SECRETARYPLANNINGANDDEVELOPMENTDEPARTMENT

GOVERNMENTOFSINDH

Sindh-Acasestudy

ByDrShereenMustafa

SAFANSIRoundtable|Kathmandu|September7-8,2017

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PAKISTAN

AzadKashmir

Balochistan

Sindh

KhyberPakhtoonkhuwah

FederallyAdministredTribalarea

Punjab

GilgitBalUstan

SAARC Countries - A Comparison of Stunting

3 Source: UNICEF Stop Stunting, South Asia, Progress Report, 2016

Nutrition Status in Pakistan and Sindh

4 NNSsurvey2011

NNS Survey – Key findings

§  35% deaths under 5 years

§  72% houses food insecure

§  28% severely food insecure

§  32% population have access to piped water

§  Hidden Hunger /Micronutrient Deficiency

5

Malnutrition Status in Different Regions

57,652,2 50,6 49,8 47,8

39,2

31,7

FATA Balochistan GB Sindh KP Punjab AJK

FATA Balochistan GB Sindh KP Punjab AJK

NNS2011

MICS 2014 – Key Findings

•  Acute Malnutrition /wasting 15.4 %

•  Chronic Malnutrition/stunting 48 %

•  Underweight 42% (4 out of ten children)

•  Early Initiation of Breastfeeding 20.7%

•  Most challenging districts 07 Out of 29 districts)

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In Sindh, 1 in 2 children suffers from stunting (the irreversible outcome of chronic nutritional deficiency)

Sindh = 48%

Height for age (Stunted) - Districts

Paradigm Shift

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With the support of World Bank a multi sectoral

approach was adopted to prepare an Accelerated Action

Plan at an estimated cost of US$ 525 million

Goals

§  To reduce stunting at rate of 1.5% /year

§  Projects will target 23 districts on priority

§  Target Population

•  Pregnant & lactating Women •  Adolescent Girls •  Children 0-59 months ( under 5 years)

§  Above all, 1000 days opportunity ( from conception to child second birthday)

§  Identified indicators to be met within result framework

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Major Interventions

Ø  Nutrition Support Program -WB

Ø  Accelerated Action plan for Nutrition - WB

Ø  UN Maternal and Child Nutrition Stunting Reduction Program, Sindh – USAID, UNICEF

Ø  Improved Nutrition in Sindh - EU

Ø  Prevention of Stunting -WFP

Ø  Saaf Suthro Sindh- WASH -WB

Ø  Nutrition Sensitive Agriculture - WB 11

Objectives

Ø  Improve accessibility and coverage of health services

Ø  Addressing Food Security to vulnerable population

Ø  Improve and strengthen BCC

Ø  Direct food supplement

Ø  Encourage consumption of diversified food

Ø  ODF and hygiene

Ø  Introduction of CCTs to support nutrition programs 12

ACHIEVEMENTS

•  Nutrition Policy guidelines 2012

•  Steering Committee formed in 2012

•  Sindh Inter-Sectoral Strategy 2013

•  Nutrition Section established in P&D, 2015

•  SUN Secretariat established in Nutrition Section in P&D Sindh, 2016

•  Task Force established in 2017 13

Stakeholders

Health

LocalGovernment

SocialWelfareEducaUon

Agriculture

PopulaUonWelfare

14

Planning&Development

Finance

Institutional Arrangement

15

PolicyOversight

•  Taskforceformedon12thJanuary2017,chairedbyMinisterforPlanning&Development

ProgramOversight

•  ProvincialNutriDonSteeringCommiGee,headedbyChairman,P&DBoardmeeDngBi-annually

ProgramImplement

aUon

•  ProgramUnitsinProvincialLineDepartments

CoordinaUon

• District/TalukaCoordinaDonCommiGees

Government’s Response

•  Complete political ownership

•  Commitment from Government

•  Resource availability

•  Resolve to achieve the targets 16

What is needed !

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•  Institutional capacity to implement program

•  Integrating and synergizing the efforts

•  Aligning design of programs to achieve single objective

•  Evidence based research to support programs in short and medium term

•  Continuous partners’ and government coordination

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