KARACHI: Speakers at a policy dialogue to discuss malnutrition in Sindh on Wednesday said the largest stakeholder of the rising malnutrition was the feeble child who unlike the stakeholders in other sectors facing deficiencies had no voice to be heard by people at the helm.

`The area of nutrition in Sindh and the rest of the country is highly neglected, finding ownership from nowhere. The child who suffers from malnutrition is the largest stakeholder, does not raise the voice, because the child could not raise the voice for being denied its basic rights,` said Haris Gazdar, a senior researcher, at the workshop organised by the Save the Children at a hotel.

He spoke about `feminisation` of agriculture showing that more than 74 per cent of workforce in agricul-ture was women. He said a woman who was tasked to work in fields and at home was solely made responsible to take care of the nutrition of her children as well. He said it was extremely difficult for a woman, already entangled with poverty and male dominance, to find time to keep her child healthy besides contributing to family`s economic needs.

`We need social change to face all these issues successfully. Nutrition, in particular, is something which has no direct link unlike other issues.

And it has to be interpreted in an easy-to-fathom manner to combat it effectively.

Mr Gazdar said malnutrition was an issue closely linked with governance and political economy and its complexity could be unfolded through research and dialogues. He said politicians, policy makers, the media and stockholders must work together to deal with food insecurity and malnutrition.Iqbal Detho, a provincial manager of the Save the Children, shared objectives of the seminar and said malnutrition should be debated as a national issue and should receive attention of policy makers, legislators, civil society and the media.

Dr Irshad Danish, also from the host organisation, said Pakistan, particularly Sindh, was facing a silent crisis of malnutrition that was among the worst in the world and had not improved for decades. He said the malnutrition crisis in Pakistan was estimated to cost the economy 3pc of the GDP.

He said about half of the children in Pakistan were malnourished.

Sharing findings of the National Nutrition Survey 2011, Dr Shabina Ariff, a consultant neonatologist, said Sindh, with just under a quarter of Pakistan`s population, had a dangerously high rate of nutritional stunting among children under five (49.8pc.) She said the prevalence of underweight children in Sindh was40.5pc, while wasting prevalence was 17.5pc.

`These figures have not changed significantly in the past decade, said Dr Ariff. She said unlike many other areas in South Asia, there were no significant differences in the nutritional status of young girls and boys in Sindh. Only 52.5pc of women in Sindh had normal body mass index, while 23.7pc were underweight and 24pc overweight or obese.

Dr Saifullah Jamro, dean of the paediatrics department, Chandka Medical College Larkana, said malnutrition made children prone to acquiring communicable diseases such as measles and exacerbated their complications. He said malnutrition also reduced effectiveness of certain vaccinations. He said if Pakistan implemented health sector interventions to address malnutrition, rates of stunting (chronic malnutrition) could be cut by one-third.

Dr Salma Shaikh of the LiaquatMedical University said poverty was not the only reason behind child malnutrition in the country.

Dr Asif Iqbal, nutrition manager of the Save the Children, shared initiatives of his organisation taken in the flood-affected areas of Sindh through shortand long-term interventions. The Save the Children is committed to supporting the government to combat malnutrition in Sindh, said Dr Iqbal.

Dr Iqbal Memon, a senior paediatrician, warned of a serious risk for the country to suffer from a `demographic nightmare` of an increasingly unskilled and economically unproductive population if Pakistan failed to address the issue of malnutrition.

He asked the provincial government to focus on the implementation of the Sindh Protection of Breastfeeding and Young Child Nutrition Act 2013. He said Pakistan produced more wheat than ever, yet malnutrition rates were static.