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December 14, 2019

Iron-deficient generation


December 14, 2019

Iron deficiency poses a severe and alarming public health problem. It’s quite widespread in developing countries facing malnutrition for most of their population.

The incidence and scale of this micronutrient deficiency impacts greatly on the quality of life, both physiologically and socioeconomically, and hence needs urgent and practical interventions to overcome the issue.

In Pakistan, the burden of maternal and child malnutrition attributed by iron deficiency continues to remain unacceptably high. Some of the common symptoms of iron deficiency are depression, fatigue, memory loss and weakness. Unfortunately, the recent National Nutrition survey (NNS) 2018 did not show any marked improvement in the indicators as compared to NNS 2011; showing the low level of effort and willingness by the government to address the malnutrition crisis.

With one of the highest prevalence in the world, stunting is a rising emergency in the country. Four out of 10 under-five children are stunted, says the National Nutrition Survey 2018; more than half (53.7 percent) of Pakistani children are anemic and 5.7 percent are severely anemic. Maternal under-nutrition is also a significant problem; the reason mainly being deficient iron in their body. These malnutrition rates are very high by any global standards and much higher than the national level of economic development could warrant.

Iron deficiency not only adversely affects the country’s Gross Domestic Product (GDP) but has serious implications for the country’s most important asset – the future human resource. It is evident that the window to prevent malnutrition deficiencies especially stunting is very small, spread over a period of 1000 days from conception to two years of age.

Stunting at two years of age is associated with ill-health, poorer school performance, and an increased risk of obesity, diabetes and other chronic diseases later in life.

The economic analyses have indicated that poor nutrition in early life negatively affects the overall economic development of nations. Moreover, the first five years in children are of significant importance as under five-year-old children are more susceptible to be anemic because of their rapid body growth, and hence they need more iron.

According to the World Health Organization, children should start taking complementary foods, also called weaning food at six months of age as mother’s milk cannot provide all the nutritional requirements of infants, hence other foods and liquids are needed. Complementary food should be given 2-3 times a day between six and eight months initially, increasing to 3-4 times daily between 9 and 11 months and 12 and 24 months.

The NNS 2018 again shows a dismal picture regarding complementary feeding and reflects numbers that are quite below the acceptable levels; only one out of every three young children receives complementary food between six and eight months of age. These gaps are more pronounced in the rural areas where the majority of our population resides.

It is generally seen that people, especially mothers, are not aware about the significance of weaning stage or complimentary food. The best way to overcome the issue of iron deficiency in infants and children is provision of in-home iron fortified food at the weaning stage, which effectively impacts body growth and ensures to meet the body demand of iron without altering the traditional diet of children.

Though various misconceptions prevail about fortified food – such as: that it might be genetically modified food or expensive – they are not true.

Fortification simply means addition of micronutrients like iron, vitamins, calcium etc, and is the most effective and cheapest method to feed children with malnutrition and improve nutrient intake. Adding a cost in just minimal amount per person can create a cost-to-benefit ratio unlike any other development investment.

There is a desperate need to remove myths and misconceptions about fortified complementary food to have healthy generation. Mexico presents an outstanding example of addressing issue by highlighting the significance of feeding fortified food at early development stages of infants and children using digital and social media.

This resulted in 91 percent of mothers supporting fortification and 74 percent deciding to nurture their children with fortified food. According to latest data from the Global Fortification Data Exchange (GFDx), food fortification interventions are quite impactful and two-thirds of the world’s countries mandate the intervention. However, many developing countries are not adopting these policies for their healthy future.

It is imperative for a country like Pakistan, which has low nutrition indicators, to address the issue on an emergency basis.

Focusing on health at the early development stages of an individual can definitely nurture a healthy generation. The government should take into consideration starting and scaling strong fortification programmes – especially for infants and children.

Through public-private collaboration, initiatives can be launched to undertake advocacy and communication activities to create an enabling environment, and ensure a partnership for the availability and marketing of fortified complementary foods targeting maternal exposure to overcome the iron deficiency within the population.

The writer is a public health consultant.

Email: [email protected]