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[KARACHI] Pakistan could greatly reduce infant deaths by concentrating on basic nutrition interventions such as promoting exclusive breastfeeding and complementary feeding programmes, says a leading expert. 
Zulfiqar A. Bhutta, head, division of women and child health at the Aga Khan University Hospitals, Karachi, and lead author of a study on nutrition intervention, published in the Lancet last month (6 June), estimates that Pakistan needs just USD 18 million annually to implement a programme of exclusive breastfeeding and complementary feeding.
Bhutta tells SciDev.Net that he also favours social safety nets for the poor, including income support programmes that target women and children in the poorest sections of Pakistan’s population.
According to Bhutta, malnutrition is directly or indirectly responsible for 35 per cent of all under-five deaths, with the situation worst in Balochistan and Sindh provinces. "The fact that thousands of children were affected by an outbreak of measles in Sindh and southern Punjab provinces reflects poor nutritional status," Bhutta said.
The study in the Lancet said nearly 15 per cent of deaths of under-five children could be reduced (one million lives saved) if ten core nutrition interventions are scaled up. It estimates the additional cost of achieving 90 per cent coverage of these interventions, in 34 of the worst affected countries, to be around USD 9.6 billion per year.
Bhutta says that so far as Pakistan is concerned, a mere eight out of ten essential nutrition interventions could save 33 per cent of all newborns, and at 60 per cent coverage 21 per cent child deaths could be prevented.
Other than exclusive breastfeeding and feeding promotion, salt iodization for families at risk would cost only USD 8 million annually, Bhutta says. However, treating severe acute malnutrition in children can be costly at USD 179 million annually, he tells SciDev.Net.
A report published in 2012 by the non-governmental organisation Save the Children says that despite investments annual reduction in child mortality rate in the 2000—2010 period was only 0.9 per cent. According to a 2011 UNICEF report, Pakistan is among the top three countries where babies (32 per cent) have low birth weight.
"The problem in Pakistan is that plans and reports are only made in computers and never reach the grass root level," says Samrina Hashmi, head of the Pakistan Medical Association’s Sindh chapter.
Hashmi told SciDev.Net that Pakistan’s health sector receives international funding but lacks the mechanisms to spend it in a proper manner. 
Link to article in the Lancet

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