In fact, around the world, many types of health risk factors rise despite urbanization and industrialization. For instance, nutritional diseases rise in both rural and urban areas of developed and developing countries. For example, various types of NCDs[1] are good examples of nutritional diseases. Every year thousands of people are dying due to diet-related NCDs. Similarly, worldwide diet-related NCDs cost billions of dollars per year. However, we can protect ourselves from various types of health risk factors through micro and macro duties. For instance, a balanced diet and regular physical activities are two main micro responsibilities for an individual against protection from many types of nutritional diseases. Similarly, macro responsibilities refer to food laws and regulations implemented by a government that plays an essential role in controlling health risk factors. Therefore, proper implementation of effective food policies leads to protecting people from many diet-related diseases.[2]
Internationally, many issues such as health development, gender equality, and malnutrition are well placed in SDGs. However, still, worldwide the targeted issues do not vanish or decrease dramatically. In my view, the essential flaws are due to the imperfect implementation of SDGs regarding health development and gender equality. For example, governments and international communities target mostly under-nutrition through various interventions. Particularly, in the case of Pakistan BISP, NPGP, and Ehsaas interventions target only extreme poverty and diseases associated with under-nutrition.
However, over-nutrition in urban areas for middle and higher-income people is a great challenge too. In fact, globally, over-nutrition cost an estimated US$2 trillion per year and is responsible for about 68 percent of overall mortality. In fact, most NCDs are diet-related diseases namely cardiovascular diseases, cancers, and diabetes [3], which cannot be treated just by an individual’s dietary and physical activity behaviors. Rather, there is a need for comprehensive food security along the whole food chain, which cover all food production, food transaction, food marketing, food distribution, and food consumption. In fact, such food safety over the food chain for the poor and rich requires holistic interventions by national and international communities. [4]
Similarly, according to various studies higher consumption of industrial food which is mostly higher processed food increase NCDs worldwide. Specifically, in urban areas, the increase in industrial food tends to rise over-nutrition and associated diseases. Thus, in our era the increase of industrial food containing various chemical ingredients and highly processed causes mortality and social and economic costs.[5] Therefore, there is a need for such policies and interventions to protect both the production and consumption sides of food.
Moreover, in LMICs[6] there are high gender inequalities. For instance, specifically in rural areas along with inequalities in education, labor market, and empowerment, there are many gender biases in physical activity for health.
According to GNR (2016), nearly 2 billion people are obese and overweight worldwide among them women have a higher ratio.[7] Besides diet and treatment, regular physical activity plays vital for health development. It helps improve overall health and fitness, maintain a healthy weight, and reduce the risk of many diet-related diseases. However, despite the importance of physical activity for preventing disease few women obtain the recommended levels of physical activity. Therefore, it is important that national and international communities focus on the barriers to physical activity that affect women.
Despite this, women in Pakistan legally have equal rights and women in urban areas are much better comparatively with respect to education, voting, and social and political contribution. Still, there are challenges with respect to sports and physical activities for women. In fact, their chances of participation decline as they grow up.[8]
In Pakistan, due to various economic, behavioral, environmental, and social barriers like gender inequality, women are not actively involved in regular physical activities related to health development. For instance, they cannot be regular due to lack of time. Because they are responsible for house chores and children. They are not motivated by family and community. They do have not many skills, awareness, and information. Similarly, behaviorally they feel embarrassed and weak. Even some overweight and obese women in rural areas of Pakistan cannot do regular exercise despite doctor advice due to, a lack of access to places to exercise. Even with access to places for a physical activity many of them are unable due to culture and lack of support from family and community. Furthermore, sometimes climate condition is also a considerable environmental barrier to the physical activity of women.[9]
In conclusion, SDGs related to health development and gender equality requires perfect implementation. They cannot be achieved till 2030 unless we do not have macro-level targets instead of micro-level. For instance, to end poverty we need to have holistic interventions and graduation of the ultra-poor by targeting the dynamics of poverty instead of small-size social protection at the household level. For instance, we should remove the miss of information in society for all elites.
According to a report released by PIDE (2022), more than 31% of youth with degrees and professions in Pakistan are unemployed.[10] Even though the youth is educated with the best skills they cannot find a job. Still, many people have much land however, they cannot utilize their capital efficiently. Similarly, many people have enough income to modernize their living standards however, they live under bad living standards. Therefore, there is a need for a scheme under the SDGs agenda to motivate, make aware, and provide enough information and opportunities to people in rural and urban areas of Pakistan.
[1] Non-communicable diseases
[2] Zubair, A. (2022). Exploring Association between Food Law and Double Burden of Malnutrition: A case study of Afghanistan. Journal of Clinical Cases & Reports, 2022(S7), 12p.
[3] Htenas, A., Tanimichi-Hoberg, Y., & Brown, L. (2017). An overview of links between obesity and food systems: implications for the agriculture GP agenda.
[4] Acton, R. B., & Hammond, D. (2018). The impact of price and nutrition labelling on sugary drink purchases: Results from an experimental marketplace study. Appetite, 121, 129-137.
[5] Monteiro, C. A., Cannon, G., Moubarac, J.-C., Levy, R. B., Louzada, M. L. C., & Jaime, P. C. (2017). The UN Decade of Nutrition, the NOVA food classification and the trouble with ultra-processing. Public Health Nutrition 21(1), 5–17.
[6] Low-and middle-income countries
[7] Global Nutrition Report 2016: From Promise to Impact: Ending Malnutrition by 2030. Washington, DC.
[8] Laar, A. R., Perveen. S., & Ashraf, M.A. (2022) Young Women as Change Agents in Sports and Physical Activities in the Punjab (Southern) Province of Pakistan. Front. Psychol. 13:857189.
[9] Samir, N., Mahmud, S. & Khuwaja, A.K. (2011). Prevalence of physical inactivity and barriers to physical activity among obese attendants at a community health-care center in Karachi, Pakistan. BMC Res Notes 4, 174.
[10] https://tribune.com.pk/story/2342344/over-31-of-educated-youth-unemployedreveals-pide
