KARACHI: Pakistan, like many developing countries, faces the challenge of the triple burden of malnutrition where stunted growth and deficiencies of essential nutrients are prevalent alongside a trend of rising overweight and obesity.

The country needs to reinvigorate its focus with a sustained viable strategy for ensuring improved health and nutrition for all to meet global targets in the near future.

These comments were shared by Aga Khan University (AKU) faculty members Prof Zulfiqar A. Bhutta and Dr Jai K. Das, against the backdrop of Lancet’s latest series on Maternal and Child Under-nutrition Progress — including three new papers that build upon the findings from the previous 2008 and 2013 series — published on Monday.

Prof Bhutta and Dr Das are lead authors of two papers in the series which conclude that despite modest progress in some areas, maternal and child undernutrition remains a major global health concern, particularly as recent gains may be offset by the Covid-19 pandemic.

Lancet series calls for more financing to scale up proven interventions

They noted that more than half of Pakistan’s population is food insecure and many essential nutritional interventions such as breastfeeding and complementary feeding indicators are far below the desired levels.

High anaemia prevalence

The series found that the prevalence of childhood stunting rates fell in low-income countries from 47.1 per cent to 36.6pc from 2000 to 2015, but less so in middle-income countries where rates fell from 23.8pc to 18pc. Yet, the world is falling short of achieving the World Health Assembly Nutrition Target of reducing stunting by 50pc by 2025.

By comparison, there is little progress in the percentage of children who are wasted in both middle- and low-income countries. A new finding also shows that nearly 5 (4.7) pc of children are simultaneously affected by both stunting and wasting, a condition associated with a 4.8-times increase in mortality.

The incidence of stunting and wasting is highest in the first six months of life, but also exists in part at birth. For maternal nutrition, although the prevalence of undernutrition (low body mass index) has fallen, anaemia and short stature remain very high.

The series reiterates that previously highlighted interventions continue to be effective at reducing stunting, micronutrient deficiencies, and child deaths and emphasises the importance of delivering these nutrition interventions within the first 1,000 days of life.

However, despite this evidence, programme delivery has lagged behind the science and further financing is needed to scale up proven interventions.

“Governments and donors must recommit to the unfinished agenda of maternal and child under-nutrition with sustained and consistent financial commitments,” said Prof Bhutta, who also serves as co-director at the Centre for Global Child Health at The Hospital for Sick Children in Toronto, Canada, and is the series coordinator.

“Governments must expand coverage and improve quality of direct interventions — especially in the first 1,000 days; identify and address the immediate and underlying determinants of under-nutrition through indirect interventions; build and sustain a political and regulatory environment for nutrition action; and invest in monitoring and learning systems at national and subnational levels.”

Published in Dawn, March 11th, 2021

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