ACCORDING to a recent Multiple Indicators Cluster Survey, every third child under the age of five in Punjab suffers from stunted growth. Figures for children in the rural parts are particularly alarming at 34.3pc, compared to 26pc in the urban areas. Just a day before these figures were revealed in a report by the Punjab Planning and Development Board, Prime Minister Imran Khan announced his grand social welfare and poverty alleviation programme, while mentioning that the prevalence of malnutrition and stunting among children was one of the biggest challenges facing the country. It was in a similar vein to his inaugural speech to the nation as prime minister in August during which he held out X-ray images of brains of children suffering from stunting — these were significantly smaller than the brains of healthy children. According to Unicef, 38pc of children under the age of five are stunted in South Asia, ie 64m children. In Pakistan, the figure is even higher than average at 44pc — the third highest in the world. The main causes of stunting amongst children are poor diets resulting in insufficient nutrients in the first two years of life, combined with poor hygiene and sanitation practices in households. Unwashed fingers are used to feed children, resulting in faecal bacteria entering their bodies. Additionally, a report by the World Bank last year revealed high rates of E. coli in ground and surface water when untreated faecal sludge and wastewater seeps into the irrigation supply due to open defecation and badly planned sewerage drains.

There is another factor that causes high rates of stunting in South Asia, and that is the poor nutrition of mothers before and during pregnancy. Indeed, a significant percentage of stunting in early childhood occurs in the womb due to maternal malnutrition. Due to deeply ingrained societal biases, women’s health and well-being are largely ignored. In many households, girls are often fed after the boys or given the leftovers to eat. Consequently, over half of all South Asian adolescent girls are underweight or anaemic. The importance of breastfeeding in the early years, along with awareness of better nutrition and hygiene practices, must be reinforced through various forums, including the media, in order to obtain the desired behavioural changes in the population. But unless the gross gender imbalances in our society are addressed, children (and women) will continue to suffer on account of choices they have not made.

Published in Dawn, March 31st, 2019