Malnutrition in Pakistan: A Battle Yet to be Won
Malnutrition or improper nutrition in children has been a problem for paediatricians and parents world wide. Malnutrition is defined as deficiency of one or more of the essential diet ingredients. Primary malnutrition is caused by lack of essential nutrients such as vitamins, minerals and proteins. Various indicators are used to measure and monitor malnutrition which include stunting of growth, muscle wasting and being underweight at 5 years of age.
Over one-third of all child deaths are due to malnutrition causing an estimated 3.5 million deaths annually, malnourished children who survive tend to start school late, are weaker at studies and have lower adult earnings. The resulting compromised human capital means that malnutrition deprives many developing countries of at least 2-3% of economic growth.
Chronic food deficits affect about 792 million people in the world (FAO 2000), including 20% of the population in developing countries. Worldwide, malnutrition affects one in three people globally (WHO, 2000). Malnutrition affects all age groups, but it is especially common among the poor and those with inadequate access to health education and to clean water and good sanitation. More than 70% of children with protein-energy malnutrition live in Asia.
Malnutrition is one of the major plights of Pakistan today. Globally, one quarter of children under-five are stunted. In Pakistan more than 33% children under 5 years of age are underweight while around 53% are stunted and wasted indicating the poor nutritional status in the country. The incidence of iodine deficiency goiter is also amongst the highest in the world.
The recent floods that hit Pakistan in 2010 and 2011 affecting more than 20 million people, damaging different urban and rural areas and causing immense damage to the infrastructure and agriculture of the country also worsened the scenario, increasing the percentages. The deficiency of essential nutrients has increased the incidence of infectious diseases, leading to an overall increase in the pediatric mortality and morbidity.
Malnutrition in Pakistan is mainly due to poverty, rising inflation, lack of proper hygiene, clean water, and sanitation systems and the lack of interest by the government and health care providing authorities. But children from wealthier households also suffer from malnutrition either due to improper eating habits or excessive calories in the diet.
Malnutrition has devastating effects not only on the child but on the society as a whole. Severe malnutrition can lead to marasmus (chronic wasting of fat, muscle and other tissues); cretinism (congenital hypothyroidism) and irreversible brain damage due to iodine deficiency, blindness, recurrent infections and ultimately death. This in the long run would lead to a physically and mentally retarded generation which would be unable to cope with the global standards of living and education.
Prevention and treatment of malnutrition are complementary. Both strategies must work in coordination to avoid malnutrition from occurring and to help recovery and treatment for those who are moderately or severely malnourished and at risk of death and/or severe disability. Although the actions for prevention differ from those necessary for effective treatment, they should be seen as part of a joint plan needed to combat and completely eradicate malnutrition.
Pakistan along with other world leaders adopted the Millennium Development Plan in the year 2000, and pledged to ‘spare no effort to free our fellow men, women and children from the abject and reduce conditions of extreme poverty. With less than 2 years remaining to achieve this goal, Pakistan still has a long way to go before it can completely get rid of this menace. Some of the targets that were set in the Millennium Development Goals in Pakistan included:
- To reduce the percentage by half, the proportion of people whose income is less than one dollar a day.
- To reduce the percentage by half, the proportion of people who suffer from hunger.
- Ensure that, by 2015, children everywhere, boys and girls alike, will be able to complete a full course of primary schooling.
- Eliminate gender disparity in primary and secondary education, preferably by 2005, and to all levels of education no later than 2015.
- Reduce by two thirds, between 1990 and 2015, the under-five mortality rate.
- Reduce by three quarters, between 1990 and 2015, the maternal mortality ratio.
- Have halted by 2015 and begun to reverse the spread of HIV/AIDS.
- Have halted by 2015 and begun to reverse the incidence of malaria and other major diseases.
- To reduce the percentage by half by 2015 the proportion of people without sustainable access to safe drinking water.
Malnutrition has been a major cause of loss of lives for centuries but despite all this planning and efforts, much of the targets stated above have not been achieved. It is hoped and expected that with all the researches and vigorous efforts being made in this regard, mankind will soon defeat malnutrition and undernourishment and relieve the globe of this menace.
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