Malnutrition has been identified as a core issue contributing to morbidity and mortality amongst children all over the world. Those belonging to vulnerable segments of society are more affected than others. The consequences of malnutrition (under-nutrition) include both short and long-term (irreversible) adverse health outcomes for the child including stunting, wasting and underweight.
Globally, nearly half of all deaths in children under 5 are because of undernutrition. Asia continues to have both the highest rates and the largest number of malnourished children in the world. Adults who have suffered malnourishment as a child grow up to be less physically and intellectually productive and suffer from more chronic illnesses and disabilities. It is now established that meeting the specific nutritional needs during the first 1000 days (from a woman’s pregnancy to the child’s 2nd birthday) have an influence on the rest of the individual’s life.
In Pakistan, malnutrition is recognised as a major public health problem and a threat to the social and economic development of the nation. Punjab, one of the most populous province of Pakistan with an estimated population of approximately 110 million as of 2017, shows the same dismal picture of malnutrition. Despite its elevated status as economically productive province of Pakistan and contributing to more than three quarters of the country’s annual grain production, Punjab is also facing a considerable threat of food insecurity and malnutrition. The findings of the 2011 National Nutrition Survey reveal a very grave picture of Punjab showing prevalence of chronic malnutrition among children under-5 years of age at 39.2 % and maternal anemia at 49.6%. Similarly the prevalence of acute malnutrition among children is 13.7% and child anemia in Punjab is 60.4%.
Similarly, micronutrient deficiencies, frequently referred in undermining maternal well-being are quite prevalent in the province. Deficiency of micronutrients like Iron; Zinc; Vitamins A and D; and Iodine is still a major health problem among women of childbearing age. Although micronutrient deficiencies are affecting the entire lifecycle of human population but pregnant women, lactating mothers and young children are more vulnerable due to relatively greater need for these micronutrients and higher susceptible to harmful consequences of deficiencies.
One of issues identified for micronutrient deficiencies is widespread lack of awareness about micronutrients among the population. Findings of National Nutritional Survey 2011 revealed that mothers had very low knowledge about micronutrients in the country. Although situation in Punjab is comparatively better than the national averages but it is still far below the optimum
Evidence through literature shows that low-cost methods of reducing all forms of malnutrition are available and proved to be quite successful. Among them, fortification of food is the most simplest and cost effective method. Fortification means adding micronutrients infood to cover dietary deficiencies.eg adding iodine in salt, iron in wheat flour or Vitamins in milk etc.
To combat issue of malnutrition and micro nutrient deficiency through process of food fortification, there is a need to involve various sectors like government, private sector, academia, media etc. Government can play its vital role in provision of fortified food through mandatory legislation for food/dairy fortification.Considering this is an election year and all political parties will be announcing their manifestos soon, there is a need for politicians and political parties to highlight issues of malnutrition and interventions like fortification in their manifestos. They should clearly describe solutions especially fortification as their party high priority agenda.
At community level, there is a need for a massive community awareness especially focusing on women. While giving health education, good nutritional practices especially significance of fortified food should be emphasized that are affordable for different types and level of communities. Food enriched with micronutrients or essential nutrients use should be promoted through involvement of private sector also. On one hand Government Programmes can generate demand for such products and at the same time on the other hand private sector can provide and market products targeting improvement in nutrition. The emphasis on nutrition needs to be included in health and other related multi-sectoral programs like agriculture, education, water and sanitation hygiene and social protection programs etc. A focused and holistic approach, involving all related sectors and stakeholders can definitely improve nutrition status of the province and can save many more lives.
Managing malnutrition contributes towards alleviation of poverty and offers the most effective and sustainable development solutions.World has entered into Sustainable Development Goals era; targeted to reduce poverty and improve health of population. Pakistan, being signatory to SDGs should prioritize to address malnutrition issue and raise awareness at all platforms to achieve SDGs successfully. That’s why I would like to make a public pledge that I will be pushing my political party to include malnutrition and ways to address it as a manifesto item. I hope other parties will also join in.
The writer is a Member Provincial Assembly (MPA) from Punjab, representing the Pakistan Muslim League-Quaid (PML-Q)