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Outline
Nature of the Malnutrition problem The consequences The opportunities in Pakistan Pointers to action
Malnutrition in Pakistan
60% 50% 40% 30% 20% 10% 0% NSWP:1965 NNS:1977 NNS:1985-7 Underweight
Lawrence Haddad, IDS Sussex
NNS: 2001-02
NNS 2011
Malnutrition in Pakistan
60% 50% 40% 30% 20% 10% 0% NSWP:1965 Stunting NNS:1977 NNS:1985-7 Wasting NNS: 2001-02 Underweight
Lawrence Haddad, IDS Sussex
32%
11%
9%
11%
12%
15%
NNS 2011
In terms of children..
A doubling of the numbers of stunted children under 5 years of age
6.35 million stunted in 1985 11.8 million stunted in 2011 Increase of 200,000 per year--or 547 a day
12%
10%
1% Pakistan
1%
Urban NNS 2001
Consequences
Mortality
45 % of all under 5 child deaths (3 million deaths) are caused by undernutrition
Health
Underweight is the number 4 contributor to the Burden of Disease in South Asia
Education
Preventing stunting adds about one grade to school attainment
Jobs
Hourly earnings up by 20% Wage rates up by 48% 33% more likely to escape poverty
Economy
Asian GDP 11% lower given its stunting rates compared to Latin America
Source: Haddad 2013, Nutrition for Growth Background Paper
Lawrence Haddad, IDS Sussex
Table 12 HANCI commitment levels and stunting levels for children under 5 years of age Percentage of under-5 stunting (severe and moderate) <20 High commitment Brazil 20-29 Peru 30-39 Philippines >=40 Guatemala Malawi Madagascar Indonesia Moderate commitment Gambia Ghana Burkina Faso Vietnam Mali Tanzania Bangladesh Mozambique Rwanda Zambia Low commitment China Senegal South Africa Uganda Sierra Leone Cambodia Nepal Niger Ethiopia Benin Pakistan India Nigeria Cameroon Kenya Liberia Lesotho Sudan Myanmar Afghanistan Yemen Burundi Congo, DR
Source: www.hancindex.org
Things to Strengthen
Potential for innovation and expanded accountability for nutrition due to the 18th Amendment
But have resources also been devolved?
The PPP Election manifesto mentioned nutrition 6 times, the PML-N manifesto, not at all
But the PML-N is focused strongly on economic growthand we know what better nutrition status can deliver Lawrence Haddad, IDS Sussex
Potential "Demographic Dividend will not be realised without investment in maternal and early childhood nutrition
Lawrence Haddad, IDS Sussex
1. A good education 2. Better job opportunities 3. An honest and responsive government 4. Better healthcare 5. Protection against crime and violence 6. Affordable and nutritious food 7. Support for people who cant work 8. Freedom from discrimination and persecution 9. Access to clean water and sanitation 10. Equality between men and women
http://www.myworld2015.org/?page=results
Lawrence Haddad, IDS Sussex
South-Eastern Asia 2.25 Latin Am. & Carib. South-Central Asia 2.00 Western Asia Northern Africa Sub-Saharan Africa 1.75
1.50
1.25
Conclusions
Nature of the Malnutrition problem in Pakistan is severe and not improving The consequences are substantial, particularly for economic growth There are opportunities in Pakistantime is right to scale up action Pointers to action
Actively participate in the SUN movement, establish a nutrition budget Increase health spending to scale up reproductive, maternal, newborn and child health interventions Focus BISP on nutrition Look for opportunities to connect agriculture and nutrition more, improve womens status
Lawrence Haddad, IDS Sussex