Pakistan’s children are living on borrowed time
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For decades, widespread malnutrition has been impeding Pakistan’s development. The country is ranked third on the global burden for stunting with a current status of 9.8 million children. Malnutrition is also responsible for 177,000 child deaths annually, and close to 50 percent of child mortality. The surviving lot suffers from poor cognitive and motor development, leading to low educational attainment, compromised labor productivity, and an unsurmountable strain on the public health system. Each year, Pakistan loses $7.6 billion or 3 percent of its GDP due to malnutrition.
Nutrition traditionally has been a low-priority area in Pakistan. It was institutionalized in the Planning Commission in 1973, however there was little improvement in indicators for two decades, mainly due to a lack in technical and operational expertise. The operationalization of nutrition came three decades later in 2002, when it was delegated as a sub-set of health activities in the health ministry. In 2002, a ‘Nutrition Wing’ was incorporated within the Ministry of Health to accelerate Pakistan’s progress toward stunting reduction and Millennium Development Goals (MDGs). However, post 2010, the Federal Ministry of Health was devolved and autonomy was given to the provinces. A year later, the 2011 National Nutrition Survey showed a glaring disparity in response to undernutrition among the provinces. In 2012, MNHSRC was reconstituted, and the nutrition wing was re-established.
It is a recognized fact that strategies to address malnutrition should be multi-sectoral, including ministries of health, education and social protection. The Ministry of Planning has the overarching role of coordinating interventions by various ministries. Ministries and Directorates of Health play a key role in delivering essential nutrition promotion interventions and services through their platforms, having the technical and operational expertise to deliver direct interventions through service delivery and guidelines. Additionally, most of the legislations and policies are strongly linked with the health system enforcement. No other ministry has the capacity to reach out to pregnant and lactating mothers and children.
Time has proven that the Planning Commission doesn’t have the technical or operational capacity to deal with the issue of malnutrition.
- Mehreen Mujtaba
Regionally and globally, there are success stories from various countries like Sri Lanka, Nepal, Bangladesh, Indonesia, Peru etc. By setting up nutrition directorates and divisions within their respective ministries of health, they have shown great achievements in reducing the rates of stunting and wasting among children under five as well as anaemia and micronutrient deficiencies among women of child bearing age, hence moving the needle in the right direction.
In Pakistan however, it’s an altogether different story. A country with the highest rates of stunting and wasting, ranking third globally, and with all indicators showing declining trends, there is a debate going around in the boardrooms of power about whether MNHSRC or Planning Commission should deal with nutrition as a subject. It makes one wonder about their commitment to the future of the country. Time has proven that the Planning Commission doesn’t have the technical or operational capacity to deal with the issue of malnutrition. Those responsible for taking these decisions don’t realize the massive and long lasting damage this synchronized chaos will lead to. We are living on borrowed time.
In the words of Grant M Bright, “You reap what you sow: Life is like a boomerang. Our thoughts, deeds and words return to us sooner or later, with astounding clarity.”
Our problem is we know we are hurtling toward disaster, but like ostriches we bury our heads in the sand and wishfully believe the storms will pass us by.
- Dr. Mehreen Mujtaba is a freelance consultant working in the areas of environment and health.
