Nutrition and Health Policies in Pakistan

Public policies serve as foundational guidelines for promoting and implementing services that contribute to societal well-being, particularly in critical sectors such as nutrition, agriculture, and public health. In developing countries like Pakistan, where systemic challenges and resource limitations persist, the intersection of these three domains plays a vital role in determining population health outcomes.

Nutrition, agricultural practices, and public health are deeply interwoven, and any policy aimed at improving one area must consider its implications for the others. For instance, poor agricultural practices can lead to nutrient-deficient food, thereby contributing to malnutrition and disease, especially among vulnerable populations. Effective public policies must therefore adopt a multi-sectoral approach to address food insecurity, promote healthy dietary habits, and improve overall public health (FAO, 2022).

In recent years, global discourse has increasingly focused on the development of sustainable and resilient food systems, emphasizing the need for integrated policy interventions that influence both dietary behaviors and long-term health outcomes (WHO, 2023). In the case of Pakistan, where the population now exceeds 240 million (World Bank, 2023), these challenges are compounded by rapid urbanization, population growth, and increasing environmental degradation. As demand for food rises, the pressure on farmers and supply chains intensifies, often leading to a dependence on high-yield but chemically intensive farming practices. While such methods may boost short-term productivity, they also pose serious threats to environmental sustainability and human health due to exposure to pesticides and reduced nutritional quality of crops (Pakistan Economic Survey, 2022–23).

To mitigate these risks, public policy must evolve to promote agroecological practices, strengthen nutrition-sensitive agriculture, and ensure access to safe, nutritious food for all. This requires collaboration across government ministries, the private sector, and civil society to build a coherent, health-focused food policy framework that supports both human and environmental health.

Agricultural Policies and Their Impact on Public Health

Agricultural policies play a critical role in shaping public health outcomes by governing domestic food production, imports, and distribution systems. These policies influence not only the quantity and quality of food available but also its safety, affordability, and nutritional value. In Pakistan, agriculture is a cornerstone of the economy, contributing 22.7% to the national GDP and employing 37.4% of the labor force (PBS, 2023). However, the sector faces growing threats from climate change, resource depletion, and outdated agricultural practices, all of which have significant implications for food security and public health.

One of the most pressing concerns is climate vulnerability. Pakistan is consistently ranked among the top ten countries most affected by climate change (Global Climate Risk Index, 2023). Erratic weather patterns, rising temperatures, and extreme climate events, such as the catastrophic floods of 2022, have severely disrupted food production, damaging over 4.4 million acres of agricultural land and threatening the livelihoods of millions (NDMA, 2022). Without proactive policy interventions to promote climate-smart agriculture and disaster preparedness, the risks to both food availability and nutritional quality will continue to grow.

Another critical issue is the lack of adequate support for smallholder farmers, who make up 65% of the agricultural workforce in Pakistan (Ministry of National Food Security, 2023). These farmers often lack access to modern technology, credit, fair markets, and extension services, making them especially vulnerable to economic shocks and environmental stress. Strengthening policies around agricultural subsidies, skill development, and access to inputs is vital for improving productivity and rural livelihoods.

Moreover, weak infrastructure, particularly in road networks and storage systems, results in post-harvest losses of 30–40% annually (FAO, 2021). These losses not only reduce food availability but also affect affordability and nutrition. Investments in cold chain logistics and transportation infrastructure are necessary for minimizing waste and ensuring a stable food supply that supports public health.

Nutrition Policies and Public Health Interventions

Nutrition policies in Pakistan are designed to enhance dietary quality and tackle the complex, interrelated issues of malnutrition. The National Nutrition Survey (NNS, 2018) revealed a troubling triple burden of malnutrition: 40.2% of children under five are stunted, 17.7% suffer from wasting, and 28.9% of women of reproductive age are overweight or obese (UNICEF, 2018). These figures highlight a paradox of both undernutrition and overnutrition coexisting within the same population, largely due to poor dietary diversity, food insecurity, and limited awareness about balanced nutrition. Various national programs have been launched to address these issues. The Benazir Nashonuma Program, a conditional cash transfer initiative, provides pregnant women and young children with fortified foods to combat chronic malnutrition and stunting (Ministry of Poverty Alleviation, 2023). Similarly, the National Food Fortification Program mandates the addition of essential micronutrients like iron and folic acid to wheat flour to reduce anemia and other deficiencies (Pakistan Standards and Quality Control Authority, 2021). Additionally, pilot school meal programs in provinces like Sindh and Punjab aim to improve child nutrition through structured feeding schemes during school hours (WFP, 2022). Despite these efforts, the implementation of nutrition policies has faced multiple challenges. According to a WHO report (2023), Pakistan’s nutrition strategy lacks operational clarity, robust monitoring systems, and inter-ministerial coordination, which results in fragmented delivery and uneven impact.

Parallel to nutrition, public health services are delivered through immunization campaigns, health education, and disease control initiatives. However, access to basic healthcare remains unequal, with 48% of the rural population still deprived of essential services (Pakistan Demographic and Health Survey, 2022). Vaccination coverage is inadequate, with only 66% of children receiving complete immunizations (EPI, 2023). Non-communicable diseases, such as diabetes, now affect 26.7% of the adult population (IDF, 2023), largely due to poor diets and sedentary lifestyles. Furthermore, maternal health indicators remain concerned, with 62% of rural births occurring without skilled birth attendants (NIPS, 2022). Although the National Health Vision 2025 outlines goals to strengthen healthcare systems, progress remains hindered by limited funding, governance issues, and systemic inefficiencies (Ministry of Health, 2023).

Challenges in Aligning Food Systems with Public Health

Pakistan’s food system faces deep-rooted structural and policy-related challenges that hinder the alignment of agriculture with public health objectives. One of the primary issues is the presence of conflicting policies. For instance, while the government promotes nutrition-sensitive programs to combat malnutrition, it simultaneously maintains subsidies for sugar and edible oil industries, which contradict broader public health goals by encouraging the consumption of ultra-processed, nutrient-poor foods (PIDE, 2023). These contradictions reflect the lack of a unified national strategy that integrates food production with health and nutrition priorities. Food insecurity remains a significant concern, affecting approximately 36.9% of the population (WFP, 2023). Rising inflation and the increasing cost of staple foods have worsened hunger, especially in rural and low-income urban households. In addition, while food safety authorities such as the Punjab Food Authority have made progress in urban areas, the enforcement of food standards and hygiene regulations remains weak or virtually absent in many rural and peri-urban regions, leading to widespread consumption of unsafe and contaminated foods.

Addressing these challenges requires a systemic and coordinated approach. Agriculture must be reoriented from a production-focused model toward one that prioritizes nutrition and health outcomes. Key policy recommendations include promoting climate-resilient agriculture by encouraging drought-tolerant crop varieties and investing in water-efficient irrigation methods, which can help stabilize food production amid climate shocks. At the same time, scaling up nutrition-specific interventions such as large-scale food fortification and maternal-child feeding programs can directly address micronutrient deficiencies and malnutrition. Better coordination between ministries of agriculture, health, food security, and education are essential, and the formation of inter-ministerial task forces could enhance policy coherence and implementation. Furthermore, increasing public health expenditure to at least 5% of GDP, in line with WHO recommendations, would strengthen healthcare infrastructure and support nutrition-sensitive health services. A cross-sectoral, collaborative approach is vital to transforming Pakistan’s food systems and improving population health sustainably.

Conclusion

The intersection of nutrition, agriculture, and public health policies in Pakistan reveals a complex but critical landscape where coordinated action is essential for long-term societal well-being. Despite significant efforts and numerous initiatives, fragmented policy frameworks, limited resources, and institutional inefficiencies continue to hinder the full realization of public health goals. The coexistence of undernutrition and overnutrition, along with the persistent burden of non-communicable diseases, underscores the need for a holistic and integrated approach to policymaking.

Agricultural practices must transition from productivity-centered models to nutrition-sensitive strategies that promote sustainable, diverse, and safe food systems. Strengthening climate resilience, investing in rural infrastructure, and supporting smallholder farmers are essential for food security and health equity. At the same time, public health services must be expanded to ensure universal access, particularly in underserved rural regions. Improved coordination across ministries and increased public health funding, aligned with WHO recommendations, are critical to achieving these outcomes. As Pakistan continues to face environmental, economic, and demographic pressures, a multisectoral, inclusive policy framework that bridges gaps between agriculture, nutrition, and health is not just necessary, it is imperative for building a healthier, more food-secure future for all citizens.

References: FAO; WHO; Pakistan Economic Survey; UNICEF; World Bank; PBS; Global Climate Risk Index; NDMA; PIDE; WFP; Ministry of Health; EPI; Pakistan Demographic and Health Survey; NIPS; IDF; Ministry of National Food Security

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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