Addressing the Multisectoral Challenges to Child Wellbeing in Pakistan
- Authored by Sarosh Sultan | Research Associate, Human Development
- Co-Authored and Artwork Illustrated by Maheen Salman | Associate Communications
This blog post has been published in observance of International Children’s Day 2024.
In response to the pressing challenges faced by children in Pakistan, conducting impactful research that shapes policy and educational practices across Pakistan will be essential. We must ensure that every child has the opportunity to thrive in a world that is safer, more equitable, and just.
As the world observes World Children’s Day, we must turn our attention to the multidimensional challenges faced by Children in Pakistan.
Almost half of Pakistan’s population, roughly 112 million people, are under the age of 18. Yet, as the country grapples with the uneven effects of climate change, social inequalities, and economic uncertainty, the future of the nation’s children remains uncertain.
Staggering malnutrition, widespread educational exclusion, and the compounded effects of environmental crises, have resulted in the country’s children being caught in a cycle of adversity which demands urgent global attention. These issues also threaten the future of human capital development, deeply impacting economic growth and poverty reduction.
The State of Child Wellbeing in Pakistan
Children in Pakistan are caught at the intersection of overlapping crises affecting their health, education, and future economic prospects. Nearly 40% of the population is living below the poverty line and almost 23 million children—36% of the school-age population—are excluded from formal education. This reflects not only a lack of infrastructure but also systemic issues that restrict access to opportunities and perpetuate cycles of generational poverty. Moreover, with an estimated 3.3 million children being engaged in child labour and 1.5 million living on streets in urban centers, the children are exposed further at risk of exploitation.
Issues like gender inequality add another layer of complexity. Young girls, particularly in rural regions, face cultural barriers and gender biases that hinder access to education. 12 million girls aged 5 to 16 are out of school in Pakistan due to issues such as early marriage, societal expectations, and gender-based expectations.
Young children are also exposed to a number of public health crises, aggravated by the lack of accessible healthcare services and proper sanitation infrastructure in Pakistan. 75% of newborn deaths are caused by treatable conditions including infections like pneumonia, dengue, and diarrhea. Diarrhea alone, contracted due to poor water and sanitation practices and infrastructure, is responsible for 53,000 deaths in children under 5 years old.
The country also experiences some of the highest rates of childhood malnutrition globally, contributing to roughly 29% of children being underweight and 40% experiencing childhood growth stunting; some of the highest numbers in South Asia. Childhood stunting is particularly prevalent in rural areas, where rising temperatures and erratic rainfall patterns affect crop yields, leading to increased food insecurity. A vast number of children suffer from micronutrient deficiencies that can create lifelong developmental consequences. Furthermore, merely 37.7% of children are exclusively breastfed, significantly contributing to poor cognition and physical development.
Another overarching factor impacting children in Pakistan is the climate change, causing severe disruptions to education, health, and nutritional access. The occurrence of extreme heatwaves, droughts, and floods is frequent, with each creating vulnerabilities for young children. In the aftermath of the 2022 flooding, over 2.14 million children in the country are suffering from acute malnutrition and facing disruptions in crucial services such as healthcare, access to safe drinking water and sanitation, and shelter.
Pakistan also experiences one of the highest levels of air pollution globally and 11 million children under the age of five are being exposed to smog in the worst affected districts of the country. Children are particularly vulnerable to prolonged levels of exposure to air pollution that can cause low birth weight, asthma, reduced lung function, respiratory infections, and allergies.
Generating Evidence for Improving Outcomes for Children
A child’s health, development, well-being and ability to thrive is influenced by interconnected factors; including healthcare and nutrition, education, safe environments and familial and community support. Furthermore, the needs of children are rapidly changing as they age; their hopes, worries, dreams and expectations are vastly different from the adults around them. Applied multi-disciplinary research can generate evidence to help improve outcomes for children. Some of the projects at IDEAS adopt a multidimensional, multisectoral lens to generate this evidence.
Using accessible technology to improve monitoring of children’s health and addressing chronic child nutrition
Child wellbeing is deeply tied to health and nutrition, and the importance of supporting families in better understanding child health and nutrition. IDEAS Associate Fellow Agha Ali Akram’s work uses a simple tracking tool to test the effectiveness of home-based growth monitoring for increasing parents’ awareness and help them understand the benefits of better nutrition. The project, supported by community health workers, encouraged parents to make better food choices for children and demonstrated how basic in-home counseling can significantly impact child growth outcomes.
Improving access and learning experience of marginalized children
Children experience schooling differently based on their disability, gender, caste, religion, and where they live, and these distinctions have real consequences for learning outcomes and enrollment. To address a gap in policy and academic discourse to create inclusive education for all children, particularly the most marginalized, the TEACh study documented teacher practices and student experiences in government schools in three districts in Pakistan. The study, undertaken by Rabea Malik, Faisal Bari, and colleagues from the REAL Centre at Cambridge, generated qualitative evidence of exclusion in classrooms and found that teachers’ beliefs and attitudes were an important factor in how teachers addressed the needs of marginalized children. The policy recommendation from the program was that for teacher training and coaching programs designs needed to incorporate ways of addressing teachers beliefs and attitudes in addition to their practices and knowledge.
Tackling Child Marriage and Child Labour in Pakistan
The burden of child marriage is borne disproportionately by girls and is linked with issues of poverty and social norms. To address the gap in evidence on the incidence, socioeconomic impact, and associated costs of child marriage in Pakistan, a study by Faisal Bari and Maryam Khan, estimates the social costs of child marriage and generates evidence for policy and legal reform. The study advocated for the eradication of child marriage through evidence-based research and demonstrated that child marriage not only harms individuals but also has significant economic implications. Conservative estimates showed that Pakistan’s GDP suffered a loss of $0.8 billion in 2019-202 due to child marriage.
As part of our broader efforts, we have led dialogues on child rights issues, each contributing to critical conversations on pressing social challenges. IDEAS dialogue on Unpacking the Debate on the Minimum Legal Age with lawyers and activists contributed to bring both legal perspectives and socio-cultural dimensions to the debate on child marriage and emphasized the need for a uniform legal approach while considering the complexities of agency and consent in each case. Additionally, through discussion on Criminalising Child Domestic Labour in Pakistan with National Commission on the Rights of Child (NCRC) Chairperson, Senator Ayesha Raza Farooq, we advocated for a greater awareness and reforms on child rights violations, and to steer evidence-based research to support provincial and federal governments in drafting legislation around protecting child rights. The conversation stressed the need for integrated strategies to combat child labor while simultaneously focusing on increasing opportunities through education. It underscored the value of fostering IT skills and computer literacy as vital tools for enhancing educational opportunities and emphasized on the need for robust monitoring mechanisms to protect children.
Prioritizing Child Wellbeing for a Prosperous Future
Children’s well-being is not only a fundamental right, but a powerful tool in shaping the future of any nation. As we observe World Children’s Day, we believe it is crucial to remain cognizant of the multi-dimensional and multi-sectoral challenges faced by children in Pakistan, and to re-emphasise the need for comprehensive policy reforms which prioritize child protection, education, nutrition, and the climate crisis.
Our children’s future depends on swift, strategic, and evidence based action to address these challenges in an effective and pragmatic manner.
