Pakistan, with an area of 800,000 square kilometers with an population 180 million people is the most densely populated NMA focus country. The poverty ration is 21% and it ranks 146th on Human Development index. Agriculture as a key sector of the national economy (one fifth of the net GDP), has been experiencing stagnation. In all provinces the emphasis is given on cash crop, which have higher income gains than kitchen farming.This has resulted in cash crop policies and the state focusing on wheat rather crop diversification and political, economic, and technical support to small farmers for land cultivation and crop diversification.
NMA project focuses on Khyber Paktunkhwa (KP) provinces, which is second most economically disadvantaged province of Pakistan with a population of around 21 million. The province of Pakistan with a population of around 21 million. The province has suffered a protracted situation over the last fifteen years with law and order issues in various pockets with human and material losses. Health care services in rural and especially remote areas are poor, with a shortage of health care professionals and high costs due to weak regulatory mechanisms. Moreover, the difficult terrain, poor transport infrastructure and low level of government support contribute to poor nutritional status of the population in these areas.
According to the National Nutritional survey of 2010-11, over 40% of the women are either underweight, overweight/obese, anemic, iodine deficient or zinc deficient while 40.9% of children under 5 years are stunted, 30.3% are underweight; and 16.8% are wasted. Poor sanitation and hygiene practices and unavailability of safe and clean drinking water particularly in rural areas further exacerbate the nutritional status of women and children with increased morbidity and losses of nutrients from the human body.
Prior to 2011, Pakistan lacked a national nutrition policy, with the 2002 National Nutrition Strategic Plan never having been implemented. The 2011 Pakistan Integrated Nutrition strategy (PINS), however, sets out of an incremental plan for implementation of a host of nutrition-related interventions and is now in its preliminary stages of adoption. Each of the four provinces and three regions of Pakistan have drafted inter-sectoral nutrition strategies.
In 2013 Pakistan joined the SUN movement. At the same time,Pakistan had established a Nutritional development partners group to help improve development partners' coordination and multi-sectoral platforms at provinces level. A high level National Nutrition Committee (NOC) at the ministry of Planning and development (MPD) oversees nutrition interventions. The NCC is the highest level decision making committee headed by the minister of planning and development and includes participation of all of the secretaries of the key ministries.
They are three types of RSPs active in the country: Government (manifest in the Lady Health Care Workers program), Semi-government (Farm Services Centers, member-based, facilitated by the Agriculture Extension Department) and Private NGOs. Agriculture extension in Pakistan was a sole public funded services for almost 40 years, during the period since the independence in 1947 till 1988. In 1988, a new experiment was tired, this time, to allow the private sector and especially the input supply companies to initiate their own advisory services along with their product delivery system. The idea was to gain to impetus for commercialization of agriculture and attain food security. Today, after 20 years of this decision, there are several such companies successfully providing advisory services to the farming community and the experiment can be termed as very positive.
Besides the availability of the public and private sectors RSPs, business development services providers (BDSP) also exist at community level that are established by INGOs, NGOs for implementation of their projects. The BDSPs mostly belong to agriculture and livestock sectors and are rendering their services mostly in hilly and mountain areas where the access to the above mentioned RSPs (public + companies) are very limited.