The National Nutrition Survey 2011 released here has indicated that stunting, wasting and micronutrient malnutrition are endemic in Pakistan. The report said the increasing rate of chronic and acute malnutrition is primarily due to poverty, high illiteracy rates among mothers and food insecurity.

The survey was conducted by the Aga Khan University’s Division of women and child health, Pakistan’s Ministry of Health and UNICEF. The last such survey was conducted in 2001-2002, according to federal planning minister Ahsan Iqbal who said task forces must be formed to address the situation.

The survey found widespread micronutrient deficiencies among women especially in those pregnant — 51 per cent surveyed were anaemic; 46 per cent had vitamin A deficiency; 47.6 per cent had zinc deficiency; and 68.9 per cent had vitamin D deficiency. Anaemia was high at 50.4 per cent in other women too.

Among children under five, 43.7 per cent were stunted in 2011 as compared to 41.6 per cent in the 2001 National Nutrition Survey. Children under five also suffered from: anaemia-61.9 per cent; iron deficiency-43.8 per cent; vitamin-A deficiency- 54 per cent; and zinc deficiency 39.2 per cent. In the Saarc, Pakistan has the second highest stunting rate for children under five years- 43.7 per cent. About 32 per cent of the children were underweight. The elderly population too was not spared with over 53.9 per cent not having normal weight.

More than 30 per cent of the population lives below the poverty line, the report said and the poorest 20 per cent earns 6.2 per cent of the total income. Most households spend almost half their income on food.

While the fertility rate is high, ante natal care is very low and in 2011, trained personnel attended only 39 per cent of the births. About 27, 963 households took part in the survey. The food security situation showed no signs of improvement since the last assessment. This revealed that 51 per cent of the population did not have food security and now the situation has deteriorated.

In focused group discussions, women said they lacked freedom to access medical care for themselves and their children unless their household decision maker allowed them to do so. In Balochistan, rural Sindh and southern Punjab, water and sanitation were major issues. Women also have a large amount of physical work to do even during pregnancy.

The key finding of this report is that very little has changed for the better in the last decade in terms of core maternal and childhood nutrition indicators though it does point towards gains in iodine status nationally after the implementation of a universal salt iodisation and promotion strategy. Though a draft nutrition strategy was developed in 2003-04 and approved by the planning commission, it was not implemented. In addition, the importance of nutrition has remained unrecognised in current social safety nets and income support programmes. Women and girls suffer particularly in the absence of effective intervention.

The problems reflect a combination of dietary deficiency, poor maternal and child health and nutrition, a high burden of morbidity and low micronutrient content of soil specially for iodine and zinc. These micronutrients have a profound effect on immunity, growth and mental development the report added. There is a Pakistan Poverty Reduction Strategy and the government has formed several committees to tackle this situation .