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April 24, 2017

Addressing malnutrition


April 24, 2017

Childhood stunting is one of the major impediments to human development. Stunting, or low height for age, generally occurs before age two, and its effects are generally irreversible. The main causes are long-term insufficient nutrient intake and frequent infections. Stunting rates are persistently high throughout Pakistan and are one of the worst nutrition indicators. During 2001-2011, although the proportion of underweight children under five years of age declined from 38 percent to 32 percent, the levels of stunting increased from 37 percent to 44 percent. According to the budget analysis conducted by one of the research institutes of the government, merely 10 percent of the health budget is spent on nutrition of which 10 percent is contributed by the government and 90 percent by development partners in Pakistan.

There is a dire need to recognise the urgency with which malnutrition needs to be addressed as a top priority in the country. There is a need to create new opportunities and change the way nutrition is approached at national, local and individual levels. In this regard, multi-stakeholder partnership models can prove as robust, cost-efficient and effective ways of tackling nutrition issues. Promotion of continuous engagement and increased coordination between public and private sectors will definitely bring rewarding results to meet the zero hunger agenda of Sustainable Development Goals (SDG).

One of the successful global examples of a multi-stakeholder public-private partnership is the school feeding/nutrition programme that addresses malnutrition issues in many developing countries. The programme is run by the UN agencies and local governments to achieve set targets of nutrition. According to contextual needs, Pakistan can also adopt the model by using rural and urban schools as platforms to create a culture of healthy eating where children are assisted in making healthy food choices. Both, government and development agencies should work in collaboration with each other to utilise their specific resources and access malnourished children using this strategic platform.

A simple, low-cost and universally effective technical solution to overcome malnutrition is the provision of fortified milk (dairy solution) and fortified food to children in schools. Under the umbrella of the programme, various incentives like food vouchers or mid-day meals should be introduced at the primary level – an initiative that will in turn encourage enrolment and increased attendance of children, especially girls. Moreover, the education sector should review its curriculum for nutrition coverage and develop key nutrition messages, including promotion of micronutrient rich food and healthy eating habits.

Moreover, awareness sessions for teachers, introduction of nutrition concepts in teacher-induction training programmes and relay of key nutrition messages to parents during parent-teacher meetings can bring tremendous change. Healthy Kids Programme led by a renowned multinational is a good example of raising awareness. It aims to share knowledge about nutrition and health among school-going children through curriculum-based intervention. Over the last five years, the programme has reached more than 100,000 children and trained around 450 teachers in partner schools. This needs to be incorporated and taken to the next level by provincial and federal governments in multi-stakeholder approach to address the challenge of malnutrition.

In addition to that, as adolescent females are at greater risk of iron deficiency or anaemia, a health and nutrition component should be added in the curriculum for secondary classes to reach out to girls between the ages of 12 and15 years. School-based programmes to provide students with skills, social support and environmental reinforcement need to be adopted on a long-term basis. Healthy eating behaviours should be implemented through teacher-training programmes, revised curriculum and a system where schools are connected with local health and nutrition facilities. Also, as it is evident that the percentage of stunting is much higher among children whose mothers are illiterate versus those whose mothers have completed at least 10 years of education, a mother’s literacy programme through non-formal education comprising major education on nutrition component can also be initiated in the rural districts of the country.

Corporate/private sector can play a significant role in addressing malnutrition through the multi-stakeholder partnership model. Private companies that are involved in food processing, packaging and marketing of hygiene products should come forward for service delivery. They should advocate healthy practices and conduct awareness sessions on how to eat healthy and maintain hygiene and sanitation. One good example is a recent initiative undertaken by the United for Healthier Kids Movement under the auspices of the Ministry of Planning Development and Reforms. The partnership involves multi-stakeholders and aims to synergise public and private sectors to create awareness among teachers and parents so that the common goal of adopting healthier lifestyles can be achieved.

The world has entered into an era of SDG 2030. Pakistan is also an important stakeholder and signatory to these goals. In order to achieve SDG 2 – that focuses on zero hunger – there is a dire need for the government to explore new opportunities and adopt innovative techniques to address the challenges of malnutrition. Involving and working in collaboration with the private sector can definitely facilitate the country in fulfilling its international commitments.


The writer is a public health consultant.

Email: [email protected]


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