Malnutrition is one of the foremost socio-economic problems faced by developing countries like Pakistan. It takes place owing to insufficient or imbalanced nourishment and poor sanitary conditions and hygiene practices. It results in poor health and education outcomes and impedes economic growth and human development.

Major nutritional problems in Pakistan are low birth weight due to poor maternal nutrition, protein-energy malnutrition, anaemia, and iodine deficiency. To combat these malnutrition challenges, Pakistan has been part of the global movement of Scaling Up Nutrition (SUN) since 2013.

Sindh is severely affected by intensifying malnutrition and stunting indicators. As many as 48 per cent children under the age of five are stunted while 35pc of them are severely stunted.

The incidence of global acute malnutrition (GAM), a measurement of the nutritional status, in Tharparkar is 22.7pc followed by Sanghar (16pc) and Qamber-Shahdadkot (13.8pc). The situation is worsening despite the Accelerated Action Plan (AAP) on Stunting and Malnutrition that the province has recently adopted. The APP aims to reduce stunting from 48pc to 30pc by 2021 and to 15pc by 2026. It plans to expand the coverage of multi-sector interventions to reduce stunting.

These figures paint a bleak picture of the overall state of nutrition in Sindh. They demonstrate that the issue of undernourishment has received little attention from the government and the media.

Malnutrition is a deep-rooted governance problem. Had the government shown any seriousness, such acute malnutrition conditions would not prevail in many parts of Sindh.

A nationwide multi-sectoral nutrition strategy has been prepared based on similar provincial strategies to address the alarming nutrition crisis. The policy is aligned with Pakistan Vision 2025. In addition, national dietary guidelines for better nutrition have also been prepared to provide nutrition-related information for healthy living to the masses. The food fortification strategy has also been revised to take sustained action for overcoming micronutrient deficiencies.

Statistics paint a bleak picture of the state of nutrition in Sindh. The issue of undernourishment has received little attention from the government and the media

Moreover, a number of local and international non-governmental organisations are working in the malnutrition-hit areas to improve the lives of the poor. We need to take immediate action to bring strength to the institutions tasked with combating malnutrition. The state should arrange sufficient resources for these institutions to battle this menace.

The government needs to create a sense of ownership among people working for these institutions and improve coordination, networking and communication to mitigate stunting and malnutrition. Workers in the relevant departments should undergo capacity-building and skill development programmes to be able to better serve the public.

A decrease in malnutrition will prevent child deaths, improve the overall health conditions, increase school enrolment ratios, raise wages and curb poverty because well-nourished children break the intergenerational cycle of poverty.

It is a national responsibility of state institutions to fight malnutrition and stunting. They need to bring all stakeholders to a single platform and implement policies by mobilising resources from domestic as well as international sources.

The writer is a socio-economic development professional

Published in Dawn, The Business and Finance Weekly, August 13th, 2018



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