A new challenge

Stunted growth, also known as stunting and nutritional stunting, is an affliction in human development

The writer is Editor of The Express Tribune

We are told that Pakistan has a severe problem both now and in the future when it comes to the stunting of its children. As many as 48 per cent of all children under five in Pakistan suffer from inhibited growth and development, one of the highest levels of stunting in the world.

Stunted growth, also known as stunting and nutritional stunting, is an affliction in human development. According to its definition, it is a primary manifestation of malnutrition (or more precisely under-nutrition) and recurrent infections, such as diarrhea and helminthiasis, in early childhood and even before birth, due to malnutrition during fetal development brought on by a malnourished mother.

In other words, pregnant women in Pakistan are unable to provide the nutrition needed for their babies to grow normally. This affects their growth after birth as well.

Despite the strides we claim to have made in health and education, we are unable to ensure that pregnant women are given the nutrition they need. And like everything, we seem to sweep this issue under the carpet. This isn’t just about poor people not being able to afford the required food. It is about a workforce that will be unable to deliver in a globally competitive environment in 15 years from now.

The definition of stunting according to the World Health Organisation (WHO), is for the “height for age” value to be less than two standard deviations of the WHO Child Growth Standards median.

We need bright young men and women, both educated and competitive, to take our country forward. But half of our potential workforce will be unable to compete through no fault of their own. And this will have dire consequences for our economy.

In the words of our editorial published some days back, the food insecurity of today is going to feed the jobs insecurity of tomorrow. Stunted children make for a stunted workforce generation, hence stunted children are less likely to be adequately educated and are anyway poorly served by the government in terms of providing education.

We understand that the issue of stunting thus has implications that reach far beyond nutritional needs and runs deep into the way in which the nation develops in the medium- to long-sterm.

With half of all under-five stunted children today, the future fairly murky. So, we need to address this issue on a priority.


The needs of pregnant women — indeed women in general — must be better addressed if inequalities are to be mitigated. We are not alone in this problem.

In a world where there is food and nutrition aplenty, on a global scale what we see is that as of 2012 an estimated 162 million children under 5-years age, or 25%, were stunted in 2012. More than 90% of the world’s stunted children live in Africa and Asia, where respectively 36% and 56% of children are affected.

Once established, stunting and its effects typically become permanent. Stunted children may never regain the height lost as a result of stunting, and most children will never gain the corresponding body weight. Living in an environment where many people defecate in the open due to lack of sanitation is an important cause of stunted growth in children. There are other factors as well.

On his visit to Pakistan, the president of the World Bank, Dr Jim Yong Kim, drew the attention of both the government and the public to the issue of stunting.

He told his audiences that Pakistan should address the high prevalence of stunting among its children on a priority basis, given that we have one of the highest prevalence of stunting in the world.

Dr Kim said Pakistan must focus on inequality, starting with pregnant women. At the same time, he also made it clear that the issue can be tackled if the government took the right steps now.

Pakistan needs to invest in both its health and education so that the future generation can be saved from the dark path it seems to be pursuing. While local politicians made the right noises, there is still little to show for in terms of action. This is the real challenge facing Pakistan. To make the commitment, and work for the results with honesty and dedication. So far we have only seen corruption.

Published in The Express Tribune, February 22nd,  2016.

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