In Pakistan, malnutrition poses a silent yet catastrophic threat to the health, development, and future of millions, particularly children and women, suffer from its effects. Pakistan has the largest population of stunted children in South Asia, an indication of chronic malnutrition in children under 5 years of age. Around 40 percent are stunted, 18 percent wasted, 29 percent underweight and more than half of them are anemic. Over 5 million children nationwide urgently need critical nutrition services, around 1.5 million of these reside in areas affected by climate crisis. Malnutrition weakens the immune system, making individuals more vulnerable to disease, and disrupts cognitive development, thereby reinforcing a vicious cycle of poverty and underdevelopment.
Tackling malnutrition requires a comprehensive & multisectoral approach that addresses its root causes, including poverty, limited access to quality healthcare and education, inadequate sanitation, gender disparities, cultural practices, insufficient dietary diversity, and food insecurity. The impact of malnutrition goes beyond individual suffering, affecting economic growth, human capital, and straining the healthcare system.
In 2024, IRC launched “The Movement Against Malnutrition” a venture with a single goal: to ensure that no child dies of hunger, especially when we have scalable and proven solutions. The Movement builds on IRC’s track record, including the design and research of ground-breaking innovations, delivery of malnutrition services to millions of children a year, and advocacy for urgent action to end this global crisis. We believe there is strength in the alliance building that will result in more lives of children being saved. The International Rescue Committee (IRC) believes that strengthening local community-based organizations is essential for combating malnutrition by enabling responsive governance and improving service delivery in the nutrition sector. As CSOs are deeply rooted in communities, they possess vast potential to complement government efforts, strengthen and support nutrition programming, and facilitating a responsive feedback loop between the service providers and the communities.
With the support of European Union in Pakistan, IRC alongside partner organizations, Medical Emergency Resilience Foundation and Strengthening Participatory Organization have substantially invested in organizational development of 15 local Civil Society Organizations from five districts: Sukkur, Khairpur, Ghotkhi, Nosheroferoz and Kashmore in Sindh. This entails improving program effectiveness, accountability, and enhancing the management capacity of CSOs. The capacity development support to the CSOs have been ensured through need-based training workshops on financial management, leadership and advocacy skills, accountability to target populations and further equipping CSOs with essential tools for community engagement and program development and implementation.
The local organizations supported through an extensive organization development interventions and continuous technical backstopping, have now embarked upon implementing innovative community-based nutrition specific programs. These 15 initiatives, one by each of the CSO, are aimed at creating a demand at the root level for nutrition through a multipronged approach entailing community awareness programs, screening and referring children and women for nutrition treatment and advocating for improved service delivery in the target districts through extensive engagement of village committees. The involvement of CSOs brings unique locally rooted insights into program assessments and delivery to identify and mitigate social and environmental drivers of malnutrition such as climate change, food insecurity, social isolation and poverty.
Another key aspect of the programs by CSO’s is the inclusion of the community change makers, outreach health workers like Lady Health Workers from the health department, community mid-wives and fostering linkages with community leaders . As the LHWs are well connected with the communities and health facilities, they can play an instrumental role in screening, referrals and sustainable management of malnutrition cases. Community based organizations have the potential to become key drivers of policy advocacy, shaping decisions and outcomes. However, their inclusion in policy formulation and planning has been sporadic. In cognizance of this constraint the aforementioned 15 CSO’s were capacitated through trainings and then engaged in rigorous policy review exercises on Sindh Protection and Promotion of Breast-Feeding Act, Poverty reduction strategies and Pakistan Multi Sector Nutrition Strategy. Moreover, the CSO’s have been connected with the leading networks of Scaling Up Nutrition (SUN) and Sindh Climate Action Network (SCAN) where they can plug in localized perspectives, challenges and opportunities.
Alongside civil society organizations, the program closely collaborates with the Health Department, Accelerated Action Plan Taskforce and People’s Primary Healthcare Initiative (PPHI). The involvement of the local civil society organizations and collaboration with service providing institutions is expected to have a vast impact of addressing the malnutrition issues in five districts of Sindh. With the help of these community-based organizations and its core partners MERF and SPO, IRC will be able to reach to more than 300 communities in five districts and will provide nutritional support to more than 245,000 women and 415,000 children. The evidence generated by this intervention will offer valuable insights to policymakers, guiding future community-based nutrition initiatives.
Shabnam Baloch
The writer is the Country Director at the International Rescue Committee Pakistan.