Understanding the Extent of Undernourishment in Pakistan
Undernourishment, a specific form of malnutrition caused by insufficient calorie intake, has long been a serious concern in Pakistan. Beyond the 2022 figure of 20.7% prevalence, more recent assessments paint a complex and challenging picture. In February 2025, an IPC analysis revealed that a significant portion of the population in flood-affected districts of Balochistan, Sindh, and Khyber Pakhtunkhwa faces high levels of acute food insecurity. This reflects not only chronic issues but also acute vulnerabilities exacerbated by climate shocks.
Undernourishment is just one part of Pakistan's broader nutrition challenge. The country faces a 'triple burden' of malnutrition, which includes high rates of undernutrition alongside an emerging trend of overweight and obesity. This dual problem adds complexity to public health interventions, as strategies must address deficiencies while also promoting healthy eating habits to prevent overnutrition.
Key Drivers of Undernutrition in Pakistan
The factors contributing to high rates of undernutrition are multifaceted, extending beyond just food availability to include issues of access, utilization, and stability.
Economic and Social Factors
- Poverty and Low Purchasing Power: For many of the poorest households, income is insufficient to purchase a diverse and nutritious diet, especially with persistent food inflation. A significant portion of household income is spent on food, making families highly vulnerable to price fluctuations.
- Food Price Volatility: Economic crises and inflation, amplified by global events, lead to rapid increases in food prices, pushing nutritious options out of reach for vulnerable populations.
- Gender Inequality: Deep-seated social and cultural norms often prioritize food for men and boys, leading to insufficient nutrition for women and girls, particularly among poorer families. Poor maternal nutrition is a leading cause of child malnutrition.
Health and Maternal Factors
- Inadequate Maternal Nutrition: Malnourished mothers are more likely to give birth to underweight babies, perpetuating the cycle of undernutrition. A lack of awareness about healthy diets for pregnant women is a critical issue.
- Poor Infant Feeding Practices: Despite breast milk being the ideal food for infants, only 38% of children in Pakistan are exclusively breastfed for the first six months. This is exacerbated by a lack of education and resources on proper infant and young child feeding practices.
- Insufficient Healthcare: Limited access to healthcare, especially in rural and remote areas, means that illnesses that can worsen undernutrition, such as diarrhea, often go untreated.
Environmental and Political Factors
- Climate Change and Disasters: Extreme weather events like the severe floods of 2022 and ongoing climate shocks destroy crops, disrupt supply chains, and displace communities, directly impacting food security.
- Political Instability: Internal displacement and general political instability can disrupt livelihoods and access to resources, increasing the vulnerability of populations to malnutrition.
- Inadequate Sanitation and Water: Poor sanitation and access to safe drinking water contribute to illness and infections, which hinder the body's ability to absorb nutrients, even when food is available.
Devastating Consequences of Undernutrition
The impacts of undernourishment in Pakistan are widespread, affecting both individuals and the country's long-term development. These consequences are social, economic, and medical.
Impact on Health
- High Mortality and Morbidity: Undernutrition is a major contributor to high morbidity and mortality rates, particularly among children under five.
- Stunted Development: Children who are stunted (low height for their age) due to chronic undernutrition suffer from long-term cognitive and physical developmental deficits.
- Wasting and Micronutrient Deficiencies: High rates of wasting (low weight for height) and deficiencies in crucial micronutrients like iron, zinc, and Vitamin A are prevalent, leading to increased susceptibility to disease and developmental issues.
Economic Impact
- Reduced Productivity: Lower adult productivity and reduced economic output are direct results of undernutrition. Anemia alone reduces work performance in manual labor by 5-17%.
- Financial Burden: The economic costs are staggering. One assessment estimated the cost of under-5 malnutrition at US$ 7.5 billion annually, or 3% of the GDP, through lost workforce, healthcare expenses, and reduced productivity.
Comparison of Key Nutrition Indicators
| Indicator | NNS 2018 Data | Latest Trends/IPC Analysis |
|---|---|---|
| Child Stunting | Over 40% of children under five | Remains persistently high, hindering SDG progress |
| Child Wasting | 17.7% of children under five | Still extremely high, with emergency levels in some areas |
| Child Underweight | 28.9% of children under five | Remains a serious public health issue |
| Acute Food Insecurity | 36.9% of households food insecure | 22% of population in analysed districts faced high levels Nov 2024-Mar 2025 |
| Maternal Anemia | 49% of women are anemic | Persists, requiring scale-up of targeted programs |
Strategies to Address Undernourishment
Combating undernourishment requires a holistic and multi-sectoral approach that involves government agencies, international partners, and communities.
Key Intervention Areas
- Strengthening Multi-Sectoral Coordination: Integrating nutrition efforts across ministries for health, agriculture, water, and sanitation is crucial to avoid working in 'silos'.
- Scaling Up Targeted Programmes: Initiatives like the Benazir Nashonuma Programme, which provides cash assistance and specialized food to malnourished women and children, are vital for high-risk groups.
- Community Awareness and Education: Educating mothers and communities on proper infant and young child feeding practices, diverse diets, and hygiene can make a substantial impact.
- Improving Food Systems: Focusing on climate-resilient agriculture and improving the efficiency of food distribution can help stabilize food supplies and prices.
- Emergency Response: Due to ongoing climate vulnerability, ensuring that nutrition is part of disaster relief and recovery efforts is critical for populations facing displacement and crop destruction.
Conclusion
Pakistan's struggle with undernourishment is a deeply entrenched problem with severe consequences for its population and economy. While statistics indicate a persistently high prevalence, the issue is compounded by multiple and interconnected factors, from poverty and inflation to climate change and inadequate healthcare. Addressing this requires sustained political will, multi-sectoral cooperation, and targeted interventions that reach the most vulnerable, especially mothers and young children. Progress is possible, but it depends on leveraging partnerships and prioritizing nutrition at all levels of government to build a more resilient and food-secure future for all Pakistanis. UNICEF and other international organizations play a critical role in these efforts.
