Foro Global sobre Seguridad Alimentaria y Nutrición (Foro FSN)

Dear all,

Please accept the attached template describing a food systems-oriented partnership between Government of Pakistan, WFP and private sector that focused on improving local production of nutrient-dense foods for treating and preventing undernutrition. This work includes elements of supply (working with agro-processors) as well as demand (partnership with retailers and linkage with national safety net programme).

Quinn Marshall, on behalf of WFP Nutrition Division

World Food Programme

Date/Timeframe and location
2008 until current

Main responsible entity
Government of Pakistan

Nutrition context
Pakistan’s nutrition context includes a mix of different outcomes and trends. While on the one hand child underweight decreased from 2001 to 2011, stunting and wasting increased over this same time period. Current rates are 45% and 10.5% respectively (Global Nutrition Report 2016). The 1,000 day period from conception to 2nd birthday, as well as adolescence, have been identified as periods of high risk. Maternal undernutrition plays a role, with low birthweight experienced by a quarter of newborns and 18% of women of reproductive age underweight (body mass index less than 18.5). Exclusive breastfeeding for the first 6 months is low (13%) and the quality of home available foods given as complementary foods to children 6-23 months is also poor. In addition to these significant challenges in reducing undernutrition, Pakistan is experiencing a growing double burden of malnutrition, with overweight and obesity on the rise, particularly among women in urban areas.

The Pakistan Ministry of Planning, Development & Reform and WFP recently carried out a Fill the Nutrient Gap assessment, which found that 67% of Pakistani households are unable meet minimum nutrient requirements with their income. In addition to unaffordability of nutritious food, there is limited availability of fruits and vegetables for the poor.

Key characteristics of the food system(s) considered
Pakistan is characterized by the Global Nutrition Report (2015) as having an “emerging” food system. These systems are noted for more reliance on staple crops (dietary diversity is low) and lower agricultural productivity, in addition to a lack of production diversity and fewer nutrient-dense options for consumption. Pakistan is more urban than many other South Asian countries, meaning that more households rely on food purchases from the market to meet nutrition needs. In this context, the lack of availability and access to affordable, nutrient-dense foods in local markets was a key gap recognized by WFP, the government and partners.

At the same time, agri-business and food processing industries are regarded as mature in Pakistan. Manufacturing companies have production capacity, including the necessary equipment and knowledge of production processes, to produce a variety of processed foods. The key for this project has been how to harness this production capacity to address the nutrition needs highlighted above, particularly related to acute and chronic malnutrition.

Key characteristics of the investment made
The Government has prioritized use of ready-to-use lipid based nutrient supplements (LNS) as an appropriate response to address malnutrition, especially in crises. WFP, working together with private sector food manufacturing companies in Pakistan, sought to develop a chickpea-based version of LNS, which was more adapted to local tastes. Through the course of the assistance, WFP also aimed to support companies to enhance their capacity to produce LNS, including by engaging in R&D and designing, developing and testing of the chickpea-based recipe. WFP did not provide financial investment to the food manufacturers. The investments made in new production lines were taken on by the food manufacturers themselves. These companies were also aware of the potentially limited demand and relatively low financial returns that would be associated with a producing a nutritious food that is used in humanitarian programming, but senior management was committed to a long-term partnership. Future efforts are now being invested in means of commercializing the foods with the Scaling Up Nutrition (SUN) Movement, including by working with retailers and who can stock them in their stores, as well as with government, who may provide access to the foods via social protection programmes that are targeted to the poor.

Key actors and stakeholders involved (including through south-south/triangular exchanges, if any)

  • WFP
  • Private sector food manufacturing companies
  • Government of Pakistan
  • SUN Movement

Key changes (intended and unintended) as a result of the investment/s

  • Through the collaboration between WFP and private sector manufacturers, a nutrient supplement was developed that meets international standards for stability, quality and safety, as well as nutrient requirements for energy and micronutrients. Additionally, the product is adapted to local tastes and preferences.
  • Local production capacity of lipid-based nutrient supplements increased substantially, from 100 metric tons per year in 2009 to over 10,000 metric tons per year in 2013.
  • Through these efforts, there is better availability of nutrient-dense fortified foods that can be used to address several types of undernutrition that Pakistan faces, and easily integrated into humanitarian programmes which respond to crises, ensuring access for the most vulnerable, food insecure populations.

Challenges faced
Though the private sector manufacturers partnered with WFP knowing that demand was likely to fluctuate and returns were likely to be low, this does not mean that issues of sustainability do not need to be considered. Continued production at the necessary scale will rely on enhanced demand creation for the nutrient supplements. For this reason, WFP is now partnering with retailers to increase access to and awareness of the product among consumers in the open market. Additionally, the Fill the Nutrient Gap exercise that WFP conducted with the government enabled them to identify the national social protection programme (known as the Benazir Income Support Programme), as one of the most cost-effective entry points for improving nutrition in the short term and preventing another stunted generation. Efforts are now underway to pilot an approach in Southern Punjab whereby the unconditional cash transfers provided as part of the programme is complemented by a nutritional supplement for pregnant and lactating women, as well as children 6-23 months old.

Lessons/Key messages

  • Fortified complementary foods, including lipid-based nutrient supplements, are an effective tool for addressing multiple forms of undernutrition among key vulnerable groups within the 1,000 days.
  • Pakistan has shown that local private sector food manufacturers are capable of adapting their production processes to increase availability of these foods. Private sector partnership has been a key success factor, but realistic expectations have to be set on the returns and demand that will be available.
  • While humanitarian programmes can procure these foods for use in responding to shocks, long term sustainability will depend on generating more demand through market-based approaches, as well as utilizing social protection programmes that are capable of enabling better access among poor households on a large scale.