The World Bank has said that 44 percent children under five in Pakistan are stunted due to lack of proper nutrition while the lowest spending on health and education in the region has made it difficult for Pakistan to meet the MDG targets on these two sectors by the year 2015.
The World Bank in its report, 'Partnership Strategy Progress Report for the Period FY 2010-2014' dated November 16, 2011 has said that despite the worrying state of education and health, especially amongst the poor, the resource allocation in these two sectors as a percentage of the GDP in Pakistan has always remained low. The report says that the net enrolment rates in education have been increasing in Pakistan but still lag behind South Asia countries. Infant and under five mortality rates represent a similar story. Gender disparities persist in education, health and all economic sectors.
Pakistan has one of the lowest female labour force participation rates in the region. Despite the worrying state of education and health, especially amongst the poor, the resource allocation as a percentage of the GDP remained. The main challenge in water supply is not of quantity (access) rather that of quality as Unicef estimates that access to safe drinking water is less than 25 percent.
Similarly in sanitation, access has steadily increased in the last decade but the challenge is that of open defecation, especially in rural settings. The operating environment in Pakistan has become daunting and so there are high risks across many aspects of World Bank operations in Pakistan. These include political uncertainty, lacklustre economic performance, natural disasters and security issues.
The report reveals that the present elected government, which assumed office in 2008, had to face many challenges including continuing pressures of coalition politics, militancy crises and consequent violence in many parts of Pakistan, recurring natural disasters like the 2010 and 2011 floods, devolution of increasing responsibilities to the provinces, and a difficult economic situation. The Eighteenth Constitutional Amendment has devolved a number of key functions to the provinces. As expected, the devolution has posed institutional and capacity challenges at the provincial level, some dispersal of retained functions at the federal level, and requisite expenditure rationalising under tight fiscal space. Meeting these challenges will require concerted efforts to enhance sub-national capacity and institutional development, which varies across provinces.