Nutrition

Mal-nutrition is a major problem in Balochistan. Approximately 14% children in Balochistan are wasted (Low weight for Height). After the devastating flood in the June 2007, the situation further deteriorated. Poverty is endemic in the province; literacy rates less than 40 percent (only 20 percent for women) and health facilities extremely poor. Keeping in view the gravity of the problem, BRSP stepped in the Nutrition sector to prevent the mortality and morbidity caused by malnutrition. Therapeutic Feeding program in five district and Community-based therapeutic Care in five districts and Supplementary Feeding Program were started in one district of Balochistan.

Balochistan Rural Support Program has developed an integrated approach to improve poor nutrition conditions caused due to deficiency of micro and macro nutrients intake in poor rural areas of Balochistan. The strategy is to build its Program on recent initiatives undertaken by NGOs/donor agencies/government in order to address nutrition needs of the flood affected areas in Balochistan.

Vision/ Goal

To improve the nutrition statue of children under five and pregnant and lactating women the most vulnerable group of our society.

Programmatic objectives

To prevent an increase in child mortality and morbidity after flood through life saving nutrition interventions;
To built the capacity of organization in the field of feeding program which has never addressed;
To built the capacity of the health care provider in the field of nutrition;
To build the capacity of community for prevention of malnutrition;

Strategy for program implementation

To intervene and address the issue of malnutrition in rural areas of Balochistan through social mobilization, community awareness and services delivery;

Major components of Community Management of Acute Malnutrition (CMAM)

Community Mobilization and Supplementary Feeding Program:
LHWs/ CHWs are oriented to screen children 6-59 months, pregnant and lactating mothers through MUAC in the community. All the identified moderately malnourished children and women are registered under the SF program and provided with their first ration of fortified blended food for two weeks with key messages. The team registers severely malnourished children/complicated cases and refers them to the OTP. Community mobilization, follow-up of the children and women registered under the nutrition program, promotion of IYCF practices are an on-going process conducted by the LHWs/ CHWs.
Out-Patient Care (OTP) at Community Level:
Medical Officers are mobile with Field supervisor. The doctors are responsible for taking MUAC and weight for height and clinically examine the child. Severely malnourished children with no complications are registered under the OTP program. The children are provided with one or two weekly rations of RUTF and necessary medicines. The complicated cases are referred to the in-patient facility in the district and field supervisor monitors all screening process and health sessions and she also insures 100% participation of the community in SFP an OTP.
In-patient care for complicated malnourished children:
The community based Supplementary feeding (SFP) and the facility based Out-patient care program (OTP) refers all the complicated malnourished children to the facility based in-patient care at the TFC or the stabilization center. A medical officer (preferably government staff) is trained to follow the protocols of the in-patient care. The child’s weight for height and necessary information is noted and the child admitted in the program for a week (phase one of TFC). Once the complications have been treated the child is referred back to the OTP or community site from where the child was initially referred. The child is given his/her further treatment at the OTP or the SFP site in his/her community.

Establishment of three component of the CMAM:

Community Mobilization
Supplementary Feeding Program
Outpatient Therapeutic Care

BRSP’s current intervention in Nutrition

BRSP is implementing a project in collaboration with UNICEF Quetta in three districts of Balochistan i.e. Khuzdar, Kharan and Nushki. The project spans over for a period of six months (May-Nov 08). The project will build local capacities of LHWs, CHWs, medical technicians, doctors, Community health Promoters, Social Mobilizers in nutrition related activities including supplementary feeding and therapeutic feeding. BRSP will also facilitate the provision of supplies including Unimix, Plumpy Nuts, necessary medicine and anthropometric equipments for the project.

Project objectives:

To facilitate the improvement in nutritional status of moderately malnourished children, pregnant and lactating mothers through supplementary feeding points at community level
To facilitate treatment of severely malnourished children with no complications at community level through OTP
To facilitate treatment of severely malnourished children through in-patient care facility or TFC in the district
To provide health and nutrition related information including breastfeeding, complementary feeding, health, hygiene, hand washing, clean drinking water to mothers and community members.

Direct Beneficiaries in Ongoing Project:

Severely malnourished children with complications: 334
Severely Malnourished Children with no complications: 1895
Moderately Malnourished Children: 8486
Pregnant/Lactating mothers: 4554

Indirect beneficiaries:

Women provided health and nutrition education
Community health promoters, social mobilizes, local NGOs, doctors, paramedics working in the areas.
Staff who are involved in the implementation of the project as they will gain technical expertise in nutrition intervention.

Expected outcomes

The project is expected to achieve the following outcomes upon its completion:

Contribute in reducing the child mortality and morbidity in the flood affected areas in district Khuzdar, Kharan and Noushki by saving lives of severely malnourished children through the provisions of facility based and community-based therapeutic care facilities.
Prevent further deterioration of the nutritional status in the mild and moderately malnourished children (six to fifty nine months) pregnant and lactating mothers by providing them with immediate access to fortified supplementary food.
Share key messages on infant and young child feeding, hygiene and sanitation
Build capacity of doctors, community health promoters and social immobilizers in providing nutrition related services including general screening, Supplementary feeding, OTP and facility based treatment.

Top of Page