State of water supply, sanitation major health hazards in Pakistan: WB

ISLAMABAD: With a stunting rate of 38 percent, Pakistan is still among the group of countries with the highest rates of stunting globally and the pace of decline remains slow and uneven, a World Bank (WB) report disclosed on Tuesday.

The WB report cited example of Sindh where things worsened over time, with one in two children now stunted.

The alarming state of water supply and sanitation in Pakistan is creating major health hazards for the entire population and young children are particularly at risk, the report states.

The report titled “When Water Becomes a Hazard: The State of Water Supply, Sanitation and Poverty in Pakistan and its Impact on Child Stunting” launched here on Tuesday states that Pakistan has made significant progress on reducing poverty, improving dietary diversity and reducing open defecation. Despite this, critical markers of child health – rates of diarrhea and stunting – still do not show any real improvement.

On establishing linkages among water supply, sanitation and poverty, the report states that the incidence of poverty declined significantly in Pakistan over the past decade and a half, falling from 64 percent in 2001 to about 30 percent in 2014. The reduction was coupled with an increase in asset ownership and dietary diversity, with substantial gains in the bottom quintile. Khyber Pakhtunkhwa (KP) saw the largest decline in poverty, followed by Punjab and Sindh. Balochistan remained the poorest province in the country, with a headcount poverty rate of almost 57 percent in 2014.

Regional differences in living standards remain large, both within and across provinces. Rural areas continue to lag behind their urban counterparts in terms of both poverty and access to basic services like health and education and the gaps persist across all quintiles of the income distribution.

District-level poverty is equalizing over time, but there is a clear north-south divide. Both within and across provinces, the poorest districts registered the largest declines in poverty, but most of the poorest districts are in Balochistan, followed by Sindh and southern Punjab. A north south divide is also evident within the two most populous provinces of the country, with the bordering districts of southern Punjab and northern Sindh registering the highest poverty rates within the two provinces

Districts vary widely in poverty, with the richest district (Abbottabad, KP) at a headcount rate of 5.8 percent and the poorest district (Washuk, Balochistan) at 72.5 percent.

Much of this variation reflects differences in poverty across provinces. The vast majority of the 40 poorest districts are in Balochistan, followed by Sindh. Only three districts each in Punjab and KP fall in this set, and they are not among the poorest in the group. Not a single district in Balochistan is among the richest 40, and only Karachi and Hyderabad in Sindh fall in this set. The divide between KP and Punjab (in the north) and Sindh and Balochistan (in the south) is apparent and quite stark.

The report finds that bacterial contamination of surface and ground water is on the rise because of the lack of treatment of human waste. Rural areas where the majority of poor households reside are the worst affected. Contamination levels are much higher in poorer and more rural districts and there is virtually no treatment of water at the household level.

Fecal waste is also finding its way into surface soil and into the water used for crop irrigation. This in turn contaminates food supplies which find their way into urban centers posing health hazards for millions of city dwellers. Young children are most at risk due to diarrhea as well as growth faltering due to environmental enteropathy, which limits the absorption of nutrients even during periods when the child shows no signs of diarrhea—eventually leading to stunting.

“This report provides timely evidence and clear policy advice on the importance of safe water and sanitation for addressing malnutrition”, says Illango Patchamuthu, World Bank Country Director for Pakistan.