ISLAMABAD: Early marriages and the practice of feeding girls less than boys are key reasons for stunting in children, the country director of the Global Aliiance for Improved Nutrition said on Tuesday.

Dr Qaiser Munir Pasha was speaking at a seminar on Adolescent Nutrition in Pakistan: Identifying Opportunities and Setting Priorities, which was organised by the Ministry of National Health Services (NHS).

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Boys are generally given more food than girls, he said, because of which girls are unable to compete with boys in many fields, and malnourished mothers cannot give birth to health babies.

“Currently, 41pc of children do not go to school in Pakistan. The worst situation is in Balochistan, where only 20pc children go to school. There is need to ensure women and children are properly nourished because only that is how the mother and child mortality rate can be reduced,” he said.

Seminar on adolescent nutrition in Pakistan held

Dr Baseer Khan Achakzai, a health expert, said the first 1,000 days remain a critical period of nutritional need. Adolescence, the period between 10 and 19 years of age, is characterised by rapid biological and psychosocial growth and development. Up to 45pc of skeletal growth takes place and 15 to 25pc of adult height is achieved during adolescence.

“It is a vulnerable time with increased nutritional requirements, particularly for girls who are biologically vulnerable, while often lacking access to nutritious food, education, and other opportunities owing to gendered cultural norms,” he said.

NHS ministry representative Dr Khawaja Masood said the establishment of a platform dedicated to adolescent nutrition, the National Technical Advisory and Advocacy Platform for Improved Adolescent Nutrition, was a landmark achievement.

“This has not only served to bring together key partners in the adolescent nutrition space but will also anchor and drive further actions for adolescent nutrition in the country,” he said.

During the technical session, speakers explained that Pakistan has a high burden of malnutrition, costing $7.6 billion, or 3pc of the GDP, every year.

The evidence review suggested that adolescents experience a high burden of stunting, thinness, and being overweight. Girls appear to experience a higher burden of stunting (11-23pc) and being overweight/obesity (8pc) than boys (5pc for both).

Boys have a slightly higher prevalence of thinness (12pc) than girls (10pc).

Thinness is more common in rural areas and being overweight/obesity in urban areas. Anaemia is prevalent among adolescent girls (54pc) as well as deficiencies in folic acid (49pc), zinc (42pc) and vitamin A (40pc).

It was informed that household food insecurity is a major barrier to obtaining an adequate diet, especially in rural areas where more than half of households are food insecure.

The review further suggested that adolescent diets are generally poor, not sufficiently diverse, and are overwhelmingly of wheat and low in fruits, vegetables, pulses, potatoes, meat and eggs.

Adolescent girls rarely have control of food expenditure or distribution within the household; the primary decision makers for the purchase of packaged foods are their mothers, who have limited nutritional knowledge.

Although the age at first marriage is rising, one-third of women between 25 and 49 were married by 18, and 8pc of women between 20 and 24 gave birth by 18, increasing their risk of poor birth outcomes. Adolescents also have poor access to sexual and reproductive health care: only 13pc of adolescents between 15 and 19 use family planning services and 37pc of women between 15 and 49 receive at least four antenatal visits.

Published in Dawn, January 16th, 2019