GOVERNMENT OF Punjab Multi-sector Nutrition Strategy For Addressing Malnutrition in Punjab Page 1 Table of Contents Executive Summery ........................................................................................................................... 76 1 CHAPTER 1: INTRODUCTION & BACKGROUND .......................................................................... 1211 1.1 Introduction ....................................................................................................................... 1211 1.2 Situation Analysis (nutrition related) National level ............................................................ 1312 1.3 Causality framework .......................................................................................................... 1413 1.4 Punjab profile .................................................................................................................... 1615 1.5 Rationale for Multi-Sectoral Strategy ................................................................................. 1615 1.6 Development Process of Nutrition Strategy ........................................................................ 1817 2 CHAPTER 2: OVERVIEW OF THE STRATEGY ................................................................................. 2019 2.1 Objectives .......................................................................................................................... 2019 2.1.1 Strategic Objectives .................................................................................................... 2019 2.1.2 Specific Objectives/Expected outcomes ...................................................................... 2119 2.2 Conceptual framework ....................................................................................................... 2322 2.2.1 Strategic direction ...................................................................................................... 2422 2.2.2 Guiding principles ....................................................................................................... 2524 2.2.3 Intervention Framework ............................................................................................. 2624 3 CHAPTER 3: SECTORAL PERSPECTIVE – STRATEGIC SECTORAL PLANS ......................................... 2726 3.1 PLANNING AND DEVELOPMENT (P&D) ................................................................................... 2726 3.1.1 Overview of the sector ................................................................................................... 2726 3.1.1.1 Potential role in nutrition improvement, engagement and role within the multisectoral framework ..................................................................................................................................... 2726 3.2 HEALTH SECTOR ..................................................................................................................... 2827 3.2.1 Overview of the sector ................................................................................................... 2827 3.2.1.1 Lady Health Workers (LHW) ........................................................................................ 2827 3.2.1.2 MNCH program: ......................................................................................................... 2827 3.2.1.3 School Health & Nutrition Program:............................................................................ 2827 3.2.2 Potential role in nutrition improvement ......................................................................... 2928 3.2.2.1 Causal Pathway of Malnutrition .................................................................................. 2928 3.2.2.2 Care for Mothers and Children ................................................................................... 3029 3.2.3 Objectives ...................................................................................................................... 3130 3.2.4 Intervention framework ................................................................................................. 3231 Page 2 3.2.4.1 Strategy 1: Mainstreaming Nutrition in Health ............................................................ 3231 3.2.4.2 Strategy 2: Equitable access to Nutrition services to poor and marginalized people .... 3332 3.2.4.3 Strategy 3: Strengthening capacity of Provincial and local governments on nutrition to provide basic services in an inclusive and equitable manner ...................................................... 3635 3.3 WASH .................................................................................................................................... 3736 3.3.1 Overview of the sector ................................................................................................... 3736 3.3.1.1 Public Health & engineering department (PHED) ....................................................... 3736 3.3.1.2 Achievements of Public Health & Engineering Department ......................................... 3836 3.3.2 Potential role in nutrition improvement, engagement and role within the multisectoral framework ..................................................................................................................................... 3837 3.3.4 Intervention framework ................................................................................................. 4039 3.3.4.1 Strategy 1: Equitable access to safe & clean water ...................................................... 4039 3.3.4.2 Strategy 2: Promote best practices & behavioral change regarding hygiene practices . 4341 3.3.4.3 Strategy 3: Equitable access to Total Sanitation Services ............................................. 4543 3.3.4.4 Strategy 4: Development and implementation of Policies and Strategies .................... 4847 3.4 FOOD ................................................................................................................................. 4947 3.4.1 Overview of the sector ................................................................................................... 4947 3.4.2 Punjab Food Department ........................................................................................... 5048 3.4.2.1 Potential role in nutrition improvement, engagement and role within the Multisectoral framework ..................................................................................................................................... 5048 3.4.2.2 Food Security ............................................................................................................. 5048 3.4.3 Overall Sectoral objectives .................................................................................................... 5250 3.4.3.1 Nutrition specific objectives: related to nutrition specific strategic plan ........................ 5250 3.4.4 Punjab Food Authority ................................................................................................... 5250 3.4.4.1 Potential role in nutrition improvement: .................................................................... 5250 3.4.5 Overall Objectives ...................................................................................................... 5351 3.4.5.1 Nutrition specific objectives: related to the Nutrition Specific Strategic Plan ............. 5351 3.4.6 Intervention framework ............................................................................................. 5351 3.5 SOCIAL PROTECTION .............................................................................................................. 5957 3.5.1 Overview of the sector ................................................................................................... 5957 . Implementation of U.N. Conventions ratified by Government of Pakistan .............................. 6058 3.5.2 Potential role in nutrition improvement, engagement and role within the multisectoral framework ..................................................................................................................................... 6158 Page 3 3.5.3 Food Insecurity and Vulnerability ............................................................................... 6260 3.5.4 Women Empowerment .............................................................................................. 6360 3.5.6 Intervention Framework ................................................................................................ 6461 3.5.6.1 Strategy 1: Strengthen social protection sector to scale-up nutrition-sensitive interventions ............................................................................................................................. 6461 3.5.6.2 Strategy 2: Improving the economic access to address nutritional needs through poverty alleviation and social protection ................................................................................................ 6764 3.5.6.3 Strategy 3: Promote nutrition awareness for healthy & safe dietary practices ............ 6866 3.6 AGRICULTURE ........................................................................................................................ 7067 3.6.1 Crop Sector .................................................................................................................... 7067 3.6.1.1 Overview of the sector ................................................................................................... 7067 3.6.1.1.1 Live Stock & Diary Development