Multi-Sectoral Mapping for Nutrition (MS4N) in Sindh, Pakistan

Abstract

Service mapping has gained increasing significance in development work during the last decade, partly due to growing public demand for measurement and accountability in the use of resources. In Pakistan, childhood stunting (42%), acute malnutrition (23%), anemia (53.7%), and other micronutrient deficiencies among the women and children of Pakistan remain persistently high. In response to this crisis-like situation, each provincial government for the first time drew up multi-sectoral, integrated nutrition programs. In 2016, Sindh, one of the four provinces, designed an “Accelerated Action Plan (AAP) for Reduction of the Stunting and Malnutrition” whereby nutrition specific and sensitive strategies of eight sectors (Agriculture, Health, Education, Social Welfare, Population Welfare, Livestock, Fisheries and WASH) are integrated at all levels from the province to the district. 

In response to address the need of M&E and Multi sectoral nutrition, a Multi-Sectoral Mapping for Nutrition (MS4N) - a computer based interactive system is being developed.  The primary objective of the MSM4N is to strengthen nutrition surveillance systems and to streamline services (input) by each implementing partner. MSM4N is expected to be user friendly, robust, and capable of fostering multi-sectoral collaboration and complex system-wide problem solving. Specifically, it will help in identifying gaps and duplication of inputs within districts by mapping services (input) at all levels from province to village, and visually presenting these by sector and by implementing partners. Hence, offering a detailed mapping of stakeholders, their interventions, geographical and population coverage for decision making within the province.

Despite that the innovation is still a work in progress; we were able to document several key lessons. Firstly, only socially desirable, economically feasible and institutionally viable are sustainable solutions. Second, the quality of service delivery also suffers from inadequate attention to legislative obligations and compliance control. For MIS, it is important to  have Standardization, particularly in nomenclature, data coding and classification systems enables accurate capturing of data and leads to good reporting, thus making the content more beneficial. Finally, users- in this case province and district based programme staff and managers- must drive MIS, not the data collectors. This means that users need to be educated and enabled in demanding both control, administrative and inferential tabulations, that inform decision-making.