The sun shines down upon Sindh nearly every day yet 70.6 per cent of mothers and 43.3 per cent of children face a deficiency of Vitamin D.
According to the National Nutrition Survey released earlier this year by a team of doctors from Aga Khan University (AKU), anaemia, vitamin A and zinc deficiencies are very common. Their survey showed that 62 per cent women and 73 per cent children have anaemia, while 44.5 per cent women and 38.6 per cent children have an acute deficiency of zinc. Around 46.7 per cent of mothers and 53.3 per cent children have vitamin A deficiency, as well.
The research was conducted by the Division of Women and Child Health, AKU, in partnership with the Institute of Development Studies, Sussex. They study was funded by the Department For International Development, UK.
At a roundtable discussion on Friday, the health experts presented the findings of their survey. The problem is not only apparent in rural areas that form 53.1 per cent of the total population of Sindh, but also in urban centres. Unfortunately, this means that Pakistan will probably not meet its millennium target.
According to the head of AKU’s Division of Women and Child Health, Dr Zulfiqar Bhutta, Sindh has a very high proportion of underweight, stunted and wasted children. “One in every second child is stunted and deficient in vitamin A, and more than half the women and children are anaemic,” he said.
Dr Bhutta termed the prevalence of underweight children a national tragedy. “Children are not given a proper diet, which hampers their growth – physically and mentally,” he explained. He agreed that the iodine salt policy of the government had brought positive results.
In her presentation, Prof. Dr Shehla Zaidi pointed out that almost two-thirds of the people in the province are food insecure. The poorest households spend 58 per cent of their income on food and have already “stretched food budgets” therefore, whenever food prices increase, they switch to low quality food and a less diverse diet.
She added that law and order concerns detract attention from development issues, such as nutritional issues, that are exasperated by pockets of poverty, low access to food, and predominantly patriarchal power structures in the society.
“Nutrition is usually confused with hunger, which has higher political visibility,” she said, adding that nutrition is a more ambitious subject that includes preventive health coverage, poverty reduction, dietary awareness, safe water and sanitation, apart from resolving hunger. She added that, in comparison, Sindh has a better coalition of nutrition experts and private philanthropists working to deal with hunger.
How to improve nutrition
In order to move toward a visible policy framework, Dr Zaidi added that civil society and the media come across as interested actors, but their understanding and organisation around nutrition is weak.
To improve nutrition levels, she suggested stronger coverage of health clusters and working together with other health programmes. School feeding programmes to increase enrolment have been present off and on but they miss the critical pre-school group where nutrition needs to be addressed most, she said.
Vitamin A supplementation integrated with the EPI programme has been a success story and there is potential to expand salt iodisation to all districts if the provincial legislation on mandatory iodisation is passed, she said, adding that there are many opportunities after devolution as developmental priorities are being sorted.
Dr Bhutta said that without women empowerment it was not possible to achieve these objectives easily. “A visible change is about to come in Sindh’s rural areas. Poor people, including women, are coming out with their issues sidelining the influence of the feudal.”
Published in The Express Tribune, December 1st, 2012.