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ACCESS to proper nutrition is one of the fundamental human rights and a precondition for overall human health and well-being. Adequate nutrition, especially in early childhood, is a prerequisite for optimal physical growth, brain development and the survival of children, leading to sustainable social and economic growth of a country.
Well-nourished children are better able to grow and learn, to participate and contribute to their communities and are resilient in the face of disease, disasters and other global crises.
Also read: Analysis — Focus on food security
On the other hand, malnutrition — in all its forms including under-nutrition, micronutrient deficiencies and over-nutrition — not only affects human health and development but also poses high economic, social and human development costs on individuals, families, communities and nations.
Malnourished children are much more likely to die as a result of a common childhood disease than those who are adequately nourished. Nutritional deficiencies in early childhood not only reduce a child’s chance of survival, but they can also have long-term consequences on cognitive and social abilities, school performance and work productivity. Malnutrition affects millions of children and contributes to an estimated 3.1 million child deaths each year, accounting for over a third of all deaths of children globally.
In KP, more than 85pc children aged six to 23 months do not receive the recommended amount and quality of diet, mainly due to ignorance
The economic consequences represent losses of 11 per cent of gross domestic product (GDP) every year in Africa and Asia, according to World Economics data, whereas preventing malnutrition delivers $16 in returns on investment of every $1 spent.
Improvements in nutrition will contribute significantly to reducing poverty, and to achieving health, education, and employment goals. The co-occurrence of undernutrition, micronutrient malnutrition and obesity and overweight poses challenges and underscores the reality that malnutrition is a global phenomenon, affecting virtually all countries, according to the International Food Policy Research Institute.
Malnutrition results from the interaction of poor-quality diets and poor-quality health and care environments and behaviours, which are shaped in part by a host of underlying factors, such as political instability, poor economic development, conflict, inequality, and some dimensions of globalisation.
Achieving the goal of optimal nutrition encompasses the prevention, control and treatment of undernutrition, micronutrient malnutrition and overweight and obesity, promoting optimal care and feeding practices (eg exclusive breastfeeding) and dietary diversity, and addressing food safety and quality, and ensuring access to and use of health services and a safe, hygienic environment.
KP children suffer
Pakistan in general and Khyber Pakhtunkhwa in specific have a huge burden of all forms of malnutrition. Every second child (an estimated 800,000 children under the age of five years) in the province is stunted (having low average height for a given age) and every sixth child (an estimated 100,000 children) is wasted.
The situation of micronutrient deficiencies is alarmingly high in children under the age of five years, with 68.5pc having vitamin A deficiency, 49pc being anaemic and 45.4pc having zinc deficiency.
Only 40.5pc of newborn babies receive mother’s milk within one hour of birth while 38pc infants less than six months of age receive exclusively mother’s milk, which means that more than 60pc of children under six months receive mixed feeding.
Recent in-depth analysis of complementary feeding practices in the country using data from the Pakistan Demographic Health Survey 2012-13 showed more than 85pc children aged six to 23 months in KP do not receive the recommended amount and quality of diet, mainly due to ignorance regarding types, quantity and frequency of recommended complementary feeding practices.
Awareness among masses regarding nutrition issues remains low and ideal nutrition practices remain very weak. Nutrient-rich food groups are rarely consumed, less than one in five children consume meat or fish, legumes or vitamin-A rich fruits and vegetables.
Common risk factors for poor child feeding are poor access to health and nutrition services in the community in addition to poverty. This underlies the need to improve the capacity of programmes, health professionals and community workers to support good complementary feeding practices.
The current status of malnutrition in KP can be translated into around a million children under five years of age suffering from stunting, anaemia or iodine deficiencies suffering deficits in mental and physical development, which may lead to lower school performance and lower productivity as adults, depressing the gross domestic productivity.
Realising the gravity of the situation, the Planning and Development Department of KP, under the oversight of a high-level steering committee chaired by the additional chief secretary, formulated nutrition policy guidance notes and a multi-sector integrated nutrition strategy to holistically address the problem of malnutrition in the province.
The Scaling Up Nutrition Cell in the planning and development department established in September 2016 is coordinating the implementation of the multi-sector integrated nutrition strategy encompassing both nutrition-specific interventions and nutrition-sensitive strategies through relevant departments, including health, education, local government, public health engineering, social welfare, food and agriculture departments.
In the current year, a multi-sector integrated nutrition project titled ‘Khyber Pakhtunkhwa Stunting Prevention and Rehabilitation Integrated Nutrition Gain’, or KP SPRING, was approved to reduce stunting in the province over the next three years.
The project will strengthen the capacity of different relevant departments in nutrition-sensitive and nutrition-specific intervention and establish a coordination mechanism through District Integrated Nutrition Committees and Steering Committee at the provincial level for effectively implementing KP SPRING.
The writer is consultant at the Scaling Up Nutrition Unit, KP’s Planning and Development Department
What is malnutrition
Malnutrition is an abnormal physiological condition caused by deficiencies, excesses or imbalances in energy, protein and/or other nutrients.
It manifests itself in many different ways:
Under-nutrition: A condition in which the body contains lower than normal amounts of one or more nutrients, ie deficiencies in macronutrients and/or micronutrients.
It encompasses stunting, wasting and deficiencies of essential vitamins and minerals.
Individuals suffer from under-nutrition if their diet does not provide adequate calories and protein for growth and maintenance or they are unable to fully utilise the food they eat due to illness.
Over-nutrition: It includes overweight and obesity. Over-nutrition is caused by consuming too many calories.
Diet-related: non-communicable chronic diseases due to excess intake of sugar, salt or cholesterol.
Published in Dawn, The Business and Finance Weekly, April 2nd, 2018
