KARACHI, April 25: The Sindh province, which has the highest rate of malnutrition among children and women in comparison to other provinces as confirmed by the national nutrition survey (NNS)-2011, immediately needs interventions against hunger, said participants of a forum on Wednesday.
According to the NNS-2011, about 58 per cent of the survey households were food insecure (adults and not children or both experienced the inadequacy of the household food supply without hunger or with hunger in the household) at the national level. Against that, Sindh was determined as the poorest and most food deprived province of the country with only 28.2 per cent households having food security, while the remaining (about 72 per cent) were found to be food insecure.
The meeting “Dialogue on nutrition in Sindh” was organised by Save the Children, a non-governmental organisation, as part of its post NNS-2011 initiatives aimed at enhancing the national awareness and well-designed interventions to reduce widespread malnutrition and poor dietary practices, particularly among women and children in Sindh.
Dr Khalid Sheikh, an additional secretary of the Sindh health department, said that the most recent national nutrition survey found global acute malnutrition rate of 17.5 per cent (moderate acute malnutrition-10.9 per cent and severe acute malnutrition-6.6 per cent) in the Sindh province, which was an alarming situation and needed to be managed to save the children, pregnant and lactating women from malnutrition or under nutrition and micronutrient deficiencies.
Dr Sheikh said that anticipating financial support from the World Bank the Sindh government was already in the process of finalising a PC-1 costing Rs5.5 billion to address both chronic and acute malnutrition in children and women in the province.
The PC-1 would be executed during the next financial year, he said, adding that nutrition management should be part of a regular development strategy of the government.
He further said that the underlying causes of malnutrition included illiteracy, poverty, unhealthy environment and others, which could be overcome through a well-coordinated functional linkages developed between the health department and other line departments like education, social welfare, population welfare, agriculture departments and civic agencies handling the issues of sanitation and water supply.
Sharing the details of the NNS-2011, Dr M Atif Habib of the Aga Khan University, one of the coordinators for the survey, said that the NNS had confirmed that maternal and child under nutrition remained a major issue for Pakistan as well as Sindh in its dimensions. Overall, the major indicators of under nutrition like stunting and wasting in children remain unchanged, he added.
However, he said, there was a dire need to scale up current coverage rates for many key interventions addressing maternal and child under nutrition.
Giving the provincial (Sindh) dimension of the survey, which was conducted after a decade, he said that the survey involving about 30,000 sample households was conducted in all urban and rural areas of the four provinces in 2010 and 2011. The sample households numbered around 6,460, including 3,140 in urban areas and 3,320 in rural areas in Sindh.
He said that a gain in iodine status had been noted, which was however counterbalanced by significant deterioration in vitamin A status and little to no gain in other areas of micronutrient deficiencies.
The proportion of food insecure household was categorised as food insecure without hunger (21.1 per cent), food insecure with moderate hunger (33.8 per cent) and food insecure with severe hunger (16.8 per cent).The data regarding pregnant women indicated that 51 per cent of women were haemoglobin deficient at the national level. Of them, 60.2 per cent belonged to Sindh.
It was also found that there was a widespread deficiency of Vitamin D in Pakistan’s non-pregnant mothers (85 per cent) and 90.5 per cent of them lived in Sindh. Also of the 86.1 per cent pregnant women with Vitamin D deficiency at the national level, Sindh had 84.6 per cent.
Talking about night blindness, he said that 16.2 per cent of the women population in question had poor sight at night, largely caused due to vitamin A deficiency.
Discussing the prevalence of malnutrition among children in Sindh, Dr Habib said that the survey found against the rate of 43 per cent stunting at the national level, Sindh had 70 per cent rate. Wasting in Sindh was found at 19.4 per cent against the overall national rate of 16.8 per cent.
Against the national level rate of anaemic children 62.1 per cent, Sindh had 73.3 per cent of sample children anaemic (severe to moderate deficiency of haemoglobin level).
While holding that getting enough vitamin A in children’s diet was essential for good vision, Dr Habib said that against the rate of 14.3 per cent (severe and mild) determined after the NNS-2001, the latest number of child found deficient of Vitamin A was 53.3 per cent (severe and mild cases).
He said that there was still much needed to be done to make up the zinc and vitamin deficiencies in Pakistan in general and Sindh children in specific.
He said that indicators for water, sanitation and hygiene remained poor and burden of diarrhea (23.3 per cent) and respiratory infections remained high.
Speaking on behalf of the Save the Children, its coordinators, including Huzan Waqar and Muhammad Farouk, lauded the survey and suggested more and more propagation of it.
Malnutrition and diseases formed a vicious circle and there was a need that efforts should be expedited, they said, adding that improving the nutrition was the key to the survival of children, particularly the poverty stricken ones.
Syed Abid Ali made a presentation on nutrition issues in Sindh and Save the Children’s response, particularly in the wake of 2011 floods in Sindh.
“During the six months following the flood, our institution reached to one million people in the province and provided them relief in key areas, including child protection, education, food aid, food security, health and nutrition, water and sanitation,” he added.