A SNAPSHOT OF ADOLESCENT GIRLS' NUTRITION AND RELATED ISSUES IN PAKISTAN

Policy Brief A Snapshot of Adolescent Girls’ Nutrition and Related Issues in Pakistan Time for Action

Policybrief

A Snapshot of Adolescent Girls Nutrition and Related Issues in PakistanTime for Action

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here is an increasing realisation at the global level that the health and social well being of poor and marginalised adolescent girls is of critical significance for the achievement of Millennium Development Goals (MDGs) 4 and 5 and implementation of the Conventions on the “Elimination of All Forms of Discrimination against Women” and “Rights of the Child”.

Globally, approximately 18 million girls under the age of 20 years give birth each year of which two million are adolescent girls under the age of 15 years. Adolescents aged 15 through 19 years are twice as likely to die during pregnancy or child birth compared to those over age 20 and girls under 15 years age are five times more likely to die (WHO, 2010). Infant and child mortality rates are similarly disproportionately high among babies delivered by adolescent girls. The UNFPA “Addis Call to Urgent Action for Maternal Health”, therefore puts adolescent girls health among three key measures (with prioritizing family planning and strengthening health services being the other two) to reduce maternal mortality and achieve MDG 5 (UNFPA, 2009).

Adolescent girls in Pakistan –Situation Analysis

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here is scant information on the health and nutritional status of adolescent girls in Pakistan- a reflection of the low recognition of their specific health and nutrition needs.

Their marginalisation is further evident from the lack of recognition of their needs and issues in policies and programmes implemented currently and in the past. As is being recognised at the international level, this neglect of the poor adolescent girls, if not addressed, is likely to keep the country away from boosting up its slow progress towards the achievement of MDGs 4 & 5.

The research project entitled “studying the knowledge, beliefs and practices of unmarried and married adolescent girls with respect to nutrition and on the sources of nutrition information the adolescent have access to and use”, was undertaken to document an overarching view of adolescent girls nutrition and health and associated issues in Pakistan with the purpose of bringing these under focus in policies, programmes and strategies being implemented and planned to be developed and implemented. The key findings of the study are:

Socio-demographic picture  The median monthly income of poor adolescent girl’s households is Rs. 9,000 overall and Rs. 8000 in urban and Rs. 9000 in rural areas.  70% of the poor households have to rooms or less for sleeping.  22% of poor unmarried and 40% of married adolescent girls are illiterate.  The age at marriage of 35% of married girls is 15 years or less and of 75% 17 years or less.  Education increases the age at marriage significantly  88% of poor girls have never been gainfully employed.  The unmarried ever-employed girls receive a mean salary of Rs. 1733/and the married ever employed Rs. 2426/Food and nutrition situation  Overall 40% of households are spending 50% to <75% of their monthly income on food.  Overall 40% households had occasional or frequent food shortages in the previous year.  Hunger: Overall 60% of both unmarried and married girls said they never had enough food to eat.  Health workers are the source of nutrition and health information for 2% unmarried girls and 11% married girls overall.  18% of unmarried and 12% of married girls are thin and severely

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thin categories on the basis of their body mass index (BMI).

Overall 60% of adolescent girls have access to Lady Health Workers (LHWs).

Household and community members are not satisfied with the services provided by LHWs and CMWs. Health managers and LHWs and CMWs themselves suggested revision of nutrition training curricula and counselling and communication skills development of LHWs and CMWs For 58% unmarried and 52% married a nearby health facility is available but 40% of both married and unmarried girls have never visited their nearby health facility.

Reproductive health related opinion and practices:  Mean age at first pregnancy of married adolescent girls is 16.44 years overall.  44% are not in favour of family planning;  Overall 80% of married girls are not using any contraceptives;  35% of the married girls are not in favour of visiting health facilities for antenatal care and 30% want antenatal care from lady doctor.  For 65% the preferred place of delivery is hospital. About 30% prefer home delivery.

Recommended Actions

1. Review all health, nutrition and youth related policies and programmes to include poor adolescent girls nutrition, health and social and financial empowerment as specific areas of focus.

2. Programmes and their implementation strategies must focus on awareness creation and behaviour change at the household and community level.

3. Community health services providers need to be recognised as agents for change and their capacities developed as promoters of and counsellors on nutrition and health to adolescent girls and their households.

4. The health services provider need to understand the nutritional value of inexpensive and easily available food items and their combinations to be able to make more practical suggestions for the improvement of dietary intake.

5. School teachers as community members are available to the adolescent girls even if they are not school going. They need to be trained as nutrition counsellors for adolescent girls and their families.

6. Utilise available local schools facilities and infrastructure for undertaking nutrition and lifestyle change awareness creation activities and capacity building activities.

7. Develop Programmes that offer adolescent girls vocational training and employment opportunities.

8. Develop an integrated approach to enhancement of poor adolescent girlsâ&#x20AC;&#x2122; overall well-being. Programmes should combine life-skills training and social support with strategies to promote access to financial services and employment.

9. To provide baseline data and inform the development and implementation of policies and programmes related to adolescent girlsâ&#x20AC;&#x2122; health, nutrition and social wellbeing institutionalise systems research.

For more information on the study, please reach us at Nur Center for Research and Policy, Fatima Memorial Hospital, Shadman, Lahore Info@nurfoundation.org www.nurfoundation.org/ncrp www.facebook.com/NurCenterforResearchandPolicy Fax: +(92-42) 3750 3692 | Tel:+(92-42) 3750 3694