sindh- a case study - secure nutritionsecurenutrition.org/sites/default/files/safansi... · §...

SECRETARYPLANNINGANDDEVELOPMENTDEPARTMENT

GOVERNMENTOFSINDH

Sindh-Acasestudy

ByDrShereenMustafa

SAFANSIRoundtable|Kathmandu|September7-8,2017

2

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)

7

8

2429

33 34 35

44 4449 51 51 52

53 53 54 55 5555 56 56

58 59 60 6063 64

66 66 67Ka

rachiCen

tral

KarachiEast

KarachiM

alir

KarachiSou

th

KarachiW

est

Hyde

raba

d

Nau

shah

roFeroze

Tand

oAllahyar

Sukkur

Khairpur

Larkan

a

Gho

tki

Sangha

r

Jamshoro

MaU

ari

Shah

eedBe

naziraba

d

Mirp

urkh

as

Sujawal

Shikarpu

r

Dadu

Tand

oMuh

ammad

Kha

n

Tha^

a

Kambe

rSha

hdad

kot

Tharpa

rkar

Jacoba

bad

Kashmore

Umerko

t

Badin

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

9

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

10

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 !

17

•  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

18

19