Purpose of AAP

Multidimensional Poverty report 2016 developed by Ministry of Planning, Development & Reforms with Technical Cooperation of UNDP states “the poor people in Pakistan experience 19.7% deprivations and country’s multidimensional poverty headcount ratio is estimated at 38.8% of population”. Another indicator of caloric poverty is also considerably higher i.e. 40% and multidimensional headcount poverty with incidence rate 43.1% and other specific health determinants like 59.7% of anemic pregnant women including 48.9% moderately anemic with Hemoglobin (Hb) less than 10 gram in Sindh calls for robust integrated approach to reduce stunting in the province.

Children’s growth and development is a maturational and interactive process, and they can reach their full developmental potential (academic, behavioral, socio-emotional, and economic) when they have adequate health, nutrition, security and safety, responsive caregiving, and early learning. All these domains interact with each other and can be mutually reinforcing through the process of development. Positive associations between nurturing care and children’s health, growth, and development have been supported by neuro-scientific evidence that nurturing care during early childhood diminishes the detrimental effects of low socioeconomic status on brain development.

Recent evidence indicates that integration of interventions for early childhood development, especially those for mothers and families of children under 03 years of age, on existing health and nutrition service delivery platforms is an effective and efficient way to reach large numbers of families and children at this critical stage of their development with early childhood care interventions.

In Sindh, the NSP programis already under implementationin 09 districts of province, which last till December 2018 and other ones in hand with the donors having scattered approach. USAID/ UNICEF funded projects in Khairpur, Ghotki, Noshehroferozcovering only 30 % of the district area, which will last till June, 2018. European Union is executing its program of improved nutrition in 04 Districtsviz:Dadu, Thatta, Sujawal, Shikarpur, which will complete in March, 2017. Its targeted coverage is 55 % of the district.World Food Program has launched:

1. Community Management of Acute Malnutrition (CMAM) in Tharparkar, Umerkot,Sanghar and Jamshoro) for the treatment of moderately acute malnourished children.
2. Reduction in Stunting (Thatta, Sujawal)
3. Cash based transfers for livelihood activities (Tharparkar, Umerkot, Sanghar, Mirpurkhas, Badin)

Apart of this, the European Union is launching its second phase 2017-2021 with multi-sectoral approach in ten districts i) Sujawal, ii) Thatta, iii) Shikarpur, iv) TMKhan, v) Matiari, vi) TandoA. Yar, vii) Dadu, viii) Larkana, ix) Qamber, x) Kashmore.

At facility and community level, Maternal Neonatal & Child Health Program and Nutrition Support Program through 4 plus ANC and 3 plus PNC visits provide nutritional advices with sprinkles support to children and iron supplementation minor to chronic severely acute malnutrition cases of child bearing and pregnant mothers. Likewise the Expanded Program on Immunization provided Vitamin supplementation at fixed centers as well as in yearly during Polio campaigns. LWH Program with somehow support from muti-donors,Government of Sindh’s special and in addition, NSP provide micro nutritional supplementation including Iron-Folic acid at community level.

The Sustainable Development Goals (SDGs) have 17 goals with 169 target areas. Three goals 1:ending poverty reduction, 2:zero hunger/ achieving food security and improved nutrition and 3:healthy living and wellbeing are guiding the principles for malnutrition and stunting reduction.

The plan, therefore, will address problem of prevailing malnutrition in very poor communities dietary improvement activities for cause of healthy living in coordination of other related projects. It will make the adult persons economical productive and enhance children’s learning capacity, also economic and social empowerment of women. Hence, project is in line with SDGs 2015-2030

Sustainable Development Goals 1, 2 and 3 and their respective targets:

• 1.1 calling for by 2030 eradicate poverty for all people everywhere currently measured as people living on less than $1.25;
• 1.3 calling to implement nationally appropriate social protection system and measures for all including floors, and by 2030 achieve sustainable coverage of the poor and vulnerables;
• 2.1 calls, by 2030 end hunger and ensure access by all people, in particular the poor and people in vulnerable situations including infants, to safe, nutritious and sufficient food all year round;
• 2.2 calls, by 2030 end all forms of malnutrition, including achieving by 2025 the internationally agreed targets on stunting and wasting in children under five years of age, and address the nutritional needs of adolescent girls, pregnant and lactating women, and older persons;
• 3.1calling for ending all preventable deaths and reducing global maternal mortality ratio to less than 70 per 100,000 Live Births by 2030;
• 3.2 emphasis for ending preventable deaths of newborn and children under-05 years of age. Aiming to reduce neonatal mortality at least as low as 12 per 1,000 and under five mortality 25 per 1,000 by 2030.