Responding To The Covid 19 Pandemic In A Resource Constrained Country: The Case Of Pakistan.

BACKGROUND: Pakistan, like the rest of the world has not been spared by COVID-19, with the cases escalating nationwide. Being a developing country, Pakistan has had meagre resources and weak health systems to tackle the menace. We analysed the national response of Pakistan to the pandemic by critically analysing the interventions taken at community, health systems and multi-sectoral level and identifying the response gaps. The fragile health system of Pakistan performed fairly well according to its ability - the bed capacity was expanded, health professionals' capacity building strategies were adopted, telemedicine was put into practice, indigenous production of required personal protective equipment started, testing capacity was increased, and attempts were made to improve the surveillance mechanisms. However, the strategies adopted at the community level proved in-adequate. The severity of the disease was not communicated clearly to the public, religious leaders were not effectively on board, social distancing measures were not strictly followed specially during religious festivities, contact tracing was not extensively carried out specially in the rural areas - overall awareness of the community to COVID-19 remained low. The educational institutions were closed in time but the intermittent lockdown procedures and easing of transport restrictions led to community spread of the virus. Overall, Pakistan's performance has been acceptable, but community engagement and participation need to be improved.

Malnutrition and food insecurity in child labourers in Sindh, Pakistan: a cross-sectional study.

BACKGROUND: Child labour is common in low- and middle-income countries. Although child labour is widespread in Pakistan, no data are available on the health of child labourers. AIMS: This study aimed to assess the food security, food intake and nutritional status of child labourers aged 5-14 years working in lower Sindh, Pakistan. METHODS: Child labourers aged 5-14 years working in agriculture, manufacturing industry, hotels and restaurants, domestic work and migrant child labourers working in vegetable markets were recruited using a respondent-driven sampling technique. Sociodemographic and nutrition information was obtained by an interviewer questionnaire. The children's height and weight were measured to assess stunting (height-for-age z scores less than -2) and wasting (weightfor- height z scores less than -2). RESULTS: A total of 634 child labourers were included: 184 worked in agriculture, 120 in industry, 67 in hotels and restaurants, 63 in domestic work and 200 were migrant child labourers. Overall, 15.5% of the children were stunted and 30.0% were wasted. The prevalence of stunting was highest in children working in agriculture (27.2%) and the prevalence of wasting was highest in migrant child workers (35.0%). About half the children (51.1%) were suffering from food insecurity. Food inadequacy was mainly in consumption of vegetables/potatoes (98% of the children had inadequate intake), legumes (97%), fruits (96%), meat/ poultry (95%) and milk/dairy products (82%). CONCLUSION: The nutritional status and food insecurity of the child labourers of Pakistan are comparable with the general population, highlighting the grave situation of the country with regard to food security.