Pediatric health indicators such as neonatal and childhood mortality rates in Pakistan are some of the worst worldwide and poor pediatric Nutrition continues to be a major cause of neonatal and childhood deaths in Pakistan. The 2011 National Survey showed that 32% of children under 5 years of age in AJK were stunted, 18% were wasted, and 26% are underweight.

These conditions are even more prevalent in rural and remote areas of Northern Pakistan where poverty, lack of education and limited access to basic health services are major barriers to care.

Midland Doctors Nutrition Program supported by Mac Bevan and Canadians for Global Care has been instrumental in addressing barriers and gaps in Pediatric Health services at the Midland Doctors Medical Institute(MDMI). The objective was to develop a Nutrition Program to screen and treat children for malnutrition. A further aim was to create awareness among pregnant and lactating women about nutritional habits in the catchment population.



The Mid Upper Arm Circumference of the children visiting the hospital for screening is measured and the indicators varying from red to yellow to green indicate the severity of the condition of the child. The red indicates Severe Acute Malnutrition, the yellow indicates Moderate Acute Malnutrition and green means the child is showing normal development.The muscle wastage, tiredness and weight loss increases with the severity of the disorder. The child is prescribed to be fed on Ready to Use Therapeutic Food(RUTF) which helps to improve the the weight and well being of the child. The children are asked to be brought back over few weeks interval to monitor their improvement and health conditions.

The RUTF helps the child recover easily and effectively and can resume to be fed on breast milk and normal nutritious complimentary food at home.











The Midland Doctors also ensures the well-being of the child after ensuring the child is stable and has improved weight by counselling  mothers in effective breast feeding habits for mothers by Infants and Young Child Feeding habits counselling held at the MDMI by different specialists that visit the hospital. They are advised on the importance of including nutritional food content to be complimented with breastfeeding along with hygienic practices for maintaining good health of their families.









The Midland Doctors Nutrition Program also conducts screening of community villages for children suffering from Malnutrition. The villages around a 11 km radius of the hospital has been screened by the Midland Doctors Nutritionist and community workers to identify cases and educate them about feeding habits for infants and young children. The children identified with Severe Malnutrition are given free supplies of RUTF and asked to visit the hospital for further assessment of the development of the child.








These are the villages that have been screened for children suffering from malnutrition in the remote villages around the MDMI with the help of community workers referring them to the hospital for cases that need medical attention.

The community outreach program aims to improve  effectiveness through early detection of cases and maximizing coverage. The community should fully understand the purpose of the program, why it is important to identify and treat the children suffering from severe acute malnutrition.

Community outreach workers are on the front line and well placed to address some of the reasons why these children become malnourished, hence case identification takes place at the villages and the MDMI.