Examining Inter-Sectoral Approaches to Address Maternal, Child, and Neonatal Under-Nutrition in Sindh A Policy Analysis

Worldwide, undernutrition persists as a public health concern, with significant implications on maternal, neonatal, and child health, including Pakistan. In response to the rising mortality rates in the province of Sindh, the Integrated Reproductive, Maternal, Newborn, Child & Adolescent Health and Nutrition (IRMNCAH&N) strategy was developed with a vision to improve maternal and child health by improving access to essential health services delivered through a resilient healthcare system, aligning with global health targets. This study evaluates the formulation, implementation, and effectiveness of the IRMNCAH&N strategy for neonates, children under 5 years, and pregnant and lactating women. Through the lens of the Health Policy Triangle (HPT), the analysis assesses the policy content, context, process, and stakeholders involved. Various multifaceted political, socio-economic, structural, cultural, and international interactions were identified in shaping policy formulation and implementation. The study calls for a multi-sectoral collaboration, emphasizing the need to understand and navigate power dynamics and prioritization of women’s empowerment in addressing the root causes of maternal, neonatal, and child malnutrition especially in the presence of funding gaps, structural inequities, and social and cultural barriers. Drawing insights from successful initiatives of other countries, this policy analysis offers recommendations and lessons for policymakers and other stakeholders to enhance the effectiveness of policy interventions in Sindh ultimately contributing to improved maternal, neonatal, and child nutrition outcomes.