Alarming rates of child malnutrition in Quetta, Baluchistan

Quetta, the capital of Baluchistan Province, is Pakistan’s main urban center in the southwest and serves as a key gateway for trade, health services, and population movements due to its proximity to the Afghan border. With more than 2.27 million people, including thousands of Afghan refugees and migrants, the district is experiencing rapid population growth, urbanization, and increasing pressure on public services. 

Last May, a SMART analysis respecting SMART methodology was conducted in Quetta to determine the prevalence of global acute malnutrition in children aged 0-59 months, to gain a deeper understanding of health issues, infant and young child feeding practices, food security, and water, sanitation, and hygiene conditions. 

“The result showed a prevalence of combined global acute malnutrition of 29.1% – the emergency threshold is 15% – and the prevalence of combined severe acute malnutrition reached 8.1%, which is alarming when we know that the emergency threshold is 2%. Severe acute malnutrition is potentially deadly for children, and it is heartbreaking because it’s a treatable disease when it’s undertaken soon enough,” highlights Muhammad Aamir, Country Director for Action against Hunger in Pakistan. 

Chronic malnutrition also remains widespread, with 35.6% of children stunted, including 13.8% who are severely stunted. These findings reflect persistent long-term nutritional deprivation and repeated exposure to adverse health and environmental conditions. Furthermore, 38.1% of children are underweight, indicating the combined effects of acute and chronic undernutrition. 

The analysis showed that water, sanitation and hygiene situation presents significant health risks contributing to malnutrition. Access to improved sanitation is moderate; 31.1% of households still use unimproved facilities or practice open defecation, and 51.3% dispose of waste in unofficial dumping sites, increasing environmental contamination. In addition, 81.9% of households do not treat drinking water, despite heavy reliance on tanker trucks and communal water sources, heightening the risk of waterborne diseases and repeated infections among children.  

Moreover, the food security and livelihoods analysis indicates strong reliance on unstable income sources, with 32.9% of households engaged in daily wage labor and 31.9% in salaried employment, while agriculture-based livelihoods remain limited. These economic constraints reduce household purchasing power and dietary diversity, contributing to inadequate food access and increasing the risk of child undernutrition.  

“To effectively tackle malnutrition, we need to emphasize a more integrated approach—expanding nutrition services in the most vulnerable communities, strengthening early screening and follow-up at community level, and making sure that every child who needs treatment can access it.” explains Muhammad Aamir. “At the same time, addressing maternal malnutrition, promoting better infant and young child feeding practices—especially early initiation of breastfeeding and exclusive breastfeeding during the first six months—will be critical. Integrating care for vulnerable infants under six months into routine maternal, newborn and child health services will also help ensure that those most at risk are identified and supported early, giving them a much better chance of healthy growth and development.” 

Among other recommendations, the SMART analysis report highlights the needs for strengthening sexual and reproductive health services, maternal and neonatal health, training human resources, and securing health system funding. The recommendations also emphasize better integration between nutrition and water, sanitation and hygiene activities in order to reduce related diseases, whilst strengthening food security and the economic resilience of households through nutrition-sensitive livelihoods, access to social protection and the diversification of income sources.