With 9.8m stunted children Pakistan ranked 3rd in world

Islamabad

With a population of 9.8 million stunted children, Pakistan is ranked third in the world with the greatest number of children under five suffering from stunted growth. India topped the list of top ten countries with 48 million stunted children followed by Nigeria at the second position with 10 million such children.

The statistics were revealed in a report titled ‘Caught Short: How a Lack of Toilets and Clean Water Contributes to Malnutrition’ published by WaterAid. Others in the top ten list included Indonesia, China, Ethiopia, Bangladesh, DR Congo, Philippines and UR Tanzania.

According to the report, 45 per cent of Pakistani children are stunted, nearly 9 per cent of the population does not have access to clean water and 39 per cent do not have access to decent sanitation. As per percentage of stunted children, Pakistan is ranked eighth in the ten worst places in the world with Timor-Leste topping the list with 58 per cent such children.

The report says that currently 159 million children in the world are stunted as a result of malnutrition, their cognitive and physical growth damaged irreversibly by their inability to obtain and absorb the nutrients they need. Some 50 per cent of malnutrition is linked to infections, worm infestations and diarrhoeal illnesses caused by dirty water, poor sanitation and a lack of hygiene including hand washing with soap.

Stunting is defined as children having low height for age. It indicates that children haven’t developed as they should, physically or cognitively. Stunting is a consequence of malnutrition in the first 1,000 days from conception until age two. It is largely irreversible after the age of two, making those first 1,000 days critical to a child’s development. Maternal malnutrition also leads to low newborn birth weight, increasing the risk of a child dying in their first two years of life, and of them being more susceptible to life-threatening infections and diseases later in life. Stunting has also been shown to contribute to obstructed labour for women and girls, as their bodies are not developed enough to deliver a baby safely. And so the vicious circle goes on across generations.

The report negates the general impression that only genes, environment, and food influences child’s physical and mental development. “Only few know the impact that toilets and clean water have on children’s growth and development. In the developing world, a lack of clean water, sanitation and hygiene (WASH) is a major contributor to malnutrition. One impact of this is stunting, where severe and prolonged undernutrition makes children shorter than normal for their age, and affects their emotional, social and cognitive development.”

The report says that diarrhoeal diseases caused by dirty water and poor sanitation are the second biggest killer of children under five after pneumonia, taking 315,000 young lives every year. Even those children who survive severe bouts of diarrhoea are at risk of having their lives, and life chances, forever changed. It says that the World Health Organization estimates that 50 per cent of undernutrition – a major form of malnutrition – is associated with infections caused by unsafe water, poor sanitation and unhygienic practices, including not washing hands with soap.

Currently, more than 650 million people in the world do not have access to clean water and more than 2.3 billion do not have access to an adequate toilet. A recent study suggests that 54 per cent of international variation in children’s height can be linked to open defecation, which spreads deadly diseases and makes children more susceptible to diarrhoeal illness and infection.

The report states that direct interventions to address malnutrition, such as nutrient supplements and exclusive breastfeeding, can only reduce stunting by 20 per cent in the worst affected countries, even if they’re reaching 90 per cent of the population in need. That means improving access to clean water, sanitation and hygiene, along with measures in other sectors, plays a crucial part in reducing the remaining 80 per cent of stunting.

The report urges governments and donors to make ambitious investments in water, sanitation and hygiene for all, as a critical part of their efforts to improve nutrition and ensure that WASH interventions are embedded in their policies, plans and programmes, to reduce undernutrition, childhood diseases and newborn deaths. It recommends that Ministries of Health, Water, Sanitation, Agriculture and Education must all coordinate their efforts to tackle the underlying causes, as well as the effects, of malnutrition.