Background

Stuntingor low height for ageisan affected physical growth of children with effects largely irreversible and resulting from consistent maternal and newbornmalnutrition. The World scenario indicates that out of 128 countries Pakistan’s position is 14th with 44% country wide prevalence of stunting. Afghanistan is at the top with 55% rate of prevalence of stunting. Most stunting happens during the 1,000-day period that spans from conception to a child's second birthday. The first 1000 days in a child's life are a crucial "window of opportunity" because the brain develops rapidly, laying the foundation for future cognitive and social ability. The three main causes of stunting in most developing countries are Poor/ inadequate infant and young child feeding practices, poor maternal health & nutrition and poor sanitation resulting in diarrhea/ infections in child, contribute to child stunting.

Malnutrition in Sindh is a silent catastrophe affecting nearly half its children and mothers. According to the National Nutrition Survey (NNS 2011) the malnutrition levels across Sindh are above the cut-off for a serious public health problem [wasting=17.5%, and stunting=49.8%]. Moreover, iron deficiency Anemia women and children are at levels of severe public health significance in Sindh [women=62% & children=73%]. Moreover, more than 70 per cent of mothers in Sindh are Vitamin D deficient. These problems of poor nutrition are compounded by severe food insecurity and poor food intake, particularly by women, girls and children less than 5 years of age.

The WHO guidance indicates that stunting beyond 15% is emergency threshold. Accordingly, stunting prevalence in Pakistan, especially in Sindh, has crossed far emergency point.