When it comes to children’s health and overall well-being, Pakistan lags behind the South Asia regional average on most index indicators, let alone drawing close to international indicators. As for a more glaring example, according to the United Nations Children’s Fund (UNICEF), in Pakistan nearly half of children are chronically malnourished (stunted) and over 10 percent children are severely malnourished (wasted).
As the ground realities suggest, however, the true figure of stunted and wasted lives could be more than twice as high as reported, since the rampant malnutrition and prevailing food insecurity in the country has yet to ring alarming bells for the government. Unfortunately, malnutrition and micronutrient deficiencies are two of the biggest threats to our population and national productivity.
In the same vein, children in Pakistan are malnourished with iron deficiency being among the top deficiencies. As revealed by the National Nutrition Survey 2018, iron deficiency among children under 5 years of age is 49.1%, which is quite alarming and disturbing. The vast majority of deaths among children under 5 years of age are linked to under-nutrition, which mostly occur in low-income and vulnerable communities. Iron deficiency adversely affects children’s health and wellness and impacts child morbidity, mortality and also impairs their cognitive development.
Due to nutritional deficiencies, Pakistan suffers a loss of about 2.8 million DALYs (disability-adjusted life years), says the World Health Organisation (WHO). Each year, Pakistan loses about $7.6 billion or three percent of its GDP due to malnutrition and undernourishment, according to the Economic Consequences of Under-nutrition in Pakistan: An Assessment of Losses report by the Pakistan Scaling Up Nutrition (SUN) Secretariat in collaboration with the United Nations World Food Programme (WFP).
In the local population, the prevalence of iron deficiency, a globally-recognised public health problem, represents a heavy burden that disproportionately affects the youngest, underweight and growth-retarded children. To make matters worse, affected children are more likely to have mothers suffering from iron deficiencies. Owing to malnutrition and iron deficiency, most children do not reach their full mental and physical growth potential and productivity of their intelligence in adulthood, however, the reality still goes unnoticed in spite of all its severity and magnitude.
To address this crisis, it is imperative that children be given good sources of iron, for instance, dark green leafy vegetables (e.g. collards, mustard greens, turnip greens, chard, spinach), organ meat (e.g., liver, heart, kidneys, sweetbreads, brain), along with products fortified with iron and other essential vitamins (e.g., wheat flour, rice, cereals, pastas, milk powders, etc).
The global research community is working on preserving, improving and enhancing the nutritional value of food and beverages. For example, the Massey University of New Zealand has recently developed the Iron+, an improved iron source that offers 3 times more absorption in the human body compared to the currently available sources of iron. For the prevention of iron deficiency, we may build on such major breakthroughs by giving our children the much-needed iron in regular food items they desperately need to be fit and strong.
To address malnutrition and iron deficiency among children, therefore, the role of food fortification is vital. With this in view, the food industry can play a major role by manufacturing and introducing a whole range of fortified food products, vitamin-mineral premixes and nutrition supplements aimed at preventing micronutrient deficiencies and tackling the dietary needs of children, women and other vulnerable groups.
In this regard, food companies in Pakistan need to introduce fortified milk together with fortified milk powders at affordable prices, especially for the young children who are the most vulnerable to malnutrition, iron deficiencies and the rest of the nutrition-related health problems. But when the issue comes right down to the policy and governance levels, the bigger picture is not encouraging.
As things currently stand, the three leading political parties, namely Pakistan Muslim League-Nawaz (PML-N), Pakistan People’s Party (PPP) and Pakistan Tehreek-e-Insaf (PTI), have mentioned malnutrition prevention ambitions in their election manifestos. However, we are unable to see any long-term but result-oriented measures that have been taken at the government levels to address malnutrition crisis. In terms of food security, nutrition and livelihoods, on the other hand, Pakistan is ranked quite lower than the other nations.
According to the Global Food Security Index 2021 (GFSI-2021), Pakistan stays at the 75th place based on its performance in terms of achieving food security for all of its citizens, while the National Nutrition Survey reveals that 36.9 percent of the population in Pakistan is food insecure. Some well-thought-of, all-inclusive efforts need to be expedited at the national level to stop the upward trajectory of malnutrition and vitamin deficiencies.
Given the fact that the current food inflation rate in Pakistan is already at an all-time high, the government, the political stakeholders and both the public and private sectors must sit and work together to design and devise both short-term vertical programmes (e.g., iron supplementation) and long-term policies and horizontal programmes (e.g., milk fortification and wheat flour fortification) to prevent, contain and eradicate poverty, hunger and malnutrition from the country for good.
(The writer is former Principal, Dow Medical College and President Pakistan Medical Association. Currently Chancellor, Malir University of Science & Technology (MUST))
Copyright Business Recorder, 2022
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