National Nutrition

Programs in Pakistan
BY GROUP # 3
AYESHA KHURSHEED (18-72) KINZA TAHIR(18-90)
MAHNOOR KHAN (18-95) AMNA TAHIR (18-130)
INTRODUCTION

 Malnutrition is a serious health concern. For a developing

country like Pakistan, poverty, lack of governmental support,
and illiteracy contribute toward the widespread malnutrition
 Although there has been a general increase in awareness
and concern regarding nutrition in Pakistan
 Pakistan desperately needs nutritional programs for
surveillance, awareness, food fortification, and integration of
nutritional counseling as a part of regular medical checkups
and outreach programs
Conti…

 The need of the time is to use a multi-disciplinary, all-

handson-deck approach employing professionals from a
broad range of fields such as economists, nutritionists,
doctors, nurses, community health workers, and
agriculturists
 There is a discussion of the various nutritional programs
being run in Pakistan by the government and
nongovernmental organizations, their successes, failures,
room for improvement, and way forward
Twana Project

 This project is a governmental initiative of the Ministry of

social welfare and special education focused on primary
school girls
 It aims at combating malnutrition and increasing school
enrolment among the girls in primary schools in villages
 The project provided freshly prepared meals in the afternoon
to 418,000 girls and trained women in the community to run
nutrition awareness programs
Conti…

 Almost 94,000 women were trained through this programs to

spread nutritional awareness in their communities and a
significant drop in malnutrition, stunting, and wasting was
seen in the girls in target primary schools
 There was also an increase in the attendance of girls at
these schools
 This programs brought together an academic institution,
numerous nongovernmental organizations, and the
government for its implementation
Conti…

 The direct training of such a large number of women in

running nutritional awareness programs is certainly a big
achievement
 Not only can these women improve their own nutrition, but
they also hold the potential of improving the situation of their
children, families, and societies
 Even though focusing on girls and women is a start, however
it should grow to include boys and men in their domain as
well
National programme for family
planning and primary health care

 Commonly known as “Lady Health Workers’ Programme”,

National Program for Family Planning and Primary Health
Care was launched in April 1994
 Providing primary health care services to more than 80
million people of the country at their door steps
 The program was designed as an integral part of existing
health care delivery system of the country through locally
identified literate female workers who were trained on
primary health care and placed in the communities to which
they belonged
Conti…

 During 1970s and 80s, health indicators related to maternal

and child health were poor in Pakistan
 Major reasons were:

✓ Communication gap between community and national health

system,
✓ Resource crunch, and
✓ Spending the available resources on tertiary care and
neglecting primary health care and rural population
Conti…

 The Government of Pakistan took concrete steps in

collaboration with World Health Organization (WHO), and
launched its first nation-wide community based health
programme known as Lady Health Worker’s Program in
1994

 This programme reaches to more than 65% of the inhabited

area of Pakistan and provides free of cost services to 90
million people
Strengths of program

 Political commitment
 Wide coverage outreach – rural areas focused
 Integrations with healthcare system at upper levels
 Comprehensive healthcare provision
 Management Information System (MIS)
 Training of LHWs part of the system
 Positive impact on health indicators
 Cost effective intervention
Micronutrient Initiatives

 Together with national and provincial governments, we focus

on improving access to much needed micronutrients through
supplementation and fortification to improve health of women
and children
 The Micronutrient Initiative (MI) is dedicated to ensuring that
the world's most vulnerable-especially women and children
in developing countries-get the vitamins and minerals they
need to survive and thrive
Mission

 Our mission is to be a global leader in advancing integrated,

innovative and sustainable solutions to reduce vitamin and
mineral deficiencies through advocacy, technical and
programmatic support, in collaboration with others
➢ For every 10 children born in Pakistan, one will die before the age
of five
➢ Close to half of all children under five are moderately or severely
stunted
➢ 54% of children under five are vitamin A deficient
➢ 62% of children are anaemic
➢ Some regions show up to 86% prevalence of childhood anaemia
Solutions

 Nutrition International has been working in Pakistan since

2001 to improve the health of people in need, especially
women and children, through better nutrition.
 In partnership with national and provincial governments, we
work to:
➢ Improve and sustain the coverage of vitamin A
supplementation for children under five across Pakistan
➢ Increase the coverage and utilization of zinc supplements and
oral rehydration salts to manage childhood diarrhoea
Conti…

 Ensure that young girls, pregnant women, mothers and children

aged six to 24 months residing in remote rural areas of Pakistan
receive improved nutrition and healthcare
 Improve effectiveness of the national and provincial universal salt
iodization program
 Support the Scaling Up Nutrition (SUN) movement by hosting the
SUN Civil Society Alliance and SUN Academia and Research
Network
 Reach 50 million people with fortified wheat flour and 148 million
people with fortified edible oil or ghee
 Improve the levels of iron, vitamin B12, and folic acid among
children and women
School Health Program

School health service is a branch of community health which

provides promotive , preventive & curative health care services to
the school children
 one third children under 5 years of age are underweight
 More than 45% or over 50 million people in Pakistan are illiterate
 one third school aged children in Pakistan are not enrolled in primary schools
 30-40% enrolled children leave the school before completion of primary
education
 70% primary schools in Pakistan have only 2-room building for five classes
 Many children in rural schools either sit in congested class rooms, or study in
open air, in veranda, or under a tree
History

 Dated back to 1909 in Indian subcontinent Baroda city

 Historically, various elements of school health Programme have
been delivered in Pakistan in a fragmented manner
 In the early 70’s, School Health Services remained a component
of Health Service Delivery
 During 1980s, some form of School Health Programme was
started, with focus on health screening etc and medical doctors
were specifically appointed for this purpose at the grass root level
 Private practitioners specially in private school provide periodical
inspections but do not have follow up services
Conti…

 In June 2005, National Commission for Human Development

(NCHD) launched School Health Program in 17 districts of
Pakistan with funding from Bill and Melinda Gates Foundation
 The Programme covered 23,266 Primary Schools of these
districts and benefited 1.86 million students
 These students were screened bi-annually for health problems
and were referred for corrective actions to the established referral
outlets
 During the year, 53543 students found with weak eyesight were
provided free eyeglasses under the program
Health problem of the school child

 Malnutrition: 1. Under nutrition (Protein Energy Malnutrition) 2.

Over nutrition (Obesity)
 Communicable diseases: 1. Measles 2. Chicken pox 3. Diphtheria
 Intestinal parasites (Hook worm, Round worm)
 Disease of skin(Scabies, Ring worm)
 Disease of eye (Defective vision, Conjunctivitis )
 Disease of ear ( Otitis media)
 Dental caries
 Diarrhea
 Malaria
Objectives

 A) General objective :
➢ To provide comprehensive health care to school students in order to
prepare them physically, mentally & socially
 B) Specific objective :
➢ Promotion of Positive Health
➢ Prevention of Diseases
➢ Early Diagnosis, Treatment & Follow up of defects
➢ Awakening Health consciousness in children
Essential Components of School
Health Programme
 Screening of school children
 Environment :
➢ Satisfactory toilet facilities, Pure water supply, Good lighting & ventilation,
Clean environment, Rest room & play ground, Suitable chairs & desks
 Location:
➢ The school should ideally be located at a place -Away from busy
places and keep free from all hazards
 Class room:
➢ Height of the class room about 12 feet, Floor should be smooth, Room
soundproof & dustproof, Area not less then 480sq feet, Floor space 15sq
feet / child
 Play ground:
➢ For a primary school it should be 0.5 to 1 acre. For a secondary
school it should be 5 to 14 acres
 Seats & Desks:
➢ Zero desk: Here the posterior edge of the desk is vertically in line with
the anterior edge of the seat.Single seats and desks are ideal. Zero &
minus desks are suitable for reading & writing
 The seat should take 2/3 of the child’s thigh. Thigh remain
horizontal, Leg remain vertical, Back of the seat should
support the spine in the lumber region
 Basic sanitation, Water supply, First aid, Communicable
disease control, Health education
Strategies and approaches

 Provision of safe drinking water

 Promotion of healthful environment
 Health instruction & health education for the improvement of
knowledge
 Periodic physical examination of student
 Improving the capability of the teachers & class monitors
about any deviation from normal health
 Establishment of proper referral system
 Provision of legal support of a comprehensive school health
programme
Benefits to community

 Effective school health programmes will:

➢ Transform schools into child-friendly environment
➢ Contribute significantly to the promotion of Education for All
➢ Help student disseminate health and hygiene education messages to
their parents and community. This phenomenon is termed as child to
child, and child to community transmission of information relating to
health care and disease control
➢ School Health Programme will yield following benefits to the country
➢ Reduction in drop out rate
➢ Enhancement of quality of education and learning outcomes
➢ Improvement in health conditions of young population
➢ Disease control and an overall improvement in health conditions in the
society at large
Thank you!