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Alarm bells
By: Dr Abid Qaiyum Suleri

According to the 2011 National Nutrition Survey, Pakistan is facing a
silent crisis of malnutrition that is amongst the worst in the world and
has not improved for decades

Amrtya Sen writes that there is nothing like apolitical famine,
meaning issue of food insecurity can only be tackled through a right set
of policies and political will to implement those policies. A lot has
been said and written about some of the policy measures that may be
taken to improve food security situation in Pakistan. Few of these
policies worked, few did not work, and most produced a mixed result. 
Having said it, let us recall the few important developments which took
place on food security front in recent past in Pakistan.

The first good news is that there is a dedicated ministry of National
Food Security and Research in Pakistan. The second good news is that it
is gradually becoming clear to policy makers in Pakistan that food
security is not only getting self-sufficiency in food production [food
availability] but it also has two other equally important pillars, i.e.,
[socio-economic] access to food and food utilisation.

The third good news is that the then Prime Minister Yusuf Raza
Gillani in March 2012 launched an initiative “Zero Hunger Programme”
which aimed to provide ready to use nutritious food to the breast
feeding mothers, under five year age children and expecting mothers in
the most food insecure districts.

The PPP government also announced to establish a “national food
security council (NFSC)”. The fourth good news is that current
government also promised to revive that “national food security council”
to tackle the multi-dimensionality of food insecurity in Pakistan. The
fifth good news is that as per SDPI-WFP-FAO-and UNICEF’s forthcoming
“Food Security Analysis 2013” the state of food availability in Pakistan
has improved over the last five years.  During this period, Pakistan
has emerged as a surplus wheat producing country, and production of rice
and maize has also increased considerably.

The first bad news is that a dedicated federal ministry of food
security would not be able to offer much help on improving  food
security which is dependent on

i) availability of food which is a function of agriculture, livestock, and agri-marketing.

ii)socio-economic access which requires livelihood generation
opportunities, social safety nets, and poverty reduction strategies.

And iii) on food utilization which means getting food assimilated in
once body for which health, sanitation, clean drinking water, and
education are prerequisites.

Unfortunately the prerequisites of all of the above mentioned three
pillars of food security are now provincial functions after the
18th amendment. This means we would have to find a constitutional way of
linking federal food security ministry with different provincial
ministries which deal with agriculture, irrigation, livestock, health,
and other social sector ministries.

The second bad news is that zero hunger program could never took off.
PM Gillani announced it but could never get any funding allocated for
it in Federal budget 2012-13. Since then, this program which had
tremendous potential to take care of immediate food security threats is
lying in files waiting for some allocation.

The third bad news is that despite the fact that  promise to
establish a “national food security council” was  made by two
consecutive governments, the notification of committee members is still
pending.

The fourth bad news is that as per SDPI-WFP-FAO report despite
improvement in food availability, its socio-economic access got
deteriorated. In spite of Pakistan’s growth in national food production,
many households are not benefitting from that upward trend and there
are indications that food security has declined in notable ways for the
poorest and most vulnerable parts of the population.

Half of the Pakistani population (50.6 per cent) is caloric energy
deficient i.e., consumes less than adequate calories required for
healthy living (2,100 kcals per day), which is the internationally
recommended threshold. In GB and FATA, more than half are consuming
fewer than 1,740 kcals and 35 per cent fewer than 1,500 kcals. The
energy consumption situation is also serious in Balochistan and Sindh.

The report which draws heavily on the findings from the national
level food security survey (FSA 2013) of 14,265 households while
incorporating the findings of several important datasets including the
Household Integrated Economic Survey (HIES) 2010/11, the Pakistan Social
and Living Standards Measurement (PSLM) Survey 2011/12 and the National
Nutrition Survey (NNS) 2011 also reveal that about 40 per cent of
households had experienced a shock since 2010 and 28 per cent reported
that they had problems meeting basic food needs as a result, peaking at
42.8 per cent in Sindh followed by FATA and Balochistan. Price hikes
followed by natural disasters (chiefly flooding) and conflict were the
main shocks experienced.

Such shocks compel poor families to use coping mechanisms that
further erode their resilience such as shifting to less desirable or
less expensive food (81 per cent of households), limiting portion size
at meals (59.3 per cent), borrowing money (42.4 per cent), restricting
consumption by adults to provide food to small children (28.3 per cent)
and skipping meals (31.8 per cent). Some 24.2 per cent reported that
women were consuming less to feed children or male members — a very
significant expression of intra-household discrepancy in food access.

Around 5 per cent of households resorted to consuming seed stocks
reserved for the next planting season, selling domestic or productive
assets, and removing children from school.

According to the 2011 National Nutrition Survey, Pakistan is facing a
silent crisis of malnutrition that is amongst the worst in the world
and has not improved for decades. Some 43.7 per cent of children under
five years old — or around 10 million children — are stunted (or
chronically malnourished), a prevalence considered ‘critical’ by WHO
thresholds. In rural areas stunting is higher (46.3 per cent) than in
urban (36.9 per cent). Levels peak at 57.6 per cent in FATA, followed by
Balochistan, GB and Sindh where more than half of young children are
stunted.

Some 15.1 per cent of under fives (around 3.5 to 3.7 million
children) are wasted (weight too low for height), indicating a
‘critical’ acute malnutrition situation according to the WHO’s 15 per
cent threshold and almost double the 1997 prevalence (8.6 per cent).
Again it is more prevalent in rural areas (16.1 per cent) than urban
(12.7 per cent) and above 16 per cent in AJK, Sindh, KP and Balochistan.

The price of food has steadily increased since 2008, rising more
sharply in the last couple of years. The food security of poorer
households is hit hardest by rising prices. The casual wage labour rate
has not kept up with the price increase in cereals, particularly in the
last year. The most food insecure and malnourished tend to be poor rural
households that have been impacted by food price inflation, repeated
natural disasters (chiefly floods) or insecurity. Wage labourers, the
uneducated and socially excluded are most likely to be trapped in
poverty and therefore most vulnerable.

There is a clear link between household food security status and
education levels of the household head. Better educated women with more
knowledge of nutrients and micronutrients, as well as food preparation
and hygiene, are more likely to improve the nutritional situation of the
whole family. According to the FSA 2013, 77.1 per cent of women
surveyed have no education compared to 43 per cent of male heads of
households. The figure rises to 83.3 per cent of women in rural areas.

To determine the overall food utilisation situation for all districts
across the country, a weighted composite index was used on the basis of
access to safe drinking water, access to sanitation facilities, female
education, and complete immunisation coverage of children obtained from
secondary data collected from districts in 2012. Based on this the food
utilisation situation is poorest in FATA and Balochistan.

The multiple dimensions of food and nutrition security are influenced
by and equally impact multiple sectors in Pakistan. Thus, efforts to
address food insecurity and under-nutrition require addressing the
social, economic, educational, agricultural, political and security
dimensions. I have used these pages to say many times that insecurity
breeds insecurities.

Food insecurity leads to human insecurity which, in turn, can
threaten regional, national and global securities. It is about time that
all stakeholders start working to enhance collective political will not
only to formulate right set of policies but also for an effective
implementation of those policies.

One should remember that when individual insecurities get any
collective identity, be it class, sect, ethnicity, provincial, or
rural/urban can immediately lead to clash between the haves and have
nots. Pakistan is already passing through turbulent times and cannot
afford any aggravation of such clashes.

Source : http://tns.thenews.com.pk/alarm-bells-of-malnutrition-in-pakistan/#.VE3NWBZFiZR

 

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The opinions expressed in this article are the author's own and do not necessarily reflect the viewpoint or stance of SDPI.