WITH nearly 44pc of children in Pakistan stunted, a sustained approach to ending malnutrition, as opposed to applying quick-fix solutions, has become critical. Indeed, the global sustainable development agenda has plugged stunting as a ‘new’ health threat, a catastrophe calling for humanitarian action targeted at poor communities. It would be an achievement if malnutrition were to be reduced by donor aid, but as the chasm of health inequality between the rich and poor widens such an intervention by itself is not sufficient. The perception of donor-driven solutions working miracles is problematic given that malnutrition is linked with the related determinants of maternal health, social status, child marriage, educational access, gender empowerment, etc. A recent report in this paper recommended support for long-term health and education programmes — incorporated within current social protection programmes — in order to improve human capital. Only when provincial governments adopt nutrition as a political priority, thereby linking health and food programmes with poverty alleviation, will the incidence of stunting come down. Consider how the Peruvian model decreased stunting by targeting families through the provision of conditional cash transfers to pregnant women, food distribution and educating mothers to stimulate their children mentally. It didn’t matter who was in power because nutrition as a political priority was overseen by the office of the prime minister.

With widespread poverty, health-sector programmes depend on international agencies that usually disburse aid with strings attached, limiting the scope and benefit of such assistance. Interim, simplistic solutions will not end malnutrition unless resilient systems are built within vulnerable communities to mitigate the effects of inequality and poverty — and equitable policies and related infrastructure are instituted. The government should realise that shifting global politics drives donors to prioritise agendas. So it is best to manage existing funds effectively to bridge health gaps rather than allow them to lapse. Meanwhile, with international donors driving the discourse on stunting while working with provincial governments as best as is possible, there is scant evidence of intra-governmental coordination in the health sector or of implementation of any multisectoral plans. Moreover, it appears that the government has no plans to redress stunting rates that could result in substantial losses to the economy. In the long term, it is only cost-effective solutions and proper budgeting with monitoring and accountability factored into national programmes that will reduce malnutrition in the country.

Published in Dawn, December 5th, 2016