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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.
 

Afghanistan’s prosperity rests on investing in its people

Shubham Chaudhuri's picture
Also available in: دری | پښتو
Afghanistan’s prosperity rests on investing in its people
Primary school students are attending their class in northern Balkh Province. Photo credit: Rumi Consultancy/ World Bank

Today, the World Bank Group released the first Human Capital Index (HCI), a new global indicator to measure the extent to which human capital in each country measures up to its full potential.
 
The HCI is part of the World Bank Group’s Human Capital Project intended to raise awareness about the critical role human capital plays in a country’s long-term growth and to galvanize the country’s will and resources to accelerate investments in its people as its most important asset.
 
Afghanistan’s overall HCI indicates it fulfills only 39 percent of its full potential, conceptualized as 14 years of quality education and survival until age 60
 
As dire as this may sound, the overall HCI score places Afghanistan just around a place where it is expected given its income level—in fact, slightly higher than an average low-income country.

د افغانستان سوکالي پر خلکو پانګونې سره تړلې ده

Shubham Chaudhuri's picture
Also available in: English | دری
Afghanistan’s prosperity rests on investing in its people
د بلخ ولایت په یو ښوونځی کې د زده کوونکو حضور. انځور: د رومي مشورتي شرکت/ نړیوال بانک

د نړيوال بانک ګروپ، پر خلکو د پانګونې څرنګوالي په تړاو نن خپل لومړنی راپور خپور کړ، دا نوی راپور په نړۍ کې د هر تن له وړتيا څخه په بشپړ ډول د استفادې پر بنسټ د پانګونې د نړيوالې ځانګړنې کچه ښيي.

پر وګړو د پانګونې ځانګړنى راپور(HCI)، پر وګړو د پانګونې پروژې يوه برخه ده چې د نړۍ په هر هېواد کې د نړيوال بانک ګروپ له لوري د پانګونې د اوږدمهالو پرمختګونو په اړه د خلکو پوهاوي او عامه ذهنيتونو روښانتيا لپاره ترسره کېږي.
د دې پروژې پر بنسټ به هر هېواد و هڅول شي، چې له شته سرچينو څخه ګټه واخلي او دا ګام  به پرخلکو د پانګونې  برخه کې مهم نقش ولوبوي.

د دې راپور د موندونو له مخې، افغانستان پر خپلو وګړو د پانګونې د ځانګړتيا له اړخه يوازې ۳۹ سلنې وړتيا ته رسېدلی دی، چې تر ۱۴ پورې د نيمه لوړو زده کړو تحصيلي درجه او تر ۶۰ کلونو پورې د ژوند کچه ښيي.

پر وګړو د پانګونې ځانګړتيا راپور له مخې، افغانستان په داسې موقعيت کې ځای لري، چې د دې هېواد اقتصادي وضعيت سره اړخ لګوي، دا په داسې حال کې ده، چې افغانستان د نورو لږ عايد لرونکو هېوادونو په پرتله څه ناڅه لوړه درجه کې ځای لري.

رفاه افغانستان مستلزم سرمایه گذاری بالای مردم است

Shubham Chaudhuri's picture
Also available in: English | پښتو
Afghanistan’s prosperity rests on investing in its people
حضورشاگردان در یکی از مکاتب ابتدایی ولایت بلخ.  عکس: شرکت مشورتی رومی/ بانک جهانی

گروپ بانک جهانی، امروز نخستین گزارش شاخص سرمایه گذاری بالای مردم را منتشرنمود. این گزارش جدید شاخص بین المللی میزان سرمایه گذاری را نظر به استفاده مکمل ظرفیت هر فرد در کشور های جهان نشان میدهد.

گزارش شاخص سرمایه گذاری بالای مردم (HCI) بخش از پروژه سرمایه گذاری بالای مردم میباشد، که توسط گروپ بانک جهانی بمنظور اگاهی دهی و روشن ساختن اذهان عامه درمورد نقش پیشرفتهای طویل المدت سرمایه گذاری بالای مردم در هر کشور رویدست گرفته شده است. این پروژه در راستای ایجاد تحرک در هر کشور بخاطر استفاده ازمنابع موجوده برای تسریع روند سرمایه گذاری ها بالای مردم نقش مهم ایفا خواهد نمود.

براساس یافته های این گزارش افغانستان صرف به ۳۹ در صد ظرفیت بل القوه خود در شاخص سرمایه گذاری بالای مردم رسیده، که نشاندهنده ۱۴ سال تعلیم و زنده گی تا سن ۶۰ سالگی میباشد.
 
افغانستان در گزارش شاخص سرمایه گذاری بالای مردم تقریبا در رده (جایگاه) قرار گرفته که کاملاً مطابقت به وضعیت عینی اقتصادی این کشور دارد. این در حالیست که این کشور در جایگای کمی بالا تر در مقایسه با سایر کشور های داری عاید پایین همچون افغانستان قرار گرفته است.

Investing in people of South Asia for prosperity and quality of life

Hartwig Schafer's picture
A little girl in Balochistan, Pakistan, who now receives a quality education thanks to World Bank support. 
A little girl in Balochistan, Pakistan, who now receives a quality education thanks to World Bank support. Credit: World Bank 

Human capital – the potential of individuals – is going to be the most important long-term investment any country can make for its people’s future prosperity and quality of life.

Just look around the world: Technology is reshaping every industry and setting new demands for skills in every profession. The frontier for skills is moving faster than ever before.

To meet that challenge and be able to compete in the global economy, countries need to prepare their workforces now for the tremendous challenges and opportunities driven by technological change.  

To that end, the World Bank will launch next week its highly anticipated Human Capital Index to measure countries’ contribution of health and education to the productivity of the next generation of their workers.

The Index will be released on October 11 at the Bank’s Annual Meetings in Bali as part of the Human Capital Project, a global effort led by the Bank to accelerate investments in people for greater equity and economic growth.

No doubt, any country ranking gets high visibility and, sometimes, meets controversy. But I hope it triggers a dialogue about policies to promote investments in people.

To be clear, the important purpose of the Human Capital Index is to measure the distance of each country to the highest standard of complete education and full health—or the “frontier”.

The index, irrespective of whether it is high or low, is not an indication of a country’s current policies or initiatives, but rather reflects where it has emerged over years and decades.

Put simply, the index measures what the productivity of a generation is, compared to what it could be, if they had benefitted from complete education and good health.

The index ranges from 0 to 1 and takes the highest value of 1 only if a child born today can expect to achieve full health (defined as no stunting and survival up to at least age 60) and complete her education potential (defined as 14 years of high-quality school by age 18).

Clean and Green Bangladesh: A goal that can be achieved

Karin Erika Kemper's picture
 

"Think before you do, not after you're done,” says a Bengali proverb that applies to an urgent threat today for Bangladesh—major environmental problems spawned by rapid urbanisation and industrialisation. A decade of strong economic growth helped Bangladesh reach lower middle-income status while sharply decreasing its poverty rate, a remarkable achievement. But like many countries in the world, such progress has come at considerable environmental cost.

According to our just released report, "Country Environmental Analysis", Bangladesh is among the countries most affected by pollution and other environmental health risks. The monetary cost to the Bangladeshi society of environmental degradation in urban areas, measured in terms of foregone labour output was equivalent to about one percent of the Gross Domestic Product (GDP) annually.  If one takes into account the broader welfare impacts of mortality attributed to environmental risks, the economic cost is equivalent to 3.4 percent of the national GDP. Noncompliant industries and inadequate waste management of hazardous and nonhazardous materials are polluting the cities' air as well as surface and ground water. The study also indicated that many rivers around Dhaka are polluted.

Afghanistan makes better nutrition a priority

Michelle Mehta's picture
Also available in: دری | پښتو
Community based, preventative approaches to health care will improve stunting and wasting outcomes for Afghan children
Community based, preventative approaches to health care will improve stunting and wasting outcomes for Afghan children.  Photo Credit: Rumi Consultancy/ World Bank

Last year, Afghanistan became the 60th country to join Scaling Up Nutrition (SUN), a global movement to end malnutrition, and thus signaled its strong commitment to invest in a better future for its citizens.

This engagement comes at a critical time as more than 40 percent of Afghan children are currently stunted—or of low height for their age.

Stunting in early life is a marker of poor child growth and development and will reduce their potential to contribute toward their country’s growth and prosperity.

On the other hand, a well-nourished child tends to complete more years of schooling, learns better, and earns higher wages in adulthood, thereby increasing the odds that he or she will escape a life of poverty.[1] 

As such, Afghanistan stands to gain enormous benefits by reducing stunting, which in turn can help boost its economic growth, productivity, and human capital development.

To help the Afghan government invest in better nutrition, the South Asia Food and Nutrition Security Initiative (SAFANSI), the Ministry of Public Health (MoPH), World Bank and UNICEF have partnered to determine what it would take to reach more children, women, and their families and provide them with essential nutrition services that would ultimately reduce stunting and anemia.

تغذي بهتر یکی از اولویت های افغانستان

Michelle Mehta's picture
Also available in: English | پښتو
Community based, preventative approaches to health care will improve stunting and wasting outcomes for Afghan children
اتخاذ تدابیر پیشگیرانه در زمینه مراقبت های صحی مبتنی بر نیاز های مردم میتواند نتایج ناگوار ناشی از رُشد و نموی بطی اطفال و نارسایی های صحی آنها را بهبود بخشد. عکس: شرکت مشورتی رومی/ بانک جهانی

در سال گذشته میلادی افغانستان شصتمین کشورجهان بود، که شامل حرکت جهانی محو سوء تغذی گردید. با اتخاذ این تصمیم، این کشور تعهد قوی خویش را در راستای سرمایه گذاری به منظور تأمین آیندۀ بهتر برای شهروندان اش نشان داد.

شمولیت افغانستان در این حرکت جهانی در زمان خیلی حساسی صورت گرفته، زیرا بیشتر از چهل در صد کودکان افغان از رُشد و نمو مطلوب باز مانده اند و مصاب به سوء تغذی مزمن یا قد کوتاهی میباشند.

باز ماندن از نمو در سن کم نشانه یی از انکشاف و تکامل ناکافی کودکان است که توان مشارکت آن ها را در رشد اقتصادی و پیشرفت کشور شان کاهش میدهد.

از سوی دیگر، کودکی که خوب تغذیه شده باشد، تمایل بیشتر به تحصیل و آموزش داشته، و دروس خویشرا خوبتر فرا میگیرد، که این امر بالنوبه در زمان بلوغ زمینه کسب درآمد بیشتری را برای آنها فراهم میکند. بناً احتمال این که این چنین اطفال با تکامل مراحل نمو و شرایط مساعد تغذی از فقر رهایی یابند، بیشتر میگردد.[1]

در نتیجه میتوان گفت که با کاهش مشکلات رُشد و نموی کودکان، دولت افغانستان میتواند فواید زیادی را حاصل کند که  دست یابی به این هدف به نوبۀ خود به رشد اقتصادی کشور، افزایش تولیدات و انکشاف سرمایۀ بشری کمک میکند.
جهت کمک به دولت افغانستان در سرمایه گذاری بالای تغذی، نهاد جنوب آسیا برای مصؤنیت غذایی و تغذیه ، وزارت صحت عامه، بانک جهانی و صندوق حمایت از کودکان سازمان ملل متحد  (یونسیف) در همکاری با همدیگر تلاشهای همه جانبه به خرج میدهند، تا تشخیص نمایند که چگونه میتوانند کودکان، زنان و خانواده های بیشتر را تحت پوش قرار داده، خدمات مورد نیاز را به منظور فراهم سازی تغذی های مطلوب عملی سازند، تا بالاخره میزان کم خونی و رشد ناکافی در کودکان کاهش یابد.

ښه تغذي د افغانستان یو له لومړیتوبونو څخه

Michelle Mehta's picture
Also available in: English | دری
Community based, preventative approaches to health care will improve stunting and wasting outcomes for Afghan children
د روغتیا پالنې په برخه کې د خلکو د اړتیاوو پر بنسټ د مخنیونکو تدابیرو نیول کولاۍ شي د ماشومانو د پڅې ودې او د هغوی د روغتیايي نیمګړتیاوو له امله ناوړه اغېزو کې ښه والۍ راولي. انځور: د رومي مشورتي شرکت/ نړیوال بانک

افغانستان شپېتم هېواد وو چې تېر کال د خوارځواکۍ د له منځه وړلو د نړیوال خوزښټ سره مل شو. د خلکو لپاره د یوې سوکاله او غوره راتلونکې د برابرولو لپاره دغه هېواد د دغه تصمیم په نیولو سره خپل پیاوړۍ هوډ کې څرګند کړ او دا پانګونه ېې خورا اړینه وبلله.
 
په دغه نړیوال خوخوزښټ کې د افغانستان ګډون په خورا حساس وخت کې ترسره شوی ده، ځکه له څلوېښت سلنې زیات افغان ماشومان اړینه وده نلري او په مزمنه خوارځواکۍ اخته دي او یا ټیټ قدونه لري.
 
په لږ عمر کې له ودې څخه پاتې کېدل د ماشومانو د ناکافي تکامل او ودې بېلګه بلل کېږي، چې د هېواد د اقتصادي ودې او پرمختګ لپاره د هغوی د مشارکت ځواک راکموي.
 
له بلې خوا، هغه ماشوم، چې ښه تغذیه شوی وي، تحصیل او زده کړو ته زیاته لېوالتیا لري، او خپل درس ښه زده کوي، چې دا په خپل وار سره د ځوانۍ په مهال د هغه لپاره د زیات عاید د ترلاسه کولو زمینه برابروي. له همدې کبله دا احتمال، چې دغه شان ماشومان د ودې د پړاونو په بشپړولو او د تغذېې لپاره د وړ شرایطو پوره کولو سره له بېوزلي څخه وژغورل شي، زیاتېدونکی ده.[1]

Are Pakistan’s urban professional women immune to sexual harassment?

Saman Amir's picture

Woman face harassment in all type of jobs, no matter where or who. One can’t say that she works in a big firm so she is safe… [but] she doesn’t know who will believe her if she reports harassment – she… fears that the others will say she is asking for it.  Thus, she doesn’t say anything.” -Young working woman in Quetta.

This statement was echoed by 93 educated women of all ages in the Pakistani cities of Quetta, Peshawar, Lahore, and Karachi.

In the era of the #MeToo Movement, focus group discussions with these women affirmed that sexual harassment continues to be a part of the experience of urban educated Pakistani women seeking jobs.
 
The good news is that there’s legislation to protect against harassment, the bad is that few know about it and fewer feel comfortable reporting harassment.

For employed women, sexual harassment disrupts careers and dampens professional potential; its fear can deter women from entering the labor force at all.

We explore this as part of a study on female labor force participation in Pakistan with the Center for Gender and Policy Studies and support from the Pakistan Gender Platform. 

The women we spoke with talked about experiencing sexual, physical, verbal, non-verbal or psychological harassment at the hands of supervisors, senior staff members and colleagues, as well as strangers in public transport and spaces.

They also highlighted cyberstalking, staring, phone numbers being leaked, lewd comments, stalking in public places and harassment on public transport as common occurrences, and that such harassment occurs regardless of a woman’s age or socio-economic status.

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