Pakistan has one of the highest malnutrition burdens in the world. Stunting, wasting and micronutrient deficiencies are endemic. The National Nutrition Survey 2018 revealed that 42.6% of women of reproductive age were anemic, 46.9% of pregnant women were iron deficient, 81.2% of pregnant women and 62.7% of children were vitamin D deficient. The same survey reported that 40.2% of children under five were stunted, 17.7% were wasted and 9.5% were overweight.
Diet is the number one risk factor in the burden of disease and is a central driver for all forms of malnutrition. The Pakistan Cost of Diet Analysis 2016 estimates that 67% of the households in Pakistan are unable to afford a nutritionally-adequate diet and approximately 5% of all households are unable to afford a diet that meets even the minimum requirements for energy. As per SOFI 2023, 82.8% (more than 192million) of Pakistani People are unable to afford a healthy diet (figures for 2021). Adolescents, who account for 23% of the population, suffer from poor nutrition. Data from a recent literature review and secondary data analysis conducted by GAIN point to relatively high levels of stunting (22%) and overweight (16%) amongst adolescent girls between 15 and 19 years of age. Micronutrient deficiencies are particularly alarming: more than half of the adolescent girls between 15 and 19 suffer from anaemia, 21% are iron-deficient, 49% lack folic acid, 42% suffer from zinc deficiency, and 40% from vitamin A deficiency.
Poor diets do not just cause micronutrient deficiencies, but also overweight and obesity, whose levels are rising. The prevalence of overweight among children under five has almost doubled over seven years, increasing from 5% in 2011 to 9.5% in 2018 (as per NNS 2018). This causes further health problems, such as increases in heart diseases, higher blood pressure, and diabetes.
The Global Alliance for Improved Nutrition (GAIN) is working in Pakistan since 2007 to tackle malnutrition, with an initial focus on Large-Scale Food Fortification. Later GAIN’s focus expanded to include adolescents’ nutrition and private sector engagement through SUN Business Network. GAIN plays a significant role in the public policy landscape in Pakistan, as it does in many other countries around the world. GAIN partners with governments, businesses, and civil society organizations.
In Pakistan, malnutrition, particularly among children and women, remains a significant public health challenge. GAIN's work in the country is aimed at helping the government address these issues through evidence-based policies and programs, and by fostering collaboration among various stakeholders. GAIN's role in the public policy landscape in Pakistan is aligned with the global effort to achieve Sustainable Development Goal 2, which aims to end hunger, achieve food security, improve nutrition, and promote sustainable agriculture.
Following the launch of the GAIN’s new global strategy 2023-27, our work in Pakistan has been realigned with both the organisation’s global strategy and the changing nutrition context in the country especially related to food system transformation for improved nutrition outcomes.
Today, together with our partners, we are implementing various programmes, including Commercialization of Biofortification of Crops, Large Scale Food Fortification - LSFF, Sub National Food System Dashboard, Access to Better Dairy, Social Protection Project, and support to businesses through the SUN Business Network (SBN).
GAIN has done a significant work on Large Scale Food Fortification in collaboration with Provincial Food Safety and Quality Authorities, Private Sector, Civil Society organizations and Academia. GAIN advocated and successfully ensured tax exemption on Wheat flour and Edible Oil Premix in 2017.
The Wheat and Ghee/Oil industry has been facilitated and capacitated to produce fortified food products.
GAIN Pakistan in collaboration with partners is working on the nutrient enriched crops by significantly expanding the availability and reach of food and food products made with biofortified staple crops. GAIN facilitated the production, segregation, procurement and processing of the Biofortified Zinc Wheat to make the biofortified Zinc Wheat Products available in the market. The project also engages government at different levels through advocacy to influence relevant policies.
The second phase of the project named as "LSFF TA PK (Large Scale Food Fortification, Technical Assistance Pakistan)" was started by GAIN Pakistan in 2022 with an aim to increase the availability, access and affordability of the nutrient enriched crops (Biofortified Zinc Wheat) in Pakistan while also addressing livelihood, gender, and climate perspectives with a focus on "South-South Learning".
GAIN facilitates the SUN Business Network (SBN) Pakistan, a global network of businesses committed to improving nutrition, and aims to increase the availability and affordability of safe, nutritious foods to consumers, especially low-income consumers through innovative solutions at global and national levels.
In Pakistan, GAIN is a co-convener (with World Food Programme) of the SUN Business Network under the stewardship of the SUN Secretariat.
Under SBN, GAIN endeavours to:
GAIN in collaboration with other stakeholder has established a Subnational Food System Dashboard in Pakistan in partnership with the Government of Pakistan to collect subnational data across a range of key food systems indicators to support national and sub-national level stakeholders with the data they need to better understand their national and subnational food systems.
After taking over the Food System Dashboard by the government, Pakistan Agricultural Research Council, the Ministry of National Food Security and Research and GAIN are leading the process to strengthen Pakistan’s evidence gap where the federal and provincial Bureaus of Statistics are playing an integral role in data collection across various food systems indicators.
The "Subnational Food Systems Dashboard" is an initiative that bridges this gap through credible national, city, and district data across a range of key food systems indicators. It is a comprehensive data source to understand food systems and identify the required transformative actions to improve diets and understand the impact on the climate.
The Subnational Food Systems Dashboard will help track progress and accountability against commitments and action plans for food systems transformation, strengthen evidence-based policymaking, improve coordination and integration of policies and actions on food systems, and support the monitoring of progress in food systems over time.
Using "waste-to-value" approach, GAIN Pakistan launched a new initiative funded by DANIDA Market Development Partnerships supported by GAIN’s other partners to co-create solutions that fulfil several objectives simultaneously: low price, good taste, high nutritional value, food safety, environmental protection, and business sustainability. The partnership brings together private companies, government agencies, civil society organizations, and academia to co-develop dairy products that are affordable to low-income consumers in Pakistan.
The collaboration uses fortification to address micronutrient gaps while ensuring a low retail price point per serving. The project catalyses the market development of dairy value chain and increase profitability for local processors and other value chain actors. Additionally, it also reduces the environmental impact of unsafe disposal of whey water.
The greening and scaling aspects, integrated into the project have three wins i.e. profitability for local dairies by opening a new revenue stream, environment protection by reducing waste and contribution in reducing malnutrition by making available a healthy and nutritious whey-based drink.
The Social Protection, a five-year project aimed at strengthening the body of evidence on the implementation and possible nutrition impacts of nutrition SBCC in social protection; and creating enhanced awareness and buy-in among social protection system actors regarding the uptake/expansion of SBCC.
Later the SBCC, further be integrated into and mainstreamed across Pakistan’s social protection programmes under the Ministry of Poverty Alleviation & Social Safety to effectively include Social and behavior change communication (SBCC) as an integral and impactful component of nutrition-sensitive social protection programs.
GAIN is a strategic partner to the Government of Pakistan in providing technical assistance to relevant federal ministries (MoNFSR, MoPDSI Nutrition Section, and MoNHSRC Nutrition Wing) to improve the food policy landscape by providing technical assistance and assisting in the formulation of governance mechanisms to oversee and review the "National Food System Transformation Pathways" implementation.
This will help operationalise the five Action Tracks of the National Pathway Document and assist GoP and MoNFSR for alignment, strengthening and prioritization of the actions towards food systems transformation at the national and sub-national levels. To further strengthen the policy landscape and embed the use of data for decision making, GAIN is also helping GoP formulate national-level policies: Multisectoral National Nutrition Policy 2023-2030, National Healthy Diet Policy, National Food Safety Policy as well as develop a National Nutrition Research Agenda 2022-2030.
GAIN is also working with Pakistan SUN Secretariate in establishing Pakistan SUN youth Network. The Pakistan SUN Youth Network (PSYN) will play an essential role under the Pakistan SUN (Scaling Up Nutrition) Secretariat in establishing and promoting nutrition initiatives and advocacy efforts in Pakistan., including, Nutrition Advocacy, Youth Mobilization, Community Engagement, Capacity Building, Networking and Partnerships, Data and Research, Innovation and Creativity and finally championing SUN Movement Principles in Pakistan.
Climate change, food insecurity, and malnutrition are some of the biggest challenges in Pakistan. The interdependency of these issues urges the need to find ways to simultaneously address all of them through integrated solutions, and this project serves as a prime example.
The dairy sector in Pakistan plays an important role in per capita greenhouse gas emissions, land use, water use, and eutrophication. This project addresses this by decreasing environmental pollution from waste streams from cheese production. The waste, whey-water, will be transformed into a tasty, safe, affordable, and healthy drink for children. This will foster inclusive green private sector growth in the dairy sector, create new revenue streams, new jobs in processing and distribution, particularly for youth and women, as well as address malnutrition among children in Pakistan.
Administrative Partner: The Global Alliance for Improved Nutrition (GAIN)
Key Commercial Partner: Arla Food Ingredients
Other Partners: Confederation of Danish Industries (Dansk Industri), Fauji Foods Limited, Ajmair Foods Private Limited/Cakes and Bakes
Sector: Agriculture & agro-processing
