Agriculture Policies in Pakistan: Transforming Rural Health

Agriculture policies play a crucial role in shaping rural economies, food security, and public health outcomes. In Pakistan, where nearly 65% of the population resides in rural areas (World Bank, 2023) and agriculture contributes 22.7% to the national GDP (Pakistan Economic Survey 2022–23), these policies directly affect the quality of life and health of millions. This article explores the interconnectedness between agricultural policymaking and rural public health outcomes, drawing upon recent data, programs, and structural challenges.

Agriculture is not only the backbone of the economy but also the primary source of livelihood for 38.5% of Pakistan’s labor force (Pakistan Bureau of Statistics, 2023). Government initiatives such as fertilizer and seed subsidies, minimum support prices for crops like wheat, and interest-free credit schemes are intended to stabilize rural incomes and incentivize food production. Programs like the Kamyaab Kisan Program, which provides cash assistance to smallholder farmers, have demonstrated a positive impact on rural income security and household resilience (Ministry of National Food Security & Research, 2023). A stable income improves rural families' ability to afford health services, nutritious diets, and schooling, thus reducing the prevalence of malnutrition, anemia, and related diseases—particularly among women and children. According to UNICEF (2022), 40% of children in rural areas are stunted due to chronic undernutrition, a condition strongly linked to agricultural performance and food access.

However, the potential of agriculture policies to positively influence public health is often undermined by policy inconsistency, inequitable resource distribution, and limited outreach of support services. Small and marginal farmers, who constitute the majority, frequently lack access to timely subsidies, extension services, and healthcare infrastructure. Additionally, current agricultural policies focus heavily on staple crop production, which has led to a neglect of crop diversification and nutrient-rich farming. This imbalance contributes to poor dietary diversity, exacerbating micronutrient deficiencies.

Moreover, overreliance on chemical inputs, such as pesticides and fertilizers, without adequate training or regulatory oversight, has resulted in water contamination, respiratory illnesses, and increased pesticide poisoning in rural populations. Thus, integrating public health perspectives into agriculture policy, such as promoting sustainable farming, biofortified crops, and safe water practices, is critical.

Challenges Surrounding Food Security and Public Health

Pakistan continues to grapple with complex challenges surrounding food security and public health, many of which are intricately linked to agricultural policies and rural development dynamics. One of the most pressing issues is the dual burden of malnutrition, where both undernutrition and obesity coexist. According to the National Nutrition Survey (2018), 28.9% of children under five are stunted, indicating chronic malnutrition, while adult obesity rates are steadily increasing due to imbalanced diets. A significant contributor to this issue is the policy emphasis on staple crops such as wheat, rice, and sugarcane, which dominate both production and consumption patterns. These crops, although calorie-dense, lack the essential micronutrients needed for a balanced diet. Despite policy frameworks like the Prime Minister’s Agriculture Transformation Plan (2020–25), which aims to diversify crop production toward high-value and nutrient-rich options such as fruits, vegetables, and pulses, progress in implementation remains limited. Nevertheless, there are promising developments, such as the introduction of biofortified wheat varieties like Zincol-2016, which are designed to address widespread zinc and iron deficiencies (Pakistan Agricultural Research Council, 2022).

Simultaneously, environmental and occupational health risks are rising, particularly in major agricultural zones. In Punjab and Sindh’s cotton-growing belts, the unregulated and excessive use of pesticides has been associated with higher incidences of cancers and neurological disorders, particularly among farm workers (Pesticide Action Network, 2021). Although Pakistan has adopted the Pest Warning and Quality Control of Pesticides Act (2019), enforcement is often weak or inconsistent, rendering the legislation ineffective in protecting rural health. Water-related issues further complicate rural health outcomes. With 70% of Pakistan’s water deemed unsafe for consumption (PCRWR, 2023), rural communities are highly vulnerable to waterborne diseases like diarrhea, which remains a leading cause of mortality among children under five (WHO, 2022).

Access to healthcare in rural Pakistan remains insufficient to address these growing risks. Despite efforts such as the Sehat Sahulat Program, which offers health insurance to low-income families, many rural clinics remain understaffed and poorly equipped. Public health infrastructure lags behind, and only 30% of the rural population has access to adequate medical services (Ministry of Health, 2023). Complementary programs like the Clean Green Pakistan Initiative have initiated improvements in sanitation and water quality, but these efforts require more sustained investment and monitoring to achieve meaningful impact across rural areas.

Challenges in Policy Implementation and Strategic Recommendations

The implementation of agriculture and health policies in Pakistan faces multiple challenges that hinder their effectiveness, particularly in rural areas where vulnerability to environmental, economic, and institutional risks is highest. Climate change remains a critical concern, with Pakistan ranked the 8th most vulnerable country globally to climate impacts (Germanwatch, 2023). The devastating floods of 2022 submerged over 4.4 million acres of cropland, displacing millions and severely disrupting food production and supply chains (NDMA, 2022). These events not only exacerbated food insecurity but also led to widespread outbreaks of waterborne and vector-borne diseases due to standing water and compromised sanitation systems.

Policy fragmentation is another major obstacle, particularly the lack of coordination between federal and provincial governments. Agriculture, health, and environment sectors often operate in silos, resulting in poorly integrated strategies. The absence of a unified framework prevents the scaling of successful pilot projects and weakens the overall policy response to interrelated rural development challenges. Furthermore, smallholder farmers, who make up the majority of the agricultural workforce, remain largely marginalized in policymaking processes. Women, who constitute 74% of the agricultural labor force, own only 3% of land (FAO, 2021), limiting their economic and decision-making power. Their exclusion from institutional structures not only perpetuates inequality but also impedes the adoption of inclusive and gender-sensitive agricultural and health strategies.

Addressing these challenges requires a multidimensional approach. Strengthening intersectoral coordination among the agriculture, health, and environment ministries is vital to ensure a unified policy response. Promoting climate-resilient farming practices, such as the adoption of drought-resistant crops and subsidies for sustainable irrigation technologies like drip systems, can mitigate the impacts of climate variability. Enforcement of pesticide regulations must be prioritized, particularly in regions where chemical misuse is common, to protect both human health and environmental sustainability.

In addition, the government should incentivize nutrition-sensitive agriculture by supporting the cultivation of pulses, vegetables, and biofortified crops to improve rural dietary diversity. Expanding rural healthcare infrastructure through increased funding for clinics, mobile health units, and trained personnel will ensure early detection and treatment of climate-related and occupational diseases. Only through integrated, inclusive, and well-enforced policies can Pakistan address the interconnected challenges of agriculture, health, and rural development in a sustainable and equitable manner.

Conclusion

Agriculture policies in Pakistan hold transformative potential for improving rural public health, food security, and socio-economic outcomes. While the country has made strides in supporting smallholder farmers through financial aid programs and crop subsidies, structural challenges, such as policy fragmentation, weak implementation, and environmental degradation, continue to undermine the full impact of these initiatives. The persistence of malnutrition, poor dietary diversity, pesticide-related health risks, and limited access to clean water and healthcare are symptoms of deeper systemic gaps that require urgent attention.

Moving forward, an integrated policy approach is critical. Agriculture and public health must no longer function in isolation. Instead, coordinated efforts among government ministries, provincial authorities, and community stakeholders should be prioritized. Investments in climate-smart agriculture, nutrition-sensitive policies, and gender-inclusive reforms can drive meaningful progress. Enhancing rural healthcare systems, enforcing pesticide regulations, and promoting sustainable water practices will be equally essential in safeguarding health outcomes.

Pakistan’s path toward resilient and equitable rural development lies in recognizing the interdependence of agriculture and health. By fostering inclusive, sustainable, and health-conscious agricultural policies, the nation can build a future where rural communities not only survive but thrive economically, nutritionally, and environmentally. This holistic transformation is essential for achieving long-term national stability and development.

References: World Bank; Pakistan Economic Survey (2022-23); UNICEF; Ministry of National Food Security & Research; National Nutrition Survey; PCRWR; NDMA; FAO; Germanwatch

Please note that the views expressed in this article are of the author and do not necessarily reflect the views or policies of any organization.

The writer is affiliated with the Department of Epidemiology and Public Health, Faculty of Health and Pharmaceutical Sciences, University of Agriculture, Faisalabad, Pakistan.

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