More than 50 percent of households in Pakistan are food-insecure, out of which 98 percent are facing hunger, as per the National Nutrition Survey (NNS). Research has demonstrated links between higher levels of gender differences and higher levels of under-nutrition. The question that now arises is whether gender inequality is the main roadblock to achieving nutrition targets in Pakistan.
Of course, malnutrition has many contributing factors. However, there can be no doubt that the constructed gender and societal roles of men and women in Pakistan interact with their biological roles to affect the nutritional status of both genders and, by extension, the entire family. Moreover, it has been demonstrated that women and adolescent girls are more vulnerable to deficiencies in micronutrients like iron, vitamin A and iodine – the nutrients that are essential for normal growth and development.
More than 50 percent of women and girls in Pakistan are anaemic and have difficulties during pregnancy. It goes without saying that the nutritional status of pregnant women is important, not only for the mother, but also for the child. Poor nutrition before and during pregnancy can cause chronic malnutrition, which is dangerous for both the mother and her child. Based on research, around 150 calories per day are required for the healthy development of a baby.
In addition, nutritionists and doctors recommend food that is rich in iodine, calcium, protein, vitamin A and folic to reduce the risk of multiple disorders and infant mortality.
Poor access to socioeconomic and basic health resources have also created shocking conditions for women and young children in Pakistan. Over 40 percent of children are underweight, nearly half of them are affected by stunting and nearly nine percent of them suffer from wasting. Infants between six to 12 months need adequate amounts of appropriate fortified food along with intake of breast milk. This is because breast milk on its own is not a sufficient source of iron.
Solid to semi-solid feedings with iron-fortified baby cereal mixed with breast milk or formula is considered ideal. Between 12 months to 24 months, the stomach of an infant has developed a little and he or she can be given whole milk. Wholegrain, protein foods and vegetables can be given to a child at this age to aid growth. Iodine can be provided via iodised salt. However, the level of fortification must be monitored by national authorities. Educating and empowering pregnant and new mothers can also help combat future malnutrition.
There is a pressing need in Pakistan for a supportive system that can address these issues in order to allow women to make the choices that work best for them and their families. An International Food Policy Research Institute study stated that as much as half of the reduction in hunger can be attributed to improvements in the societal status of women. Sometimes, this leads to the core of complex and unequal power relationships in a family and in the social and economic status of women within our community.
Recently, a Multi-Sectoral Nutrition Strategy (MNS) 2018-2035 was introduced by the Ministry of Planning, Development and Reform along with the World Food Programme (WFP) to tackle the malnutrition epidemic in the country. This strategy provides a framework to develop a strategic guide for scaled-up equitable and high-quality nutrition services, including both sensitive and specific interventions.
An amount of Rs10 billion is to be allocated in the Public Sector Development Programme 2018-2019 to improve the country’s nutrition situation. Furthermore, the Ministry of National Health Services is collaborating with the Aga Khan University and Unicef to collect data at the district level to identify areas that face nutrition challenges and work on barriers.
In order to completely eradicate malnutrition, we need to look beyond women, and educate men on the right kind of food, agriculture, poultry and livestock. We must also make them recognise the role of women in the community and family. Discouraging child marriages, creating a safe environment, and providing social and economic security to ensure the wellbeing of all members of society is also paramount. Women’s participation in agriculture can also bring financial ease to families, allowing them to focus on health and education in a much better way.
Creating awareness and highlighting the important link between women’s empowerment and science-based nutrition is integral at all levels. Gender inequality, nutrition-related issues and the lack of access and control over resources among women is not only unfair to women and their children, but also reflects bad socioeconomic practices. This results in the misallocation of scarce resources, increased healthcare costs, lowered productivity, and poor human development trends.
Given the vulnerable situation of women and girls in Pakistan, it is crucial to incorporate gender-sensitive nutrition components into programmes at all policy levels. However, regular monitoring and accountability is critical if Pakistan is to break the logjam to address malnutrition.
An effective and culturally relevant behavioural change and communication strategy must be implemented and sustained. Religious leaders, teachers, and social leaders can play an important role in promoting healthcare. Healthy women and children will produce improved, empowered, and developed communities who will, in turn, make a healthy contribution towards Pakistan’s development and future.
The writer is a Lahore-based nutritionist.