There should be a policy framework addressing all forms of malnutrition
bout 75 percent growth of a child’s brain takes place in the first year. After six months, an infant can see the world as young children do. His immune system, not fully developed at birth, continues to strengthen as well. Proper nutrition drives these advances.
Consuming a healthy diet helps prevent malnutrition in all its forms as well as a range of non-communicable diseases. Increased consumption of processed food and the changing lifestyles have led to a shift in dietary patterns.
People are now consuming more foods high in fat, sugar, or salt/ sodium. Many people cannot afford enough fruits, vegetables and fibre such as whole grains.
The exact make-up of a diversified, balanced and healthy diet varies depending on an individual’s needs (age, gender, lifestyle, degree of physical activity), cultural context, locally available foods and purchasing power. But the basic principles of what constitutes a healthy diet remain the same.
In the first two years of a child’s life, optimal nutrition fosters healthy growth and improves cognitive development. It also reduces the risk of becoming overweight or obese and developing NCDs later in life. Advice on a healthy diet for infants and children is similar to that for adults but the following elements are also important.
Maternal nutrition is one of the most critical elements for mother and child health and needs special focus and attention to prevent stunting and wasting among children. Healthy pregnancy and early childhood, the foundations of proper growth and well-being of a child, depend upon good maternal care and nutrition. According to the National Nutrition Survey 2018 by the UNICEF, maternal nutrition indicators in Pakistan are poor. Women of reproductive age bear the triple burden of malnutrition, undernutrition, overweight/ obesity and micronutrient deficiencies.
Ideally, infants should be breastfed during the first two years. However, it is also recommended that infants should be breastfed exclusively during the first six months after birth and from six months, infants’ diet should be complemented with a variety of adequate, safe and nutrient-dense complementary foods. However, salt and sugars should be avoided.
Pakistan has an alarmingly high level of overall malnutrition. 24 percent of the population is undernourished. The most recent estimates by the United Nations Food and Agriculture Organisation state that 37.5 million people in Pakistan are not receiving proper nourishment. The problem is complex and widespread, with deficiencies ranging from protein to iodine, along with other health problems due to insufficient intake of these essential nutrients.
Malnutrition in Pakistan is usually associated with poverty and the main causative factors include low consumption of food and foods with low nutritional value. The most common and significant nutrient deficiencies are listed here.
Iodine deficiency is a major public health problem in Pakistan. It is a threat to the social and economic development of the country. The main factor responsible for iodine deficiency is a low dietary supply of iodine. When iodine requirements are not met, thyroid hormone synthesis is impaired, resulting in hypothyroidism and a series of functional and developmental abnormalities.
The government, its development partners, NGOs and academic and policy institutes should come together to build consensus for the right to adequate nutrition. An agreement on a nutrition policy framework is the first step in this direction.
The most damaging disorders induced by iodine deficiency are irreversible mental retardation and cretinism. If iodine deficiency occurs during the most critical period of brain development (from the fetal stage up to the third month after birth), the resulting thyroid failure leads to irreversible alterations in brain function. The National Nutrition Survey 2018-19 found that 17.5 percent women in reproductive age suffer from various types of iodine deficiency.
Iron deficiency also leads to impaired cognitive development and poor performance for school-going children. Iron deficiency is one of the most prevalent nutritional disorders and has a large impact on economic productivity.
Protein-energy malnutrition is also very common in Pakistan. A lack of protein can cause growth failure, loss of muscle mass, decreased immunity and weakening of the heart and respiratory system. A survey by the World Health Organisation has shown that the number of underweight pre-school children (0-5 years of age) in Pakistan is 40 percent. Such children often remain weak and undernourished throughout their life.
The malnutrition issue in Pakistan is a major corporate social responsibility opportunity for food companies since the possible solution lies in the widespread availability of essential nutrients in low-cost food products. Food companies can utilise their resources to develop low-to-moderate-cost nutritional foods. Using a bit of ingenuity, this can be achieved with low additional costs to the company and a long-term product investment with guaranteed gains.
The government, with the support of its development partners and local non-governmental organisations has taken certain steps to address the nutrition challenges through various initiatives.
Currently, there is no nutrition policy framework at the federal or provincial level. However, guidelines and strategies exist. The Ministry of Planning, Development and Reform, in collaboration with some development partners, launched Pakistan Multi-Sectoral Nutrition Strategy in 2018 to address malnutrition comprehensively.
There should be a policy framework focusing on addressing all forms of malnutrition. It should engage various government departments and ministries to design and implement nutrition policy at the national and provincial levels. Governments should aim to integrate nutrition considerations into sectors like health, agriculture, education, social protection and other relevant sectors.
Various community-based initiatives, in collaboration with non-governmental organisations and development partners, can be started to provide nutrition education, counselling and support at the grassroots level.
It’s important to note that the effectiveness of these policies and initiatives can vary, and challenges, such as limited resources, infrastructure and coordination can impact their implementation and outcomes.
It is globally established that achieving nutrition security requires a complex multi-sectoral response through well-coordinated efforts of diverse sectors engaging in multi-sectoral planning, sectoral implementation and monitoring with a multi-sectoral approach. This translates into improving the quality and coverage of nutrition-specific interventions, maximising synergies for nutrition-sensitive approaches and the creation of a conducive enabling environment to shape political, institutional and policy processes for nutrition.
The government, development partners, NGOs, academic and policy institutes should come together to build consensus for the right to improved nutrition. An agreement on a nutrition policy framework is the first step in this direction.
The writers are associated with the Sustainable Development Policy Institute. The views expressed by them do not necessarily reflect SDPI’s official stance