1、,An Overview of Food And Nutrition Situation in Pakistan Freedom from hunger and malnutrition is a basic human right. Nutrition has been expressed as a right in various international declarations and human rights instruments from time to time. According to UN Article 24, states are mandated to provi
2、de medical assistance and health care to all children, combat disease and malnutrition through provision of adequate nutritious foods, safe drinking water and adequate sanitation and provide families with information about the advantages of breast feeding.,Intake of Food by Food Groups,Source: FAO (
3、2000). Food Balance Sheet. Rome. National Institute of Health (1988). National Nutrition Survey, Islamabad.,Dietary Pattern of Adult Males (%) in Different Provinces,Source: National Institute of Health (1998) National Nutrition Survey, Islamabad,Availability of Dietary Energy from various Food Grou
4、ps,Sources: FAO (1990, 2000) food Balance Sheet. Rome Pakistan is not a food insecure country.,Quantity and Nutritional Quality of Diets Available During 1990 & 2000,Indicators Per capita Per day Criteria for balance diet 1990 2000Quantity Calories 2392 2452 Proteins (g) 58.4 62.5 Fats (g) 58.5 64.2
5、Quality Percent Calories from: Protein 9.8 10.2 10.-15 Carbohydrates 68.2 66.2 55-70 Fats 22.0 23.6 20-30,Causes of Malnutrition,Poverty Shortage of food Maldistribution of Food Infections Ignorance,Food Insecurity Profile District Wise,Calories/Capita/day of all food (Consumption Vs. Production),So
6、urce: State of food insecurity in rural Pakistan. SDPI, 2003. National Outlook: Out of 120 district settings, 74 (62%) were found to be food deficit.,Nutritional Status,Nutrient Intake of School Girls (6-15 Years) % of RDACalories 86% Protein 118 Iron 67 Prevalence of Malnutrition (Under Five)Low bi
7、rth weight 25-34% (1.42 -1.94 million) Under Weight 40% (9.5 million) (Low Weight for Age) Stunting 50% (12 million) (Low Height for Age) Wasting 9% (12 million) (Low weight for Height) Anemia 51% (Iron Deficiency) Goitre (Iodine Deficiency) 77% School age children Bitots Spot (Vitamin A Deficiency)
8、 5.8%,Incidence of Malnutrition (Under five) in Pakistan,Malnutrition NHS NNS FAO_ Indicators 1990-94 2000-02 1990 1999-2000 _Underweight 39% 38% Stunting 35% 37% 35% 50% Wasting 14% 13% _Child Mortality in PakistanMortality/1000 live births 1990 1999 Infant mortality 104 90 Under five mortality rat
9、e 138 126 _Cost of Malnutrition Malnutrition costs the country Rs 200 billion every year equivalent of more than 5% of GNP in lost lives, disability and productivity.,Breast Feeding Practices,Duration UNICEF NNS1990 2000 2000 - 2 0-3 months 87% 16% 62% 6-9 months 74% 31% 35%,Other Indicators Related
10、 To Child Nutrition,Infant mortality rate 90 per 1000 live births Under five mortality rate 126 per 1000 live births Adult female literacy rate 24% Female literacy as % of males 48% Number of children out of school 8.2 million Number of girls out of school 5.9 million Primary school enrollment 46% M
11、iddle school enrollment 16% Secondary school enrollment 52% Drop out of rural girls at primary school Level 75% Rural girls (12 year old) continue school 3% Rural boys (12 year old) continued school 18% Coefficient of educational efficiency 68% No of Government primary school Without water and sanit
12、ation facilities 90% No of primary school without shelter And boundary wall 50%,Quality of Life,Poverty % population below poverty line 34 % population below $ 1 a day 31 % population below $ 2 a day 85 New born weighted at birth (%) 12 Babies registered at birth (%) 30 Breast feeding practices0-3 m
13、onths (%) 166-9 months (%) 31 Access to sanitation 30(% of population) Access to improved water source 60(% of population) Parasitic Infections 60(% of population) Consumption of iodized salt 19 (% of households) Vitamin A supplementation 1(% coverage of pre-school children) Physicians (Per 1000 peo
14、ple) 0.6 Health Expenditure (% of GDP) 0.9 Education Expenditure (% of GDP) 2.7Economic cost of Malnutrition 200(Billion rupees per year) (5% of GDP) Life Expectancy Males 61 yearsFemales 63 years,REPRODUCTIVE HEALTH,Female Population 48.2 (% of Total)Total Fertility 4.8(Births per Women) Adolescent
15、 Fertility Rate 100(Births per 1000 Women)Contraceptive Prevalence Rate 24(% of Women) Pregnant Women Receiving Prenatal Care 27Births Attended By Skilled Health Staff 19(% of Total) Prevalence Of Anemia 37(% of Pregnant Women) Maternal Mortality Rate 340/100,000(600,000/ year),Indicators Indicating
16、 the Progress of a Nation% of children adequately nourished% of being educated to at least 5th grade% of children surviving to age of fiveNational Performance Gap *Children under five mortality -27%Children under weight -13%Children reaching grade five -18% _* A measure of the extent to which positi
17、ve child right are being honored in relation to available resources. * Country has not achieved considerably social progress * Low level of education and poor health and nut status are limiting pale productivity and adversely affecting economic growth and poverty redirection prospects.,Indicators fo
18、r Assessing and Monitoring Nutritional Problems,Food CrisesProduction patternsmarket pricesFood stocksFall in body weights Protein energy malnutrition Childrens anthropometry (weight for height for age, weight for age, height for weight) Childrens growth Infectious disease rate Food intake relative
19、to need Body mass index Micronutrient deficiencies Iron deficiency : rates of anemia Vitamin A deficiency: night blindness/xerophthalmia Iodine deficiency: goiter, cretinism Household food security Employment levels Market prices Changes in real income and purchasing power Dietary energy supply Cari
20、ng capacity Maternal education Maternal employment, public expenditure Literacy rates Breast feeding (duration and percentage),NUTRITIONAL CHALLANGES,Poor Household Food Security Low Birth Weight Child Feeding Malpractices Childhood Under-Nutrition (PCM) Micronutrient Deficiencies(Vitamin A, Iodine,
21、 Iron, Zinc),Interventions for Improving Nutrition Status,Interventions BenefitsBreast Feeding Improved breast feeding practice Can reduce child malnutrition and reduced bottle feeding mortality and can save more children Improved Food IntakePer capita food availability Can reduce child malnutrition
22、 by 26%During pregnancy Can reduce LBW by 40%, infant disability by 33% and infantmortality by 50% Vitamin A SupplementationDuring Pregnancy Can reduce maternal mortality by 44%To new born in the first 48 hours Can reduce infant mortality by 24% Improved Health Environment Can reduce child malnutrit
23、ion by 19% Improved Education Level Of Mothers Primary School Can reduce child stunting by 13% Secondary School Can reduce child malnutrition by 43% Income Increased per capita income by 10% Can reduce child stunting by 2%,Nutrition and Consumption Plan 2000 - 2003,Allocation Rs 534 MillionTargets t
24、o be achieved Baseline Target Deficiency 2000 2003Vitamin A 40% 0Iodine 40-60% 10%Fe Women 65% 15%Children 45% 10%LBW 25% 7%Population Calorie Intake (Less than 70%) 34% 6% of RDA (2300 Cal)PEM 39% 10%Source: Planning Division Government of Pakistan. 2000.,Policies and Strategies to Improve Nutritio
25、n,By improving household income and food security Education levels of mothers Children feeding practices Nutrition education and investment in nutrition Health environment National nutrition surveillance and statistical system Biotechnology applications Communication between public and private secto
26、rs Good governance Political stability,Some points to ponder,Good nutrition in early life pays dividends in childhood and in later life. Malnutrition adversely affects mental development, physical development, productivity and span of working years, all of which significantly influence the economic
27、potential of man. Poverty is closely correlated with under nutrition. No progress in child health can be achieved unless under nutrition among children is eliminated. A malnourished nation cannot participate in economic development effectively unless its nutritional problems are solved. Low levels o
28、f education and poor health and nutrion status are limiting Pakistans productivity and adversely affecting economic growth and poverty reduction prospects. Investment in nutrition reduces health care cost and the burden of non-communicable diseases. The country has not achieved normalcy in nutrition
29、al stability due to poor nutrition planning and implementing national programmes.,Nutritional Interventions of Tawana Pakistan Project,Nutritional Interventions,Deworming Drugs,Noon Meal,Micronutrient SupplementsIncluding iron, iodine and Vitamin A,Improves Nutritional StatusPrevents Infections and
30、Nutritional Deficiency Diseases Improves School Enrollment and Performance,Benefits To School Girls,Tawana Pakistan Project: School Nutrition Package for Girls,Objectives Improve nutritional status of school girls (5-12 years) through school feeding programme, deworming and micronutrient supplements
31、. Increase enrollment and sustain attendance of girls and to reduce gender gap in School Enrollment. Create community awareness for healthy living through health and nutrition education. Beneficiaries Number of high poverty districts: 29 Number of girls (5-12 years): 530,000 Number of schools: 5,300 Communities in target villages: 5,300 (10.5 million),
