Stunting among children in Sindh has been brought down from 48 per cent in 2014 to 30 per cent in 2021 through the World Bank-assisted multi-sectorial Accelerated Action Plan (AAP). The stunting rate in the province is expected to further decrease to 15 per cent by 2026.
Sindh Chief Minister Syed Murad Ali Shah said this on Monday as he met a delegation of the World Bank led by Country Director Najy Benhassine. He maintained that critical environmental factors contributing to stunting, including water, sanitation, hygiene, and agri-food system, were being addressed through effective interventions.
“These interventions have been implemented through ADP [Annual Development Programme] schemes and ongoing World Bank projects,” he said. The discussion focused on the child stunting mission. Others who were present on the occasion included Sindh Health Minister Dr Azra Fazal Pechuho, acting Chief Secretary Musadiq Ahmad, Principal Secretary to the CM Agha Wasif, Planning and Development Board Chairman Najam Shah and Health Secretary Agha Wasif.
The World Bank delegation comprised economist Ghaza Mansuri and health specialists Hinn Hinn Pyne and Ziauddin Hyder. Shah noted that the stunting rate in Sindh, assessed at 48 per cent in a 2014 survey carried out by Unicef, had begun to decrease. The Sindh government launched the World Bank-assisted AAP in 2017 to reduce stunting and it had resulted in the decrease of stunting rate to 30 per cent in 2021.
The CM and World Bank team agreed to address the environmental drivers of stunting by expanding access to safely managed water and sanitation. Shah highlighted efforts by the local government and public health engineering departments to ensure treatment of drinking water, sewage and effluent.
It was said that a behavioural change campaign was under way, involving the private sector and health department, to shift cultural and behavioural practices. The meeting was told that the declaration of open-defecation-free (ODF) villages was being pursued through water source testing for contaminants, construction of household latrines, and community-led total sanitation (CLTS) initiatives.
The World Bank team was informed that the public health engineering department had been focusing on small community-level drinking water schemes targeting poor geographic conditions.
Shah said that following directives from Pakistan Peoples Party Chairman Bilawal Bhutto Zardari, the Sindh government had prioritised investments in water treatment and sanitation, along with increasing the operation and maintenance budget to make non-functional schemes, including reverse osmosis plants, operational.
To address stunting, the CM said he was strengthening access to and quality of basic preventive/curative health care, improving childcare and feeding practices, and enhancing nutritional supplementation for high-risk situations. Family planning initiatives were also in progress, he added.
It was said that outpatient therapeutic (OPT) sites and nutrition stabilisation centres (NSC) had been established in 23 districts providing treatment for severe acute malnutrition (SAM), and nutrition commodities and medicines to children, adolescents, and pregnant and lactating women.
To improve the agri-food system, the CM said his government was promoting sustainable and regenerative farming, crop diversification and livestock productivity to increase access to nutritionally dense and diverse foods for small farmers. Efforts to ensure food safety and reduce post-harvest waste and losses were also being carried out, Shah added.