In Pakistan, the nutritional status of children under five years of age is extremely poor.
At a national level almost 40% of these children are underweight. Over half the children are affected by stunting and about 9% by wasting. A positive relationship exists between the age of the child and the prevalence rates of stunting and underweight. There are significant provincial variations in malnutrition rates in Pakistan, whereas no differences in malnutrition rates are apparent between sexes. The prevalence of stunting appears to be associated with the overall level of development of the provinces, being lowest in Punjab and highest in Balochistan, the least developed province.
The anthropometric deficits are systematically higher in rural areas probably due to the lower socio-economic status and to very poor access to basic health services.
According to the nation-wide food consumption surveys conducted in Pakistan, the average daily per caput energy intake covered the daily requirements in the periods 1984-85 and 1987-88. Unfortunately, since no recent nation-wide food consumption surveys are available, no information on the adequacy of present food consumption can be given.
In the Pakistani diet cereals remain the main staple food providing 62% of total energy. Compared to other Asian countries, the level of milk consumption is significant in Pakistan, whereas the consumption of fruits and vegetables, fish and meat remains very low. The consumption of fruit and fresh vegetables, which are highly dependent on local seasonal availability, is also limited by the lack of organised marketing facilities throughout the country. Fluctuations in the availability of these important foods is likely to be one of the factors responsible for the micronutrient deficiency disorders observed in Pakistan.
Food consumption is just one of the multiple factors which interact and have an impact on the nutritional status of the overall population. Other important influences include morbidity, poor coverage of health infrastructures and socio-economic factors.
Since Pakistan's independence (1947), the provision of health infrastructures has improved over time but remains inadequate particularly in rural areas. The under-five mortality rate, an important index of health and nutritional status of a community, is high by international standards: 137 for 1,000 births. A large number of infectious diseases such as respiratory and intestinal infections remain responsible for up to 50% of deaths of children under five, with malnutrition being an aggravating factor especially in the most populated areas.