Gaps and Challenges in addressing Child health

From infancy to adolescence, children encounter a multitude of health challenges that impact their overall growth and development. Some of the major issues affecting them include:


Malnutrition is a significant public health concern in Pakistan, particularly among children. It refers to the condition where individuals do not receive adequate nutrients, either due to insufficient intake, poor absorption, or excessive loss of nutrients. Malnutrition can manifest in various forms, including undernutrition, overnutrition, and micronutrient deficiencies.

According to UNICEF, nearly one-third of Pakistani children under the age of five are underweight, and almost half are stunted, meaning they have low height for their age. This condition, known as stunting, is a visible manifestation of chronic malnutrition and indicates long-term nutritional deprivation during the critical stages of growth and development. Stunting has serious consequences for children’s physical and cognitive development. It not only affects their height but also impairs brain development, leading to cognitive deficits and learning difficulties. Stunted children are more vulnerable to infections and chronic diseases, and they often face lifelong health challenges, including reduced earning potential and increased risk of chronic illnesses in adulthood.

Several factors contribute to the high rates of malnutrition and stunting in Pakistan. Poverty plays a central role, as it limits families’ access to nutritious food, clean water, and healthcare services. Poor maternal nutrition during pregnancy and inadequate breastfeeding practices also contribute to malnutrition among infants and young children. Additionally, lack of education and awareness about proper nutrition and hygiene practices exacerbate the problem.

Addressing malnutrition and stunting requires a comprehensive approach that addresses the underlying determinants of poor nutrition. This includes improving access to nutritious food, promoting breastfeeding and complementary feeding practices, enhancing healthcare services, and implementing nutrition education programs. Additionally, interventions targeting maternal health, sanitation, and poverty reduction are essential for tackling the root causes of malnutrition and improving the health and well-being of children in Pakistan.

Infectious Diseases

Infectious diseases (such as measles, diarrhea, pneumonia, etc) remain a significant public health challenge in Pakistan, particularly among children. Despite advances in healthcare and immunization programs, preventable infectious diseases continue to affect large segments of the population, leading to high morbidity and mortality rates, especially among children under five years old.

Infectious diseases are influenced by a range of contributing factors in Pakistan. Insufficient immunization coverage, particularly among underserved populations, leaves communities vulnerable to vaccine-preventable diseases, contributing to their prevalence. Additionally, inadequate healthcare infrastructure hinders timely diagnosis and treatment of infectious diseases, allowing them to spread unchecked. Poor hygiene practices and limited access to sanitation facilities create environments conducive to the transmission of infectious pathogens, leading to outbreaks of diseases like diarrhea. Malnutrition further exacerbates the situation by weakening the immune systems of individuals, making them more susceptible to infectious diseases and increasing the severity of illness.

Poor Maternal Health

Poor maternal health during pregnancy has profound implications for child health outcomes in Pakistan. Maternal malnutrition, characterized by inadequate intake of essential nutrients during pregnancy, deprives the developing fetus of vital nutrients crucial for optimal growth and development. This nutritional deficiency can lead to intrauterine growth restriction (IUGR), resulting in low birth weight and stunted fetal growth. Additionally, poor maternal health, including untreated infections, chronic diseases, and mental health issues, can negatively impact the developing fetus and increase the risk of complications during childbirth. Inadequate prenatal care, prevalent in many parts of the country, further exacerbates these challenges, as pregnant women may not receive essential medical interventions, such as prenatal vitamins, screenings, and vaccinations, to safeguard their health and that of their unborn child. The consequences of poor maternal health extend beyond childbirth, affecting the long-term health and well-being of the child, including increased susceptibility to infections, developmental delays, and chronic health conditions.

Lack of Water, Sanitation, and Hygiene (WASH) Services

Limited access to clean water, adequate sanitation, and hygiene facilities, collectively referred to as Water, Sanitation, and Hygiene (WASH) services, poses a significant public health challenge in Pakistan, contributing to a myriad of health problems. The scarcity of clean water sources forces many communities to rely on contaminated water, increasing the risk of waterborne diseases such as cholera, typhoid fever, and diarrhea. Inadequate sanitation facilities, including lack of proper toilets and sewage systems, lead to open defecation practices, contaminating the environment and water sources with fecal pathogens. This contamination not only spreads infectious diseases but also contributes to soil and water pollution, further compromising public health. Poor hygiene practices, exacerbated by limited access to hygiene education and resources, increase the likelihood of disease transmission through unwashed hands and improper food handling. The cumulative impact of these WASH-related challenges is profound, disproportionately affecting vulnerable populations, including children, who are more susceptible to waterborne illnesses and suffer the most severe consequences.

Inadequate Access to Quality Healthcare Services

Inadequate access to quality healthcare services for children, especially in rural and underserved areas, presents a significant barrier to their well-being in Pakistan. The disparities in healthcare infrastructure and resources between urban and rural regions result in limited availability of pediatric medical services, pediatricians, and child-specific diagnostic facilities in remote areas. This geographical imbalance forces many families with children to travel long distances to access even basic pediatric care, leading to delays in seeking medical attention and exacerbating children’s health conditions. Moreover, the scarcity of pediatric healthcare facilities in underserved areas contributes to overcrowding and overwhelmed healthcare systems in urban centers, further compromising the quality of care for pediatric patients. Additionally, socio-economic factors such as poverty, lack of transportation infrastructure, and cultural barriers exacerbate the challenges of healthcare access for children in rural communities. These barriers not only impede timely diagnosis and treatment of childhood illnesses but also deter parents from seeking preventive care and essential pediatric health services, perpetuating disparities in children’s health outcomes.

Lack of Parental Education on Child Health and Nutrition

Education and awareness regarding child health and nutrition are critical components of ensuring the well-being of children in Pakistan. Low levels of parental education and awareness exacerbate health disparities and hinder the adoption of healthy practices within families. Parents with limited education may lack the knowledge and skills necessary to provide adequate nutrition and healthcare for their children, leading to poor health outcomes. Additionally, a lack of awareness about the importance of early childhood development, proper nutrition, hygiene practices, and preventive healthcare measures further compounds the challenges faced by children in marginalized communities. This dearth of knowledge often results in missed opportunities for early intervention and preventative care, increasing the risk of malnutrition, infectious diseases, and developmental delays among children.

Cultural Practices

Cultural practices encompass a wide range of traditions, customs, and beliefs that influence societal norms and behaviors, including those related to child health. In some cases, these cultural practices can have adverse effects on children’s well-being, perpetuating harmful traditions that impact their physical, mental, and emotional health. Examples of harmful cultural practices include child marriage,  gender-based discrimination, and beliefs surrounding child-rearing practices and healthcare-seeking behaviors. Child marriage, for instance, often deprives girls of their right to education and exposes them to early pregnancy and childbirth, increasing the risk of maternal and infant mortality. Similarly, female genital mutilation, prevalent in certain communities, can cause severe physical and psychological trauma to young girls and have long-term health consequences.

Gender-based discrimination may result in differential access to healthcare and educational opportunities for boys and girls, leading to disparities in health outcomes. Moreover, cultural beliefs surrounding child-rearing practices, such as the use of traditional remedies or reluctance to seek medical care, may delay or impede necessary healthcare interventions for children, exacerbating health conditions and hindering their overall development.

Lack of Immunization

The lack of immunization refers to the incomplete or absent vaccination coverage among populations, resulting in heightened vulnerability to outbreaks of vaccine-preventable diseases. This deficiency in vaccination efforts exposes individuals, particularly children, to the risk of contracting infectious diseases for which safe and effective vaccines are available. Without adequate immunization coverage, communities remain susceptible to outbreaks of diseases such as measles, polio, diphtheria,  and hepatitis, among others. These vaccine-preventable diseases cause severe illness, complications, and even fatalities, especially among vulnerable populations such as infants, the elderly, and individuals with weakened immune systems.

 Impact of Disasters and Displacement

Disasters and displacement have devastating consequences on the health and well-being of children, exacerbating existing vulnerabilities and creating new challenges. In regions affected by conflict as well as disasters in past, children were exposed to heightened risks of violence, trauma, and injury, with long-lasting psychological and emotional effects. Displacement disrupted families and communities, leading to loss of access to essential healthcare services, education, and social support networks. Children living in displacement camps or temporary shelters faced inadequate sanitation, limited access to clean water, and overcrowded living conditions, increasing their susceptibility to infectious diseases and malnutrition. Moreover, disruptions to healthcare infrastructure and the targeting of healthcare facilities during disasters further compounded the challenges of accessing medical care for children in need.

Increasing Incidence of Non-communicable Diseases 

The rising incidence of non-communicable diseases (NCDs) among children, such as obesity and diabetes, represents a significant public health concern in Pakistan. Factors contributing to this trend include changes in dietary patterns, sedentary lifestyles, urbanization, and socio-economic disparities. High consumption of processed foods high in sugar, fat, and salt, coupled with a decrease in physical activity levels, has contributed to the obesity epidemic among children. Childhood obesity increases the risk of developing chronic conditions such as type 2 diabetes, hypertension, and cardiovascular disease later in life, imposing a heavy burden on healthcare systems and compromising quality of life. Moreover, socio-economic factors such as poverty and limited access to nutritious foods exacerbate the prevalence of NCDs among marginalized populations.

Low Health Budget

With the public health expenditure amounting to only 1.4 percent of GDP in the year 2022, the healthcare sector faces the challenge of a low healthcare budget. The notably low investment in the health sector has a significant impact on the quality of services and the availability of resources within the healthcare system. Insufficient funding for healthcare infrastructure, medical equipment, and human resources constrains the capacity of healthcare facilities to provide quality care to patients. Consequently, patients often experience long wait times, overcrowded facilities, and restricted access to essential medical services. Furthermore, the shortage of resources extends to essential medications, medical supplies, and diagnostic tools, forcing healthcare providers to make challenging decisions regarding patient care and treatment options. Particularly, rural and underserved areas bear the brunt of this underfunding, exacerbating existing health disparities.


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