"programme_id","programme_title","programme_language","programme_type","other_program","iso3code","country_name","program_location","area","status","start_date","end_date","brief_description","references","related_policy","new_policy","partner_gov","partner_government_details","partner_un","partner_un_details","partner_ngo","partner_ngo_details","partner_donors","partner_donors_details","partner_intergov","partner_intgov_details","partner_national_ngo","partner_nat_ngo_details","partner_research","partner_research_details","partner_private","partner_private_details","partner_other","partner_other_details","cost","fsector_0","fpartner_0","fdetails_0","fsector_1","fpartner_1","fdetails_1","fsector_2","fpartner_2","fdetails_2","fsector_3","fpartner_3","fdetails_3","fsector_4","fpartner_4","fdetails_4","fsector_5","fpartner_5","fdetails_5","fsector_6","fpartner_6","fdetails_6","fsector_7","fpartner_7","fdetails_7","fsector_8","fpartner_8","fdetails_8","fsector_9","fpartner_9","fdetails_9","fsector_10","fpartner_10","fdetails_10","fsector_11","fpartner_11","fdetails_11","fsector_12","fpartner_12","fdetails_12","fsector_13","fpartner_13","fdetails_13","fsector_14","fpartner_14","fdetails_14","fsector_15","fpartner_15","fdetails_15","fsector_16","fpartner_16","fdetails_16","fsector_17","fpartner_17","fdetails_17","fsector_18","fpartner_18","fdetails_18","fsector_19","fpartner_19","fdetails_19","fsector_20","fpartner_20","fdetails_20","fsector_21","fpartner_21","fdetails_21","fsector_22","fpartner_22","fdetails_22","fsector_23","fpartner_23","fdetails_23","fsector_24","fpartner_24","fdetails_24","fsector_25","fpartner_25","fdetails_25","fsector_26","fpartner_26","fdetails_26","fsector_27","fpartner_27","fdetails_27","fsector_28","fpartner_28","fdetails_28","fsector_29","fpartner_29","fdetails_29","fsector_30","fpartner_30","fdetails_30","fsector_31","fpartner_31","fdetails_31","fsector_32","fpartner_32","fdetails_32","fsector_33","fpartner_33","fdetails_33","fsector_34","fpartner_34","fdetails_34","fsector_35","fpartner_35","fdetails_35","fsector_36","fpartner_36","fdetails_36","fsector_37","fpartner_37","fdetails_37","fsector_38","fpartner_38","fdetails_38","fsector_39","fpartner_39","fdetails_39","fsector_40","fpartner_40","fdetails_40","fsector_41","fpartner_41","fdetails_41","fsector_42","fpartner_42","fdetails_42","fsector_43","fpartner_43","fdetails_43","fsector_44","fpartner_44","fdetails_44","fsector_45","fpartner_45","fdetails_45","fsector_46","fpartner_46","fdetails_46","fsector_47","fpartner_47","fdetails_47","fsector_48","fpartner_48","fdetails_48","fsector_49","fpartner_49","fdetails_49","action_id","theme","topic","new_topic","micronutrient","micronutrient_compound","target_group","age_group","place","delivery","other_delivery","dose_frequency","impact_indicators","me_system","target_pop","coverage_percent","coverage_type","baseline","post_intervention","social_det","social_other","elena_link","problem_0","solution_0","problem_1","solution_1","problem_2","solution_2","problem_3","solution_3","problem_4","solution_4","problem_5","solution_5","problem_6","solution_6","problem_7","solution_7","problem_8","solution_8","problem_9","solution_9","other_problems","other_lessons","personal_story","language" "24649","Nutrition International - Pakistan - Food Fortification Programme","English","National","","PAK","Pakistan","","","on-going","03-2016","","
Pakistan has one of the highest burdens of malnutrition in the world. More than half of the under-five year old population suffers from either stunting (chronic malnutrition), wasting (acute malnutrition), or both. One in four pregnant women are suffering from iron deficiency anaemia; and zinc, vitamin D and vitamin A deficiencies affect 37%, 41% and 56% of children under five respectively, on a national level [1]. Meeting nutrient needs is a prerequisite to preventing malnutrition, in combination with other proven health interventions.
In March 2016, Mott MacDonald as the Management Lead, with Nutrition International (NI) as the Technical Lead were awarded a 5-year grant with the main objective of fortifying commercially produced wheat flour (with iron, folic acid, vitamin B12 and zinc) and edible oil/ghee (with vitamins A and D) throughout Pakistan. This is one of the largest fortification programs in the world and it is expected to reach ~150 million people with fortified food staples.
The program aims to cover more than 100 edible oil/ghee mills and over 1,000 wheat flour mills to ensure adequate fortification. It will achieve its objectives by:
Pakistan has one of the highest burdens of malnutrition in the world. More than half of the under-five year old population suffers from either stunting (chronic malnutrition), wasting (acute malnutrition), or both. One in four pregnant women are suffering from iron deficiency anaemia; and zinc, vitamin D and vitamin A deficiencies affect 37%, 41% and 56% of children under five respectively, on a national level [1]. Meeting nutrient needs is a prerequisite to preventing malnutrition, in combination with other proven health interventions.
In March 2016, Mott MacDonald as the Management Lead, with Nutrition International (NI) as the Technical Lead were awarded a 5-year grant with the main objective of fortifying commercially produced wheat flour (with iron, folic acid, vitamin B12 and zinc) and edible oil/ghee (with vitamins A and D) throughout Pakistan. This is one of the largest fortification programs in the world and it is expected to reach ~150 million people with fortified food staples.
The program aims to cover more than 100 edible oil/ghee mills and over 1,000 wheat flour mills to ensure adequate fortification. It will achieve its objectives by:
Vitamin A deficiency (VAD) is a public health problem all around the world, affecting more than 100 countries [1]. A lack of vitamin A weakens the immune system, putting a child at greater risk of disease and early death; and it is also the leading cause of preventable child blindness. The solution for correcting vitamin A deficiency lies in improving the child’s diet – through increased consumption of vitamin A-rich foods, naturally rich or commercially fortified foods such as processed oils or sugar.
In countries where this remains a public health problem, and while food-based solutions are gradually being implemented and scaled-up to reach those populations, giving children 6 to 59 months of age two doses of vitamin A per year can impact a child’s health. Specifically, the range of impact on deaths averted can range from a lower bound cause-specific effect size of 28% (diarrheal deaths averted) to an upper bound of 12%-24% all-cause mortality reduction [2].
Nutrition International is committed to supporting vitamin A supplement (VAS) programs for children 6 to 59 months of age in settings where VAD is a public health problem, as one of the most cost-effective ways to improve child survival.
The main aims of NI’s VAS program in Pakistan are to:
These activities are being implemented in partnership with the Federal Government of Pakistan and the National VAS Technical Working group that includes the MOH and VAS stakeholders, including NI and UNICEF. This work is being conducted on a national level through technical and operational assistance to the Ministry of Health and on a sub-national level in four provinces; Punjab, Sindh, Baluchistan and Khyber Pakhtunkhwa . NI support to Pakistan’s VAS program began in 1999 and is ongoing.
","[1] WHO. (2013). Micronutrient deficiencies. Retrieved from http://www.who.int/nutrition/topics/vad/en/
[2] Imdad A, Herzer, K, Mayo-Wilson E, Yakoob MY, Bhuta ZA. Vitamin A supplementation for preventing morbidity and mortality in children from 6 months to 5 years of age. Cochrane Database of Systematic Reviews 2010, Issue 12.
For more information:
The first 1000 days from conception to two years of age are critical to the health and development of a child. Adequate infant and young child nutrition (IYCN) is crucial for survival and long-term health and well-being. Approximately 45% of deaths of children under five years of age can be attributed to malnutrition [1], and are often associated with inappropriate feeding practices during the first years of life [2]. The first two years of life provide a critical window of opportunity for ensuring children’s appropriate growth and development through optimal feeding. Many countries experience a sharp increase in the prevalence of malnutrition for this age group.
NI supports countries to implement their IYCN program in line with WHO/UNICEF recommended IYCF practices. This includes the timely initiation of breastfeeding, exclusive breastfeeding to the age of six months, introduction of solid, semi-solid and soft foods at 6 months of age and continued breastfeeding until 24 months of age, recommended minimum meal frequency and dietary diversity. NI also supports recommended practices such as responsive feeding, hand washing with clean water and soap, and safe food preparation and storage.
NI’s approach to IYCN in Pakistan is to align all IYCN activities with national and provincial policies. The program aims to improve IYCN practices by strengthening the capacity of the front line health workers with primary focus on interpersonal counselling skills to deliver a comprehensive package of services for maternal and newborn child health at the community level, with an emphasis on the promotion and support for exclusive breastfeeding to the age of 6 months, and optimal complementary feeding for children 6-23 months of age. Most activities are implemented through two existing government programs, namely, the Lady Health Workers (LHWs) and the community midwives deployed in the communities from the Maternal, Neonatal, Child Health (MNCH) program.
These activities are being implemented through key partnerships on the national level (Ministry of National Health Services, Regulations and Coordination), Provincial level (Director General Health Services (DGHS), Departments of Health; Integrated Maternal, Newborn, Child Health and Nutrition Program (IRMNCH & NP), Punjab of Primary and Secondary (P&S) Health Department, Government of Punjab; Policy Strategic and Planning Unit (PSPU), Primary and Secondary (P&S) Health Department, Government of Punjab; Maternal Newborn and Child Health Program (MNCH); National Lady Health Workers Program (LHWP); Provincial Nutrition Cells; Nutrition Support Program (NSP); Integrated Health Program) and through local NGOs (National Rural Support Program). This program is being implemented sub-nationally in seven districts; Lodhran, Jamshoro, Mirpurkhas, Khaipur, Swabi, Nowshera and Mardan across the three provinces; Punajb, Sindh and Khyber Pakhtunkhwa. NI support to IYCN in Pakistan began in 2016 and is ongoing.
","[1] Black RE et al. Maternal and child undernutrition and overweight in low-income and middle-income countries. The Lancet. 2013; 382(9890):427-451
[2] Sankar MJ, et al. Optimal breastfeeding practices and infant and child mortality: a systematic review and meta-analysis. Acta Paediatr. 2015 Dec;104(467):3-13
For more information:
The first 1000 days from conception to two years of age are critical to the health and development of a child. Adequate infant and young child nutrition (IYCN) is crucial for survival and long-term health and well-being. Approximately 45% of deaths of children under five years of age can be attributed to malnutrition [1], and are often associated with inappropriate feeding practices during the first years of life [2]. The first two years of life provide a critical window of opportunity for ensuring children’s appropriate growth and development through optimal feeding. Many countries experience a sharp increase in the prevalence of malnutrition for this age group.
NI supports countries to implement their IYCN program in line with WHO/UNICEF recommended IYCF practices. This includes the timely initiation of breastfeeding, exclusive breastfeeding to the age of six months, introduction of solid, semi-solid and soft foods at 6 months of age and continued breastfeeding until 24 months of age, recommended minimum meal frequency and dietary diversity. NI also supports recommended practices such as responsive feeding, hand washing with clean water and soap, and safe food preparation and storage.
NI’s approach to IYCN in Pakistan is to align all IYCN activities with national and provincial policies. The program aims to improve IYCN practices by strengthening the capacity of the front line health workers with primary focus on interpersonal counselling skills to deliver a comprehensive package of services for maternal and newborn child health at the community level, with an emphasis on the promotion and support for exclusive breastfeeding to the age of 6 months, and optimal complementary feeding for children 6-23 months of age. Most activities are implemented through two existing government programs, namely, the Lady Health Workers (LHWs) and the community midwives deployed in the communities from the Maternal, Neonatal, Child Health (MNCH) program.
These activities are being implemented through key partnerships on the national level (Ministry of National Health Services, Regulations and Coordination), Provincial level (Director General Health Services (DGHS), Departments of Health; Integrated Maternal, Newborn, Child Health and Nutrition Program (IRMNCH & NP), Punjab of Primary and Secondary (P&S) Health Department, Government of Punjab; Policy Strategic and Planning Unit (PSPU), Primary and Secondary (P&S) Health Department, Government of Punjab; Maternal Newborn and Child Health Program (MNCH); National Lady Health Workers Program (LHWP); Provincial Nutrition Cells; Nutrition Support Program (NSP); Integrated Health Program) and through local NGOs (National Rural Support Program). This program is being implemented sub-nationally in seven districts; Lodhran, Jamshoro, Mirpurkhas, Khaipur, Swabi, Nowshera and Mardan across the three provinces; Punajb, Sindh and Khyber Pakhtunkhwa. NI support to IYCN in Pakistan began in 2016 and is ongoing.
","[1] Black RE et al. Maternal and child undernutrition and overweight in low-income and middle-income countries. The Lancet. 2013; 382(9890):427-451
[2] Sankar MJ, et al. Optimal breastfeeding practices and infant and child mortality: a systematic review and meta-analysis. Acta Paediatr. 2015 Dec;104(467):3-13
For more information:
Pregnancy and the postnatal period are critical times for ensuring the health and wellbeing of women and their children. Anaemia during pregnancy is common and can have serious consequences for both mother and child, including increased risk of low birthweight and preterm birth, as well as maternal and perinatal mortality.[1&2] Iron deficiency is a major cause of anaemia among pregnant women.[3] Iron requirements increase substantially during pregnancy and it is difficult to meet these needs with food alone. Based on evidence of reduced risk of anaemia, iron deficiency and other adverse outcomes including having a low birthweight baby, WHO recommends daily iron and folic acid (IFA) supplementation throughout pregnancy.[4] This is in addition to a series of other recommendations for nutrition interventions as part of antenatal care for a positive pregnancy experience and other important maternal and child outcomes.[4]
Optimal care and feeding of newborns helps ensure babies survive and sets the stage for healthy growth and development. For example, initiating breastfeeding within the first hour of life, as recommended by WHO[5&6], increases the likelihood of exclusive breastfeeding and reduces the chance of newborn illness or death [7]. The newborn period, which is the first 28 days of life, is the most vulnerable time in a child’s life, and accounts for almost half (46%) of the total deaths in children under five years of age [8]. Fortunately, many of these deaths are preventable through evidence-informed, low-cost care, such as supporting mothers to start breastfeeding soon after birth, which can be delivered even in resource-limited settings.
Nutrition International works in collaboration with government and other partners to improve maternal and newborn health and nutrition (MNHN) through enhancing the provision, quality and integration of health and nutrition services and empowering women and their families to seek care and adopt healthy behaviours.
Nutrition International's (NI) support to MNHN programming in Pakistan began in 2015. Since then, NI has contributed to improving MNHN in Pakistan by:
This work is in partnership with the Ministry of National Health Services, Regulations and Coordination, Provincial Director General Health Services (DGHS), and Departments of Health Integrated Maternal, Newborn, Child Health and Nutrition Program (IRMNCH & NP). The program is being implemented in three districts Lodhran, Jamshoro and Swabi across the three provinces Punajb, Sindh and Khyber Pakhtunkhwa, respectively.
Although this section describes MNHN, wherever possible, Nutrition International’s work in Pakistan follows a comprehensive and integrated approach, with a strong focus on the first 1000 days, from pregnancy through 2 years of age.
","For more information:
Pregnancy and the postnatal period are critical times for ensuring the health and wellbeing of women and their children. Anaemia during pregnancy is common and can have serious consequences for both mother and child, including increased risk of low birthweight and preterm birth, as well as maternal and perinatal mortality.[1&2] Iron deficiency is a major cause of anaemia among pregnant women.[3] Iron requirements increase substantially during pregnancy and it is difficult to meet these needs with food alone. Based on evidence of reduced risk of anaemia, iron deficiency and other adverse outcomes including having a low birthweight baby, WHO recommends daily iron and folic acid (IFA) supplementation throughout pregnancy.[4] This is in addition to a series of other recommendations for nutrition interventions as part of antenatal care for a positive pregnancy experience and other important maternal and child outcomes.[4]
Optimal care and feeding of newborns helps ensure babies survive and sets the stage for healthy growth and development. For example, initiating breastfeeding within the first hour of life, as recommended by WHO[5&6], increases the likelihood of exclusive breastfeeding and reduces the chance of newborn illness or death [7]. The newborn period, which is the first 28 days of life, is the most vulnerable time in a child’s life, and accounts for almost half (46%) of the total deaths in children under five years of age [8]. Fortunately, many of these deaths are preventable through evidence-informed, low-cost care, such as supporting mothers to start breastfeeding soon after birth, which can be delivered even in resource-limited settings.
Nutrition International works in collaboration with government and other partners to improve maternal and newborn health and nutrition (MNHN) through enhancing the provision, quality and integration of health and nutrition services and empowering women and their families to seek care and adopt healthy behaviours.
Nutrition International's (NI) support to MNHN programming in Pakistan began in 2015. Since then, NI has contributed to improving MNHN in Pakistan by:
This work is in partnership with the Ministry of National Health Services, Regulations and Coordination, Provincial Director General Health Services (DGHS), and Departments of Health Integrated Maternal, Newborn, Child Health and Nutrition Program (IRMNCH & NP). The program is being implemented in three districts Lodhran, Jamshoro and Swabi across the three provinces Punajb, Sindh and Khyber Pakhtunkhwa, respectively.
Although this section describes MNHN, wherever possible, Nutrition International’s work in Pakistan follows a comprehensive and integrated approach, with a strong focus on the first 1000 days, from pregnancy through 2 years of age.
","For more information:
Pregnancy and the postnatal period are critical times for ensuring the health and wellbeing of women and their children. Anaemia during pregnancy is common and can have serious consequences for both mother and child, including increased risk of low birthweight and preterm birth, as well as maternal and perinatal mortality.[1&2] Iron deficiency is a major cause of anaemia among pregnant women.[3] Iron requirements increase substantially during pregnancy and it is difficult to meet these needs with food alone. Based on evidence of reduced risk of anaemia, iron deficiency and other adverse outcomes including having a low birthweight baby, WHO recommends daily iron and folic acid (IFA) supplementation throughout pregnancy.[4] This is in addition to a series of other recommendations for nutrition interventions as part of antenatal care for a positive pregnancy experience and other important maternal and child outcomes.[4]
Optimal care and feeding of newborns helps ensure babies survive and sets the stage for healthy growth and development. For example, initiating breastfeeding within the first hour of life, as recommended by WHO[5&6], increases the likelihood of exclusive breastfeeding and reduces the chance of newborn illness or death [7]. The newborn period, which is the first 28 days of life, is the most vulnerable time in a child’s life, and accounts for almost half (46%) of the total deaths in children under five years of age [8]. Fortunately, many of these deaths are preventable through evidence-informed, low-cost care, such as supporting mothers to start breastfeeding soon after birth, which can be delivered even in resource-limited settings.
Nutrition International works in collaboration with government and other partners to improve maternal and newborn health and nutrition (MNHN) through enhancing the provision, quality and integration of health and nutrition services and empowering women and their families to seek care and adopt healthy behaviours.
Nutrition International's (NI) support to MNHN programming in Pakistan began in 2015. Since then, NI has contributed to improving MNHN in Pakistan by:
This work is in partnership with the Ministry of National Health Services, Regulations and Coordination, Provincial Director General Health Services (DGHS), and Departments of Health Integrated Maternal, Newborn, Child Health and Nutrition Program (IRMNCH & NP). The program is being implemented in three districts Lodhran, Jamshoro and Swabi across the three provinces Punajb, Sindh and Khyber Pakhtunkhwa, respectively.
Although this section describes MNHN, wherever possible, Nutrition International’s work in Pakistan follows a comprehensive and integrated approach, with a strong focus on the first 1000 days, from pregnancy through 2 years of age.
","For more information:
Pregnancy and the postnatal period are critical times for ensuring the health and wellbeing of women and their children. Anaemia during pregnancy is common and can have serious consequences for both mother and child, including increased risk of low birthweight and preterm birth, as well as maternal and perinatal mortality.[1&2] Iron deficiency is a major cause of anaemia among pregnant women.[3] Iron requirements increase substantially during pregnancy and it is difficult to meet these needs with food alone. Based on evidence of reduced risk of anaemia, iron deficiency and other adverse outcomes including having a low birthweight baby, WHO recommends daily iron and folic acid (IFA) supplementation throughout pregnancy.[4] This is in addition to a series of other recommendations for nutrition interventions as part of antenatal care for a positive pregnancy experience and other important maternal and child outcomes.[4]
Optimal care and feeding of newborns helps ensure babies survive and sets the stage for healthy growth and development. For example, initiating breastfeeding within the first hour of life, as recommended by WHO[5&6], increases the likelihood of exclusive breastfeeding and reduces the chance of newborn illness or death [7]. The newborn period, which is the first 28 days of life, is the most vulnerable time in a child’s life, and accounts for almost half (46%) of the total deaths in children under five years of age [8]. Fortunately, many of these deaths are preventable through evidence-informed, low-cost care, such as supporting mothers to start breastfeeding soon after birth, which can be delivered even in resource-limited settings.
Nutrition International works in collaboration with government and other partners to improve maternal and newborn health and nutrition (MNHN) through enhancing the provision, quality and integration of health and nutrition services and empowering women and their families to seek care and adopt healthy behaviours.
Nutrition International's (NI) support to MNHN programming in Pakistan began in 2015. Since then, NI has contributed to improving MNHN in Pakistan by:
This work is in partnership with the Ministry of National Health Services, Regulations and Coordination, Provincial Director General Health Services (DGHS), and Departments of Health Integrated Maternal, Newborn, Child Health and Nutrition Program (IRMNCH & NP). The program is being implemented in three districts Lodhran, Jamshoro and Swabi across the three provinces Punajb, Sindh and Khyber Pakhtunkhwa, respectively.
Although this section describes MNHN, wherever possible, Nutrition International’s work in Pakistan follows a comprehensive and integrated approach, with a strong focus on the first 1000 days, from pregnancy through 2 years of age.
","For more information:
Pregnancy and the postnatal period are critical times for ensuring the health and wellbeing of women and their children. Anaemia during pregnancy is common and can have serious consequences for both mother and child, including increased risk of low birthweight and preterm birth, as well as maternal and perinatal mortality.[1&2] Iron deficiency is a major cause of anaemia among pregnant women.[3] Iron requirements increase substantially during pregnancy and it is difficult to meet these needs with food alone. Based on evidence of reduced risk of anaemia, iron deficiency and other adverse outcomes including having a low birthweight baby, WHO recommends daily iron and folic acid (IFA) supplementation throughout pregnancy.[4] This is in addition to a series of other recommendations for nutrition interventions as part of antenatal care for a positive pregnancy experience and other important maternal and child outcomes.[4]
Optimal care and feeding of newborns helps ensure babies survive and sets the stage for healthy growth and development. For example, initiating breastfeeding within the first hour of life, as recommended by WHO[5&6], increases the likelihood of exclusive breastfeeding and reduces the chance of newborn illness or death [7]. The newborn period, which is the first 28 days of life, is the most vulnerable time in a child’s life, and accounts for almost half (46%) of the total deaths in children under five years of age [8]. Fortunately, many of these deaths are preventable through evidence-informed, low-cost care, such as supporting mothers to start breastfeeding soon after birth, which can be delivered even in resource-limited settings.
Nutrition International works in collaboration with government and other partners to improve maternal and newborn health and nutrition (MNHN) through enhancing the provision, quality and integration of health and nutrition services and empowering women and their families to seek care and adopt healthy behaviours.
Nutrition International's (NI) support to MNHN programming in Pakistan began in 2015. Since then, NI has contributed to improving MNHN in Pakistan by:
This work is in partnership with the Ministry of National Health Services, Regulations and Coordination, Provincial Director General Health Services (DGHS), and Departments of Health Integrated Maternal, Newborn, Child Health and Nutrition Program (IRMNCH & NP). The program is being implemented in three districts Lodhran, Jamshoro and Swabi across the three provinces Punajb, Sindh and Khyber Pakhtunkhwa, respectively.
Although this section describes MNHN, wherever possible, Nutrition International’s work in Pakistan follows a comprehensive and integrated approach, with a strong focus on the first 1000 days, from pregnancy through 2 years of age.
","For more information:
","","","Health","Ministry of National Health Services, Regulations and Coordination, Provincial Director General Health Services (DGHS), and Departments of Health Integrated Maternal, Newborn, Child Health and Nutrition Program (IRMNCH & NP)","","","Nutrition International","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","26321","","Feeding of LBW infants","","","","Newborns (up to 28 days of age)","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","English"