Action - Nutrition International - Pakistan - Maternal Newborn Health and Nutrition (MNHN) Program - Feeding of LBW infants - Newborns (up to 28 days of age)

Programme: Nutrition International - Pakistan - Maternal Newborn Health and Nutrition (MNHN) Program

Programme description

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:

  • Increasing access to antenatal care (ANC) quality and attendance as well as a package of care for women and newborns at delivery and in the postnatal period.
  • Reducing the risk of anaemia among pregnant women by supporting the provision of and adherence to iron and folic acid supplements. 
  • Supporting the government in demonstrating an integrated multipronged program model for implementing community outreach health and nutrition interventions. 
  • Supporting the identification and referral of pregnant women and children 6-23 months of age with malnutrition.
  • Promoting an enabling environment through advocacy among key decision-makers for commitment to MNHN.
  • Providing technical assistance for scaling up best practices.
  • Supporting procurement and supply chain strengthening.
  • Capacity-building of health care managers, midwives, and service providers at facility and community levels, through training and mentoring/supportive supervision.
  • Developing and implementing a behavior change communication materials and tools.
  • Supporting the establishment of KMC centers in hospitals.
  • Supporting program monitoring and assessment, and use of this information to inform decision-making.

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.

Programme type



  1. Allen, L. H. (2000). Anemia and iron deficiency: Effects on pregnancy outcome. The American Journal of Clinical Nutrition,71(5). doi:10.1093/ajcn/71.5.1280s
  2. Black, R. E., Victora, C. G., Walker, S. P., Bhutta, Z. A., Christian, P., Onis, M. D., . . . Uauy, R. (2013). Maternal and child undernutrition and overweight in low-income and middle-income countries. The Lancet,382(9890), 427-451. doi:10.1016/s0140-6736(13)60937-x
  3. WHO. The global prevalence of anaemia in 2011. Geneva: World Health Organization; 2015. 
  4. WHO. (2016). WHO recommendations on antenatal care for a positive pregnancy experience. (Rep.). doi:
  5. WHO. (2017). Protecting, promoting and supporting breastfeeding in facilities providing maternity and newborn services: Guideline(Rep.). doi:
  6. WHO. (2018). WHO recommendations: Intrapartum care for a positive childbirth experience(Rep.). doi:
  7. NEOVITA Study Group. (2016). Timing of initiation, patterns of breastfeeding, and infant survival: Prospective analysis of pooled data from three randomised trials. The Lancet Global Health,4(4). doi:10.1016/s2214-109x(16)00040-1
  8. United Nations Inter-agency Group for Child Mortality Estimation (UN IGME), ‘Levels & Trends in Child Mortality: Report 2017, Estimates Developed by the UN Inter-agency Group for Child Mortality Estimation’, United Nations Children’s Fund, New York, 2017.

For more information:

Target group: 
Newborns (up to 28 days of age)

Revision log

Mon, 10/22/2018 - 19:10zillmerkpublishedpublished
Mon, 10/22/2018 - 15:07GINAadminNIEdited by GINAadminNI.needs_review
Mon, 10/22/2018 - 15:07GINAadminNIAction created by GINAadminNI.draft