Submission ID 130803
| Issue/Objective | Malnutrition remains a persistent public health challenge in Pakistan, the National Nutrition Survey of 2018 found that 17.7% children are suffering from wasting, the highest wasting rate in Pakistan's recorded history, well above the regional Asia average of 21.8%. Existing national surveillance systems primarily capture aggregated information from public facilities, leaving a critical gap in monitoring and management of child malnutrition in private provider settings. To address this gap, the Mazboot Bunyad Digital Nutrition Program was implemented in private clinics serving urban slums of Karachi. This study aimed to assess the implementation of the digital nutrition registry using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework. |
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| Methodology/Approach | A multi-method study was conducted between July 2024 and June 2025 across 33 private provider clinics. Children aged 6-59 months were screened by MUAC and managed per severity via counselling, MNP sachets and RUTF, with 15-day reassessment. Quantitative analysis included secondary data from 22,443 children registered in the digital nutrition system. Qualitative data were collected through 42 in-depth interviews with social counsellors (n=16), parents (n=16), and policymakers (n=10), and analysed using thematic analysis guided by the RE-AIM framework. |
| Results | Overall, 19% of screened children were identified with global acute malnutrition, including 14.5% with MAM and 4.5% with SAM. At the second follow-up mark (4-5 weeks), 23.5% and 6.3% of children with moderate acute malnutrition and severe acute malnutrition had transitioned to normal status. Female children had significantly higher odds of developing both severe (OR=1.39) and moderate acute malnutrition (OR=1.24) compared to males. High maternal parity was strongly associated with increased risk of malnutrition, while older maternal age and increasing child age were protective factors. Qualitative findings indicated high acceptability and perceived appropriateness of the digital registry due to improved case tracking, structured follow-ups, and enhanced workflow efficiency. Implementation challenges included poor internet connectivity, community misconceptions regarding RUTF and private sector data sharing. |
| Discussion/Conclusion | The Mazboot Bunyad digital nutrition program demonstrates promise for strengthening child-level nutrition surveillance and service delivery in underserved urban settings through digitally powered tools. Addressing operational barriers and establishing sustainable public-private partnerships will be critical for long-term scale-up. |
| Presenters and Affiliations | Muhammad Fazal Hussain Qureshi Aga Khan University Nimra Qaiser Aga Khan University Ammarah Ali Aga Khan University Wafa Zehra Jamal Aga Khan University Zahid Ali Memon Aga Khan University Shifa Salman Habib Aga Khan University |
