Saving children from stunting

Better food, safe drinking water, and hygiene and sanitation help reduce stunting

Fatima Shahryar
A village family from Sindh province, Pakistan looks at the camera as they enjoy some family time on a hot summer day.
Fatima Shahryar

05 April 2019

Khairpur, Pakistan - 5 April 2019: “For past many years, beginning of the summer season meant beginning of a round of stomach and intestinal illness for our children, and us,” says Liaquat Ali, a farmer living in village Loung Soomro of Khairpur district, Sindh. 

“Seasonal illness and infections would really take a toll on us, as my work only helps me earn enough for everyday expenses.”

Village Loung Soomro is a small settlement located in the outskirts of Khairpur District. The village inhabits approximately 90 households and 700 residents, who earn their living through small-scale agriculture and cattle farming. Living in mud houses, most families are poor and have shared spaces, with rooms around joint courtyards.

“Initially, building toilets, maintaining hygiene and consuming nutritious food seemed like fancy ideas, but it was also our last resort to finding a way out of the never-ending cycle of illnesses,” says Liaqat. “We didn’t know the reason but were particularly concerned as more than half of the children in our village are short-heighted. The elderly believed it to be a curse.”

“Seasonal illness and infections would really take a toll on us, as my work only helps me earn enough for everyday expenses.”

Liaqat Ali, a farmer
A husband and wife making dinner preparations for the family in a village in Sindh, Pakistan.
Fatima Shahryar
Liaquat Ali, resident of village Laung Soomro in Khairpur district of Sindh province, pours boiled water in a storage bottle with the help of his wife, Zahida Khatoon.

“Having learned about the ill effects of unsafe water, poor hygiene, lack of nutritious food and improper childcare practices, we are changing our lifestyle and can already feel the difference. My wife is breastfeeding our youngest daughter and we both try to convince others to adopt healthy practices.”

In Pakistan, 38 percent of the children under five years of age are stunted. With one of the highest prevalence in the world, stunting is a rising emergency in the country. The situation is particularly worse in Sindh, where it has affected approximately 50 percent of the children - and the number is increasing.

To address this issue and ensure that all children enjoy their right to a healthy life, UNICEF implemented a stunting reduction programme in close coordination with the Government of Pakistan and with support from the United States Agency for International Development (USAID).

Shazia, a CRP, who organized mother-to-mother groups, has single-handedly led the process of change in the community.

Women and children from a village attentively listen to a UNICEF-supported community resource person speak about nutrition, health and hygiene for their children.
Fatima Shahryar
Shazia, the community resource person in village Laung Soomro of Khairpur district shares key messages with a group of mothers, informing them on importance of Water, Sanitation & Hygiene (WASH) and Nutrition.

“People drank water from the same pond that they bathed their animals in, mothers were unaware of their children’s nutritional status and lifestyle was as unhygienic as it could get."

Shazia, a community resource person

“Two years ago, I could see children defecating in the open,” says Shazia. “People drank water from the same pond that they bathed their animals in, mothers were unaware of their children’s nutritional status and lifestyle was as unhygienic as it could get. Bringing about any change in the prevailing conditions looked impossible. However, with guidance and access to resources, communities are adopting the way to a better life.”

Shazia is the daughter of a school teacher and was amongst the first ones in the village to adopt healthy behaviors. However, despite belonging to a relatively educated family, lack of awareness had its ill effects even on her siblings. One of her sisters and a nephew are stunted and shall remain so, as stunting is irreversible.

"With guidance and access to resources, communities are adopting the way to a better life.”

Shazia, a community resource person

Stunting does not only impact physical growth but also affects the cognitive and mental development of the child. With an onset at an early age, lack of exclusive breastfeeding, inadequate complimentary feed, and unhealthy childcare practices coupled with poor sanitation, unhygienic environment, and unsafe drinking water can be the leading causes of stunting. Prevention being the only way, stunting has no cure.

To ensure that the interventions are sustained beyond the project life, the stunting reduction program was based on community-driven interventions. To strengthen the community engagement, more than 1200 mothers and father groups each were formed, through which more than 200,000 children and half a million women and girls received multi-micronutrient supplements. In addition, more than 2,000 villages were made Open Defecation Free, which means that more than a million people, including 300,000 women and 600,000 children now have access to toilets and adequate hygiene. The community ownership of these interventions will help and are critical in sustainability and provision for the vulnerable and marginalized communities of Sindh.