Sindh fails to control children’s chronic malnutrition: WB report

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Province allocated less than 10 per cent of total health budget to be spent on nutrition

LAHORE: More than 60 per cent of children in Sindh, below 5 years of age, are feared entering into acute and chronic malnutrition as Sindh government has failed in moving forward despite adopting an Accelerated Action Plan (AAP) for reduction of malnutrition, World Bank’s (WB) latest status report has revealed.

The Multi Indicator Cluster Survey (MICS) 2014 for Sindh found out that 72 per cent of households were food insecure, 49.8 per cent of the children under five were malnourished, and 17.5 per cent of these children suffered from wasting – low weight for height.

The report mentions that despite establishing a Provincial Stunting Task Force (PSTF) as a decision-making body to direct and oversee all programmatic and operational activities envisioned by the AAP, the province could not move forward. The task force, under the chairmanship of the chief minister and which also includes ministers and secretaries of the relevant sectors and representatives from the civil society and academia, is still inoperative.

According to details, the nutrition coordinator to the chief minister was not able to ensure coordination among different sectors and the implementing authorities. The coordinator was also supposed to be supported by a secretariat comprising of program, technical, fiduciary and strategic communications staff responsible for coordinating the implementation of AAP across the province.

According to the report, the budget analysis shows that the population of Sindh, which is the most food-deprived province, has been allocated less than 10 per cent of the total health budget to be spent on nutrition. Out of this amount, 90 per cent is financed by the development partners of nutrition-related activities in the province.

With a contribution from Department for International Development (DFID), the Pakistan Partnership for Improved Nutrition (PPIN), a multi-donor trust fund administered by the WB, plans to finance key interventions such as sanitation and hygiene in 13 districts, and nutrition sensitive agriculture interventions in four districts. On the flip side, under Pakistan’s Vision 2025, nutrition has received increased attention and the government has established a secretariat to coordinate and support the up scaling of nutrition.

Pakistan had joined the global movement of Scaling-Up-Nutrition (SUN) in 2013 while Sindh has recently adopted AAP which has the ambitious goals of reducing stunting from 48 per cent to 30 per cent by 2021 and to 15 percent by 2026. It plans to achieve it by increasing and expanding the coverage of multi-sector interventions proven to reduce stunting during the first five years of life.

The objectives and expected outcomes are dependent upon certain underlying causes of stunting, such as health, population, sanitation and hygiene, agriculture, social protection, education, and behavioural change. The government has committed itself to match every US dollar of Overseas Development Aid (ODA) funding by 0.5 US dollar domestic financing and has allocated Rs1 billion per year for the next three years out of the development budget, as an indication of this commitment and ownership.