UN Maternal And Child Stunting Reduction Programme In Three Target Districts In Sindh, Pakistan

The purpose of this evaluation is to assess the effects of the integrated WASH and Nutrition programme and to gather evidence-based learnings on how to design and implement such integrated programme in future that may work more effectively towards stunting reduction. This evaluation is expected to support advocacy purposes among Nutrition and WASH sectors for an integrated approach towards stunting reduction in future programmes. Moreover, the evaluation will contribute to improve the design and implementation as well as monitoring and evaluation of future integrated Nutrition and WASH interventions within UNICEF in Pakistan and globally.

Description

Childhood stunting is the consequence of maternal and child inadequate dietary intake (poor maternal health and nutrition, inadequate infant and young child feeding practices, micronutrients deficiencies), repeated bouts of infections and/or combination of both. Underlying these immediate causes are socio-economic factors including poverty, gender inequalities, food insecurity, inadequate care of mothers and children, low women literacy and poor availability and quality of water, sanitation, hygiene and health services.

The nutritional status of the children and women in Pakistan denotes both a chronic long-term problem and an acute on-going emergency. A large proportion of Pakistan‘s children are stunted (one in every three children), which represents an estimated 6% of the global stunting caseload. Sindh is the worst hit province in Pakistan in terms of malnutrition and food insecurity, with a prevalence of 49.9% for stunting, 16.1% for wasting and 4.4% for severe wasting. In the given context of Sindh province, UNICEF with support of USAID designed and implemented integrated nutrition-specific and nutrition-sensitive programme to complement Government of Sindh (GoS) efforts in stunting reduction. The interventions focused on improving the nutritional status of children from conception until age 2, pregnant & lactating women (PLW), adolescent girls and women of reproductive age.

There exists a knowledge gap in Pakistan on how Nutrition-Specific interventions and Nutrition-Sensitive approaches can be integrated to combat the menace of stunting. The objective of the evaluation was to identify good practices and draw lessons from the cash transfer pilot project regarding overall relevance, effectiveness, efficiency, sustainability and equity of the design and implementation of the project. This evaluation will use mixed method approach.