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Poor sanitation is stunting children in Pakistan

Ghazala Mansuri's picture
A nutrition assistant measures 1 year old Gullalay’s mid-upper arm circumference (MUAC) at UNICEF supported nutrition center in Civil Dispensary Kaskoruna, Mardan District, Khyber-Pakhtunkhwa province, Pakistan.
With a stunting rate of 38 percent, Pakistan is still among the group of countries with the highest rates of stunting globally and the pace of decline remains slow and uneven. In Sindh, for example, things have worsened over time, with one in two children now stunted. Credit: UNICEF


More than one in every three children born in Pakistan today is stunted.

Child stunting, measured as low height for age, is associated with numerous health, cognition and productivity risks with potential intergenerational impacts.

With a stunting rate of 38 percent (Demographic & Health Survey 2018), Pakistan is still among the group of countries with the highest rates of stunting globally and the pace of decline remains slow and uneven.

In Sindh, for example, things have worsened over time, with one in two children now stunted!

The policy response to this enormous health crisis has been almost entirely centered on interventions at the household level—reducing open defecation (OD), improving household behaviors like child feeding and care practices and food intake.  

A recent World Bank report, which I co-authored, suggests that a major shift is this policy focus is required for significant progress on child stunting.

The report begins by showing that over the past 15 years Pakistan has made enormous progress in reducing extreme poverty, with the poverty rate falling from 64 percent to just under 25 percent in 2016.

This has improved dietary diversity, even among the poorest, and increased household investment in a range of assets, including toilets within the home.

This has, in turn, led to a major drop in OD, from 29 percent to just 13 percent. Curative care has also expanded, with the mainstreaming of basic health units and the lady health worker program.
 

Agriculture holds the key to tackling water scarcity

Rimma Dankova's picture

Agriculture is both a victim and a cause of water scarcity. Water of appropriate quality and quantity is essential for the production of crops, livestock, and fisheries, as well as for the processing and preparation of these foods and products. Water is the lifeblood of ecosystems, including forests, lakes, and wetlands, on which the food and nutritional security of present and future generations depends. At the same time, agriculture is the largest water user globally, and a major source of water pollution. Unsustainable agricultural water use practices threatens the sustainability of livelihoods dependent on water and agriculture.

Additionally, climate change will have significant impacts on agriculture by increasing water demand, limiting crop productivity, and reducing water availability in areas where irrigation is most needed or has a comparative advantage. A growing number of regions will face increasing water scarcity. Climate change will bring greater variation in weather events, more frequent weather extremes, and new challenges requiring the sector to take mitigation and adaptation actions.

Why water presents special challenges: a brief rationale for water resource economics

Susanne M. Scheierling's picture
Photo: Christopher Walsh/World Bank Group

For the first time, the International Water Resource Economics Consortium (IWREC) held its annual meeting at The World Bank from September 7-9, 2014. The meeting, an annual gathering of water economists, serves as a place to exchange the latest information and research findings in the field.