Healthy and well-nourished children are one of the keys to Pakistan’s prosperous future. When we talk about the overall health and nourishment of the children, Pakistan is way behind and nowhere close to the international indicators. The United Nations Children’s Fund (UNICEF) reports indicate that almost half of children in Pakistan are chronically malnourished resulting in stunting ie, delayed growth and development, and almost 10 percent of the children are critically malnourished (wasted). The high infant mortality as well as the under five mortality results from this underlying malnutrition, which not only predisposes children to various infectious diseases like diarrhea and pneumonia, those suffering from under nutrition are much more likely to die of these diseases than an otherwise well nourished child. Even those who survive are pushed further down the ladder of malnutrition, only to suffer from another episode of infection and possibly death.
Healthy and well-nourished children are one of the keys to Pakistan’s prosperous future. When we talk about the overall health and nourishment of the children, Pakistan is way behind and nowhere close to the international indicators. The United Nations Children’s Fund (UNICEF) reports indicate that almost half of children in Pakistan are chronically malnourished resulting in stunting ie, delayed growth and development, and almost 10 percent of the children are critically malnourished (wasted). The high infant mortality as well as the under five mortality results from this underlying malnutrition, which not only predisposes children to various infectious diseases like diarrhea and pneumonia, those suffering from under nutrition are much more likely to die of these diseases than an otherwise well nourished child. Even those who survive are pushed further down the ladder of malnutrition, only to suffer from another episode of infection and possibly death.
Perhaps, the ground realities are even worse than the reported figures, with the number of stunted and wasted lives much more than reported. The huge load of malnutrition and undernourishment across the country are yet to be addressed by the government. Although, the figures and the data is staring us in the face, the task needed to fix this is humongous as well as a multi-faceted and requires a long-term approach, something which is not attractive for the political leadership, who are often more engaged in coming up with the next election strategies.
Adding to the burden of malnutrition, micronutrient deficiencies also plays a huge role. For example, iron deficiency is amongst one of the topmost micronutrients deficiency both in children and adults, especially women. According to most recent National Nutrition Survey (NNS) 2018, 53.7 percent of children under the age of five years are iron deficient, 5.7 percent of them being severely iron deficient. Other deficiencies affecting children include Zinc (18 percent), Vitamin A (12 percent) and Vitamin D (39.4 percent). These high figures in themselves are very alarming and upsetting. Iron deficiency adversely affects children’s health and wellness and impacts child mortality in addition to impairment of their cognitive development.
Also according to NNS, over 40 percent of children under five are suffering from stunting whereas 17.7 percent suffer from wasting. In the same age group, the double burden of malnutrition is becoming increasingly evident, with one in three children underweight (28.9 percent). A study done by United Nations World Food Programme reveals that malnutrition, including lower productivity, healthcare expenses and lost workers, costs Pakistan three percent or $7.6 billion of its GDP every year.
In the neighbourhood populace, the pervasiveness of iron deficiency, and all around the world perceived general medical condition, addresses a significant weight that lopsidedly influences the most youthful, underweight, and development hindered children. To exacerbate the situation, impacted children are bound to have mothers suffering from iron deficiency, which then results in increased incidences of premature and low birth weight babies further adding to the burden. By reason of malnutrition and lack of iron, most children don't arrive at their full mental and actual development potential and intellectual efficiency in adulthood, nonetheless, the truth actually goes unrecognised despite all its seriousness and extent.
To address the problem, children must be given good sources of iron, such as, leafy green vegetables (spinach, chard, mustard, turnip greens, and collards), offal (like heart, brain, kidney) and mainly products with high content of iron and other essential nutrients and vitamins such as cereal, nuts, legumes, oats etc.
The research community around the world is working on saving, improving and upgrading the health benefit of food and drinks. For instance, the Riddet Institute, a leading research institute of food science developed a unique technology to address iron deficiency, while not compromising the food and beverage taste. The food science research institute came up with unique protein-iron complex with food-grade materials and a novel processing technique. This complex offers a benefit over other food sources while having ferrous sulphate, the leading recognised iron supplement.
The role of food fortification is crucial to address the issue of micronutrient malnutrition including iron deficiency among children. Given this situation, the food industry plays a key role by making and launching a complete range of products of fortified food, nutrition and vitamin supplements and premixes of vitamins and minerals targeted at averting nutrient deficiencies and addressing the dietary needs of not just of children but also women and other vulnerable communities.
In this context, both small and big brands need to come up with fortified milk products at an affordable price to cater to children who are vulnerable to maybe malnutrition or iron and some other deficiencies and health-related issues. However, the bigger picture is not encouraging with a definite lack of policies and governance to curb this issue and come up with adequate measures.
Over the years, all the ruling parties and governing bodies have made claims to bring in measures and programmes to combat increasing malnutrition and the food security issues. The status quo, however, shows something entirely different. More than half (63 percent) of our households are food insecure. In addition, the recommended dietary diversity is seen only in 14 percent of the population, and minimum meal frequency is seen in only 18 percent of children requiring complementary feeding.
We are yet to see any long-term and result-oriented measures to be taken by the government to address the crisis of malnutrition. Also, there has been a lack of measures by the government related to food security and nutrition with the country ranked fairly lower than the other countries.
It is high time for the governing bodies to implement some well thought-of, inclusive measures at the national level to halt the upward flight of malnutrition and iron and vitamin deficiencies. The seriousness of the issue is evident in the 75th place of Pakistan in terms of obtaining food security for all its citizens, as per the Global Food Security Index 2021 (GFSI-2021).
With the current inflation rate being all time high in Pakistan, it is imperative for the government, political stakeholders along with the public and private sectors to sit and work together to devise both short-term vertical programmes (such as iron, vitamin and nutrient supplementation) and long-term policies and horizontal programmes (like fortification of wheat flour and milk) to check and contain poverty, hunger and malnutrition in Pakistan.
The writer is a medical practitioner
