Peer-reviewed article
Development and implementation of “Mazboot Bunyad”: a digital health intervention for the screening and management of undernutrition among children aged 6–59 months, at private provider clinics in urban slums of Karachi, Pakistan
Shifa Salman Habib, Ammarah Ali, Muhammad Fazal Hussain Qureshi, Shehla Abbas Zaidi, Fasih Hansmukh et al. ·
Summary
Written by AI, not yet AICS's view · claude-sonnet-5-5This paper describes how a digital nutrition registry called Mazboot Bunyad was developed and put into use at 33 private clinics in low-income areas of Karachi, Pakistan. The app and web dashboard screen children aged 6–59 months using mid-upper arm circumference, classify them automatically, and send follow-up reminders. In the first six months (July to December 2024), 8,406 children were screened and enrolled. The authors report that real-time tracking helped supervisors follow up defaulters and stock, but supply chain gaps could affect implementation.
Key points
- 8,406 children aged 6–59 months were screened and enrolled over six months (1 July to 31 December 2024).
- 71.4% of children were classified as normal, 22.3% as moderately acutely malnourished and 6.2% as severely acutely malnourished.
- The largest share of enrollments was among children aged 13–24 months (40.5%).
- Severe acute malnutrition was higher among girls (7.3%) than boys (5.3%), although boys were 52.2% of enrollments.
- Supervisors used the dashboard to identify defaulters, monitor stock and follow recovery timelines, but supply chain gaps were a challenge.
Limitations
This is a description of development and early implementation, based on a retrospective review of routine programme data over six months, with no comparison group and no reported data on recovery or health outcomes. The findings cannot show whether the tool improves child nutrition.
Abstract
Abstract Background Undernutrition remains a leading driver of child mortality and morbidity in low- and middle-income countries, yet surveillance and case management in Pakistan still rely largely on infrequent surveys and paper-based registers that cannot track nutritional status in real time. The private sector, where most Pakistani households seek care, has been largely excluded from nutrition programming. We describe the development and early implementation of Mazboot Bunyad, a digital nutrition registry embedded within an integrated nutrition–immunization programme at private provider clinics in high-risk, low-income settlements of Karachi. Methods The Android application and web dashboard used in this implementation study were designed through a participatory process using the AHEAD framework, in consultation with provincial health authorities, immunization staff, and community nutrition worker. The system used QR-linked child records, an embedded digital decision-support system that classified children by mid-upper arm circumference and has automated follow-up reminders. The tool was deployed across 33 clinics, and routinely collected programme data, a preliminary analysis of data from 1 July to 31 December 2024 were retrospectively reviewed. Results During the period of 6 months, the Mazboot Bunyad application was used to screen and enroll 8,406 children aged 6–59 months. Field teams used the embedded Digital Decision Support System (DDSS) to classify children aged 6–59 months in real-time. Of these, 71.4% were classified as normal, 22.3% as moderately acutely malnourished (MAM), and 6.2% as severely acutely malnourished (SAM). The largest share of enrollments was among children aged 13–24 months (40.5%). Male children represented a slightly larger share of total enrollments (52.2%), but SAM burden was higher among females (7.3%) compared to males (5.3%). Supervisory teams used the dashboard to identify defaulters, monitor stock availability, and follow case recovery timelines. Conclusions Early implementation of Mazboot Bunyad highlighted opportunities for enhanced nutritional surveillance using real-time tracking, but also challenges such as supply chain gaps that could affect the overall implementation. These offer valuable lessons for scaling digital tools in real world settings across Pakistan and other LMICs.