he malnutrition crisis continues to impact Sindh. The situation is dire, with nearly half of the children under the age of five suffering from stunting, wasting or being underweight. The consequences of malnutrition are far-reaching and have a long-lasting impact, not just on the individuals directly affected by it but also on the rest of the community and the region’s development.

Sindh has a rich cultural heritage and great potential for growth. However, it is currently in the shadow of malnutrition. Children suffering from malnutrition face lifelong challenges, including cognitive impairment, poor physical health and limited opportunities for personal and economic development. The impact of malnutrition extends beyond individuals, affecting the social fabric and economic growth of the region.

The reasons behind this crisis are multifaceted. These include poverty, inadequate healthcare facilities, limited access to safe drinking water and sanitation, and a lack of awareness regarding proper nutrition. Moreover, there is often a gap between public policies and their effective implementation at the grassroots level.

It is ironic that despite decades of learning, experience and awareness of best practices many developmental projects are designed in silos with a “top to bottom approach” disconnected from the needs of local communities. The International Rescue Committee has been working in Pakistan for longer than four decades. Part of its mandate is designing multipronged nutrition programming.

The IRC believes that one of the key solutions to this crisis lies in strengthening local community-based organisations as actors in promoting responsive governance and service delivery in the nutrition sector. A recent development in its nutrition programming is the launch of a two-year initiative to enhance local CBO capacities. With the financial support of 5.5 million euros by the European Union in Pakistan, IRC alongside partner organisations, MERF and SPO, will reinforce the capacity of 15 local CBOs.

This entails improving facility-based treatments, increasing community outreach of nutrition programmes and facilitating the CBOs in leading advocacy and policy dialogues. These interventions will be carried out in five adversely affected districts of Sindh and will provide nutritional support to more than 245,000 women and 415,000 children.

It is ironic that despite decades of learning, experience and awareness of best practices many developmental projects are designed in silos with a “top to bottom approach” disconnected from the needs of local communities. 

A multi-pronged approach is needed to combat malnutrition in Sindh. Strengthening CBOs as key actors in the nutrition sector is not just a recommendation but a necessity. To achieve this, a collaborative effort between the government, civil society and international organisations is essential. This involves providing CBOs with training, resources and the autonomy to effectively address malnutrition in their communities.

The rationale behind this project design is that local CBOs are deeply embedded in the communities they serve. They understand the unique challenges and needs of their communities, This makes them effective advocates for responsive governance. These organisations can bridge the gap between the government and the marginalised communities, ensuring that policies and programmes are not just designed in a top-down manner but are also responsive to the realities on the ground.

Strengthening CBOs can enable them to provide valuable inputs on the specific requirements of their communities, thereby ensuring that nutrition interventions are tailored to local needs.

CBOs can also play a significant role in service delivery. They can serve as intermediaries, helping to bring healthcare, nutrition and sanitation services closer to the communities. By building the capacity of CBOs to provide basic healthcare and nutritional support, we can expand the reach of services to those in the most remote areas. This not only improves the availability of services but also fosters community ownership and participation in addressing malnutrition.

Furthermore, CBOs can take on a vital role in raising awareness about the importance of nutrition. Through community-led initiatives and education programmes, they can help communities understand the significance of proper nutrition, hygiene and safe drinking water. Empowering communities with knowledge is a key step in preventing malnutrition and ensuring long-term sustainability.

The fight against malnutrition in Sindh is a daunting challenge. However, by investing in and strengthening local CBOs, we can foster responsive governance and improve service delivery in the nutrition sector. The time has come for Sindh to rise above the shadows of malnutrition, ensuring a brighter, healthier and more prosperous future for its children and communities.

The writer is country director for International Rescue Committee