Nutrition Policy Gap Analysis

The world’s highest concentration of under nutrition is found in South Asia and sub-Saharan Africa. The majority of nutritionally vulnerable populations in both the regions is dependent in some way upon agriculture as a primary source of livelihood. The agriculture sector and wider agri-food system is considered to be central for sustained progress in reducing under nutrition – and yet not enough is known about how to unleash this potential. Globally, there is a scarcity of information on wider political, institutional and policy-related challenges relating to the agriculture-nutrition nexus. Contextualized research into policy processes and the political economy of agriculture and nutrition is needed to better characterize “enabling environments” for Nutrition Sensitive Agriculture (NSA), and how these environments can be shaped and sustained.
Despite rich and growing agricultural production, Pakistan is grappling with major levels of food insecurity and undernourishment, poverty, and gender inequalities. In 2014–2016, the proportion of undernourished people in the total population was 22% i.e. more than 41.4 million people were found undernourished in Pakistan. The situation in Pakistan is a cause for serious concern which was also confirmed by the National Nutrition Survey 2011, that brought to light widespread nutritional deficiencies especially among women and children. Nutrition is a multi-sectoral issue and while there is much greater recognition of nutrition after 18th constitutional amendment and devolution of major sectors to the provinces, the progress on reducing deficiencies is quite slow. There has been an increasing focus on developing key frameworks to guide nutrition efforts to address under-nutrition, including Pakistan Integrated Nutrition Strategy (PINS) and Inter-sectoral Nutrition Strategies at the provincial level. The complex role of how agricultural policies can effectively address nutrition is not yet well understood. There is considerable conceptual knowledge on this topic, but little understanding of how to carry concepts and policy objectives into effective implementation and delivery of food-based approaches that impact nutritional status of population. Policies and programmes are clearly relevant, but the tangible impact of food processing, storage, and transformation, into improvements in dietary patterns and nutritional outcomes is fragmented.
The purpose of this analysis is to contribute to the on-going dialogue on our understanding of multisectoral challenges in achieving effective nutrition, role of agriculture in improving nutrition, food policies, and commitments. Relevant policies at National level and from Khyber Pakhtunkhwa (including nutrition, health, agriculture, climate change and water) were reviewed for their comprehensiveness and nutrition sensitivity and specificity. Our review suggests that nutrition is mostly viewed in isolation. For instance the interconnectedness of agriculture or water and their impact on improving nutrition is not yet clear in any of the policies. KP Multi-Sectoral Integrated Nutrition Strategy is an exception – however sectoral policies seem uninformed of the commitments made in the strategy.
In order to improve the situation of nutrition as a multi-dimensional subject, three broad areas – namely Policy, Programmes’ design, and Implementation – require long term commitment and proactive actions by all stakeholders including government, private sector, civil society, academia, media and International development agencies. The main areas of focus include advocacy and technical support for integrating nutrition across relevant policies, building technical capacity of people involved in programmes’ design and implementation, incorporating a robust monitoring and accountability mechanism at all levels, increased focus on inter connectedness across relevant sectors for nutrition sensitive interventions and translating policies and programmes into actions. 

This study has been conducted under the auspices of Nutrition in Mountain Agro-ecosystems (NMA) project (2015-2018) financed by SDC Global Programme for Food Security (GPFS) to IFOAM and partners for five countries including Pakistan. HELVETAS Swiss Intercooperation implements NMA in Pakistan. The NMA project replicates and scales sustainable agriculture practices in mountain ecosystems to promote improved nutrition and resilience driven by an action network of empowered rural service providers aiming at a broad impact on micro and national levels.

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