Arielle Gajer
Nutrition in Pakistan
From: Secretary of Health, Pakistan
To: Minister of Finance, Pakistan
Introduction:
About one third of the children under fiveyears old in Pakistan are malnourished [i] from micronutrient deficiencies, such as iodine and iron. This is mainly a result of the widespread food insecurity that millions of people in the country face. The food insecurity in Pakistan is largely influenced by extreme poverty, civil unrest and natural disasters. Malnutrition and food insecurity mainly affect women and children in rural, especially conflict-affected, areas. It is extremely important to address these problems to create a healthier and more productive population in addition to the overall development and economic growth of the country. Since food insecurity and poverty are the main causes of malnutrition in Pakistan we must provide food to vulnerable populations through expansion of food fortification programs for increased salt iodization and relief operations to areas of conflict or after natural disasters.
Nature and Magnitude of the Problem:
The prevalence of malnutrition in our country is extremely severe. About 24% of the population is undernourished.[ii] The underlying cause of this widespread malnutrition is food insecurity or the consumption of less than 1,700 Kcal per day. Widespread conflict and displacement of people from their homes has a huge impact on the quantity and quality of food intake. The proportion of the population experiencing food insecurity has increased by 56% since 2008 in conflict-affected rural areas.[iii]
Food insecurity and poverty has caused 38% of the children to be underweight, 37% to be stunted, and 13% of children under five to be moderately or severely wasted. As a result many of the children face significant micronutrient deficiencies. About 64% of school aged-children face iodine deficiencies and 50% of children under five are anemic. The prevalence of anemia in women is also as high as 30%.[iv] Protein energy malnutrition and other micronutrient deficiencies are underlying causes of death in about one-third of all deaths of children under five in Pakistan.
Affected Populations:
Malnourishment in Pakistan largely affects poor women and children in addition to those in severely conflict-affected rural areas. Extremely low literacy rates and poor nutrition are a direct influence on the malnutrition of women and children. About two-thirds of all women in Pakistan are illiterate.[v]Low education and literacy rates among women lead them to have unequal access to proper health care and knowledge of health practices.
People in conflict-affected areas are also at high risk for malnutrition because of the major displacement of people from their homes and the inability to attain the proper quantity or quality of food in those areas. Children are most affected by this because they become at risk for undernourishment and micronutrient deficiencies, which can lead to underdevelopment both physically and mentally. Additionally, the development disparity between urban and rural populations in Pakistan continues to grow, placing those people in rural area at high risk for many problems, including severe malnourishment. [v]
Risk Factors:
As mentioned above, malnutrition and food insecurity are mainly results of the widespread poverty, civil unrest and natural disasters that exist in Pakistan. About 36% of the population continues to live below the poverty line. This directly affects one’s ability to attain food as food prices have spiked since 2008.[v]
Civil and political unrest are major issues that directly affect the nutrition of people in Pakistan. Continued fighting and conflict have caused million of people to become displaced from their homes and thus severely food-insecure. About 45 million people in the country are food-insecure as a result of security crises. Data shows that Buner, Lower and Upper Dir, Shangla and Swat Districts, where much of the fighting has occurred, remain the most food-insecure areas in the country.[iii]
As natural disasters continue to plague Pakistan, the incidence of malnourishment and food insecurity continues to increase. After the major monsoon flooding that hit last month, the incidence of severe and moderate malnutrition was reported to rise dramatically in flood-affected areas. It was estimated that about 27% of children in the Larkana district are severely malnourished and 20% are facing moderate malnutrition. Additionally, 17% of pregnant and lactating women were found to be malnourished. [vi]Other natural disasters such as earthquakes and drought also exacerbate the alarming prevalence of malnutrition in Pakistan.
Economic and Social Consequences:
The high rates of malnutrition have several economic and social consequences on our country. Children experience a window of opportunity in which it is crucial for them to intake the proper quantity and quality of food or they will not develop properly. However, over one-third of the children under 5 years old are underweight and stunted. [vii] This is a result of the large prevalence of micronutrient deficiencies such as Iodine and Iron deficiency. Micronutrient deficiencies lead to several physical and metal problem and impede the growth and development of children. They lead to issues such as mental retardation and anemia. Deficiencies directly impact the productivity of the population, for they are not able to effectively participate in the workforce; therefore, slowing down economic growth. Additionally, deficiencies that lead to problems such as mental retardation will further slow human development and education rates.
Priority Action Steps:
Pakistan has developed several cost-effective ways to address the major problem of malnutrition. The micronutrient initiative has partnered with various organizations and industries to enable the production of iodized salt and fortified iron into food products. However, of the current estimated 1.33 million tons of salt produced, 72% is for human use and only 6% of the salt units are iodizing salt.[viii] This shows us that we need to drastically increase the amount of salt iodization and be sure to distribute it to at-risk populations, such as those in rural and conflict-affected areas.
Moreover, it is important to continue to provide adequate relief operations throughout the country. Pakistan is overwhelmed with conflict and natural disasters that leave many people displaced from homes and food insecure. It is crucial to continue to provide assistance with programs, such as Assistance to Food Insecure Households: Balochistan and the Federally Administered Tribal Areas (FATA) and Food in Return for Work. FATA provides support to Pakistan’s most underdeveloped and socio-politically volatile regions by addressing basic nutritional and health needs and promoting education. Food in Return for Work is a program which provides employment opportunities for very poor and hungry, and often many displaced people throughout Pakistan in return for food.[v] These are very important programs that we must expand upon to reach all parts of the country, especially the most vulnerable and affected populations.
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[i] “World Bank Seeks Innovative Ideas to Improve Nutrition in Pakistan.” Press Release. The World Bank. 31 October 2010. COUNTRIES/SOUTHASIAEXT/PAKISTANEXTN/0,,contentMDK:22066245~menuPK:293071~pagePK:141137~piPK:141127~theSitePK:293052,00.html
[ii] “Countries: Pakistan.” Facts and Figures. World Food Program. 31 October 2010.
[iii] “Pakistan.” Critical Issues for Women and Children. UNICEF Humanitarian Action Report 2010. 31 October 2010. UNICEF_Humanitarian_Action_Report_2010-Full_Report_WEB_EN.pdf
[iv] “Pakistan.” Pakistan Country Profile. Micronutrient Initiative. 31 October 2010.
[v] “Counties: Pakistan.” Overview. World Food Program. 31 October 2010.
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[vi] “Monsoon Flooding in Pakistan.” Operational Highlights. World Food Program. 31 October 2010. communications/wfp227103.pdf
[vii] “Pakistan: Operations, Facts and Figures.” Key Documents. World Food Program. 31 October 2010. communications/wfp224848.pdf
[viii] “Situational Analysis of Salt Analysis of Salt Production and Iodization in Pakistan.” Micronutrient Initiative. 31 October 2010. MI%20Around%20the%20World/Asia/Poster-6-Noor-Ahmad-Khan-(Salt).pdf
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