In Gilgit-Baltistan, northern Pakistan, 46 percent of children under five are stunted.
In the village of Immit, on the southern slopes of the Pamir mountains, many families live on very little. Jamjur Naroz’s husband earns £3 a day as a labourer, the family’s entire income. “We are a poor family,” Jamjur says. “We cannot afford a balanced diet.”
Undernutrition can have lifelong consequences. When mothers and young children do not get enough protein, carbohydrates, fats, vitamins and minerals during pregnancy, breastfeeding and early childhood, severe nutritional deficiencies can affect a child’s physical and brain development. This can increase the risk of poverty later in life, with the next generation potentially facing the same challenges, what nutritionists call the intergenerational cycle of hunger.
But this cycle can be broken.
The Central Asia Stunting Initiative (CASI), run by the Aga Khan Health Service, helps families prevent and reduce undernutrition through growth monitoring, guidance on breastfeeding and complementary feeding, dietary diversity and hygiene, and nutritional supplements where needed. Its work sits alongside other efforts to tackle poverty in the region, including IFAD's farming cooperatives and irrigation projects, and Pakistan's national cash transfer programme, BISP.
Three years ago, Urwa Hussain was stunted. Through CASI, her parents learned better feeding and hygiene practices, and Urwa received the nutritional supplement Ronaq for a year, with her growth checked every month. Today, her height and weight are average for her age.
In areas of Gilgit-Baltistan where CASI works, stunting among children under five dropped from 41 to 35 percent over five years, according to an Aga Khan University evaluation. This was a faster decline than the global average, based on UNICEF data.
But despite these programmes, serious undernutrition remains a reality for many families. Nearby, four-year-old Hafiz Ur Rehman still struggles with severe anaemia that leaves him unable to concentrate or attend school. His story raises the question of what his future could have been had he and his mother been able to eat well during those early years when she was pregnant and for a year or two after his birth. He might have gone on to study engineering, medicine or law, supporting his family and his community, and pursuing his own dreams. His story is a reminder of why the work continues.
Breaking the cycle of hunger starts with making sure children get the food they need to grow and thrive.
Watch the animation above, or read the full story: Breaking the Cycle of Hunger: Tackling Intergenerational Stunting and Undernutrition in Northern Pakistan
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