D West, Fazl-e-Haq Road, Blue Area Islamabad Tel: (051) 9202445