Key Points
- Over 40% of children stunted in Pakistan: WB
- Burundi has highest rate of stunting around 55.8%
- Latvia has the lowest rate of stunting approximately 0.5%
ISLAMABAD: Shabbir Ahmed cannot run in the race competition as fast as his other schoolmates.
The eight-year-old from Bannu—a southern district of Khyber Pakhtunkhwa, abutting militancy-torn North Waziristan tribal district—wishes to make his father proud by winning a race someday. However, his weak body structure appears to be the major hurdle in achieving his dream.
His growth shows clear signs of malnutrition.
Stunting has also affected his cognitive abilities. Like his other classmates, he wants to go to a tuition centre. Nevertheless, his humble background not only stops him from having an adequate diet but puts him behind the eight ball in accessing essential educational facilities that are easily available to others.
“I want to hire someone to teach me English and mathematics, but my father, a labourer at a local brick kiln, cannot afford it.”
This is the story not only of little Ahmed but it speaks of millions of other children in Pakistan, living in far-flung and deprived regions of Pakistan.
Stunting, defined as impaired growth and development in children due to chronic malnutrition, remains a significant global health challenge.
According to the article, “Stunting in Childhood: An Overview of Global Burden, trends, determinants, and Drivers of Decline, published in the National Library of Medicine, the prevalence of stunting varies across countries. Some nations experience alarmingly high rates, while others have successfully minimised its occurrence.
Indonesia’s innovative strategies
For the Indonesian people, this initiative is the first bold and charitable programme launched by their government. It mobilises most of the state institutions, both civilian and military, to deliver free meals to children.
Many countries occasionally take such initiatives; however, this is one of the largest, considering the massive scale of Indonesia’s population.
According to the Jakarta Post, an English-language daily in Indonesia, stunting adversely affects nearly 21.5 per cent of Indonesia’s children under five.
To deal with this societal menace, the country recently launched an ambitious $4.3 billion Free Nutritious Meal programme. The initiative is indigenously arranged under the leadership of President Prabowo Subianto.
As a result, around 83 million Indonesian children and pregnant women will receive free meals until 2029. The programme, launched on 6 January, is receiving appreciation both at domestic and international levels.
High stunting rates
Burundi, an African country, reports a stunting rate of around 55.8 per cent among children under five. It indicates that over half of the nation’s young children suffer from malnutrition, according to the United Nations International Children’s Emergency Fund (Unicef).
With a stunting prevalence of approximately 52.5 per cent Eritrea, another African country, faces significant challenges in child nutrition and health, states the World Bank.
Papua New Guinea, from Oceania, has a stunting rate of approximately 49.5 per cent for children under five. Almost half of all children under the age of five (700,000) are stunted or shorter than average for their age, reports the World Bank in its database.
Reasons behind stunting
In the abovementioned countries, stunting in children is caused by poverty, conflict, food insecurity, poor maternal health, lack of clean water, cultural dietary habits, and limited healthcare access.
Poverty limits access to quality food. In the same manner, wars as well as conflicts disturb supply chains and healthcare services, resulting in malnutrition.
Economic instability as well as food insecurity, intensified by climate change adds fuel to the fire. In these countries, poor maternal nutrition results in underweight babies prone to stunting.
Poor countries lack adequate sanitation systems which cause frequent infections, further hindering affected children’s growth.
Low rates of stunting
Latvia, a European state, is among the countries with the lowest stunting rates. It reports a prevalence of around 0.5 per cent, indicating minimal instances of stunted growth in children under five.
Estonia, another European state, reports around 1.2 percent stunting. The country ranks among the nations with the lowest stunting rates.
South Korea, an Asian country, has a stunting rate of approximately 1.7 per cent. The country has effectively addressed child malnutrition.
South Korea has successfully addressed essential factors that contribute to child malnutrition. Its strong and streamlined economies provide access to nutritious food and quality healthcare.
Appropriate healthcare systems ensure maternal and child health through prenatal care and growth monitoring. In addition, access to clean water and sanitation reduces disease risks.
Cultural emphasis on healthy diets and hygiene further supports the development of healthy children.
Stunting in Pakistan
The prevalence of stunting among children under five is alarmingly high in Pakistan. The data from the World Bank indicates that over 40 per cent of children are affected, according to the World Bank Blogs titled “Addressing Pakistan’s high level of stunting, now!”
Stunting rates in different provinces of Pakistan vary. According to an article published in the National Library of Medicine, Punjab, the largest province by population, has a stunting rate of around 36.5 percent, followed by Khyber Pakhtunkhwa at 39.4, Sindh at 45.7, and Balochistan at 46.8 percent.
This represents an estimated 6 percent of the global stunting caseload. Unfortunately, it also means that Pakistan will not be able to take advantage of its youth’s cognitive abilities, as shown in Ahmed Shabbir’s case study.
The modern world is an era of knowledge-based economies, where people earn their livelihoods by selling their skills to the highest bidder. Silicon Valley in the United States is an example of a knowledge-based economy. Similarly, India earns billions by exporting its software services.
Dr. Afzal Ali Khan, a Bannu-based health expert, says Pakistan’s rate of stunting is double that of Indonesia. Learning from Indonesia’s approach and strategy, Pakistan, too, can implement a nationwide free nutritious meal programme targeting vulnerable groups, such as schoolchildren and pregnant women.
He fears, “If this issue is ignored, Pakistan will keep knocking at the doors of the International Monetary Fund (IMF) for years to come.” If today’s children are stunted, they will not be able to contribute to their national economies as they cannot compete for international jobs.
Stunting in big cities
Before shedding light, once again, on the miserable conditions of children in rural areas, the travails of a mother—sitting by the roadside in sector G-13, Islamabad, along with her almost two-year-old son who looks pale, weak, and under the grip of intense cold—are heart-wrenching.
“If I do not sit here, my other children will die of hunger,” she says.
This is just one instance; this scene is common in the federal capital and other big and small cities of Pakistan.
Currently, Islamabad is overwhelmed by children who are lean, stunted as well as poor; they can be seen asking for food and money outside big shopping malls, tourist points, and all sectors.
“We do not know what you are talking about. We eat what we get from people and hotels. I do not have fruits and vegetables to feed my five children. They are healthy and fine,” says Tehmina. She is the mother of five weak and stunted children who do not appear to be the age they should be.
She sits in front of eateries in G-10 Markaz, Islamabad. She claims that her husband is a common labourer who cannot earn sufficient to adequately look after his family.
A study, published in the National Library of Medicine, reports that 32.6 per cent of children are stunted in Islamabad. Besides, four in ten under-five children are stunted according to the new National Nutrition Survey (NNS), published by the Government of Pakistan in 2019.
The survey showed a four per cent decrease since the last research conducted in 2011, and that nearly two out of every 10 children under five also suffer from wasting.
Stunting in rural Pakistan
Back in the rural areas, people do not even know about these terminologies: stunting, malnutrition, balanced diet, and nutritionist.
Arsalan is a 48-year-old daily wager from Lakki Marwat district of Khyber Pakhtunkhwa. He believes that his children are under demonic possession because their ribs are coming out of their bodies and “their flesh is eaten by evil spirits.”
“I am very upset; I made demons angry when I built a room which was, indeed, their abode.” It is often said that ignorance is a blessing, but here, it is a recipe for disaster.
These stories are common in every second to third village in Pakistan. Being poor and a common labourer, Arsalan is unable to provide sufficient food for his children.
“Our statesmen know that 22 million children are out of school, but, at the same time, they ignore the fact that over 40 per cent of them also go hungry to their schools,” says child Faisal, a rights activist hailing from Shangla.
“Copying the Indonesia programme in Pakistan would require substantial investment and careful planning to ensure sustainability and effectiveness.”
Indonesian example has not yet achieved its goals as it was launched on 6th January; however, it is a step in the right direction.
“Additionally, integrating nutrition education, improving maternal health services, and enhancing food security through local agricultural support could be essential components in reducing stunting rates,” says the rights activist.
