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Food security, Hunger and Nutrition in Sindh

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Presentation by Haris Gazdar at the Seminar on 'Food security, hunger & nutrition' hosted by the Planning & Development Department, Sindh and EU PFM-SPP

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Food security, Hunger and Nutrition in Sindh

  1. 1. Food Security, Hunger and Nutrition in Sindh: Concepts, Situation and Policies Haris Gazdar 14 February 2018
  2. 2. Overview • Concepts • Indicators • Situation • Linkages between Food Security, Hunger and Nutrition • Policy
  3. 3. Concepts • Hunger • Experience of hunger and vulnerability • Discounted because ‘subjective’, but critically important, I will argue • Food Security – FAO definition • ‘a situation that exists when all people, at all times, have physical, social and economic access to sufficient, safe and nutritious food that meets their dietary needs and food preferences for an active and healthy life’ • Nutrition – WHO definition • ‘Nutrition is the intake of food, considered in relation to the body’s dietary needs. Good nutrition – an adequate, well balanced diet combined with regular physical activity – is a cornerstone of good health. Poor nutrition can lead to reduced immunity, increased susceptibility to disease, impaired physical and mental development, and reduced productivity.’ • Historical associations • Famine and starvation deaths – preventing these is part of legacy of statecraft • Shortages, price spirals, hoarding – preventing these is current ‘social contract’ in Pakistan • Need to go beyond these if not addressing food security, nutrition, and hunger
  4. 4. Concepts • Focus on individual wellbeing • In place of national, provincial, or community • Emphasis on situation of households, and what happens within households • From output to consumption • Whether, to what extent, and how, food needs are met • Own production, market, welfare, charity • From consumption to nutritional outcomes • Physical wellbeing – depends on dietary adequacy AND (public) health • Framing food security as ‘right to food’ • Making policy responsible for expansive definition of food security
  5. 5. Indicators and data • Food intake • Household or individual • Recall data in household surveys • Dedicated dietary intake surveys • Subjective experience of hunger and food insecurity • Anthropometrics • Measurement of physical attributes • Weight, height, mid-upper arm circumference (MUAC) • Blood sample examination
  6. 6. Energy deficiency Daily caloric intake up to 2005-06 2007-08 2010-11 2011-12 1500 kcal 10.9 10.2 7.0 9.2 1800 kcal 24.9 25.5 20.9 24.2 2000 kcal 36.7 38.0 33.9 39.1 2150 kcal 46.3 48.3 44.6 50.7 2500 kcal 66.3 69.2 67.5 72.5 Distribution (per cent) of population by daily energy intake – kcal per adult equivalent Source: Author’s calculations based on HIES, several rounds
  7. 7. Total Cereal Non-cereal N All 2,232 1,178 1,054 15785 Urban 2,072 1,008 1,064 6729 Rural 2,312 1,263 1,049 9056 All (poorest) 1,751 1,056 695 1578 Urban (poorest) 1,652 986 666 672 Rural (poorest) 1,715 1,042 673 905 Energy intake by found source (kcal per adult equivalent per day) for various population groups, 2011-12 Source: Author’s calculations based on HIES, 2011-2012 Poverty and Energy Intake, Dietary Diversity
  8. 8. Subjective Experience of Hunger and Vulnerability to Hunger • Qualitative research • “Hungry days”: days when adults or adults as well as children have gone hungry • “Nothing to eat”: literally no food; only roti; roti with black tea; roti with chillies chutney; roti with milk/lassi • “Good days”: potatoes; other vegetables; lentils; meat • Various indices based on recall • Not just actual experience of hunger, but also experience of fear of going hungry
  9. 9. Food security status by province (per cent) Source: National Nutrition Survey 2011 Self-Reported Food Insecurity Food secure Food insecure without hunger Food insecure with moderate hunger Food insecure with severe hunger Pakistan 42.0 28.4 19.8 9.8 Punjab 40.5 32.2 18.5 8.8 Khyber Pakhtunkhwa 68.5 21.0 6.0 4.5 Balochistan 36.5 33.9 18.0 11.5 Sindh 28.0 21.1 33.8 16.8
  10. 10. Policy and Food Economy of the Poorest National framework • Focus on some essential foods – primarily wheat • Producer incentives • Ensure market availability and price stability • No concept of a right to an adequate diet Hunger vulnerable population • Livelihood revolves around acquisition of main staple • Non-producers • Non-market sources of food • ‘Right to food’ interpreted as ‘who deserves to be fed?’ – men, women, children
  11. 11. Hunger and Nutrition – naïve view FOOD AVAILABILITY FOOD CONSUMPTION NUTRITION Sectors implicated: • Agriculture
  12. 12. Hunger and Nutrition – realistic view ECONOMIC OPPORTUNITY FOOD SECURITY NUTRITION PUBLIC ACTION HEALTH+ CARE+ WOMEN’S EMPOWERMENT FOOD ABSORPTION Sectors implicated: • Agriculture • Health • Social Protection • Women’s Development
  13. 13. Source: Pakistan Demographic and Health Survey 2012-2013 Stunting and wasting in children under 5 years Stunting Height-for-age Wasting Weight-for-height Pakistan 44.8 10.8 Punjab 39.8 9.5 Khyber Pakhtunkhwa 41.9 12.0 Sindh 56.7 13.6 Urban 46.1 12.8 Rural 63.3 14.0 Anthropometrics
  14. 14. Source: Pakistan Demographic and Health Survey 2012-2013 Infant and young child feeding practices Among breastfed children 6-23 months, percentage fed: Among non-breastfed children 6-23 months, percentage fed: 4+ food groups Minimum meal frequency Milk or milk products 4+ food groups Minimum meal frequency Pakistan 19.7 55.3 74.7 29.5 84.6 Punjab 19.3 48.8 83.7 29.3 87.2 Khyber Pakhtunkhwa 17.9 61.5 40.3 35.5 77.6 Balochistan 8.8 61.3 63.4 10.1 73.3 Sindh 23.7 63.8 70.8 29.1 84 Urban 26.2 69.7 82.3 33.5 89.3 Rural 22.2 60.1 59.1 24.7 78.6
  15. 15. Stunting Wasting Overall 45.33 12.36 Cotton picking Yes 53.75 15.28 No 42.03 11.26 Nutritional status of children by mother’s work Source: Women’s Work and Nutrition survey, CSSR and LCIRAH, 2016 The relationship between women’s work in agriculture and mother-child nutrition Findings from WWN survey Women’s work and nutrition is a longitudinal study for LANSA (Leveraging Agriculture for Nutrition in South Asia) research in Pakistan which investigates the impacts of women’s work in agriculture on their own and their children’s nutrition in rural areas of Sindh. The survey was conducted with over 1,000 mother-child dyads, in canal-irrigated areas of Sindh province. Leveraging Agriculture for Nutrition in South Asia is a multi-country research consortium funded by the Department for International Development (DFID) UK; however, the views expressed do not necessarily reflect the UK Government’s official policies.
  16. 16. Source: Pakistan Demographic and Health Survey 2012-2013 Nutritional status of women Total normal BMI (18.5- 24.9) Total thin (BMI <18.5) Total over-weight or obese (BMI ≥25.0) Pakistan 45.9 13.9 40.2 Urban 38.2 7.4 54.3 Rural 49.9 17.1 33.0 Punjab 43.6 13.9 42.5 Khyber Pakhtunkhwa 43.4 6.3 50.3 Balochistan 55.9 9.0 35.1 Sindh 51.0 19.6 29.4 Double Burden of Malnutrition
  17. 17. Cycle of Hunger and Undernutrition – Rural Sindh Leveraging Agriculture for Nutrition in South Asia is a multi-country research consortium funded by the Department for International Development (DFID) UK; however, the views expressed do not necessarily reflect the UK Government’s official policies. POVERTY LOW BIRTH WEIGHT HOUSEHOLD FOOD INSECURITY LOW MATERNAL BMI WOMEN’S WORK – LONG HOURS LOW PAY CHILD UNDERNUTRITION Over 40% children already stunted at baseline – more whose mothers were cotton workers Over 60% stunted at endline WWN – baseline children aged 0.5-3 months – endline same children 10-12 months 60% mothers worried about family not having enough to eat in last month – 12% for over 10 days in a month Need to break cycle of hunger, work, low BMI, child undernutriition Over 80% women worked while pregnant, over 30% in strenuous jobs like cotton harvesting
  18. 18. Conclusions • Hunger remains a major issue, as well as food insecurity • Food security needs to be framed with primary focus on individual vulnerability • Much broader issue than that of food availability • Rural women bear the burden of food insecurity – cycle of hunger and undernutrition • Existing policy framework too narrowly-focused on output and preventing price volatility • Needs rights-based approach and placing women at the centre of the policy paradigm
  19. 19. Ways forward National • Right to food framework in place of present social contract around price stability • Embedding food security into social protection system rather than only agriculture • Reform of government intervention in wheat economy, starting with acknowledgement that it does not ensure food security Provincial • Incorporate more nuanced understanding of linkages between hunger, food insecurity and nutrition • Use existing platforms such as AAP to identify and break cycles of hunger of malnutrition • Recognition of women agricultural workers and provincial legislation and programmes for their rights and wellbeing

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