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January 16, 2019

Pakistan yet to frame National Adolescent Nutrition Policy


January 16, 2019

Islamabad Although several policy and strategy documents do refer to the nutritional needs of adolescents, Pakistan is yet to formulate a National Adolescent Nutrition Policy. The need to have such a policy echoed at a dissemination event organised by the Ministry of National Health Services in collaboration with the Global Alliance for Improved Nutrition (GAIN) here on Tuesday.

Delivering a presentation on the Framework for Action, Policies and Programmes, GAIN consultant Dr. Sonia Rabeneck shared that she undertook an ‘Adolescent Policy and Programme Review’ at the global, regional and local levels to guide governments and partners towards developing policies and selecting proven interventions to address adolescent malnutrition.

The policy review suggests there is no national adolescent nutrition policy in Pakistan although several policy documents do refer to the nutritional needs of adolescents. Dr. Sonia said, the recently released National Multi-Sectoral Nutrition Strategy and Provincial Multi-Sectoral Nutrition strategies refers to adolescents in the context of specific issues such as micronutrient malnutrition and gender equity. Similarly, the provincial nutrition programmes only partially focus malnutrition in adolescent girls, while adolescent boys are virtually absent from programming. She added that the Framework for Action is intended to serve as a guidance document for governments and partners to develop policies whereby all adolescents are adequately nourished and participate fully in family and community life.

Dr. Qaiser Munir Pasha, Country Director GAIN, shared the work done on adolescent nutrition through the World Bank SAFANSI funding last year. He said, even though it is recognized that adolescents in Pakistan suffer from malnutrition, only piecemeal interventions have been implemented over time.

GAIN’s current work focuses on consolidating what is known related to the nutritional status of adolescents, generating additional evidence and identifying entry points for programming opportunities, and raising awareness and establishing an advocacy platform to influence action plans. “Investment of US $4.60 per capita annually through 2030 in interventions to improve adolescents’ physical, sexual and mental health would yield ten times the benefits,” Dr. Qaiser stated.

Earlier, in his opening remarks, Dr. Baseer Khan Achakzai said that while the first 1,000 days remains a critical period, adolescence (period between 10-19 years) is characterized by rapid biological and psychosocial growth and is thus a vulnerable time with increased nutritional requirements, particularly for girls who are biologically vulnerable. “Up to 45% of skeletal growth takes place and 15 to 25% of adult height is achieved during adolescence. Investing in nutrition during adolescence improves physical and cognitive development, shaping life course and intergenerational trajectories,” he pointed out.

Dr. Khawaja Masuood Ahmed from the Ministry of National Health Services shared updates from the National Technical Advisory and Advocacy Platform for Improved Adolescent Nutrition which, he said, has not only served to bring together key partners in the adolescent nutrition space but will also anchor and drive further actions for adolescent nutrition in Pakistan.

Additional Secretary of Health Dr. Iqbal Durrani said that nutrition remains the backbone of health. “I am happy to know that a landscape analysis was done for adolescent girls, and building on that survey,” and reiterated that lack of data for this age group is a problem.

Pakistan has a high burden of malnutrition, costing $7.6 billion or 3% of GDP annually (World Food Programme, 2017). Adolescents constitute one-quarter of the population (approx. 40 million). Existing data on adolescent nutritional status is limited in scope and quality.

Going back to the evidence review, it suggests that adolescents experience a high burden of stunting, thinness, and overweight. Girls appear to experience a higher burden of stunting (11-23%, depending on the population) and overweight/obesity (8%) than boys (5% for both). Overweight and obesity increase substantially in adulthood. Boys have a slightly higher prevalence of thinness (12%) than girls (10%). Thinness is more common in rural areas and overweight/obesity in urban areas. Anaemia is prevalent among adolescent girls (54%) as well as deficiencies in folic acid (49%), zinc (42%), and vitamin A (40%).

The review further suggests that adolescent diets are generally poor, not sufficiently diverse, and are overwhelmingly of wheat and low in fruits, vegetables, pulses, potatoes, meat and eggs. Adolescents also have poor access to sexual and reproductive health care: only 13 % of adolescents (15-19 years) use family planning services and 37% of women (15-49 years) receive at least four antenatal visits.

Senior Health Specialist World Bank Dr. Aliya Kashif said that focus on adolescent nutrition is important, but the 1,000-day approach should not be forgotten. “The state should take the responsibility to move the agenda forward and show commitment. Partners are there to support,” she added.

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