Ehsaas Nashonuma Program: Tackling Child Malnutrition
The Ehsaas Nashonuma Program is a flagship initiative under the broader Ehsaas Program, launched by the Government of Pakistan to address the critical issue of child malnutrition. Malnutrition remains a significant challenge in Pakistan, with severe implications for child health, development, and long-term economic productivity. According to the Pakistan Demographic Health Survey (PDHS), stunting affects nearly 40% of children under five years of age, which translates to millions of children being deprived of the essential nutrients needed for proper physical and cognitive growth. The Ehsaas Nashonuma Program was introduced as a comprehensive response to this alarming issue, aiming to provide targeted nutritional support to vulnerable women and children during the critical early years of life.
1. Background and Need for Ehsaas Nashonuma
Malnutrition, particularly among pregnant women and young children, has been a long-standing problem in Pakistan. Factors contributing to malnutrition include poverty, food insecurity, lack of access to healthcare, inadequate breastfeeding practices, and poor maternal nutrition. These factors are exacerbated in rural and underserved areas, where access to health services is limited.
The impact of malnutrition is far-reaching. Malnourished children are at a higher risk of illness, cognitive impairment, and death. They are less likely to perform well in school and are more likely to remain in poverty as adults. Recognizing the long-term consequences of malnutrition, the Government of Pakistan launched the Ehsaas Nashonuma Program in August 2020 to specifically target and combat child malnutrition by providing nutritional support to pregnant and lactating women and children under two years of age.
The World Health Organization (WHO) has emphasized the importance of the first 1,000 days of a child’s life—from conception to the second birthday—as a critical window of opportunity for ensuring proper nutrition. The Ehsaas Nashonuma Program aligns with global efforts to address malnutrition by focusing on this crucial period.
2. Objectives of the Ehsaas Nashonuma Program
The primary objective of the Ehsaas Nashonuma Program is to reduce stunting and improve nutrition outcomes for children under the age of two. The program aims to address the underlying causes of malnutrition by providing:
- Conditional cash transfers (CCTs) to incentivize pregnant and lactating women to adopt healthy nutritional practices.
- Nutritional supplements to women and children to ensure adequate intake of essential vitamins and minerals.
- Awareness and education on health, hygiene, breastfeeding, and dietary practices to improve maternal and child health outcomes.
The broader objectives of the Ehsaas Nashonuma Program include:
- Reduction of child stunting from the current high levels to meet national and international targets.
- Improvement of maternal health, particularly during pregnancy and lactation, to ensure that women are able to provide adequate nutrition to their children.
- Promotion of child survival and development by addressing the immediate and long-term effects of malnutrition.
- Empowerment of women through education and financial support, enabling them to make informed decisions about their children’s nutrition and health.
3. Implementation and Targeting
The Ehsaas Nashonuma Program is implemented in collaboration with the World Food Program (WFP), which provides technical and operational support. The program targets some of the poorest and most vulnerable regions of Pakistan, where malnutrition rates are among the highest. The initial phase of the program was launched in nine districts across Pakistan, focusing on areas with high poverty and malnutrition rates, including districts in Khyber Pakhtunkhwa (KP), Sindh, Balochistan, and Gilgit-Baltistan.
To ensure effective targeting, the program relies on the Ehsaas National Socio-Economic Registry (NSER) to identify eligible families. Pregnant and lactating women from these households, as well as their children under the age of two, are enrolled in the program.
The key components of the program’s implementation include:
a. Conditional Cash Transfers (CCTs)
The Ehsaas Nashonuma Program provides conditional cash transfers to pregnant and lactating women, with the condition that they regularly attend health and nutrition counseling sessions and ensure the health check-ups of their children. These cash transfers are designed to provide financial incentives for women to participate in the program and adopt healthy behaviors. The cash assistance is aimed at supporting household expenses, particularly those related to nutrition and healthcare.
b. Nutritional Supplements
To address micronutrient deficiencies, the program provides specialized nutrition packages to enrolled women and children. These supplements include fortified foods that are rich in essential vitamins and minerals, which are crucial for the physical and cognitive development of children. Women are provided with iron and folic acid supplements during pregnancy, while children receive fortified complementary foods to support their growth.
c. Awareness and Education
A critical aspect of the Ehsaas Nashonuma Program is health and nutrition education. Women participating in the program receive counseling on various health-related topics, including exclusive breastfeeding, complementary feeding, and hygiene practices. These counseling sessions are designed to empower mothers with the knowledge they need to provide the best nutrition and care for their children. Additionally, information on family planning and maternal health is provided to improve the overall well-being of mothers and children.
d. Monitoring and Health Services
Women and children enrolled in the Ehsaas Nashonuma Program are required to undergo regular health check-ups at Ehsaas Nashonuma Centers, which have been set up in district hospitals and primary healthcare centers. These check-ups include growth monitoring for children, prenatal and postnatal care for mothers, and assessments of their nutritional status. The biometric system is used to ensure transparency and accountability in the delivery of cash transfers and nutritional support.
4. Impact and Benefits
Since its launch, the Ehsaas Nashonuma Program has had a positive impact on maternal and child health in the targeted districts. The program’s conditional cash transfers and nutritional support have enabled vulnerable families to access better nutrition and healthcare services, improving their overall well-being. Some of the key benefits include:
a. Reduction in Stunting
The primary goal of the Ehsaas Nashonuma Program is to reduce the incidence of stunting among children under two years old. While stunting is a long-term problem that requires sustained efforts, the program has already started to show positive trends in improving child growth outcomes in the areas where it has been implemented.
b. Improved Maternal Health
Pregnant and lactating women participating in the program have reported better access to nutritional supplements and healthcare services. This has contributed to improved maternal health outcomes, particularly in terms of reducing the risk of complications during pregnancy and childbirth.
c. Behavioral Changes
Through counseling and education, the program has succeeded in changing behaviors related to breastfeeding, complementary feeding, and hygiene practices. Mothers are now more aware of the importance of exclusive breastfeeding for the first six months of a child’s life, as well as the need for appropriate complementary foods after six months.
d. Increased Awareness and Access to Health Services
The establishment of Ehsaas Nashonuma Centers has increased access to essential health services for women and children in remote and underserved areas. These centers provide a one-stop solution for health check-ups, nutritional counseling, and cash disbursements, making it easier for families to receive comprehensive support.
5. Challenges and Future Directions
While the Ehsaas Nashonuma Program has made significant strides in addressing child malnutrition, several challenges remain. These include:
- Scaling up the program: The program is currently limited to a few districts, and expanding its reach to cover more areas with high malnutrition rates is a priority.
- Cultural barriers: In some regions, traditional beliefs and practices around child feeding and healthcare may hinder the program’s effectiveness. Continued efforts to engage communities and raise awareness are needed to overcome these barriers.
- Ensuring sustainability: The long-term sustainability of the program depends on consistent funding and political support. Ensuring that the program receives adequate resources to expand and continue its operations is essential for its success.
Conclusion
The Ehsaas Nashonuma Program represents a critical step in addressing the pervasive issue of child malnutrition in Pakistan. By focusing on the early years of life and providing conditional cash transfers, nutritional support, and health education, the program is helping to improve the health and well-being of vulnerable women and children. As the program continues to expand, it has the potential to make a significant impact on reducing stunting, improving maternal and child health, and breaking the cycle of intergenerational poverty caused by malnutrition. With sustained commitment and investment, the Ehsaas Nashonuma Program could serve as a model for other countries facing similar challenges in the fight against malnutrition.