Eventually, the disaster has aggravated pre-existing vulnerabilities in the population. World Food Program’s Vulnerability Analysis Mapping (VAM) of flood recovery assessment (FRA) showed that of all the surveyed areas, Sindh had the highest number of food insecure households at 47.9%.
According to the National Nutrition Survey (NNS), a large national level survey carried out by Aga Khan University (AKU) for the government of Pakistan, with a large sample that covers all districts of Pakistan, except three that could not be reached for security reasons and the results being representative at the provincial level, the prevalence of wasting, underweight and stunting among children under five in Sindh province stands at 17.5%, 40.5% and 49.8% respectively (NNS July 2011). In particular stunting, which is long term and chronic problem of malnutrition, figures remains very high (roughly 05 out of 10 children are stunted according to the NNS 2011 survey) and needs policy makers timely decision to trigger long term development nutrition interventions. More so, Child malnutrition rates in country including this province remained persistently high even in a non-crisis situation. The flood has simply exposed this. Indeed, malnutrition usually develops in stages over time leading to weakness and low resistance to infections in the body which causes health problems. Severe malnutrition may expose to heart diseases, breathing and kidney problems. It can also cause changes in electrolytes which lead to death if left untreated.According to the PDHS 2006-07, Sindh has the maternal mortality ratio of 314 per 100,000 live births, Infant Mortality Rate of 81 per 1,000 live births. 38% of the births are facilitated by skilled birth attendants. There is variance among the health indicators within the districts as Karachi’s health indicators are better than that of Jacobabad and Kashmore. According to NNS-2011 50 %of the newborn children in Sindh are given breast milk within one hour of birth. The median duration of exclusive breastfeeding is less than a month (0.8 months) as compared to the recommended duration of 6 months (PDHS 2006-07). In Sindh, 53 % of children aged 06-59 months were Vitamin A deficient (NNS-2011) and 23.% of children less than 5 years of age had diarrhea in the two weeks preceding the survey (NNS-2011).
Viewing these puzzling figures, it can well be deduced from the reflected data that nutrition has been least considered aspect of health care delivery system. The mega flood 2010 and torrential rain 2011 disasters simply exposed the worse side on this part of globe. Indeed, Nutrition intervention is highly desirable lest the bigger human disaster would be witnessed. Along with averting the much prophesied. The proposed project aims at to translate the Poverty Reduction Strategy Program - II (PRSP) and Medium term Development Framework (MTDF) strategy for sustainable development and poverty reduction by forging an alliance with civil society and private sector to reduce poverty and accelerate growth. The program will strengthen the ability of the health sector to implement large scale nutrition specific interventions within the purview of the health sector and also create the enabling environment to work with other public sector organizations as well as private and NGO sector.
Despite several measures and Program, health status of population of Sindh has not made an encouraging progress in pursuance to MDG targets. This can be attributed to poverty; low levels of female education, nutrition behaviour based on socio-cultural attitudes and practices, poor investment into health and nutrition Programs along with poor inter-linkage between the two. The poor level of health indicators are reflective of ineffective health system in the province and indicate that health sector in Sindh needs an urgent remedial measure for improving its effectiveness for achieving MDG related targets.
Soon after the havocs let out by the flood, UNICEF in particular and other UN partners in general, immediately came forward, along with public sector, to forestall the bigger human disaster. Based on UNICEF led Flood Affected Nutrition Survey 2010 and World Food Program’s Vulnerability Analysis Mapping (VAM) of flood recovery assessment (FRA), more specific support from all UN partners had been pouring in. More significant being UN two year response plan to avert nutrition crisis in the province. This includes support in establishing 23 Nutrition Stabilization Centres on the lines of nutrition rehabilitative support.