Sindh CM, World Bank agree on unified strategy to cut child stunting across Sindh

KARACHI, Aug 03 (APP):Sindh Chief Minister Syed Murad Ali Shah and World Bank Country Director Ms Bolormaa Amgaabazar on Monday agreed to launch a comprehensive, convergence-based strategy to accelerate the reduction of child stunting across Sindh by bringing together interventions in health, nutrition, water and sanitation (WASH), social protection, and agriculture under a unified governance and monitoring framework.

     The agreement was reached during a high-level meeting held at the CM House, where both sides reviewed a proposed governance framework designed to tackle the persistent challenge of child stunting through coordinated action across multiple sectors and districts.

  Sindh Health Minister Dr Azra Fazal Pechuho, Chief Secretary Asif Hyder Shah, Principal Secretary to CM Agha Wasif, Acting Chairman Planning & Development Bilal Memon, Acting Secretary Health Hafiz Abbasi, Secretary Social Protection Khadim Hussain Channa, CEO PPHI Javed Ali Jagirani, CEO Social Protection Irshad Ali Sodhar, Chief Foreign Aid Sajda Ayaz Kazi and others attended the meeting. (From World Bank) World Bank Lead Economist Ghazala Mansuri, Operations Officers Hina Salim Lotia and Murtaza Noonari, Senior Water Supply and Sanitation Specialist Mohammad Farhanullah Sami, and Senior Social Protection Specialist Sohail Saeed Abbasi also attended the meeting.

The Chief Minister said that stunting remains one of the most critical human development challenges facing Sindh, requiring coordinated interventions to address its underlying causes, including malnutrition, poor sanitation, inadequate healthcare, unsafe drinking water, poverty and limited dietary diversity.

Under the proposed framework, the Sindh government and the World Bank will align sectoral programmes, budgets and performance targets through a convergence model that combines interventions in health, social protection, WASH and agri-food systems to deliver measurable improvements in child nutrition and development outcomes.

Officials briefed the meeting that the strategy is based on synergistic and co-located actions across four key sectors.

In the WASH sector, efforts will focus on expanding access to safely managed drinking water and sanitation services, improving sewage and wastewater treatment systems, and promoting BabyWASH practices to reduce environmental factors contributing to stunting.

In the Health and Social Protection sectors, the programme will strengthen access to quality preventive and curative healthcare, maternal and child nutrition services, family planning, immunisation, and behavioural change interventions. Social protection initiatives, including MAMTA and Nashonuma programmes, will provide conditional cash transfers to support improved childcare and feeding practices.

In the Agri-Food sector, the strategy aims to increase access to nutritious and diverse foods through crop diversification, enhanced livestock productivity, promotion of sustainable farming practices, and widespread adoption of household kitchen gardens.

A province-wide behavioural change campaign will complement these interventions by encouraging healthier nutritional, hygiene and childcare practices.

The meeting was informed that World Bank-supported programmes already provide a strong platform for convergence across Sindh.

The National Health Support Programme covers all 29 districts of Sindh, while the Sindh Integrated Health and Population Programme currently operates in 15 districts. The Sindh Social Protection Delivery System covers the same 15 districts and is planned to expand to seven additional districts, Murad Ali Shah said.

Similarly, the STARS-WASH programme has identified service areas in all 22 rural districts of Sindh and will be implemented in phases, he added.

The first phase of convergence will focus on districts where health, social protection and WASH interventions overlap, including Badin, Jacobabad, Kashmore, Mirpurkhas, Shikarpur, Sujawal, Tando Allahyar, Tando Muhammad Khan, Thatta and Umerkot.

The Chief Minister endorsed the proposal to establish a multi-tier governance structure led by the Chief Minister himself as the champion of the initiative.

Under the proposed arrangement, a Policy and Monitoring Steering Committee, chaired by the Chief Minister, will provide strategic guidance, approve priorities, ensure alignment of policies and financing, review performance, and resolve major inter-sectoral bottlenecks.

A Stunting Convergence Secretariat, chaired by the Chief Secretary or Chairman P&D, will coordinate annual work plans, monitor implementation, align sectoral interventions and address operational challenges.

At the district level, District Coordination Committees, chaired by Deputy Commissioners, will oversee implementation, coordinate sectoral activities, monitor progress against targets and identify local bottlenecks requiring provincial intervention.

The meeting also approved the development of an integrated Stunting Management Information System (MIS) that will combine sectoral data from health, social protection, WASH and agriculture programmes into a single dashboard.

Monthly district performance scorecards will be submitted to the Chief Minister, Chief Secretary and Chairman P&D to track progress and improve accountability. The dashboard may eventually be made public to enhance transparency and citizen engagement.

The proposed MIS will integrate health facility data, outreach indicators from Lady Health Workers and Community Health Workers, vaccination records, beneficiary information from MAMTA and Nashonuma programmes, WASH infrastructure databases, water quality testing results and district-level budget allocations.

Speaking on the occasion, Chief Minister Syed Murad Ali Shah said that reducing child stunting was not merely a health objective but a fundamental development priority for Sindh. “Every stunted child represents lost human potential. If we are serious about improving education outcomes, economic productivity and social wellbeing, we must tackle child stunting through a coordinated, whole-of-government approach,” he said.

The CM said fragmented interventions could not effectively address the multidimensional causes of malnutrition and poor child growth. “The challenge of stunting cuts across health, sanitation, nutrition, poverty and food security. Therefore, our response must be equally integrated. We are bringing all relevant departments together under a single framework with clear targets, accountability and monitoring mechanisms,” he said.

The Chief Minister emphasised that district-level implementation would be the key to success. “The real impact of this initiative will be measured in our villages, communities and households. Deputy Commissioners, health teams, social protection workers and local governments must work in close coordination to ensure that services reach every mother and child who needs them.”

He appreciated the World Bank’s continued partnership with Sindh and reaffirmed the provincial government’s commitment to evidence-based policymaking. “With strong political ownership, reliable data systems and coordinated action across sectors, Sindh can significantly reduce child stunting and improve the lives of millions of children and families.”

World Bank Country Director Ms Bolormaa Amgaabazar reiterated the Bank’s support for Sindh’s efforts to strengthen human capital development and welcomed the province’s commitment to a convergence approach that integrates services, improves accountability and focuses resources on the districts most affected by stunting.

The meeting concluded with an agreement to finalise the governance framework, operational arrangements and monitoring mechanisms for early implementation of the convergence strategy across priority districts.