Category: Blog

Introduction

Child malnutrition is a significant public health concern in Pakistan, particularly in low-income areas of Punjab. This blog explores the relationship between female empowerment and child malnutrition rates. It looks at the concept of female empowerment from a mobility lens in Pakistani culture; its limitations, and the subsequent impact on access to essential resources for women and children. It also analyzes how limited access to such basic resources leads to a high prevalence of child malnutrition in Pakistan. Finally, this blog explores how efforts to empower women and enhance their mobility can contribute to a decrease in child malnutrition rates.

Restricted Mobility; A barrier to Empowerment

According to the European Institute of Gender Equality, women’s empowerment encompasses self-worth, autonomy, equal access, personal agency, and the power to shape society. In Pakistani culture, women generally do not enjoy the same freedoms and position in society as their male counterparts do; this trend is more salient in low-income areas. The Global Gender Gap Report 2024, which is a comprehensive gender equality assessment conducted by the World Economic Forum, ranked Pakistan 146th out of 147 countries on gender parity. This highlights the significant gender disparities in Pakistan. With regards to gender disparities, labor force participation is a good indicator of female inclusion thus portraying empowerment. “The overall labor force participation rate (LFPR) of women in Pakistan at 21% stands well below the global percentage at 39%. At the national level, the refined LFPR of women (aged 15-64 years) is very low at 26% compared to 84% for men” (unwomen.org).

The Punjab Commission on the Status of Women defines female mobility as a woman’s unrestricted freedom to move within and beyond her home, community, or country without facing threats or obstacles. This includes the ability to access transportation, move freely in public spaces, and travel for work or education. Women’s freedom of movement is intrinsically linked to their overall empowerment in Pakistan. While progress has been made, deeply rooted cultural norms, safety concerns, and inadequate transportation systems continue to restrict women’s ability to fully participate in society, limiting their access to education, employment, and healthcare.

Consequently, women may be unable to seek timely medical attention for themselves or their children, leading to poorer health outcomes, including higher rates of child malnutrition. Moreover, limited mobility can isolate women from support networks and hinder their ability to participate in community decision-making processes. Participation in key matters is vital as women are primary caregivers with a deep understanding of children’s needs. Their involvement in healthcare improves decision-making, promotes health education, and ensures better child outcomes.

This lack of agency can further perpetuate cycles of poverty and malnutrition. Addressing the issue of female mobility is crucial for improving the overall health and well-being of women and children in Pakistan. Efforts to empower women and promote gender equality must include strategies to enhance their mobility and access to essential services.

Malnourishment Crisis in Pakistan

Child malnutrition is a severe health condition affecting children who don’t receive adequate nutrients from their diet. This can manifest as undernutrition, where children consume insufficient food or essential nutrients, leading to stunted growth, wasting, or being underweight. Conversely, overnutrition occurs when children consume excessive calories and unhealthy fats, resulting in obesity. Both forms of malnutrition have detrimental long-term consequences for children’s physical and mental development. According to UNICEF stunting is a complex issue stemming from both insufficient and inadequate nutrition, among frequent infections and poor sanitation.

Pakistan, as a developing country, faces a severe malnutrition crisis, with alarming rates of stunting and wasting among children.” Nearly 10 million Pakistani children suffer from stunting” (unicef.org)

The graph below starkly contrasts the global and Pakistani rates of child stunting rates among children under five, with Pakistan exhibiting a significantly higher prevalence, underscoring a critical issue for children’s welfare in the country.

For the last decade, stunting rates in children under age 5 have been far greater than the worldwide average as can be seen in the graph. This is not due to any one single factor, rather it is, in most cases, a cumulation of multiple aspects. One of these major factors is the lack of access to clean drinking water. Albeit, there isn’t a direct link between malnourishment and drinking water, it plays an important role as a vector for various water-borne diseases “Contaminated water and poor sanitation are linked to transmission of diseases such as cholera, diarrhea, dysentery, hepatitis A, typhoid and polio” (World Health Organization).

Drinking contaminated water impairs the body’s ability to retain nutrients essential for growth; rather than being absorbed, they are excreted out of the body either through vomiting or diarrhea. This is a serious problem in Pakistan, as “53,000 Pakistani children under age 5 die annually from diarrhea due to poor water and sanitation” (unicef.org). Additionally, the United Nations Children’s Fund estimates that around 70% of the households in Pakistan drink bacterially contaminated water which means children living in these households have a higher susceptibility to water-borne diseases and are consequently at a higher risk for malnourishment.

Empowerment: A Better Path to Nutrition

Female empowerment is essential for effectively managing Pakistan’s complex malnutrition problem, especially when it comes to the vital element of accessing safe drinking water. Empowering women with increased mobility and the agency to fight for increased access to clean water sources is crucial for minimizing the incidence of water-borne illnesses in their children. Moreover, women with higher levels of education are more likely to recognize the significance of cleanliness, hygiene, and clean water for general health. Hence, increasing female mobility in terms of their access to education at a young age has far-reaching positive impacts on the female herself as well as her future family. In short “improvement in women’s empowerment s are expected to lead to the well-being of children in the form of reduction in their nutritional status” (ghrp.com).

The Global Health Research and Policy advocates for individuals to become financially independent, thus enabling them to make investments in water filtration systems or support neighborhood-based projects to guarantee a steady supply of safe drinking water for their families and communities. To further combat malnutrition, women’s leadership in community development is essential. It is possible to give vulnerable groups’ needs—such as those of children and expectant mothers—priority by incorporating women in decision-making processes about resource allocation and water management. Empowered women are better able to carry out nutrition programs, encourage breastfeeding, and make sure that kids have access to wholesome food and clean water. Pakistan needs to address malnutrition holistically if it is to become a healthier and more just society.

Conclusion

Albeit, the statistics paint a bleak picture, there is hope. In the struggle against child malnourishment, it is possible to utilize a potent weapon by empowering women in Pakistan. Women who have greater mobility and use it to seek employment can take advantage of their financial security by making health and nutritional investments for their children, whether it may be as simple as immunization or drinking filtered water. Women can become advocates for constructive change in their communities when they receive education about good nutrition and hygiene habits.

The way forward requires a multi-pronged approach. Investments in public transportation infrastructure and cultural awareness campaigns promoting gender equality can increase female mobility. Educational programs focused on nutrition and sanitation, coupled with initiatives to support women’s leadership in community development, will equip women with the knowledge and agency to break the cycle of malnutrition. In short, by prioritizing female empowerment, Pakistan can build a healthier future for mothers and children alike.

Tashfeen Faisal is a student at Lahore Grammar School – International. He was part of the first cohort of CDPR’s Mentorship Program. 

Sources

“Empowerment of Women.” European Institute for Gender Equality, 17 July 2024, eige.europa.eu/publications-resources/thesaurus/terms/1246?language_content_entity=en. Accessed 1 Aug. 2024.

“LinkedIn.” Linkedin.com, 2024, www.linkedin.com/pulse/pakistan-faces-challenges-gender-parity-world-forum-global-jahangir-9kxyf/. Accessed 1 Aug. 2024. https://pakistan.unwomen.org/sites/default/files/2023-07/summary_-nrsw-inl_final.pdf

World Bank. (2022). Pakistan Development Update: Harnessing the Demographic Dividend. [Report]. Washington, DC: World Bank. https://pcsw.punjab.gov.pk/system/files/overcoming.pdf

“4 Things You Need to Know about Water and Famine.” Unicef.org, 2022, www.unicef.org/stories/4-things-you-need-know-about-water-and-famine#:~:text=Unsafe%20water%20can%20cause%20diarrhoea,to%20waterborne%20diseases%20like%20cholera. Accessed 1 Aug. 2024.

World. “Drinking-Water.” Who.int, World Health Organization: WHO, 13 Sept. 2023, www.who.int/news-room/fact-sheets/detail/drinking-water#:~:text=Contaminated%20water%20and%20poor%20sanitation,individuals%20to%20preventable%20health%20risks. Accessed 1 Aug. 2024.

Yaya, Sanni, et al. “What Does Women’s Empowerment Have to Do with Malnutrition in Sub-Saharan Africa? Evidence from Demographic and Health Surveys from 30 Countries.” Global Health Research and Policy, vol. 5, no. 1, BioMed Central, Jan. 2020, https://doi.org/10.1186/s41256-019-0129-8. Accessed 1 Aug. 2024.

“Nutrition.” Unicef.org, 2017, www.unicef.org/pakistan/nutrition-0. Accessed 2 Aug. 2024.
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In recent years Lahore has consistently ranked as the most polluted city in the world; the poor air quality has become a national health emergency significantly increasing the incidence of cardiovascular issues and has resulted in the shortening of an average Lahori’s life expectancy by six years. Unchecked expansion of the city due to rapid urbanization coupled with poor urban planning has led to the degreening of Lahore. A city previously known as the “City of Gardens” has lost 75% of its green cover in the last 10 years. Moreover, the UN Population Division has predicted that by 2025 nearly half of Pakistan’s population will be living in cities and Lahore’s population is expected to rise to 10 million from 7 million. This rising population density will amplify the pressure on existing resources and consequent environmental degradation. Hence it is crucial to take action now to limit the expected adverse impacts this rapid urban growth will have and to ensure that Lahore grows into a resilient city.

International Commitments

The realization that practices which compromise environmental integrity will have disastrous consequences came long before the crisis reached its current crescendo. This is reflected in the State’s decision to become a signatory to several international treaties that aim to curtail the climate disaster. Pakistan has signed the 1992 United Nations Framework Convention on Climates Change (UNFCCC), the objective of which is the stabilization of greenhouse gas concentration in the atmosphere at a level that would prevent dangerous anthropogenic interference with the climate system. Additionally Pakistan has ratified the Paris Agreement and is hence committed to reducing its greenhouse gas emissions. Pakistan is party to the 2001 Stockholm Convention, which is a global treaty to protect human health and environment from Persistent Organic Pollution (POP). Pakistan has also joined the global community being a party to the 1985 Vienna Convention on Protection of Ozone Layer hence having agreed to adopt “appropriate measures” to prevent activities that harm the ozone layer. Pakistan is additionally a signatory of 1990 International Oil Pollution Preparedness, Response and Cooperation; a framework designed to facilitate international co-operation and mutual assistance in preparing for major pollution incidents involving hazardous and noxious substances, i.e. chemicals. Moreover, Pakistan has committed to achieving UN’s Sustainable Development Goals (SDGs) of which SDG 3.9: (Reduce illness & death from Air, Water & Soil Pollution) and SDG 11.6 (Reduce Environmental Impacts caused by Air Pollution) are focused towards environmental protection.

Local Commitments

The State does not only have international obligations to take immediate action, but an immense responsibility to fulfill the basic rights of the people of Pakistan. Article 9 of the Constitution of Pakistan which evokes the fundamental right to security “no person shall be deprived of life or liberty, save in accordance with the law” and Article 14 which evokes the fundamental right to dignity “The dignity of man and, subject to law, the privacy of home, shall be inviolable” necessitate that actions be taken to liberate the very basic element of life which is access to clean air and environment.

Efforts to incite affirmative action at a local level have been ongoing since the 1990s. A brief history of policies and legal proceedings is discussed in the following section.

In 1997 the Pakistan Environmental Protection Act (PEPA) came into effect, through which the 1983 Pakistan Environmental Protection Ordinance was repealed, to provide a comprehensive framework for regulating environmental protection . The Act principally made provisions for administration of matters affecting the environment and, marginally, for environmental impact assessment and the handling of hazardous matters. It also defined environmental offenses and prescribed penalties for those offenses. Moreover, it created federal and provincial Environmental Protection Agencies (EPAs) to implement and supervise the rules and regulations under the Act. Consequent to the Act, the Pakistan Environmental Protection Council (PEPC) was created at the federal level. In December 1999 the PEPC revised the National Environmental Quality Standards (NEQS) and adjusted them based on Pakistan’s conditions and practice in South Asia; these standards became effective in August 2000. The following year, in 2001, the National Environmental Action Plan (NEAP) came into effect as an umbrella programme to address environmental concerns in a holistic manner. Some of the major achievements of NEAP included development of policies and strategies like National Environmental Policy (2005) and the National Sanitation Policy (2006).

In 2001 a public interest litigation, the first of several future litigations, was filed by Mansoor Ali Shah and three other people which resulted in the formulation of the Lahore Clean Air Commission. The commission presented its extensive list of recommendations six years later in 2007. The recommendations included that the provincial government introduce 4-stroke rickshaw engines, expand public transport, and adopt Euro II, Euro III, and Euro IV fuel and emission standards for motor vehicles. The Lahore High Court accepted these recommendations and directed the Punjab Government to implement them.

In 2009, the quality of drinking water in Pakistan was found to be extremely poor with bacterial contamination, lead, arsenic, fluoride and nitrate and resulted in the formulation of the National Drinking Water Policy. In 2012 the National Climate Change Policy (NCCP), which was considered to be a landmark in the Climate Change response in Pakistan, was approved. The policy comprehensively addressed all possible challenges of climate change adaptation and mitigation; and was sure to provide a rock solid foundational framework for ensuring climate change action plans, programs and projects.

In 2015, another public interest petition on smog and clean air was filed by Imrana Tiwana and Colleagues. The following year in 2016 yet another public interest petition on smog by Walid Iqbal was filed. Consequently, in 2017, a smog commission, chaired by the eminent lawyer Parvez Hassan, was made; in its recommendations the commission proposed an action plan to control smog. The Commission made a number of recommendations in May 2018 including the immediate adoption and implementation of the Punjab Clean Air Action Plan, establishing Smog Response Desks at district levels, adoption of appropriate technologies that reduce emissions of harmful pollutants from brick kilns. Unfortunately, implementation, if at all done, has been weak.

The following year, in 2018, the Punjab Water Policy was notified. The objective of this Policy was to provide clear policy directions to the Government of Punjab on the sustainable management and development of water from all sources of water, for all sub-sectors of water use and for all regions at the basin level through equitable water allocations, management and development. Emissions data indicates that 46% of Pakistan’s emissions come from the transportation sector; hence In 2019, the National Electric Vehicle Policy was developed to mitigate the airborne emissions. In 2021 the National Climate Change Policy was updated with the goal to ensure that climate change is mainstreamed in the economically and socially vulnerable sectors of the economy and to steer Pakistan towards climate compatible development. It includes policy measures to address issues in various sectors such as water, agriculture, forestry, coastal areas, biodiversity and other vulnerable ecosystems. Furthermore, the updated Policy document has been designed in accordance with the requirements of the Paris Agreement on climate change, Sustainable Development Goals and Sendai Framework for Disaster Risk Reduction. Hence, appropriate measures relating to disaster preparedness, capacity building, institutional strengthening; technology transfer and international cooperation have also been incorporated as important components of the Policy.

In 2022, as a result of a case pending before the Honourable Lahore High Court, a Judicial Water and Environmental Commission was formed which convenes each week. The commission’s goal is to protect the Fundamental Right to Life of the Public, to ensure that the Government Functionaries implement the Directions given for the safeguarding of the environment, in view of scarcity of natural resources and climate change. The National Hazardous Waste Management Policy was also ratified in 2022. In 2023, the National Clean Air Policy was updated in 2023. In the same year, the National Adaptation Plan was developed. The plan provides a framework for implementing adaptation, promoting inclusivity, and facilitating collaboration among different stakeholders, and serves as an effective tool for climate finance mobilization. The plan lays out an adaptation strategy and priorities in seven key areas: the agriculture–water nexus; natural capital; urban resilience; human capital; disaster risk management; and gender, youth, and social inclusion.

Despite the existence of such extensive and holistic policies, decades later major stakeholders and interest groups continue to congregate in meeting after meeting, discussing the same issues and coming up with recommendations and action plans. This indicates that there is a major lag in the ability to implement, monitor and impose checks and balances. As illustrated above Pakistan has no dearth of strong rules and regulations but unfortunately these rules operate within a very weak institutional set up. Therefore, it is imperative that strict enforcement mechanisms are put in place. Additionally to manage rapid urbanization, strategic planning and sound management are needed; this will require a concerted and coordinated effort from the national and local governments, ideally in partnership with the private sector. This collaborative exercise should aim to formulate and implement a national urbanization strategy which prioritizes maintenance of cities’ environmental integrity.

The time for conversing about the climate crisis is long past us, it is now absolutely essential for all interest groups to come together and with renewed vigor and an unwavering sense of purpose act as a collective to exert pressure on state institutions to take the necessary actions to make Lahore and the rest of Pakistan’s cities more liveable.

This blog is based on the discussion at a policy dialogue event hosted by CDPR which explored the future of Lahore. Participants included architects, government representatives, urban planners, academics and representatives from advocacy groups. This was the first in a series of talks on the future of Lahore and served as a scoping session to identify key aspects which are pivotal to the city’s growth and development.

Emun Hafeez is a Senior Research Associate at the Consortium for Development Policy Research (CDPR).

Globally, women face reduced employment prospects in comparison to men. Particularly in developing countries, women are more likely to be unemployed, have limited job opportunities, and work in the informal sector, with the majority serving as contributing family workers. This gender inequality in the physical world also extends to the digital world, where globally a higher percentage of women are offline compared to men. The Global Systems for Mobile Communications Association’s (GSMA) mobile gender gap report (2024) reveals a concerning gender disparity in mobile phone ownership. It states that women are 8% less likely to own a mobile phone compared to men. However, the extent of this gap varies greatly across regions. South Asia, in particular, faces the widest gender gap in mobile phone ownership, reaching 15%. Among the countries surveyed, Pakistan stands out with the largest gap of 38% in mobile phone ownership. Additionally, the report highlights that only 26% of women in Pakistan own a smartphone, while the statistic for men is 52%. The statistics emphasize an urgent need to address the gender digital divide and promote equal access to mobile and smartphone technologies.

Considerable research attention has been devoted to studying the effects of digitalization on gender equality, income, and employment. Mobile and smartphones hold significant economic value for individuals with limited financial resources, as they offer greater convenience and portability compared to landline phones. Additionally, lower fixed costs associated with physical infrastructure make mobile and smartphones a more accessible asset for the economically disadvantaged. In our study, we examine the gender dimension of the mobile phone ownership divide and its relevance for female labour force participation in the context of developing countries, that is, Pakistan.

Figure 1 – % of individuals 10 years or older with mobile ownership

Source – Pakistan Social and Living Standards Measurement Survey (2019-2020)

Gender digital divide in mobile phone ownership

Figure 1 shows that there exist noticeable gender differences in mobile phone ownership. In our research, we examine the gender digital divide in mobile or smartphone ownership and identify the contribution of individual covariates (characteristics) in explaining the divide.  The results show that men, on average, are more likely to own a mobile or smartphone making them an advantaged group in our analysis. Among observable characteristics, literacy and income are the major contributors to the gender digital divide in Pakistan. However, the results show that sociocultural or institutional factors are primarily responsible for the huge gender digital divide in Pakistan. The combination of policies, laws, and social norms in developing countries creates barriers for women. These barriers lead to a vicious circle that hinders women from achieving financial independence to afford digital technologies, which can significantly enhance their economic well-being. In addition, the acquisition of technology is typically associated with men, and prevailing gender norms regarding men’s access to and use of technology restrict women’s opportunities to learn, utilize, and reap the benefits of technology. Furthermore, sociocultural factors play a significant role in shaping the actual and perceived benefits of digital tools, often leading to women being unaware of the advantages of utilizing these tools.

An important insight from Figure 1 shows a considerable digital divide between rural and urban females. We further analyse the rural-urban digital divide in mobile or smartphone ownership between females. Women in urban areas are more likely to own a mobile or smartphone compared to women in rural areas. Furthermore, the digital divide in mobile or smartphone ownership between rural and urban females is mainly driven by observable characteristics.  The differences in literacy, education, income, and wealth are the main contributors to the observed digital divide between rural and urban females in Pakistan.

Digitalization through mobile phones and female labour force participation

The widespread adoption of mobile and smartphones has transformed how females manage their time and participate in different activities (leisure and home production), thereby influencing their engagement in the labour market. The use of mobile phones and smartphones as tools for job search directly affects labour force participation, enhancing their socialization skills and enabling the creation of external social networks even from the comfort of their homes. The study reveals a significant and positive association of mobile or smartphone ownership with female labour force participation in Pakistan. The results also highlight that women living in urban areas are less likely to participate in the labour force compared to those in rural areas, although the difference is not statistically significant. This could be attributed to urban women spending more time on leisure activities facilitated by mobile or smartphones, which they are more likely to own. On the other hand, rural women use mobile phones primarily for work-related purposes. For instance, studies from Bangladesh and India show that rural women use mobile phones for various activities such as social networking, employment, education, and accessing health-related services.

Bridging the digital divide: empowerment through digitalization and upskilling

Our analysis highlights several key points regarding the gender digital divide and its implications for women in Pakistan. To bridge the gender digital divide and empower females, we strongly recommend expanding employment opportunities through digitalization. This entails that interventions that provide digital training and upskilling programs for lower-income urban women and women from rural households may not only bridge the gender digital divide but also help them in uplifting their economic well-being through increased participation in the labour force. Furthermore, interventions that ensure that rural women have affordable and reliable mobile networks along with improvement in the provision of education and health facilities can serve as instruments for attaining gender equality, hence economic growth. More customized approaches, for example, agricultural advisory and market information about prices, information on weather conditions, and quality of inputs along with off-farm employment opportunities through interactive voice response (IVR) or short messages, can help women contribute to rural development.

The blog presents the findings of the following research paper:

Amber, H., & Chichaibelu, B. B. (2023). Narrowing the gender digital divide in Pakistan: Mobile phone ownership and female labour force participation. Review of Development Economics, 1-29.