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 , and are often associated with inappropriate feeding practices during the first years of life . 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.
 Black RE et al. Maternal and child undernutrition and overweight in low-income and middle-income countries. The Lancet. 2013; 382(9890):427-451
 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
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