title: Tawana project-school nutrition program in Pakistan--its success, bottlenecks and lessons learned.
abstract: Tawana Pakistan Project, a multifaceted pilot project (Sept. 2002 to June 2005) was funded by the Government of Pakistan to address poor nutritional status and school enrollment of primary school age girls. The core strategy was to create safe environment empowering village women to take collective decisions. Through reflective learning process women learnt to plan balanced menus, purchase food, prepare and serve a noon meal at school from locally available foods at nominal costs (USD 0.12/child). Aga Khan University partnered the government for the design, management, monitoring and evaluation of the project, 11 NGO's facilitated implementation in 4035 rural government girls' schools. Training was provided to 663 field workers, 4383 community organizers, 4336 school teachers and around 95 thousand rural women. Height and weight were recorded at baseline and every 6 months thereafter. Wasting, underweight and stunting decreased by 45%, 22% and 6% respectively. Enrollment increased by 40%. Women's' ability to plan balanced meals improved and >76% of all meals provided the basic three food groups by end of project. Government bureaucracy issues, especially at the district level proved to be the most challenging bottlenecks. Success can be attributed to synergies gained by dealing with nutrition, education and empowerment issues simultaneously.
authors.affiliation: The Aga Khan University, Department of Community Health Sciences, Stadium Road, Karachi, Pakistan. salma.badruddin@aku.edu
authors.forename: Salma Halai
authors.initials: SH
authors.lastname: Badruddin
authors.forename: Ajmal
authors.initials: A
authors.lastname: Agha
authors.forename: Habib
authors.initials: H
authors.lastname: Peermohamed
authors.forename: Ghazala
authors.initials: G
authors.lastname: Rafique
authors.forename: Kausar S
authors.initials: KS
authors.lastname: Khan
authors.forename: Gregory
authors.initials: G
authors.lastname: Pappas
mesh_terms: D002648:Child; D015362:Child Nutrition Disorders / Q000517:prevention & control*; D053198:Child Nutrition Sciences / Q000193:education*; D002664:Child Nutritional Physiological Phenomena / Q000502:physiology*; D003906:Developing Countries; D005260:Female; D006266:Health Education / Q000379:methods*; D006801:Humans; D008612:Menu Planning; D010154:Pakistan; D015397:Program Evaluation; D012423:Rural Health; D012574:Schools; D016896:Treatment Outcome