FeaturedNationalVOLUME 19 ISSUE # 43

The unmet challenge of food insecurity and malnutrition

Food insecurity and malnutrition are two major health issues in Pakistan. Mothers belonging to poor sections of society are malnourished due to which children are born underweight and suffer from stunting. According to a recent report, in Pakistan 40.2 per cent of children under five are stunted, which is an alarmingly high incidence by world standard. The stunting figures have  barely improved over the years, indicating that the underlying causes of malnutrition have remained unaddressed.

Stunting is a serious public health concern. A result of persistent malnutrition, stunting impairs mental and physical development, which in turn impacts a child’s future potential and productivity. Despite numerous initiatives, Pakistan still faces high rates of childhood stunting.

A major cause of stunting is inappropriate feeding, which include delayed onset of nursing, low rates of exclusive breastfeeding, and inadequate supplemental eating. Just 48 per cent of newborns under six months old receive only breast milk, and additional feeding techniques frequently fall short in terms of quantity and quality.

The cycle of hunger and poverty goes on and on when stunted children grow up to be malnourished adults who in turn give birth to low birth weight children.Malnutrition is made worse by limited access to quality healthcare treatments. Healthcare facilities are mostly absent and there is a shortage of qualified healthcare professionals in many rural areas. Children are also more susceptible to diseases due to lack of vaccination. In Pakistan poverty continues to be the primary cause of stunting. A sizable section of the population cannot buy enough food and lives below the poverty line. The World Bank estimates that about 58 per cent of Pakistanis are living below the country’s poverty level.Inadequate hygiene and sanitation habits result in recurrent infections and illnesses like diarrhea which impede the absorption of nutrients and cause stunting. Only 36 per cent of people have access to safe drinking water, and 24 per cent of people defecate in the open, according to UNICEF.

The effects of stunting are many, affecting not just the individual but also the community at large. Children with stunted immune systems are more vulnerable to illnesses. Additionally, they have a higher chance of growing up to have chronic illnesses like diabetes and hypertension. Children who are stunted frequently have lower IQs, do badly in school, and have less education, which will limit their employment opportunities and financial stability in the future.

The financial toll of  stunting is also high. It adversely affects the human capital of the nation, which hinders economic growth and productivity. According to a study conducted by the Pakistan Institute of Development Economics (PIDE), malnutrition, including stunting, is estimated to cost Pakistan two to three per cent of its GDP annually.

A multi-sectoral strategy is needed to combat stunting. Integrated strategies and coordinated actions  in the health and education sectors are required to address the many factors that contribute to stunting. Experts recommend that the government should promote dietary diversity to provide a balanced diet to people so that they can consume better food and avoid stunting in the next generations.

To overcome the challenge of stunting, more concerted actions are required from the government and civil society organizations to address the core causes of stunting, which include poverty, food insecurity, maternal malnutrition, unhealthy feeding practices, and inadequate healthcare and WASH facilities.

Pakistan can ensure a healthier and more productive future for its children by treating stunting as a serious national health and development issue.Stunting is being fought in Pakistan by a number of non-governmental organisations and international groups. WASH activities, maternity and child health services, and nutritional programs are supported by Unicef, the World Food Programme (WFP), and other agencies. The People’s Primary Healthcare Initiative (PPHI) has played an important role in Sindh in enhancing maternity and child health services. PPHI has improved immunisation rates and encouraged breastfeeding and complementary feeding practices through community-based interventions.

Some time ago the Pakistani government initiated a number of initiatives to combat malnutrition. One such initiative is the Ehsaas Nashonuma Programme, which offers health services, nutrition education, and conditional cash transfers to women who are pregnant, nursing, and to children under the age of two.Another programme launched  a few years ago is the Accelerated Action Programme (AAP) whose main objective was to reduce the stunting numbers in Sindh from 48 per cent to 31 per cent which is the same as other South Asian countries. It may be noted here that previous initiatives to combat stunting and malnutrition could not fully succeed due to lack of adequate finance and coordination between various sectors, and limited access to rural areas.another issue is lack of public awareness. Awareness is  important as stunting is not just related to poor people. The numbers suggest that 20 per cent are rich people while 44 per cent are poor from the total 48 per cent of children that are stunted in Sindh. Balochistan faces particular difficulties because of its rough terrain and dispersed population. The primary goals of the Balochistan Nutrition Programme for Mothers and Children (BNPMC) have been to promote good hygiene and supply vitamin supplements. However, logistic problems and security concerns diminish the program’s influence.

The biggest and most logical programme for stunting is the 1,000 days program, which is also underway in other countries, in which mothers will be given nutritional diets starting from pregnancy to lactation period.In the long term, to reduce stunting It is imperative to enhance food security. Programs for social protection. Access to wholesome food for vulnerable communities  guaranteed by the government should go a long way to meet the challenge of stunting and malnutrition.

Maternal health and nutrition programs must be given top priority. Crucial actions include giving women access to healthcare services, educating them about appropriate meals, and providing vitamin supplements.

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