An insight into the perpetuating existence of malnutrition in Pakistani women and children

Abstract

Introduction: Malnutrition is a condition that occurs when the body does not get enough nutrients, mainly as a result of an unbalanced diet. Pakistan is a developing country with a high poverty rate which affects the nutritional status of the people. In addition to political and economic instability, Pakistan also hosts many refugees and internally displaced people. Therefore, the magnitude of the problem is large and despite the presence of several policies, the demand for basic nutrition for the citizens is unmet. Gender discrimination and lack of health education are also major contributors to the state of malnutrition in women and children under 5 years of age. Hence, we provide a review of articles to assess the existing reasons behind malnutrition in women and under-five children in Pakistan along with ways to improve the condition. Methods: For this review, 626 articles were reviewed out of which 40 met the inclusion criteria. The abstracts (and the full sources where abstracts were not available) were screened by two authors to identify studies adhering to our objectives. Any argument on selecting studies between these two authors was resolved by a third reviewer. After retrieval of the full texts of all the studies that met the inclusion/exclusion criteria, each study was double data abstracted into a standardized form. The key variables elicited were study setting, location, study design, participants, intervention delivered, and outcome effects. All selected studies were entered into the Endnote XI database. Results: The results from this review showed that up till 2010, the under-five mortality rate was 74 per 1000 and the maternal mortality ratio was 260 per 100,000 live births. Obstetrical hemorrhage causes 42.16% and hypertensive disorders causes 24.63% of the maternal deaths in the country, hence becoming the major reason for these deaths. Vitamin A deficiency was discovered to be high in the females, and consequently, Vitamin A deficiency in children with mothers deficient in this nutrient was high. Zinc and Vitamin D deficiencies were also seen in the female population. The incidence of maternal anemia was 27.1% during pregnancy out of which 10.5% had severe anemia. Conclusion: The review acknowledges that the status of malnutrition is well recognized in the country and the solutions to address the problem are also formulated as policies and strategies. However, due to lack of political will and leadership, implementation and sustainability of health programs fails to address the needs of the affected population. The use of nutritional surveillance system and interventions is imperative for the improvement of the nutritional status of women and children.