Making ‘nutrition’ integral to Pakistan’s COVID-19 response measures

Author: Dr Shabina Raza

As the world continues to respond to the ongoing COVID-19 pandemic, a second crisis – a malnutrition crisis – threatens to stymie those efforts and undo decades of development progress and accomplishments. Without the right nutrition, immune systems are compromised and resistance to disease falls. Focusing on nutrition now is critical to help Pakistan overcome the current crisis and strengthen the health and wellbeing of its people.

Even before the pandemic, the country’s most vulnerable populations were being impacted by the triple burden of malnutrition – the coexistence of undernutrition, overnutrition and micronutrient deficiencies. In Pakistan, as much as 20-30% of people face some form of food insecurity. With 2.5 million children who are severely malnourished, Pakistan has one of the highest stunting rates globally at 38%. A quarter of the population live below the national poverty line and the country loses US$ 7.6 billion annually to undernutrition.

Ensuring the availability of nutritious and safe foods and restarting essential health and nutrition services in a safe manner must be a top priority of the resilience building and recovery phase of Pakistan’s COVID-19 response

While efforts to control the spread of COVID-19 have worked well and the country is currently seeing a reduction in cases, the public health system, food production and supply mechanisms continue to grapple with severe challenges. The lockdowns and reduced employment opportunities have also impacted consumption patterns, with many people turning to the cheapest but least nutritious options. During strict lock down, a limited turnover of clients for antenatal care and restricted mobility of front line health workers for household visits led to interrupted Iron Folic Acid supplementation. Similarly, a pilot intervention on weekly iron folic acid supplementation for in-school adolescent girls remained on hold due to closure of schools resulted in gaps in reaching adolescent girls in rural areas. Additionally, supervision and monitoring of health and nutrition interventions were also affected due to restricted travel. Suspended nutrition programs and disrupted food security meanmillions of women and children are in dire need of nutrition support.

State-level efforts to revive nutrition strategiesare crucial in order to ensure that the population can access not just “food” that fills their stomach, but rather the food that contains the micronutrients that will help them build immunity to fight diseases. Ensuring the availability of nutritious and safe foods and restarting essential health and nutrition services in a safe manner must be a top priority of the resilience building and recovery phase of Pakistan’s COVID-19 response. This can be done by adjusting social protection schemes to include the distribution of nutritionally-balanced rations. To succeed, it is important tosustain and increase budgetary allocations in nutrition-specific and nutrition-sensitive sectors, aimed at reaching the most vulnerable households who have been directly or indirectly affected by the pandemic.

While the country continues the battle against COVID-19, including addressingthe threat to food security, it is critical that we not neglect the ‘hidden hunger’ that comes as a result of insufficient nutrition. Food security programs are important, but they prioritize availability, access and affordability of a limited range of staple foods. Nutrition programs focus on getting the right nutrients into the body at the right time, ensuring people can survive and thrive. The goal must be people’s nutrition security, of which food security is just one component. Neither approach can stand alone, the two must work together to strengthen the health and wellbeing of individuals, communities and the country.

The writer is Country Director, Nutrition International Pakistan

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