As Pakistan plans to hold general elections in a few weeks, one critical development issue has received little attention: undernutrition. Almost half of Pakistan’s children are chronically malnourished, and 70% have deficiencies of essential vitamins and minerals. These hard-hitting facts were laid out in a seminar on “The Role of Media in Highlighting Nutrition” to mainstream nutrition in the national development discourse, organized by the Pakistan Nutrition Development Partners Group (which is chaired by the World Bank) in Islamabad and attended by media professionals.
The two speakers were Professor Dr. Zulfiqar Bhutta, Founding Director of the Center of Excellence in Women and Child Health at the Aga Khan University, who presented about the nutrition situation in Pakistan; and Mr. Adnan Rehmat, Executive Director of Intermedia Pakistan, speaking about how to get the media to highlight the issue.
Malnutrition is a source of poverty around the world, and it needs to be seen as an entry point into development, rather than simply an outcome of economic growth. There are 165 million stunted children globally, which puts them at significantly higher risk than other children of dying from simple diseases. In fact, 45% of child mortality in the world can be attributed to underlying undernutrition as a cause. Malnutrition during pregnancy and in the first two years of life reduces brain development and learning ability, thus reducing learning ability and productivity during adult years.
Dr. Bhutta, who was the principal investigator of the 2011 National Nutrition Survey (pdf), laid out the magnitude of the undernutrition problem in Pakistan, along with the opportunities to improve it.
Based on nationally representative data, there has not been much improvement in the nutrition situation in Pakistan over the past two decades, with some indicators remaining near levels found almost 50 years ago. From maternal anemia rates, stunting, to children being underweight, Pakistan is trailing, even falling behind Sub-Saharan Africa. Beyond the impact on individual families and thousands of avoidable deaths, it is estimated undernutrition costs Pakistan 3% of GDP growth per year through losses in productivity.
There are vast regional differences in undernutrition in Pakistan, Dr. Bhutta illustrated, using maps created with district-level data. The provinces of Sindh and Balochistan, as well as the southern part of Punjab, lag behind the rest of the country in almost all childhood nutrition indicators.
These same regions also lag behind in maternal health indicators, showing the inter-generational relationship between nutrition, health, and poverty. The data shows that severely stunted children also have mothers who are significantly shorter than other women. Further, half of stunting in children in Pakistan happens by six months of age, underlying the need to make investments in nutrition early. While the poorest are the most adversely affected, even among the richest fifth of Pakistanis, there is 25-30% stunting, showing that undernutrition is a society-wide problem.