I ask myself what is that I can do today for women and girls around the world. And every night I count how many things I did and that’s what give me the optimism and hope, that, if many many people, millions of people around the world who are in a position to help, all come together and think in the same way, then we will in our lifetime see women and girls lives get much better then they are today “.
These lovely words of OPTIMISM and HOPE are by Dr Anita Zaidi president Gender Equality Division at Gates Foundation, USA
The above quote is quite relevant to the issue of malnutrition. In true sense mothers are responsible for infant mortality, yes mothers who were girls before becoming mothers and have been undernourished during childhood.
” Malnutrition have been severe chronic issue among mothers and children in the country overall and in Rural Sindh specifically. This is supposedly be the primary cause of stunting in children under five (5 ) years of age. The rate is as high as around 50 % .It remain a crucial health emergency even today in the year 2026 ,as critical as it was in previous years 2024-25 and even before. Seem it’s been forever, since economists started showing or taking interest in issues of malnutrition in underprivileged rural areas of Pakistan. The underline motives have been and still are: poverty eradication, food insecurity, health issues and education. Generally researchers keen interest have been to find the grass root causes of malnutrition and under nutrition. Almost 50 percent of children under the age of 5 years suffering from malnutrition. Strange enough the data recorded same percentage equal to around 50 percent of children are stunted . Stunting refer to a physical disorder which stop the normal growth of children. The reasons identified are majorly socioeconomic disparities.
Perhaps in extreme poverty driven rural areas there are multiple causes and determinants that end in stunting as a result of malnutrition. Hunger the main cause followed by clean drinking water. Absence of clean drinking water is a home of many diseases, most common is diarrhoea. Non availability of proper clinics or doctors and or even medicines. Where there are clinics but no doctors or medicines. Only untrained midwives present to take care of patients. Hence , lack of basic health care facilities a serious cause. Around 20 percent children are victim of malnutrition of acute nature. It can even result in life failure. When compared with urban households, the estimated figures show atleast
41 percent of rural households are counted underweight.
Education in this part reveal terribly low figures. For girls and women almost equal to zero. With such lows in education how one can even dream of going to school, let alone high education and reasonable employment. This conclude to a relationship as, with reasonable income food insecurity is low and visa versa. No or low food insecurity, hunger, malnutrition all depends upon the earnings of the head of the household or family income. A reasonable employment is the outcome of education. When no enough food available to feed offspring’s who can think of sending them to school. In these areas 80 percent schools are ghost schools and some far away. Thus education not easily available rather completely absent. Mothers are the one who mostly face the brunt. Prefer to feed the the young ones, while themselves starve or eat very little. Thus easily prone to anaemia. In a household chose to feed a male child then female child , with a thought he will be the future bread earner of the family. The grass root finding of the child malnutrition is the result of maternal health which happens to directly affect the underweight and premature child birth which never improve due to non availability of required amount of calorie intake in food. Reason extreme poverty as well as due to the absence of health care units. Women easily fall prey to iron deficiency that lead to chronic anaemia. This is alarming cause of high maternal mortality ratio ( MMR ). In Pakistan ( MMR ) is in-between 155 to 186 deaths per 100,000 live births as of 2924 – 2024-25 showing a noticeable decline from 276 during 2006- 2007. It is also noted that daily 27 mothers die due to pregnancy related issues as there is a dearth of qualified doctors and para medical services. Highest figures at 298 per 100,000 in Baluchistan. It is as per government report 224 deaths per 100,000 live births in Rural Sindh. In khyber Pakhtunkhwa the ( MMR ) almost 165 per 100,000 live births whereas in Punjab figures estimated are 157 deaths per 100 ,000 live births. The lowest in the country.
The province of Punjab has shown significant improvement but to reach the Sustainable Development Goals ( SDG) , still remains a challenge to attain as low as 70 per 100,000 live births by 2030 , a tough target.
The infant mortality ratio ( IMR ) estimated during 2025 for Pakistan was around 53 deaths as per 1000 live births.
UNICEF data also indicates gender inequality. As per their estimates male ( IMR ) is higher at 63 per 1000 live births, as compared to female 54 per 1000 live births. Seem strange though.
Recent research findings reveal 675 deaths occur daily. Report for the year 2025 indicate highest ( IMR ) figures as 49 for Punjab and 48 for Baluchistan.
Malnutrition, infections, diarrhoea, respiratory diseases found to be the significant cau5. Along with not only lack but absence of trained birth attendants , incubators .
Basic determinants identified include extreme poverty, absence of clean drinking water, poor sanitation, no or low education of Mother’s, food insecurity… basically absence of heath and education availability.
Few policies that must be practiced in order to improve the health care system and gender equality when it comes to feeding and educating girls. Trained and skilled birth attendants as well as emergency obstetric care units are important factors that help in reducing the number of mother and child death. To attain these results government role is important. It must make sure to invest a reasonable amount under rural health services. Secondly, governance and audit of the funds spent and of the clinics should be designed a regular feature.
With these few policies if implemented sincerely will make the difference noticeable.