Joint WHO-MOH mission to assess the nutrition emergency needs in Balochistan province of Pakistan
26 December 2018 –National Parlimentary Secretary Dr. Nausheen Hamid said all available resouces will be utilized in dealing with the situation of malnutrition in connection to the nutrition emergecy been declared in Balochistan, she said that the Government of Balochistan has declared nutrition emergency on 25 November which was endoresed by the cabinet on 10 December 2018, she appriciated overall role of Balochistan Helath Department and Provicial Nutrition Program . she was expressing these views while addressing a briefing by Balochistan Nutrition Program.
The delagtion said that on request of WHO Representative (a.i.) in Pakistan Dr Ni’ma Saeed Abid, a high level joint mission comprising of the WHO Regional Advisor Dr Ayoub Al-Jawaldeh for the Eastern Mediterranean Region, National Parlimentary Secretary Dr. Nausheen Hamid , National Nutrition Manager Dr Baseer Khan Achakzai, WHO national and provincial staff, visited to assess the Nutrition emergency situation in the province. The delegation said that ; The health care system in the province is characterized by chronic intrinsic issues of limited financial and skilled human resource to meet the requirement of local population and the cross boarder population. Weak health care system together with socioeconomic and climatic situation are the major determinants of malnutrition among population in the province. According to PDHS 2012-13 the under-five mortality in the province was 111/1000 live births. The high measles incidence, sub-optimal EPI coverage in the previous years and weak health care system to adequately response to infection episodes among under five children are responsible for precipitated malnutrition situation. The province has severe shortage of skilled human resource to sustain quality maternal, new born and child health services in the province.
Most recently, the Provincial Disaster Management Authority Government of Balochistan, based on vulnerability has declared 14 districts to seriously been affected by this longstanding drought. Based on this an assessment is carried out to assess the scale of damage. Approximately 4.4 million populations in these districts could be affected directly and indirectly variably. Amongst the population affected, most vulnerable stands the children under five years and women. The estimated number of children affected are around 0.67 million, while women 0.35 million.
The drought has further deteriorated the precarious nutrition situation in the province; which is defined by the National Nutrition Survey (2011) with prevalence of Global Acute malnutrition (GAM) 16.1%. The administrative data from Balochistan Nutrition Program for Women and Children (BNPMC) also shows high levels of wasting and stunting in the intervention districts. Moreover, according to the SMART survey (2017) conducted in 16 districts in 2017, showed GAM prevalence above 15% in 12 districts. It is worth mentioning that the district level data masks the intra-district disparities among the population for prevalence of malnutrition at the Union Council level (smallest administrative units). These disparities have been clearly identified by the community level House to house screening by the LHWs Program in Quetta, Killa Abdullah and Pishin (the final results awaited). The data from different sources, complement the findings of NNS 2011; and in most districts deterioration in nutrition situation is observed over the time.
The mission met with high echelons of the provincial government including the Chief Minister Jam Kamal Khan, Health Minister Mir Naseeb Ullah Khan Marri, Senior Judge Balochistan High Court Justice Jamal Khan Mandokhel. The role of WHO was much appreciated by the authorities in Health and Nutrition. It was requested to enhance provision of technical assistance to the Government of Balochistan for addressing current nutrition emergency and materializing health sector reforms as envisaged in provincial health policy. WHO ensured its continued techical support to build capacity of the staff especially in the area of SAM mangemnet, IYCF and nutrition surveillance.
a) The mission came up with programmatic and structural recommendations to address the current emergency;
b) issuance of official notification of the declared emergency so that nutrition cluster could be reactivated;
c) constitution of a high level multi-sectoral steering committee chaired by the Chief Minister office to oversee health and nutrition in the context of current emergency and long-term development solutions;
d) initiation of community based screening and surveillance system;
e) adoption of community based preventive approaches which are highly cost effective preventing mothers and children from getting malnourished;
f) adoption of innovative approached e.g. linking conditional cash transfer schemes to prevention of malnutrition among children;
g) improve coordination amongst UN and development partners for effective response and maximizing the impact of interventions;
h) enhance budget allocation for Health;
i) improve the health system especially in remote areas to ensure ergonomically acceptable prevention services are accessible equitable to all people.
Balochistan Nutrition Program Head Dr. Amin Khan Mandokhail, MNCH Provincial Head Dr. Gul Sabeen Azam, Provincial T.B Control Program Head Dr. Abdul Rahim Bugti were in the meeting in BNPMC office. UNICEF Nutrition Officer Dr. Faisal Shahwani, WFP provincial head Dr. Aftab Bhatti were also there. Implementing partners of Nutrition program NGOs representatives and helath officals participated in a large number.