Fighting Anaemia with Bread and Tablets
© GIZ
Across Pakistan, a quiet revolution is taking place in schools, homes, and community mills. Through the SOPRAN initiative, the Government of Pakistan, the German Government, the Gates Foundation, and partners including BISP, Nutrition International, CERP, and WFP are tackling anaemia among adolescent girls with fortified wheat flour, iron tablets, and nutrition education.
When Wajeeha, a high school student saw her classmates faint during morning assemblies, she didn’t know the cause. “I later learned it was anaemia,” she says. “Now, when I take my iron tablets and eat properly, I feel stronger and can focus better in class.”
Across Pakistan, stories like Wajeeha’s are common but they are beginning to change.
A silent crisis behind closed doors
Anaemia among adolescent girls is one of Pakistan’s most pressing yet overlooked health challenges. More than half of girls aged 10 to 19 are iron deficient, leaving them vulnerable to fatigue, poor concentration, and long-term health complications.
“In many homes, boys are still given the first share of food, while girls eat what remains,” explains Faiza Wahab, Nutrition Advisor at GIZ. “This quiet inequality weakens them day by day. Without adequate nutrition, girls cannot reach their full potential.”
The effects ripple far beyond the individual impacting education, productivity, and community wellbeing.
Breaking the silence with voices of change
Teachers, community leaders, and local health workers see the human cost every day.
“Anemia in girls is a silent illness. It eats away at their strength long before anyone realises it,”
says Muhammad Sharif, a school teacher.
Faith leaders have also joined the cause. “Daughters are a blessing in every home,” says one imam. “We must protect their health, especially when they suffer from anaemia. Sometimes it becomes so severe that it even claims lives.”
A partnership that puts nutrition at the heart of protection
To tackle this widespread problem, the Benazir Income Support Programme (BISP), Pakistan’s flagship social protection initiative, launched SOPRAN with support from the German Federal Ministry for Economic Cooperation and Development (BMZ) through GIZ, the Gates Foundation, and partners including the World Food Programme (WFP), Nutrition International, and CERP
SOPRAN brings nutrition directly into the heart of social protection. It combines three simple but powerful measures:
These steps ensure that the country’s most common staple ‘Roti’ becomes a source of strength rather than hidden hunger.
“Under BISP’s umbrella, we can reach millions of households,” says Dr. Asim Ijaz, Director General of BISP. “By combining this reach with technical expertise from our partners, we can test innovations like SOPRAN and translate evidence into policy and practice.”
“To confront this crisis, SOPRAN brings nutrition into the heart of social protection, from communities and schools to local flour mills,” adds Linda, SOPRAN Component Lead at GIZ. “At its centre are the girls themselves. With every tablet intake and every nutrition lesson learned, they become stronger and with every message shared, they become change agents in their families and communities.”
From hidden hunger to visible strength
Early results from pilot districts show encouraging signs. Girls who regularly take iron supplements and eat fortified flour report higher energy levels and better school attendance. Parents and teachers are becoming advocates for nutrition in their communities, and mill owners are proud to contribute to public health.
“Each fortified roti, each iron tablet, and each conversation in the home and in the community is a small step towards a stronger Pakistan,”
says Johanna Knoess, Project Head at GIZ.
“Nutrition is an integral part of social protection,” notes Dr. Imran Masood, Deputy Project Director, Social Health Protection at GIZ. “SOPRAN takes a multisectoral approach — leveraging Pakistan’s social protection programmes to address the critical nutrition challenges faced by adolescent girls.”
The programme’s success also lies in its local ownership. Community sessions, faith-based messages, and school campaigns are helping to shift long-standing attitudes toward girls’ nutrition and empowerment.
Looking ahead
For the partners behind SOPRAN, the goal is clear: to integrate proven nutrition measures into Pakistan’s broader social protection framework, ensuring sustainability and nationwide reach.
“When we invest in a girl’s nutrition, education, and empowerment, we don’t just change one life,” says Zeyna Sifri from the Gates Foundation. “We shape the future of families, economies, and nations.”
Healthier girls today mean stronger generations tomorrow. In Pakistan, that transformation is already underway — one tablet, one fortified roti, and one empowered girl at a time.
Farman Nawaz
November 2025