Ehsaas Nashonuma: Improving Maternal and Child Health

Maternal and child health are critical components of a country’s overall development and future well-being. Good health during pregnancy and early childhood lays the foundation for a child’s growth, cognitive development, and long-term potential. In Pakistan, however, a significant number of children suffer from malnutrition, and maternal health remains a pressing concern. To address these challenges, the Government of Pakistan has launched the Ehsaas Nashonuma Program, a transformative initiative aimed at improving the nutritional and health status of mothers and children, especially during the first 1,000 days of life — a critical period for a child’s development.

Understanding Malnutrition and Its Impact

Malnutrition, which includes both undernutrition (such as stunting and wasting) and micronutrient deficiencies, is a major public health issue in Pakistan. According to the National Nutrition Survey (2018), 40.2% of children under the age of five are stunted, and 17.7% suffer from wasting. Stunting, in particular, is a condition caused by chronic undernutrition during the early years of a child’s life, resulting in impaired growth and development. This not only affects physical growth but also cognitive abilities, learning potential, and overall productivity in adulthood.

Malnutrition in children is often linked to poor maternal health. Women who do not receive adequate nutrition during pregnancy are more likely to give birth to underweight babies, perpetuating the cycle of poor health outcomes. Additionally, maternal malnutrition increases the risk of pregnancy complications, leading to higher rates of maternal and infant mortality.

The Ehsaas Nashonuma Program was developed to break this cycle by focusing on improving the health and nutrition of pregnant and lactating women as well as children under two years of age. The program provides targeted interventions aimed at reducing stunting, improving maternal nutrition, and promoting healthy early childhood development.

Objectives of the Ehsaas Nashonuma Program

The Ehsaas Nashonuma Program is designed with a clear set of objectives, all focused on enhancing the health and well-being of mothers and children:

  1. Reduce stunting and malnutrition in children under two years of age by providing nutritional support and healthcare services.
  2. Improve maternal nutrition and health during pregnancy and lactation to ensure healthier pregnancies and better birth outcomes.
  3. Promote awareness of proper nutrition and healthy practices through education campaigns, especially in low-income and rural communities.
  4. Encourage regular health check-ups for pregnant women and young children, ensuring early detection and treatment of health issues.
  5. Empower women and families by providing them with financial and nutritional support that allows them to make healthier choices for themselves and their children.
  6. Strengthen healthcare systems and improve access to essential health services in underprivileged areas, especially for vulnerable populations.
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Key Features of the Ehsaas Nashonuma Program

The Ehsaas Nashonuma Program offers a comprehensive package of services aimed at addressing the root causes of malnutrition and poor maternal health. Some of the key features of the program include:

  1. Conditional Cash Transfers: One of the program’s most innovative features is the provision of conditional cash transfers (CCTs) to pregnant and lactating women. These cash transfers are provided under the condition that beneficiaries attend regular health check-ups, receive the necessary vaccinations, and participate in health and nutrition education sessions. The goal is to incentivize families to prioritize health and nutrition, while also providing them with the financial resources needed to access nutritious food and healthcare services. The cash transfers are typically provided through secure digital platforms, ensuring transparency and ease of access for beneficiaries.
  2. Provision of Specialized Nutritional Supplements: The program provides specialized nutritious food packages for pregnant women, lactating mothers, and children under two years of age. These food packages are designed to meet the nutritional needs of both mother and child, helping to prevent stunting and other forms of malnutrition. For children, the program includes Ready-to-Use Therapeutic Foods (RUTFs), which are energy-dense and nutrient-rich supplements used to treat and prevent malnutrition.
  3. Health and Nutrition Education: Education is a critical component of the Ehsaas Nashonuma Program. Beneficiaries are given access to health and nutrition education sessions that focus on the importance of proper maternal nutrition, breastfeeding practices, complementary feeding for children, and hygiene. These sessions are aimed at empowering mothers with the knowledge they need to make healthier choices for themselves and their families.
  4. Community-Based Health Workers: The program relies on a network of community health workers, who play a crucial role in reaching vulnerable populations, particularly in remote and rural areas. These health workers conduct home visits to monitor the health and nutrition status of mothers and children, provide counseling, and ensure that families are adhering to the recommended health protocols. This community-based approach ensures that even the most marginalized families receive the support they need.
  5. Strengthening Health Infrastructure: The Ehsaas Nashonuma Program also focuses on strengthening the local healthcare infrastructure to support maternal and child health. This includes improving access to health facilities, training healthcare professionals, and ensuring that healthcare centers are equipped to provide essential maternal and child health services, including immunizations, antenatal care, and growth monitoring.
  6. Monitoring and Evaluation: A robust monitoring and evaluation framework is built into the Ehsaas Nashonuma Program to track progress and ensure accountability. This includes regular data collection on the health and nutritional status of beneficiaries, as well as impact assessments to measure the program’s effectiveness in reducing stunting and improving health outcomes. The data collected helps inform future policy decisions and allows for continuous improvement of the program.
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Target Population and Geographic Coverage

The Ehsaas Nashonuma Program specifically targets pregnant and lactating women as well as children under the age of two. These groups are prioritized because early intervention during pregnancy and early childhood is key to preventing malnutrition and ensuring healthy growth.

The program is currently being implemented in some of Pakistan’s most vulnerable and underserved areas, including rural regions where malnutrition rates are particularly high. It initially launched in nine districts across Pakistan and is being scaled up to reach more districts and provinces over time. The focus on rural areas is critical, as these regions often suffer from limited access to healthcare and other essential services.

Addressing the Challenges

While the Ehsaas Nashonuma Program represents a significant step forward in improving maternal and child health, there are several challenges that need to be addressed for the program to achieve its full potential:

  1. Awareness and Cultural Barriers: In many rural communities, traditional practices and misconceptions about nutrition and healthcare can hinder the program’s effectiveness. Continued efforts to raise awareness and educate families about the importance of maternal and child health are essential.
  2. Access to Health Services: In some remote areas, healthcare facilities may be limited or difficult to reach. Expanding the program’s coverage and ensuring that healthcare services are accessible to all target populations is crucial.
  3. Sustainability and Scaling: As the program expands, ensuring that it is financially sustainable and can be scaled to cover the entire country is a key consideration. Collaboration with international organizations, non-governmental organizations (NGOs), and private sector partners may be necessary to achieve this goal.
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Conclusion

The Ehsaas Nashonuma Program is a critical initiative aimed at breaking the cycle of malnutrition and poor maternal health in Pakistan. By providing financial support, nutritional supplements, healthcare services, and education, the program is helping to ensure that both mothers and children receive the care they need during the crucial early years of life. As the program continues to evolve and expand, it has the potential to significantly reduce stunting, improve maternal and child health outcomes, and contribute to the broader goal of poverty alleviation and human development in Pakistan.

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