Enhancing Nutrition Support Program in Sindh, Pakistan
  • One of the provinces of Pakistan, Sindh, is currently facing a serious problem of malnutrition. According to the Pakistan National Nutrition Survey 2011, 57% of children in Sindh are stunted. The urban-rural difference is also highest in Sindh, with higher prevalence of stunting in rural children as compared to urban children. Moreover, 42% of children are underweight with 48% in rural Sindh areas. Micronutrient deficiencies are highly prevalent among children under 5 and women of reproductive years. Sindh has the highest percentage of women with low ferritin levels of 31.5 mg/dl as compared to other provinces. On a provincial level, the prevalence of vitamin D deficiency among non-pregnant women in Sindh is the highest in the country. 
    To address these issues, the Nutrition cell of Sindh health department has launched the ‘Nutrition Support Program' (NSP) 2015-2018. The three-year program has been initiated in nine districts of Sindh, the worst affected areas in terms of nutrition. These areas are Jacobabad, Kashore-Kandhkot, Larkana, Qambar-Shahdadkot, Badin, Tando Muhammad Khan, Sanghar, Umerkot and Tharparkar. The aim is to improve the nutritional status of children under the age of five and of pregnant and lactating women, with a focus on malnourished, poverty-stricken people and other disadvantaged people such as women, female children and children with disabilities.
    Dr Fahim Aijaz, the NSP program director, recognized the need for trained human personnel who would be responsible to implement the program at a community level within the Sindh province. Therefore she requested School of Public Health, Dow University of Health Sciences, Karachi, to conduct a short course on Public Health Nutrition in September 2015. The course content was specifically designed for the 30 Nutrition field officers of NSP assigned in the nine marginalized districts of Sindh. Their task is to improve the nutritional status of children aged less than 5 years and women of reproductive age group in the community. The objective of the course was to provide the participants with some basic information on macro and micro nutrients, nutritional assessment techniques, food insecurity and issues related to malnutrition in the country. The content of the course was designed to enable the participants to effectively work in the various districts of Sindh.
    The course included various topics related to community and public health nutrition such as importance of macro and micro nutrients in nutritional wellbeing, social determinants influencing nutritional health, nutrition care process including assessment, intervention and follow up of nutrition initiatives in the community. Required skills for team work & participatory approach in nutrition education and counseling techniques were also discussed using the role play model and hands on techniques. The subject of food insecurity, food safety, sanitation and storage were discussed in different sessions to highlight its linkages in reducing malnutrition in the community. The participants also had the opportunity to understand and critically review different health & nutrition surveys of Pakistan. Interactive session was also held to apprise the participants regarding Universal Salt Iodization in Pakistan.
    The teaching faculty of the course included members of the Pakistan Nutrition & Dietetic Society (PNDS) under the guidance of the course director Dr.Nilofer Fatimi Safdar. The faculty worked very closely with Saima Rasheed from National Medical Center, Lt.Cdr Rabia Anwer from PNS Naval Hospital, Faiza Shoaib from Memon Medical Institute, Ayesha Zahid Khan from Aga Khan University and Dr.Fatima Saad from Micronutrient Initiative. Others who taught in the course included faculty members from School of Public Health, Dow University – Dr. Syeda Kanwal, Dr. Zeeshan Sheikh, Sumaira Nasim, Mehreen Amer, Nadia Shah and Nida Jawed, course co-ordinator.
    Certificates were awarded to the participants at the concluding session. Dr Fahim Aijaz, in her concluding remark appreciated the effort put in by the organizers and also hoped that such endeavors will continue in collaboration with the Dow University of Health Sciences.
    Ms Nida Jawed, Senior Lecturer, School of Public Health, Dow University of Health Sciences
    Vice President, PNDS
    Dr. Nilofer Fatimi Safdar, Program Director, Nutrition. School of Public Health, Dow University of Health Sciences
    Country Rep, ICDA