Badruddin Salma Halai, Agha Ajmal, Peermohamed Habib, Rafique Ghazala, Khan Kausar S, Pappas Gregory
The Aga Khan University, Department of Community Health Sciences, Stadium Road, Karachi, Pakistan.
Asia Pac J Clin Nutr. 2008;17 Suppl 1:357-60.
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.
塔瓦纳巴基斯坦项目是一个多层面的试点项目（2002年9月至2005年6月），由巴基斯坦政府资助，旨在解决小学适龄女童营养状况不佳和入学率低的问题。核心战略是营造一个安全的环境，使农村妇女能够做出集体决策。通过反思性学习过程，妇女学会了规划均衡的菜单、购买食物、用当地可得的食物以名义成本（0.12美元/儿童）在学校准备和供应午餐。阿迦汗大学与政府合作，负责项目的设计、管理、监测和评估，11个非政府组织在4035所农村政府女子学校协助实施。对663名实地工作人员、4383名社区组织者、4336名学校教师和约9.5万名农村妇女进行了培训。在基线时以及此后每6个月记录身高和体重。消瘦、体重不足和发育迟缓分别下降了45%、22%和6%。入学率提高了40%。妇女规划均衡膳食的能力有所提高，到项目结束时，超过76%的膳食提供了基本的三大类食物。政府官僚主义问题，尤其是在地区层面，被证明是最具挑战性的瓶颈。成功可归因于同时处理营养、教育和赋权问题所获得的协同效应。
