Department of Anthropology, The Islamia University of Bahawalpur, Bahawalpur 63100, Pakistan.
Department of Psychology, University of Sargodha, Sargodha 40100, Pakistan.
Nutrients. 2024 Aug 10;16(16):2642. doi: 10.3390/nu16162642.
This study examined access to water, food, and nutrition programs among marginalized communities in Southern Punjab, Pakistan, and their effects on nutrition. Both qualitative and quantitative data were used in this study. We held two focus group discussions (one with 10 males and one with 10 females) and conducted in-depth interviews with 15 key stakeholders, including 20 mothers and 10 healthcare providers. A survey of 235 households was carried out to evaluate water and food insecurity, with the data analyzed using Wilcoxon's rank-sum test, -test, and Pearson's chi-square test. The results revealed that 90% of households experienced moderate-to-severe water insecurity, and 73% faced moderate-to-severe food insecurity. Household water and food insecurity were positively correlated with each other (correlation coefficient = 0.205; = 0.004). Greater household water ( = 0.028) and food insecurity ( < 0.001) were both associated with higher perceived stress. Furthermore, lower socioeconomic status was strongly related to higher levels of water ( < 0.001) and food insecurity ( < 0.001). Qualitative findings highlight the impact of colonial and post-colonial policies, which have resulted in water injustice, supply issues, and corruption in water administration. Women face significant challenges in fetching water, including stigma, harassment, and gender vulnerabilities, leading to conflicts and injuries. Water scarcity and poor quality adversely affect sanitation, hygiene, and breastfeeding practices among lactating mothers. Structural adjustment policies have exacerbated inflation and reduced purchasing power. Respondents reported a widespread lack of dietary diversity and food quality. Nutrition programs face obstacles such as the exclusion of people with low social and cultural capital, underfunding, weak monitoring, health sector corruption, and the influence of formula milk companies allied with the medical community and bureaucracy. This study concludes that addressing the macro-political and economic causes of undernutrition should be prioritized to improve nutrition security in Pakistan.
本研究考察了巴基斯坦旁遮普南部边缘社区获得水、食物和营养方案的情况及其对营养的影响。本研究采用定性和定量数据。我们举行了两次焦点小组讨论（一次有 10 名男性，一次有 10 名女性），并对 15 名关键利益攸关方进行了深入访谈，其中包括 20 名母亲和 10 名医疗保健提供者。对 235 户家庭进行了水和粮食不安全调查，使用 Wilcoxon 秩和检验、t 检验和 Pearson 卡方检验对数据进行分析。结果显示，90%的家庭经历了中度至重度水不安全，73%的家庭面临中度至重度粮食不安全。家庭用水和粮食不安全呈正相关（相关系数=0.205；=0.004）。家庭用水（=0.028）和粮食不安全（<0.001）越高，感知压力越大。此外，较低的社会经济地位与较高的水不安全（<0.001）和粮食不安全（<0.001）密切相关。定性研究结果突出了殖民和后殖民政策的影响，这些政策导致了水的不公正、供应问题和水管理腐败。妇女在取水方面面临着巨大的挑战，包括耻辱、骚扰和性别脆弱性，导致冲突和受伤。水资源短缺和水质差对哺乳期母亲的卫生、个人卫生和母乳喂养做法产生不利影响。结构调整政策加剧了通货膨胀，降低了购买力。受访者报告说，饮食多样性和食品质量普遍较差。营养方案面临着一些障碍，例如排斥社会和文化资本低的人、资金不足、监测不力、卫生部门腐败以及与医疗界和官僚机构结盟的配方奶粉公司的影响。本研究得出结论，应优先解决营养不良的宏观政治和经济原因，以改善巴基斯坦的营养安全。
