A new World Bank report paints a grim picture of efforts undertaken over the last two decades to tackle stunted growth in children.
Rates of diarrhea and related stunting in children have remained constant in Pakistan over the past 15 years despite substantial decline in poverty, says the study titled When Water Becomes a Hazard: A Diagnostic Report on the State of Water Supply, Sanitation and Poverty in Pakistan and Its Impact on Child Stunting.
While the report acknowledges significant differences in progress made in terms of poverty reduction across districts as a factor here, it lays most of the blame on the successive governments’ singular focus on elimination of open defecation. It stresses that efforts for safe management of fecal waste or provision of quality latrines have remained conspicuous by their absence. According to the World Bank, this has resulted in unprecedented concentration of untreated fecal waste near human settlements, often disturbingly near wells and water pumps.
The report goes on to say levels of E.Coli contamination observed in groundwater sources is shockingly high. This has sustained high levels of diarrhea and creates the perfect setting for environmental enteropathy.
The report highlights that had there not been a significant decline in poverty levels (64 percent in 2001 to 30 percent in 2014), the levels of stunting, diarrhea and related types of morbidity would most likely have risen rather than remain constant. The decline in poverty levels has been coupled with increased access to Water, Sanitation and Hygiene (WASH) infrastructure. Resultantly, open defecation reduced by more than 50 percent. Reduction in poverty levels has also resulted in increased dietary diversity, which has gone a long way in terms of keeping stunting levels at bay.
However, this only goes to show how much progress has been squandered because of lack of public investment in waste management.
Khyber Pakhtunkhwa has seen the most significant reduction in poverty, followed by Punjab and Sindh. Balochistan remains the country’s poorest province with a headcount poverty rate of approximately 57 percent in 2014.
Within provinces however, rural areas continue to lag behind urban areas not only in terms of access to WASH infrastructure, but also education, which is a significant factor in the prevalence of hygiene-related disease.