MALNUTRITION IN PAKISTAN

In Pakistan, malnutrition is widespread among all ages, and progress to address social
determinants over the last several decades had been very slow. In Pakistan malnutrition
is responsible as underlying factor for 55% of deaths of children’s under 5 years of age.
According to the National Nutrition Survey 2011, one-third of all children are
underweight, nearly 44% are stunted, 15% are wasted, half of them are anemic and
almost one-third of these children have iron deficiency anemia. These rates have hardly
changed over two decades according to the findings of a maternal and child nutrition
study group published by Lancet in 2013. Notable differences can be found between the
nutritional indicators of urban and rural populations; children among the rural and
urban poor are at greatest risk. Among women, 14% in the reproductive age bracket are
thin or wasted (with a body mass index less than 18.5 kg/m2) and this prevalence is
highest among households that are food insecure. These differences in maternal and
child malnutrition are also remarkable among various provinces and sub-regions, and
clustered in areas widely recognized as high-risk districts. It has been estimated that 170
million (30%) of children under the age of five in the world are moderately or severely
stunted, and 110 million (19%) are moderately or severely underweight. Almost half of
all stunned children reside in Asia, 51 million (8%) children below five years of age are
wasted, and two thirds of all wasted children live in Asia. Malnutrition affects the future
health and socioeconomic development of children and the dynamic prospective of the
society. Pakistan has been reported to have one of the highest levels of prevalence of
child malnutrition compared to other developing counties. According to the National
Nutrition Survey, 33%of all children were underweight, nearly 44% were stunted, 15%
are wasted, 50%were anemic, and 33%were anemic (iron deficiency). In the last two
decades, there has been a little reduction in the prevalence of child malnutrition in
Pakistan compared to other developing countries . Despite economic and social
development, childhood malnutrition still remains a major public health and social
problem in less developed countries. The contributing factors in childhood malnutrition
are low birth weight, inadequate breast feeding and exclusive breastfeeding,
inappropriate complementary feeding, maternal education, lack of proper knowledge of
nutrition, micronutrient intake, parity, birth spacing, household socioeconomic status,
food insecurity, poor sanitation, vaccination, and infectious diseases. Pakistan is among
the countries in the world with the highest rates of child malnutrition, and its progress
in child nutrition and health remains slower than in other South Asian countries .

CHILD AGE
Different studies have highlighted that the severity of malnutrition occurs in a particular
age group of children. It is pointed out that the prevalence of malnutrition is
considerably higher in children less than two years of age. It is also pointed out that the
prevalence of wasting, stunting, and underweight were higher in the age group of those
less than two years of age.

Table shows nutrition situation in Pakistan.

Nutrition Situation In Pakistan

Under five stunting 5%
Low birth weight 32%
0-5 months exclusive breastfeeding 37.7%
Under five wasting 10.5%
Under five overweight 4.8%
Women anemia 15-49 years 51.1%
Adult blood glucose (diabetes) 23%
Adult obesity 5.4%

NUTRIONAL STATUS OF CHILDRENS OF FEWER THAN FIVE YEARS

OF AGE
 STUNTING
 UNDERWEIGHT
 WASTING
 OVERWEIGHT
According to National Nutrition Survey 2018, in Pakistan four out of ten children under
five years of age are stunted while 17.7% suffer from wasting. The double burden of
malnutrition is becoming increasingly apparent, with almost one in three children
underweight (28.9%) alongside a high prevalence of overweight (9.5%) in the same age
group. The prevalence of overweight among children under five has almost doubled over
seven years, increasing from 5% in 2011 to 9.5% in 2018.

RURAL URBAN DISPARITIES

There is rural and urban disparity in the prevalence of child malnutrition across
the world. It is pointed out that in rural areas the prevalence of child malnutrition is
higher compared to urban areas. The burden of malnutrition is lower in urban areas as
compared to rural areas in Pakistan. The children belong to rural areas are highly
vulnerable of all types of malnutrition. In rural areas of Faisalabad, 65% of children
were underweight, 41% were stunned, and 33% were wasted. According to the national
nutrition survey of Pakistan, acute and chronic child malnutrition were significantly
higher in rural areas as compared to urban areas across the country.
 50
45
40
35
30
25 Stunted
20 wasted
15 under weight
10
5
0
URBAN RURAL

The graph shows the ratio of urban and rural areas. The total numbers are more in rural
areas than urban areas.

GENDER

Gender is an important indicator of child malnutrition. It was found that there

was no significant difference in stunting and wasting in male and female children.
Stunting and thinness was not associated with gender. Severe malnutrition was reported
slightly higher in males than female children. The below graph show boys are affected a
slightly more than girls. Stunted boys 40.9% and stunted girls are 39.4%. Wasted boys
are 18.4% and wasted girls are 17%. Underweight boys are 29.3% and underweight girls
are 28.4%. Overweight boys are 9.7% and overweight girls are 9.2%.

45
40
35
30
25
BOYS
20 GIRLS
15
10
5
0
STUNTED WASTED UNDERWEIGHT OVERWEIGHT
THARPARKAR (MOST AFFECTED AREA)
Since 2013, Pakistan has been receiving below average amount of rainfall. In 2018, less
than 10% of the projected annual rainfall was received in Sindh and Balochistan
provinces. This drought has had serious public health implications in the two provinces.
Tharparkar is located in Sindh. It is the most affected area by drought and many other
problems. Malnutrition is a big issue in Tharparkar. Many children’s and women’s had
been wasted and many are stunted by nutrition problems.

Over 2.5 million people in Sindh province are either directly or indirectly affected by the
drought. There is severe shortage of water and poor access to sanitation. The current
severe acute malnutrition level in Tharparkar is 22.7%. This figure is above the
emergency threshold of 15.

The average distance to the health facilities is 19.8 km (range 11.4-41 km); the cost of
transport to the health facility is high. In addition, the human resource for health in
those facilities is inadequate; road infrastructure condition is very poor; and there is
lack of transportation facilities. This is further compounded by the poor socioeconomic
situation; the population is unable to access the health services. There is inadequate
supply of essential life-saving medicines at the health facilities and non-availability of
medical equipment.

Here are some pictures from Tharparkar.

These are some pictures from Tharparkar. We can see in these pictures how the people
of Tharparkar live their life.