VULNERABILITY ANALYSIS AND MAPPING (VAM) UNIT, WORLD FOOD PROGRAMME, PAKISTAN

FOOD INSECURITY IN URBAN PAKISTAN Contents

Table of Contents Table of Contents i List of Annexes ii List of Tables ii List of Figures iv List of Maps v Abbreviations and Acronyms vi Preface vii Executive Summary 1 Chapter 1 Introduction 4 Chapter 2 2.1 Urbanization in Pakistan: Implication for Urban Food Security 12 2.2 In-Migration 13 2.3 Implications of Urbanization for Urban Food Security 18 2.3.1 Health and Productivity 18 2.3.2 Food Demand and Consumption 20 Chapter 3 Food Availability 26 Chapter 4 Gender And Food Security 32 4.1 Sex Ratio in Urban Pakistan 32 4.2 Labour Force Participation Rate 33 4.3 Social Indicators on Primary Education and Primary Health 34 4.4 Social Development in Primary Education and Primary Health 34 4.5 Primary Education 35 4.6 Distribution of Mixed School 36 4.7 Gender Gap in Primary Education 36 4.8 Gender Gap in Literacy Ratio 38 Chapter 5 Food Access 43 5.1 Habitat- Shelter for All 51 5.2 House Ownership 53 5.3 Slums Dewlling / Kachi Abadis 53 5.4 Homeless/ Street Dwelling 54 Chapter 6 Food Absorption 69 6.1 Health 69 6.2 Immunization of Children under 10 Years of Age 69 6.3 Disability Among Children and Youth in Urban Pakistan 69 6.4 Incidence of Disability 70 6.5 Institutional Support System for Children with Disability 70 6.6 The MDGs, Food Absorption and Food Security 71 6.7 The Diseases and Poverty 74 6.8 Poor Sanitation and Contamination 82 6.9 Socio – economic and Political Environment 82 6.10 Food handling, processing, and cooking practices 82 6.11 Case Study 87 6.12Wastewater use in Pakistan: The case of Haroonabad and Faisalabad 87 6.12.1 Haroonabad 87 6.12.2 Faisalabad 87 6.13 Water Quality, Crops and Cropping Intensities 87 6.14 Health Impact 89 6.14.1 Intestinal Nematodes 89 6.15 Access to Safe Water 91 6.16 Cultural Diversity and People’s Preference 93 6.17 Cultural Diversity and Ethnicity Reflected by Races and Tribes in 93 Pakistan 6.18 Food Preferences of People 94

VULNERABILITY ANALYSIS AND MAPPING (VAM) UNIT, WORLD FOOD PROGRAMME, PAKISTAN iii FOOD INSECURITY IN URBAN PAKISTAN Contents

6.19 Media Choices for Knowledge, Information and Entertainment 95 6.20 Newspaper Readership 96 6.21 Radio 96 6.22 Television 97 6.23 Cinema 98 6.24 Food Absorption 99 Chapter 7 Food Insecurity in Urban Pakistan 109

Annexes Annex 1 NWFP –Cities Population 2005 22 Annex 2 PAK – Cities population 2005 22 Annex 3 Sindh – Cities with 1-12 Lac population 2005 22 Annex 4 Cities in Pakistan 23 Annex 5 Sindh – Cities with 2-20 K population 2005 23 Annex 6 Sindh – Cities with 20-90 K population 2005 24 Annex 7 Balochistan – Cities population 2005 24 Annex 8 Punjab – Cities 9- 20 K population 2005 25 Annex 9 Punjab – Cities 50- 96 population 2005 25 Annex 10 Population of Cities in Pakistan 2005 116 Annex 11 Per Capita Income in Urban Pakistan 124 Annex 12 Numbers of Towns by Population in Pakistan 126 Annex 13 Food Insecurity in Urban Pakistan 2006 128 Annex 14 Food Insecurity Ranking in Urban Pakistan 2006 129 Annex 15 Composite Indicators of Urban Food Security 130 Annex 16 Correlation of Composite Indicators 132 Annex 17 Household Without Toilet Facilities in Urban Pakistan 2004-05 133 Annex 18 Household Without Safe Drinking Water in Urban Pakistan 2004-05 134 Annex 19 Household Without Electricity Connection in Urban Pakistan 2004-05 135 Annex 20 Population in Kacha Houses in Urban Pakistan 136 Annex 21 Population in Semi- Pacca Houses in Urban Pakistan 137 Annex 22 Population in Both Kacha and Semi Kacha Houses in Urban Pakistan 138 Annex 23 Adult Literate (Total) in Urban Pakistan 2004-05 139 Annex 24 Adult Literate (Male) in Urban Pakistan 2004-05 140 Annex 25 Adult Literate (Female) in Urban Pakistan 2004-05 141 Annex 26 Gender Gap in Literacy Rate in Urban Pakistan 2004-05 142 Annex 27 Unemployment Ratio in Urban Pakistan 143 Annex 28 Food Insecurity in Urban Pakistan 2006 144 Annex 29 Food Consumption in Kcal Per cu in Urban Pakistan 145 Annex 30 Housing Structure and Facilities in Urban Pakistan 146 Annex 31 Houeholds without Toilet Facilities in Urban Pakistan 2004-05 147 Annex 32 Housing Structure and Facilities in Urban Pakistan 148

List of Tables Table 2.1 Difference in Growth Rate Due to Migration 13 Table 2.2 Percentage of In migrants to Total Urban Population 14 Table 2.3 Top 10 most populated Cities in Pakistan 2005 15 Table 2.4 Population of Cities in Pakistan 17 Table 3.1 Calories Consumption Per capita Per day in Urban Pakistan 27 Table 3.2 Calories Consumption Per capita Per day in Urban Pakistan 31 Table 4.1 Sex Ratio Pakistan and Province 32 Table 4.2 Gender and Development- Sex Ratio in Urban Population 32 Table 4.3 Labour force Participation Rate-Urban (2003-04) 33 Table 4.4 Unpaid Family workers 33 Table 4.5 Literacy Rate-Urban Pakistan 2003-2004 34

VULNERABILITY ANALYSIS AND MAPPING (VAM) UNIT, WORLD FOOD PROGRAMME, PAKISTAN iv FOOD INSECURITY IN URBAN PAKISTAN Contents

Table 4.6 Ratio of Urban Population Under 10 Years of age 34 Table 4.7 Districts with under 10 years Population between 35-40% 35 Table 4.8 Primary Education in Urban Pakistan-NEMIS 2004 35 Table 4.9 Male Female Ratio 36 Table 4.10 Mixed School 36 Table 4.11 Gender Gap in Literacy Rate in Urban Pakistan 37 Table 4.12 Primary Education in Urban Pakistan – NEMIS 2004-05 41 Table 5.1 Per capita income in Pakistan 43 Table 5.2 Top 10 Districts based on highest per capita income 44 Table 5.3 Livelihood Access in Urban Pakistan 44 Table 5.4 Adult Literate (Total) in Urban Pakistan 44 Table 5.5 Adult Literate (Male) in Urban Pakistan 47 Table 5.6 Adult Literate (Female) in Urban Pakistan 48 Table 5.7 Unemployment Ratio in Urban Areas of Pakistan 48 Table 5.8 Percentage of House Ownership in Urban Areas 53 Table 5.9 Homeless/Street Dwelling 54 Table 5.10 Population in Kacha House in Urban Pakistan 55 Table 5.11 Population in Semi- Pacca Houses in Urban Pakistan 55 Table 5.12 Households without Electricity Connection in Urban Pakistan 59 Table 5.13 Livelihood Access in Urban Pakistan 61 Table 5.14 Adult Literate (Total) in Urban Pakistan 62 Table 5.15 Adult Literate (Male) in Urban Pakistan 63 Table 5.16 Adult Literate (Female) in Urban Pakistan 64 Table 5.17 Unemployment Ratio in Urban Pakistan 65 Table 5.18 Population in Kacha Houses in Urban Pakistan 66 Table 5.19 Population in Semi Pacca Houses 67 Table 5.20 Households without electricity connection in Urban Pakistan 68 Table 6.1 Immunization Status 69 Table 6.2 Disability Population Analysis (National Basis)2002 70 Table 6.3 Type of Disability (National Basis)2002 70 Table 6.4 Ratio of Urban Population 10 Years and Above with Disability- Province 71 Wise Table 6.5 Population 10 Years and Above – 10 Districts with lowest Disability 71 Incidence Table 6.6 Population 10 Years and Above – 10 Districts with Highest Disability 71 Incidence Table 6.7 Special Education Institutions in Public Sector- GOP MWDSW&SE Pub 72 2002 Table 6.8 Addressing Disability in Children and Youth (6-19 Years) Eligible for 73 Enrolment Table 6.9 Millennium Development Goals, Targets and Indicators 75 Table 6.10 Doctors (MBBS and above) per 20000 Population in Pakistan 79 Table 6.11 Lady Health Visitors per 20000 Population in Pakistan 79 Table 6.12 Nurses per 20000 Population in Pakistan 82 Table 6.13 Health and Sanitation in Urban Pakistan 84 Table 6.14 Water quality parameters of wastewater used for irrigation in Haroonabad 88 and Channel 4 Sites in Faisalabad, Pakistan Table 6.15 Total Nitrogen (TN) application, nitrogen ratios and total amount of 88 wastewater applied to Cauliflower in Haroonabad and Faisalabad, Pakistan Table 6.16 Vertical distribution of heavy metal concentrations in soil (mg/kg) at varying 89 soil depths in relation to type of irrigation water used at three sites in Pakistan Table 6.17 Soil and Wheat grain heavy metal concentration (mg/kg) in relation to 90 irrigation source, Faisalabad, Pakistan Table 6.18 Hookworm prevalence among wastewater – irrigating farmers and their 90

VULNERABILITY ANALYSIS AND MAPPING (VAM) UNIT, WORLD FOOD PROGRAMME, PAKISTAN v FOOD INSECURITY IN URBAN PAKISTAN Contents

children compared to a group of unexposed farmers, laborers and their children at two locations in Pakistan Table 6.19 Household without safe drinking water in Urban Pakistan 91 Table 6.20 Calories Consumption per capita per day in Urban Pakistan 91 Table 6.21 Distribution of Main Races and Tribes in Number of Districts 93 Table 6.22 Distribution of Food Choices- in Number of Districts 95 Table 6.23 Percentage of Household that subscribe 95 Table 6.24 Districts with less than 20 % subscription of Newspaper at household level 96 Table 6.25 Districts with more than 50% subscription of Newspaper at household level 96 Table 6.26 Percentage of Household Subscribing Newspaper 96 Table 6.27 Percentage of Household Subscribing Radio 97 Table 6.28 Districts with more than 15% Subscription of Radio at Household Level 97 Table 6.29 Districts with more than 60% Subscription of Radio at Household Level 97 Table 6.30 Percentage of Household Subscribing TV 98 Table 6.31 District with less than 15% Household Subscribing to TV 98 Table 6.32 Number of Cinema in District 98 Table 6.33 Districts with highest Number of Cinema 99 Table 6.34 Food Absorption in Urban Pakistan 100 Table 6.35 Number of Doctors (MBBS and above) per 20000 Population in Pakistan 104 Table 6.36 Number of LHVs per 20000 Population in Pakistan 105 Table 6.37 Number of Nurses per 20000 Population in Pakistan 106 Table 6.38 Health and Sanitation in Urban Pakistan 107 Table 6.39 Calories Consumption per Day in Urban Pakistan 108 Table 7.1 Food Insecurity in Urban Pakistan 109 Table 7.2 Food Consumption in Kcal per cu in Urban Pakistan 111 Table 7.3 Food Insecurity in Urban Pakistan 114 Table 7.4 Food Consumption in Kcal per cu in Urban Pakistan 115

List of Figures Figure 2.1 Urbanization Vs Human Development 12 Figure 2.2 Urbanization Vs Income 12 Figure 2.3 Urbanization by Regions 12 Figure 2.4 Proportion of Migrant Population to total Urban Population 14 Figure 2.5 Cities Population by Province/ Region 2005 16 Figure 2.6 Punjab – Cities 1 – 7 lac Population 2005 16 Figure 2.7 Punjab – Cities 20 – 50 k Population 2005 17 Figure 2.8 FATA- Cities Population 2005 17 Figure 2.9 Northern Areas – Cities Population 2005 18 Figure 3.1 Requirement of Food in Urban Pakistan Million MT 26 Figure 3.2 Food Shortfall Pakistan 26 Figure 3.3 Production of Wheat in Pakistan 26 Figure 3.4 Food Consumption in Urban Pakistan Million MT 29 Figure 4.1 Gender and Development-Sex Ratio Urban Pakistan 33 Figure 4.2 Unpaid Family workers 33 Figure 4.3 Percentage of Urban Population Under 10 Years of Age 34 Figure 5.1 Percentage of income shares in Urban- Rural Areas 1996-97 43 Figure 5.2 Income of Urban Population of source in Pakistan 43 Figure 5.3 House Ownership 53 Figure 6.1 Ratio of Urban Population with Disability 70 Figure 6.2 MDG Nutrition targets for Pakistan 74 Figure 6.3 Pakistan and MDG Targets Reproductive Health 74 Figure 6.4 Total cost and gross margin (000 Rs/ha) for a wastewater farmer and a 90 regular canal water farmer in Haroonabad, Pakistan Figure 6.5 Household with Ratio Subscription 97 Figure 6.6 Households with TV Subscription 96

VULNERABILITY ANALYSIS AND MAPPING (VAM) UNIT, WORLD FOOD PROGRAMME, PAKISTAN vi FOOD INSECURITY IN URBAN PAKISTAN Contents

List of Maps Map 3.1 Calories per Capita Consumption in Urban Pakistan 30 Map 4.1 Gender Gap in Literacy Rato in Urban Punjab 36 Map 4.2 Gender Gap in Literacy Ratio in Urban Sindh 37 Map 4.3 Gender Gap in Literacy Ratio in Urban NWFP 37 Map 4.4 Gender Gap in Literacy Ratio in Urban Balochistan 37 Map 4.5 Gender Gap in Literacy Ratio in Urban PAK 37 Map 4.6 Gender Gap in Literacy Ratio in Urban FANA 38 Map 4.7 Gender Gap in Literacy Ratio in Urban FATA 38 Map 4.8 Gender Gap in Literacy Ratio in Urban Pakistan 39 Map 5.1 Livelihood Access in Urban Pakistan 45 Map 5.2 Adult Literate (Total) in Urban Pakistan 2004-05 46 Map 5.3 Adult Literate (Female) 15 Years and above in Urban Punjab 47 Map 5.4 Adult Literate (Female) 15 Years and above in Urban Sindh 47 Map 5.5 Adult Literate (Female) 15 Years and above in Urban NWFP 47 Map 5.6 Adult Literate (Female) 15 Years and above in Urban Balochistan 48 Map 5.7 Adult Literate (Female) 15 Years and above in Urban PAK 48 Map 5.8 Adult Literate (Male) 15 Years and above in Urban Pakistan 2004-05 49 Map 5.9 Adult Literate (Female) 15 Years and above in Urban Pakistan 2004-05 50 Map 5.10 Adult Literate (Female) 15 Years and above in Urban FANA 51 Map 5.11 Adult Literate (Female) 15 Years and above in Urban FATA 51 Map 5.12 Unemployment Ratio in Urban Pakistan 52 Map 5.13 Population in Kacha Houses in Urban Pakistan 56 Map 5.14 Population in Semi Pacca Houses in Urban Pakistan 57 Map 5.15 Population in Both Kacha and Semi Kacha Houses in Urban Pakistan 58 Map 5.16 Households without Electricity Connection in Urban Pakistan 2004-05 60 Map 6.1 Doctors (MBBS and above) per 20000 population in Pakistan 80 Map 6.2 Lady Health Visitors per 20000 per population in Pakistan 81 Map 6.3 Nurses per 20000 population in Pakistan 83 Map 6.4 Health and Sanitation in Urban Pakistan 85 Map 6.5 Households without safe Drinking Water in Urban Pakistan 2004-05 92 Map 6.6 Food Absorption in Urban Punjab 99 Map 6.7 Food Absorption in Urban Sindh 99 Map 6.8 Food Absorption in Urban NWFP 99 Map 6.9 Food Absorption in Urban Balochistan 100 Map 6.10 Food Absorption in Urban PAK 100 Map 6.11 Food Absorption in Urban FANA 100 Map 6.12 Food Absorption in Urban FATA 100 Map 6.13 Food Absorption in Urban Pakistan 102 Map 7.1 Food Insecurity in Urban Pakistan 110 Map 7.2 Food Insecurity in Urban Punjab 111 Map 7.3 Food Insecurity in Urban Sindh 111 Map 7.4 Food Insecurity in Urban NWFP 111 Map 7.6 Food Insecurity in Urban Balochistan 112 Map 7.7 Food Insecurity in Urban FANA 112 Map 7.8 Food Insecurity in Urban FATA 112 Map 7.9 Food Insecurity in Urban PAK 112

VULNERABILITY ANALYSIS AND MAPPING (VAM) UNIT, WORLD FOOD PROGRAMME, PAKISTAN vii FOOD INSECURITY IN URBAN PAKISTAN Contents

Abbreviation and Acronyms ADB Asian Development Bank AHHFSI Aggregate House Hold Food Security Index AJK Azad Jammu & Kashmir BOP Balance of Payment CDA Cholistan Development Authority CGIAR Consultative Group on International Agricultural Research CGPRT The Regional Co-ordination Centre for Research and Development of Coarse Grains, Pulses, Roots and Tuber Crops in Humid Tropics of Asia and Pacific CRPRID Centre of Research for Poverty Reduction and Income Distribution DCs Developing Country DHS Demographic and Health Surveys DRIFE Danish Research Institute of Food Economics EAP Economically Active Population FAO Food and Agriculture Organization FATA Federally Administered Tribal Area FBOS Federal Bureau of Statistics FLR Female Literacy Rate GDP Gross Domestic Product GOP Government of Pakistan HDI Human Development Index HHIES House Hold Income & Expenditure Survey HIES Household Integrated Economic Survey HRD Human Resource Development ICESCR International Covenant on Economic Social and Cultural Rights ICMR Indian Council of Medical Research IFPRI International Food Policy Research Institute IFS International Foundation for Peace IFSA Investment and Financial Services Association Limited LHVS Lady Health Visitors MINFAL Ministry of Food, Agriculture and Live-Stock NARC National Agricultural Research Centre NAS Northern Areas NFDC National Fertilizer Development Centre NFIDC Net Food Importing Developing Country NFSA National Food Security Authority NGOs Non-Government Organization NHDR National Human Development Report NPO Non Productivity Organization NWFP North-West Frontier Province PASSCO Pakistan Agriculture Storage & Services Corporation PHCR Pakistan Human Condition Report SAARC South Asian Association for Regional Cooperation SAPS Structural Adjustment Programs SPS Sanitary & Phyto-Sanitary UNCED United Nations Conference on Environment and Development UNDP United Nations Development Programme UNU/IAS United Nations University Institute of Advanced Studies USAID United States Agency for International Development USDA United States Department of Agriculture VAM Vulnerability Analysis and Mapping WFP World Food Programme WFS World Food Summit WPPRA Wheat Production and Price Regulatory Authority WTO World Trade Organization

VULNERABILITY ANALYSIS AND MAPPING (VAM) UNIT, WORLD FOOD PROGRAMME, PAKISTAN viii FOOD INSECURITY IN URBAN PAKISTAN Preface

PREFACE

Food Security Analysis of Urban Pakistan is a unique study and carried out for the first time in Pakistan. Although, food security of the population is comparatively a new subject, the food security condition of urban people has never been assessed or addressed. The study was aimed at identifying the food insecure segments of urban areas in Pakistan, trapped in food insecurity circle and were assessed on the basis of one or more of the food security indicators. A considerable portion of urban areas was found confronted with food insecurity related problems such as malnutrition, under- nutrition, hunger, disease, and poverty. This initiative is first of its kind in Pakistan with a focus on the food insecurity at district as well as city level.

We understand that this study will divert the attention of districts governments, urban planners and donor agencies to this important and urgent issue of the urbanites. It will also provide an effective tool to planners and policy makers to address the issues objectively, and to understand the complementarities and interplay of factors responsible for it. Moreover, it will guide to understand where the most food insecure families and population are. Discussion on urban food insecurity will enable the decision makers to put it on the political agenda and to work in line with the commitment of achieving the Millennium Development Goal calling for eradication of hunger from Pakistan. The findings of the study speak loud and clear of the issues that have never been addressed in the past and that have halted the pace of development leading to disparity in terms of food security among cities in provinces, districts and intra districts level. The study also builds a link between poverty and food insecurity, which affects households in a disastrous manner.

For the first time, the urban food security study will help the stakeholders in Pakistan understand the fact that food security is not only a function of the availability (physical access) of food but it is a multifaceted problem, and if not addressed holistically the cherished goal of food security cannot be realized. Further, it underlines the reality that a macro level analysis, with a set of aggregate data at the national level, may not be a true reflection of the actual situation prevailing at micro level (district or household), in terms of intensity of food insecurity; and thus, at times, could be deceptive. Despite being primarily an agro-based economy, Pakistan has never been a food self-reliant country, as evident from the growing food import bill, as far as the sustainable food supplies from domestic resources are concerned.

Unfortunately, the imbalanced growth of cities and level of expansion of urban areas have created major serious issues due to high growth in migration. The scarcity of jobs, low level of earnings, high cost of living and inadequate provision of serivices and amenites have increased the number of food insecure people in urban areas.

The inefficient use of available technologies and research-based knowledge coupled with a poor delivery system bred inefficiencies and left hardly any space to cope with the challenge of food insecurity in the face of mounting population pressure that led to further widening of already existing disparities.

Michael P. Jones Country Director FOOD INSECURITY IN URBAN PAKISTAN Executive Summary

Executive Summary

Food security is an important development province-wise urbanization in provinces objective of every nation, and has now been continues and the districts of the Punjab province formalized under the ‘Rome Declaration’ adopted have relatively higher level of urbanization, by 186 countries at the World food Summit followed by Sindh, NWFP, Balochistan, ICT and [WFS] in 1996. The WFS Rome Declaration sets NAs. as Millennium Development Goals [MDGs] inter alia following target; There are 499 cities in Pakistan, 8 are above one million population, 4 are between 0.5-1 million “We pledge our political will and our common and 45 are in the range of 100-499 thousand of and national commitment to achieving food population. About 61% of the cities fall in the security for all, and to an ongoing effort to range of 10,000-49,999 population. eradicate hunger in all countries, with an immediate view to reducing the number of With in Punjab, there are five cities as per 2005 undernourished people to half of their present estimates, with population of more than one level no later than 2015”. million, 2 cities are in the range of 500,000- 1,000,000, while 34 cities having population Urbanization-increasing concentration of the ranges between 100,000 and 500,000. This population in urban settings, because of clearly reflects that cities in Pakistan are thickly combined result of natural increase in urban populated, and that cities like Lahore, Faisalabad, population and rural to urban migration, appears Hyderabad, Rawalpindi, Gujranwala and Multan to be irreversible process. The magnitude and are the most populated cities in Punjab province. pace of urbanization is a matter of concern for developing countries, including Pakistan. Since, In Sindh on the other hand, Karachi has emerged urbanization has several dimensions, food being as a mega city, and Hyderabad is the 2nd most central to urban issues, urban food consumption populous city of the province. Similarly, patterns, and their evolution have far-reaching Peshawar in NWFP and Quetta in Balochistan are economic, nutritional and health implications. the most populated cities of the respective Yet another problem, besides the demographic provinces. In national ranking Karachi is the problem-growing population, is the possibility of highly populated city followed by Lahore, growing urban poverty. Whereas, the proportion Faisalabad, Rawalpindi, Gujranwala, Multan, of the rural poor was projected to decrease in all Hyderabad, Peshawar, Islamabad and Quetta. regions, except Africa, during last decade of the last century, an increasing rate of urban poverty Rapid urbanization in Pakistan poses immense was foreseen throughout the developing region, challenge to this developing country, for cities in particularly in Africa and South Asia. Pakistan are ill-equipped to deal with this challenge in terms of civic infrastructure. As a As elsewhere, in the region, urban population in result emergence of urban slums, poorly designed Pakistan has been growing fast over the period. In and serviced urban satellites, and consequent 2002, it was estimated that 33 percent of the total upon that the issues related to sanitation, poor population resided in the urban Pakistan. access to potable water, diseases etc. lead According to Demographic Survey 2003, the unhygienic conditions that precipitate the food urban population is about 35.7%. It reported that, insecurity situation in urban centers because of from proportion of population living in towns and poor food absorption. cities, Pakistan was in the midst of gigantic urban increase, and the level of urbanization of 33-35.7 Although Pakistan registered reasonable percent in Pakistan was viewed as highest among economic growth rate, population increase had the SAARC member countries. Urban population been around 3 percent for decades, and thus per of three provinces of Pakistan viz., Punjab, Sindh capita income remained relatively low. There is and NWFP grew annually at almost the same rate also a strong feeling that benefits of growth were i.e., 3.31, 3.44 and 3.46 percent respectively not equitably shared among regions and between 1981 and 1998. communities. This situation has adversely imbalanced the urbanization trend, and as a result The current study on “Urban Food Insecurity in the civic environment in urban Pakistan. Pakistan” (UFIP-2006) suggests that this trend of

VULNERABILITY ANALYSIS AND MAPPING (VAM) UNIT, WORLD FOOD PROGRAMME, PAKISTAN 1 FOOD INSECURITY IN URBAN PAKISTAN Executive Summary

Agricultural production in the country was not urban farm settings that meets the demand of enough to feed more mouths, with mounting urban populace, along with some imported food pressure of population growth. The average that caters the need of upper as well as of the production of key staple i.e. wheat, increased middle class. since 1993-94 from 11,218 (000) MT to 17,653 (000) MT in 2006 in Punjab, it remained almost Given that economic access is, primarily, the stagnant in other three provinces. For example, function of income. Per capita income is a useful according to the Agricultural Statistics of indicator to access the purchasing power of the Pakistan (2002-05), wheat production in NWFP households. The Urban Food Insecurity of & Balochistan was in the range of 1064-1091 & Pakistan (UFIP-2006), has revealed that in 87 654-637 thousand metric tons, from 2002-2005 as (78%) out of 112 districts per capita income is against Punjab & Sindh, where during the same below Rs. 6,000 i.e., 100 USD per person, and in period production fell in the range of 15,355- only 25 districts it is in the range of Rs. 6,000- 17,375 &2,109-2,509 thousand metric tons 21,000 (USD100, 350), while there are 31(22%) respectively. The situation in NWFP and districts, where per capita income is in between Balochistan remained almost unimproved during Rs. 6,000 to 10,000 (USD 100-180). the period. As a result, as reported in FSA 2003, 35(29%) districts in Pakistan were highly deficit When translated into the provincial context, in wheat production in 2003. 21(62%) out of 34 in Punjab, 14 out of 20(70%) in NWFP, 15 out of 17(88%) in Sindh, 24 out of An average availability of wheat (wheat flour 25(96%) in Balochistan, 5 out of 5(100%) in excluding losses), was estimated at 17,571.8 NAs, 5 out of 7(71%) in PAK, and 3 out of (000) MT, during period from 2000-2001 to 3(100%) in FATA have per capita income below 2005-6, as against wheat demand of 17,620.6 100 USD. It is only in the Federal Capital i.e., (000) MT, suggesting a net deficit of 48.7 (000) Islamabad District, where the per capita income MT. However, during 2006-07, due to good level is Rs. 10,000-21,000(USD 180-350). weather condition, a bumper wheat crop with estimated production of 22.5 million MT is In the poverty level context, the per capita expected and Government of Pakistan forcast a income in 87 (78%) out of 112 districts i.e., surplus of 1.6 million MT. below 100 USD, implies less than USD 10 per month and 0.3 USD per day, which is a state of Since wheat is key contributor to daily caloric abject poverty. When translated into regional intake in Pakistan, the deficit in wheat context 100% of populations in regions like requirement & demand, translates into caloric FATA & NAs falls in this bracket and almost 88 shortfalls and thus to food insecurity. In 8(7%) percent of the population of Balochistan province districts out of 112, caloric intake falls in the falls in the same category. With this level of range of 3501-4855 Kcal/person, while in poverty, reliable economic access to a quality 45(40%) districts, on the other extreme the food is rather impossible. average caloric intake is in the range of 1477- 1800 Kcal/person. There are 68(61%) districts, The aforementioned evidence and discussion where the caloric intake is in between these two leads us to conclude that poor health extremes, and falls in the bracket of 1801-3500 infrastructure, unhealthy living conditions, lack Kcal per person. of good agricultural practices and poor enforcement of food safety measures implicates Economic access to food is the function of host of food absorption. Consequently, because of factors that contribute to financial well-being of inadequate food availability and poor food access the household that in turn enables the household & absorption net caloric intake is low in urban to secure food, in terms of quantity, quality & Pakistan. wholesomeness. Given the fact that Pakistan is registered as Net The urban centers of the countries have to depend Food Importing Developing Country (NFIDC) for their food either on the local production or on with the World Trade Organization (WTO) and the imported food. In some countries home that it on an average imported 1-2 million MT of gardens and back yard production, like poultry wheat each year (with few exceptions), present farming, do contribute towards household food import surge in sugar, pulses and even milk consumption. In urban Pakistan, it is mainly food powder and vegetables signals worsening state of from rural areas, along with produce of peri- food security in general and urban food security

VULNERABILITY ANALYSIS AND MAPPING (VAM) UNIT, WORLD FOOD PROGRAMME, PAKISTAN 2 FOOD INSECURITY IN URBAN PAKISTAN Executive Summary in particular. This situation is not surprising, when one looks at the growth of agricultural sector, which has declined to 2.5 percent in 2005- 6, compared to 6.7% during 2004-5.

VULNERABILITY ANALYSIS AND MAPPING (VAM) UNIT, WORLD FOOD PROGRAMME, PAKISTAN 3 FOOD INSECURITY IN URBAN PAKISTAN Introduction 1 CChhaapptteerr 11

Introduction

Right to food is acknowledged in a number of is less than $1a day, and the proportion of the international Conventions, including the 1948 people who suffer from hunger. International Bill of Human Rights (UN 1985), the International Covenant on Economic, Social Food security is thus an important objective of & Cultural Rights (UN 1966) and the Convention every nation, now formalized in the ‘Rome on the Rights of the Child (UN 1989). Similarly, Declaration’ adopted by 186 countries at the other international Declarations like World World food Summit [WFS] in 1996.The WFS Declaration on Nutrition (adopted in Rome in Rome Declaration, sets as Millennium 1992), the Declaration on Social Development Development Goals [MDGs] inter alia following (adopted at the World Social Summit in 1995) target; We pledge our political will and our and Rome Declaration on Food Security common and national commitment to achieving (FAO,1996), affirm the right of every one to have food security for all, and to an on going effort to access to safe and nutritious food, consistent with eradicate hunger in all countries, with an the right to adequate food and the fundamental immediate view to reducing the number of right of every one to be free from hunger. undernourished people to half of their present level no later than 2015. Unfortunately, despite these international commitments the situation of food security in The set of indicators chosen to substantiate many parts of the world remained dismal. For progress towards the target, envisaged in MDGs, example in Asia-Pacific, household security and highlights two important points: access continue to be the major challenge in the 1. ‘Hunger’ and ‘low income’ are not region. The region is home to nearly 500 million axiomatically the same, while linked and of equal undernourished, including 160 million children; importance with in the overall goal, they are and 800 million poor people, 2/3rd of the world separate part of a bigger problem; hungry and the poor. By 2030, the population in 2. While there are strong links among South and East Asia alone will increase by nearly ‘poverty’(low absolute or relative income), one billion to 4.22 billion, then constituting 52 ‘inequity’(the distribution of consumption percent of the world population. This increase in parameters), a population’s ‘nutrition status’ and population will require inter alia 380 million tons ‘food adequacy’(a measure of undernourishment of cereals alone. Increasing income and defined in terms of the share of a population, urbanization, in year 2030, 53 percent of the whose dietary energy consumption falls below a region’s population will be urbanites, against minimum level),the causes & consequences of current level of 34 percent) have triggered greater each are different, demand for food especially high-value food like meat, milk, dairy products, eggs, vegetable oil, In other words, MDGs provide one of the 1st fruits, vegetables and processed food etc. examples of an explicit decoupling of food- nutrition-poverty problems, along with In September 2000, The UN General Assembly recognition that action is needed simultaneously adopted Resolution No.55/2(UN2000); where by in the realm of food, nutrition and poverty, if UN members proclaimed inter alia that no effort overall development goals are to be met1. would be spared to eradicate the “abject and dehumanizing conditions of extreme poverty, to Urbanization-increasing concentration of the which more than a billion people are currently population in urban settings, because of subjected.” combined result of natural increase in urban population, rural to urban migration, appears to To give this ‘United Nation’s Millennium be irreversible process. The magnitude and pace Declaration’ substance, a set of targets was of urbanization is a matter of concern for agreed for the year 2015.The 1st one, of these developing countries (DCs). Since, urbanization targets, reads “ to halve, by year 2015, the has several dimensions, food being central to proportion of the world’s people, whose income urban issues, urban food consumption patterns,

3 VULNERABILITY ANALYSIS AND MAPPING (VAM) UNIT, WORLD FOOD PROGRAMME, PAKISTAN FOOD INSECURITY IN URBAN PAKISTAN Introduction 1 and their evolution have far-reaching economic, From a strategic perspective, inadequate energy nutritional and health implications. and micronutrient intakes, high frequency of disease, lack of safe water and sanitation are Yet another problem, besides the demographic having a major impact on pregnant women, so problem-growing population, is the possibility of that the children who constitute the next increased number of urban poor in DCs. generation are at high risk of malnutrition and Whereas, the proportion of the rural poor was disease3. projected to decrease in all regions, except Africa, during last decade of the last century, an In this backdrop, food security situation in urban increasing rate of urban poverty was foreseen Pakistan is no different from what has been throughout the developing region, particularly in discussed in this context earlier. For example, the Africa and South Asia2. city of Lahore, capital of Punjab province of Pakistan, is facing increasingly serious food In this context, ‘poverty & food insecurity’ nexus security problems mainly, as a result of many needs to be understood to address effectively the constraints affecting the way food reaches the problem of urban food insecurity. For example, city and is redistributed with in the whole urban population growth of urban areas tends to be area. Such constraints, daily faced by the traders, accompanied by increased poverty and shopkeepers and transporters, mean that malnutrition. Rapid urban growth is characterized consumers need to pay higher than normal prices by the unplanned arrival of poor migrants settling for accessing food, the quality of which is often in overcrowded conditions. Urban authorities are less than optimal. Low-income inhabitants of often unable to control this process and to Metropolitan Lahore, estimated around 50 provide adequate municipal services including percent of its 5.7 million [1999] inhabitants, face adequate water and sanitary services. a serious food security risk. Furthermore, inappropriate hygienic conditions in urban Urban lifestyles can bring about a breakdown of markets and street food sales are causing health traditional family structures, and therefore affect problems to consumers in the city4.This situation dietary habits. Newly arrived individuals and holds true for other urban settings and at times families are often marginalized as they have yet could be worse in mega cities like Karachi. to integrate into social networks that can help them meet basic requirements. One of the major issues and challenges of urbanization in developing countries is feeding In cities, most of the food needs to be purchased, the urban poor. The low-income segment of the yet employment is scarce, food insecurity urban population is disproportionately large and prominent and safety of affordable and available may continue to grow at a faster rate than the city food can be a problem. Food Security exists when average, while the gap between the urban all people, at all times, have physical and population and the number of employment economic access to sufficient, safe and nutritious opportunities keeps widening. This is an food to meet their dietary needs and food important cause of increasing poverty in many preferences for an active and healthy life. cities of the developing world. The proportion of the urban population living in slums, squatter, Malnutrition appears in poor urban dwellers as a settlements or shantytowns can hardly be result of inadequate diets, combined with estimated, but it is higher than 50 percent in sedentary lifestyles, poor living conditions and certain cities of the third world2. inadequate access to services. Fat intake often rises to a higher proportion of dietary energy, and In one of the countries of the region-India, fast obesity, chronic diseases and micronutrient growing population living in cities and towns has deficiencies become more frequent. While, created a corresponding increase in the number of stunning is observed in rural more than in urban the poor living in cities & towns. Though the areas, wasting and infectious diseases tend to scale of income and infrastructure in urban areas show a higher prevalence in cities. Rates of is higher than in rural areas, the food & nutrition underweight children in cities are now surpassing security of the urban poor is not much better than those in rural areas in a majority of the countries. their rural counterparts. The urban poor rely on wage-earning jobs to exchange for food (or non- food) items. As the majority of the urban poor are

4 VULNERABILITY ANALYSIS AND MAPPING (VAM) UNIT, WORLD FOOD PROGRAMME, PAKISTAN FOOD INSECURITY IN URBAN PAKISTAN Introduction 1 engaged in casual labor, they are increasingly food. When there is a shortage of food, the rich vulnerable to food insecurity this situation is not are unlikely to go hungry but their demand for unique in India, for fifty five percent of the food increases the price, and makes it harder for world’s poor are expected to live in urban areas the poor people to obtain food unless there are by the year 20205. humanitarian considerations. In this context, the situation in urban settings of iii. Utilized: At the household level, sufficient Pakistan may not be different and therefore, an and varied food needs to be prepared safely for urgent need to analyze food security situation in people to grow and develop, meet their energy urban Pakistan and assess the level of needs and to prevent diseases7. vulnerability so that informed policy measures could be taken. In this context, these three factors with added dimension of sustainability have different The food basket in any area determines the food implications at national and household level and security status (access, availability, effective within the household. For example, the absorption or utilization, and stability of supply) sustainability of food security is an outcome of of the household. In rural areas, as is evident food availability and accessibility, and the issue from our earlier study on “Rural Food Insecurity of food security with in the household depends on in Pakistan” is comprised of own production with the allocation of responsibilities and resources some of the commodities supplemented by among the household members. The question of purchases, varying from one area to the next. In how the resources are generated and allocated urban areas, on the contrary, the greater part of with in the household members and as a result the food basket is from purchases (the basket is who gets what, guides to the need for examining more dependent). the intra-household dynamics, i.e. how resources are generated and distributed with in a household. Hence, the fundamentals of analyzing food In Pakistan, such information is generally lacking security and for that matter vulnerability in urban and this black box is largely due to lack of settings could be based on the equation6- Fb=f (P, individual-level data on dietary intake, Ef, Ei, S, R, Ua, Ne, Cr, Df). Where: Fb (Food anthropometric measures, decision-making and basket), P (Price of commodities that comprise time allocation etc8. the basket), Ef (Earnings from formal employment), Ei (earnings from the informal The factors influencing food security inter alia sectors), S (Savings), R (Remittances), Ua (urban are: agriculture), Ne (Non-food expenses), Cr (Access to credit) and Df (Demographic factors e.g., i. Poverty: poor people lack access to dependency ratio, education level, and length of sufficient resources or to buy quality food. time in residency). Addressing poverty is important to ensure all people can afford sufficient food. In its broader context, the three major dimensions of food security, as described in the Rome ii. Health: Without sufficient calories and Declaration, namely food availability, nutrients, the body slows down making it difficult accessibility & utilization, imply that food should to undertake the work needed to produce food. be: With out good health, the body is less able to make use of the food that is available. A hungry i. Available: The amount and quality of food mother gives birth to an underweight baby, who available globally, nationally and locally can be then faces a future of stunted growth, frequent affected temporarily or on long-term basis by illness, learning disabilities, and reduced many factors including: climate, disasters, war, resistance to diseases. Contaminated water and civil unrest, population size and growth, food can cause illness, nutrient loss and often agricultural practices, environment, social status death in children. The HIV/AIDs pandemic has and trade. reduced food production in many affected countries as productive adults become ill or die. ii. Affordable: Age, status, gender, income, Thus, addressing health issues will improve both geographic location and ethnicity all affect a utilization and availability of food. person’s ability to access and afford sufficient

5 VULNERABILITY ANALYSIS AND MAPPING (VAM) UNIT, WORLD FOOD PROGRAMME, PAKISTAN FOOD INSECURITY IN URBAN PAKISTAN Introduction 1 iii. Water & Environment: Food While, there are sufficient resources in the world production requires massive amounts of water. It to provide food security for all, policy and takes one cubic meter (1000litre) of water to behavioral changes are necessary to guarantee a produce one kilogram of wheat and 5,000litres of fair share for all people, especially the poor. water for one kilogram of rice. Thus, sufficient Building on the series of global conferences, availability of food is directly related to having especially the 1992 International Conference on sufficient water. Increasing irrigation efficiency Nutrition, the 1996 World food summit, countries and limiting environmental damage through have developed national nutritional plans & salanization or reduced soil fertility is important policies in nine major strategic areas that: for sustainable food availability. Consequently, 1. mainstream nutrition goals into development where water is scarce and the environment policies and programs, fragile, achieving food security may depend on 2. improve household food & nutrition security, what has been called “virtual water”, foods 3. protect consumers through improved food imported from countries with an abundance of quality & safety, water. This may be more efficient use of scarce 4. prevent and manage infectious diseases, resources. 5. promote breast feeding, 6. care for socio-economically deprived and iv. Disasters & Conflicts: Droughts, nutritionally vulnerable, cyclones and pests can quickly wipe out large 7. prevent and control specific micronutrient quantities of food as it grows or is stored for later deficiencies, use. Conflicts can also reduce or destroy food in 8. promote appropriate diets & healthy life production or in storage. Stored food, seeds and styles, breeding livestock may be eaten or destroyed by 9. assess, analyze and monitor nutrition soldiers or opposing groups leading to long-term situations. food shortages. Government needs to prioritize food security in the recovery phase. Whereas, nine years later the progress, so far, has been a long way short of what is intended7, in the v. Population & urbanization: Population context of urban food security, a higher share of growth increases the demand for food. With most urban demand for food, especially the dietary productive lands already in use, there is pressure staple, could be fullfilled by adapting better for this land to become increasingly productive. domestic agricultural practices to produce Poor harvests and increased costs lead many poor according to the needs & preferences of urban farmers to migrate to the city looking for work. consumers. At the lower income range, prices are Expanding cities spread out across productive undoubtedly a major determinant of urban land, pushing food production further and further consumer’s food choices and the cheaper staples away from consumers. It increase the cost of all are relied upon for much of the total dietary activities associated with producion and energy intake. However, factors other than price transportation of food, and worsen the food for example, convenience, appear to influence security of the poor in the cities. food selection, even among low-income urban dwellers. For middle class consumers, price is vi. Trade: Many poor countries can produce only one of the factors that motivate food choice. staples more cheaply than rich nations but Other includes taste, quality, prestige, cultural barriers to trade, such as distance from markets, value, appeal, convenience etc. Understanding quarantine regulations and tariffs make it difficult consumer’s motivations and knowing the relative for them to compete in export markets against importance of various criteria for different highly subsidized farmers in the rich countries. consumer groups are essential to the development This deprives poor farmers of income and entire and promotion of local products. For example, countries of the agricultural base; they need to development of attractive and convenient develop other sectors of the economy. In processed foods from local staples, combined addition, trade imbalances prevent poor countries with active commercial marketing, can succeed in from importing agricultural products that could increasing urban demand of such domestically enhance their food security. produced food. Among the urban food & nutrition problems of developing countries like Pakistan, those of the

6 VULNERABILITY ANALYSIS AND MAPPING (VAM) UNIT, WORLD FOOD PROGRAMME, PAKISTAN FOOD INSECURITY IN URBAN PAKISTAN Introduction 1 poor are at present a priority issue. Hunger & the poorer childcare practices and worst malnutrition, are of course rooted in poverty. In nutritional status among children. Mother seemed these times of economic stringency, the urban to be able to juggle efficiently between their poor are growing in numbers and their condition childcare responsibilities and their income- is deteriorating in many cities2. generating role9. One of the IFPRI studies on urban food & FAO reports that in 1997-99 there were 815 nutrition, aimed at examining the nature of urban million undernourished people in the world: 77 poverty and how it relates to food insecurity and million in the DCs, 27 million in transition malnutrition in urban part of Accra, Ghana. The economies and 11 million in the industrialized main goal was to determine how the strategies countries. For DCs, the figures suggested employed by the urban poor to secure their decrease of 39 million since 1990-92(the livelihood which, affected household’s food benchmark period used at the WFS), for which security, the care of the children, and their the revised figure was of 816 million resulting health & nutritional status. The key undernourished. This means that the average findings of this study are summarized below: annual decrease now stands at about 6 million x Urban households in Accra relied heavily on people. The remarkable growth in food their labor for income. Men are likely to be availability achieved in DCs the proportion of involved in skilled or unskilled labor, whereas undernourished in the total population declined women are more likely to engage in petty trade or by more than half- from 37 percent in 1969-71 to street food vending, where they earn far less than 17 percent in 1997-99. This decrease, however, men do. was not sufficient to halve the absolute number of x Both individuals and households strived to undernourished in the developing world, diversify their income sources-the mean number estimated to be 956 million in 1969-71 and still of income-generating activities per household as high as 777 million in 1997-99. was nine, and it was significantly lower for female-headed households. Lack of means to gain access to food is major x Urban agriculture did not play as large a role source of deprivation for poor people, especially in households’ livelihood strategies with in the in urban centers. The reports questions: “Has the city of Accra as in some other African countries. world made progress in improving access and It was, however, of critical importance in the reducing the gap between the abundant and peri-urban areas. varied diet of the rich and the meager fare of the x The people of Accra were heavily reliant on poor?” the urban market for access to food-more than 90 percent of all food consumed was purchased. Prevalence of undernourishment, when studied Street foods are central to food consumption vis-a-vie poverty guides us to the issue of patterns, especially among the poor, where they inequality of distribution. FAO’s measure of the accounted for nearly 40 percent of the total food prevalence of undernourishment is based on the budget. distribution of household food consumption and x Close to 18 percent of children younger than availability, whereas the measure used by the 3 years was suffering from growth retardation World Bank to estimate the prevalence of (low height for age). extreme poverty is based on the distribution of x Child feeding practices were found to be less household expenditure on consumables. The than ideal. Although breast-feeding was the FAO, study views that estimates for extreme norm, a large percentage of mothers didn’t follow poverty are higher than those for optimal child feeding practices. Higher mother undernourishment. The exception is the North- schooling was strongly associated with better East and North Africa, where the prevalence of child feeding & care practices, where household’s extreme poverty is estimated to be only 2 percent economic resources were not, which suggested compared with 7.7 percent for undernourishment. that food security might not be the main This anomaly reflects the weaknesses in both of constraint to optimal child care practices in the the organization’s approaches, when they are population. applied at the low level of prevalence. x Although approximately 2/3rd of the mothers In this context, prevalence of undernourishment were engaged in income-generating activities, and extreme poverty was estimated at 23.6 maternal employment was not found to result in

7 VULNERABILITY ANALYSIS AND MAPPING (VAM) UNIT, WORLD FOOD PROGRAMME, PAKISTAN FOOD INSECURITY IN URBAN PAKISTAN Introduction 1 percent (1997-99) and 40 percent (1998) estimated at 64.9 percent during 1981-98, in respectively in South Asia. mega cities like Karachi the growth was even higher, and the population increased from As indicated earlier anthropometric 435,887 in 1941 to 9,802,134 in 1998. The measurements, provide an excellent indication of percent increase in population in the Karachi city the nutritional status of the vulnerable groups and was estimated at 161 percent during 1941-1951, the individuals. They are usually the central 79.70 percent during 1951-961, 76.50 percent component of the nutritional surveillance systems during 1961-1972, 50.80 percent during 1972-81, that have evolved over the past 30 years. and 86.29 percent during 1981-199812. The average annual growth rate for the corresponding Commonly used anthropometric indicators, for periods was estimated at 11.50, 6.05, 5.00, 4.96 purpose of nutritional surveillance, include inter and 3.52 percent respectively. This rate of growth alia estimates of underweight, stunting, wasting was much higher than the natural growth in in children and body mass index in adults and population and built pressure on cities in terms of elderly. food supply, and with growing population in the urban Pakistan feeding cities has become The FAO Report in this backdrop, made mention difficult. of Pakistan among countries that contributed significantly to changes in the number of 1.2. Poverty in Pakistan undernourished during 1990-92 to 1997-9910, and reported that undernourished decreased by 2 Poverty is multi-dimensional in nature and one million(2 percent). of its key dimensions is consumption poverty-the 11 An FAO/UNDP Report on Nepal suggests extent to which actual levels of private seven elements that are essential in attacking consumption of the households and individuals pervasive poverty and food insecurity problem, fall below a certain “poverty line” represents the namely: minimum acceptable standard of private x Strengthen the agricultural production base; consumption. Since early1970s to early 90s x Reinforce participatory institutional Pakistan made good progress at reducing arrangements; consumption poverty. The real GDP increased by x Foster gender-sensitive rural & agricultural about 70 percent during 1972-73 to 1994-95, and development strategies; the real per capita consumption increased by x Promote child development, education & about 50 percent. The household income also school feeding programs; remained fairly stable during 1971-72 and 1987- x Develop infrastructure and employment 88. However, there appeared to be some guarantee schemes; deterioration in income distribution during 1987- x Provide social safety nets and welfare 88 and 1990-91. Evidence of decline in supports; and consumption poverty during this period was also x Promote an investment framework based on supported by increase in real wages among market-State synergies. unskilled urban construction & agricultural workers. However, despite Pakistan’s gain in Such approaches are generally relevant to most of poverty reduction during the period 1970-1990, the DCs that depend on agricultural sectors, substantial poverty persisted through out the including Pakistan. country.

1.1. Urbanization in Pakistan It was estimated that households headed by wage earners accounted for 44 percent of the urban The population in urban areas of Pakistan has sample and 40 percent of the urban poor in 1991 increased rapidly since independence, and it was PIHS. Households headed by self-employed estimated that during 1951-61 internal migration accounted for 36 percent of the urban sample, and contributed 40.1 percent towards urban growth. 39 percent of the urban poor. The incidence of poverty was highest among households headed This rate of internal migration gradually declined 13 and registered a fall upto 20.1 percent during by casual laborers, estimated at 38 percent . 1981-98. In some cities the growth was much higher, for example, in Islamabad it was

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Unfortunately, this trend in poverty reduction people (58,000 households) consisting of 300 g couldn’t be sustained after early 90s; rather it was of wheat flour, 30 g of pulses and 30 g of reversed. Growth of the country’s GDP slowed Vitamin A fortified oil per day, providing about down in the 1990s to an annual average of 5 1400 calories per day or 67 percent of the daily percent in the 1st half, and 4 percent in the 2nd half energy requirements15. from an average of 6 percent in 1980s. Since then this downwards trend continued, and in 1999 as 1.4. Poverty, Hunger & Disease never before in Pakistan had been such a sharp Poverty, hunger & disease alternate16. Today increase in poverty. For example, GDP growth nearly, 30 percent of the world’s population declined from 6.1 percent in 1980s to 4.2 percent suffers from some form of malnutrition. Those during 1990s, the population below poverty line who do not get enough energy or key nutrients increased from 18 percent in 1987 to 34 percent can’t sustain healthy and active lives. The result in 2001. is devastating illness & death, as well as incalculable loss of human potential and social 1.3. Population Growth, Poverty, Social development. At the same time, hundreds of Safety Net and Food Security millions suffer from diseases caused by excessive or unbalanced diet. More than half of the world’s Pakistan’s population figure stood at 132.4 disease burden can be attributed to hunger, million during 1998 census that indicated unbalanced energy intake or vitamin and mineral quadrupling of the population since independence deficiencies-and developing nations are quickly in 1947. With an inter-censual population growth joining the ranks of the countries facing with rate of 2.6 percent, as many as 3 million people severe health issues at both ends of the nutritional are being added to the population every year. spectrum. Poverty, so far, is an underlying factor for high fertility rates, contributes to high population Hunger, which afflicts one in five people of the growth rate. At the same time, a rapidly growing developing world, is a profound impediment to population in turn accentuates poverty. Poverty, the advancement of individual and societies. especially the adverse health and the socio- Without proper intervention, under-nutrition, economic status of the poor women is also death & disease are repeated with each accentuated as marginal households with given generation. The hungry suffers in silence and are incomes bear the burden of larger number of often invisible, to the casual observer, and many children. The consequent constriction of food of them show no outward sign of the severity of consumption results increased malnutrition, their hunger. Chronic hunger increase greater susceptibility to disease, and hence susceptibility to disease and leaves people feeling reduced productivity and intensified poverty14. weak and lethargic, reducing their ability to work. This is reflected in economies and contributes to According to the calorie-based poverty definition devastating cycle of household hunger and (headcount ratio), the incidence of poverty has poverty. Vitamin & mineral deficiencies in increased significantly since 1990s, rising from children lead to stunted growth, blindness and 17.3 percent in 1988 to 31 percent in 1997and compromised mental development. Iron 33% in 2001. deficiency anemia contributes to 20 percent of deaths in Africa & Asia17. Inflation, as measured by the changes in the Consumer Price Index (CPI), averaged 9.7 1.5. Feeding the Urbanites percent per annum during 1990s. CPI for 2001 was estimated at 4.7 percent as against 3.4 In 2000, 1.9 billion people lived in the cities percent in year 2000. Food & Non-food inflation while in 2005, over half of the world’s population generally followed the same inflationary trends. reside in cities. This number will swell to 3.9 For example, the corresponding figures for billion by 2030, and supplying urban populace increase in food prices were 4.1 percent and 2 with safe & affordable food will strain the food percent respectively, during this period. This supply and distribution chain to the breaking increase in prices impacted access to food and point. For example, it has been estimated that net thus food security. FAO/WFP mission therefore, cereal consumption in Lahore, provincial capital recommended targeted food assistance to 349,000 of Punjab, Pakistan will reach to about 1400

9 VULNERABILITY ANALYSIS AND MAPPING (VAM) UNIT, WORLD FOOD PROGRAMME, PAKISTAN FOOD INSECURITY IN URBAN PAKISTAN Introduction 1 thousand tones in 2010 as against 900 thousand Health & nutrition problems are the result of tones in 2000. The difficulty of matching supply unsatisfactory food intake or severe and repeated & demand, and problems with transport, infections, or a combination of both. These refrigeration and markets lead to losses and raise conditions are closely linked to inadequate access prices. Urban food production helps, but farmers to food, neglected care of mothers & children, lack sufficient land, water & knowledge. insufficient health services and unhealthy environment. In Pakistan, there is significant As cities grow in population and area, they difference in the economic status, life style & require more expensive structures to bring food to nutrition between rural & urban populations, and consumers, including distribution systems and between male & female children. A study in this wholesale & retail markets. At the moment, context, conducted in one of the big cities of markets in the most of the developing world’s Pakistan namely Faisalabad, suggests that out of cities are unplanned, which leads to 1255 school going children studied, 33 percent environmental problems and increasing losses. had stunted growth, 32.7 percent were Health hazards can result from the use of underweight and 32.7 percent suffered from wastewater and untreated human waste as wasting19. fertilizer in crops. 1.6. Markets and food security Food security concerns are especially important in the developing world’s cities, where poverty The market, particularly the formal component, rates often exceed 50 percent. Although poverty still has a more limited role in the urban food is still more likely to be rural, it is growing in supply system. The food supply system should urban areas. Moreover, urban poverty is not just have following components: food producing found in capitals or mega cities, provincial areas, marketing networks, and urban centers of a few hundred thousands people can consumption centers. Urbanization affects all also have many poor inhabitants, and practical components of the system. The marketing food supply & distribution problems. networks response to urbanization (growth, spatial concentration, and changes in food The poor urban consumers spend as much as 60 demand) also affects the relative mix of to 80 percent of their income on food, making acquisition methods (exchange, production, them especially vulnerable to high food prices, transfer) among different income groups, as well such as those caused by transport costs or as the system’s use of the supply areas (domestic monopolistic practices by powerful traders. rural & urban and foreign). Over last few Moreover, they spend on an average 30 percent decades, several factors have worked together to more on food compared to the rural consumers, undermine the ability of formal southern food but they consume fewer calories. In addition, they markets to cater to the needs of the swelling are the last link in a long food chain, and have numbers of city dwellers. little choice of where to buy, increasing the risk of consuming food of poor quality. Food safety is On supply side, export-oriented and hard therefore, a serious concern in urban areas, where currency earning agricultural policies have poor handling & refrigeration, and unscrupulous increasingly dictated crop choices, credit vendors can lead to contaminated or adulterated programs & incentives, technical extension & food18. research, and distribution networks. The frequency and adverse affects of civil & natural Since, children are one of the most vulnerable disasters are growing in DCs, and are bound to segments of the population; their health status is disrupt rural food production and supply lines to usually a good indicator of the health of a cities. The migration of rural youth to the cities community. In particular, they are the first has been intense and will continue to be for victims of micronutrient deficiencies. Each year decades in many countries including Asian up to 500,000 children become partially or totally countries. This affects rural food production, blind due to vitamin A deficiency. It also which is still largely small-scale and labor increases susceptibility to diseases and retards intensive. growth & development, and is associated with increased death rate from diseases17. On the demand side, the capacity of the urban poor and middle class to purchase the good

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quality food they need is undermined by a insecurity undermines people’s ability to learn, number of factors. These include currency work and make progress on other fronts. devaluation, reduced purchasing power, salary Malnutrition is the result of pronounced food reductions, formal-job retrenchment, and the insecurity. People in large cities may suffer from informalization of employment; elimination of as much malnutrition as those in rural areas. In subsidies for needs such as food, housing, fact, the rate of malnutrition is often higher in transportation, and health care; and the very urban slums than in typical rural areas. United uneven access of different income groups to retail Nations Children Fund (UNICEF) studies showed food with in the cities. that increased food insecurity was associated with increase in urban poverty during 1980s20. No matter, how efficient urban food supply markets may be, rapid urbanization and growing 1.7. The food policies and food security poverty will complicate the demand side of the equation for decades to come. Poverty is Over last few decades, there has been a raising increasingly an urban phenomenon: more of the awareness that the nature of food production has rural poor are migrating to the cities, more of been profoundly altered from the field, in those born in cities are of poor families, and more factories, on the shelves, and in the kitchens. The urban middle-class residents fall below the resulting food policy crises is not surprising, and poverty line. It was estimated that in 1998, at one can witness areas in which food policy & least 26.5 percent of the developing world’s practice are in particular ferment21: absolute poor were living in urban areas, and then i. Public Health; Even in rich countries, the corresponding figure for 2000 would be of 56 quality of diet has a direct impact on people’s percent. Urban poverty will affect women more health. than men and children more than adults and more ii. The nature of supply: The changes in households overall as more households to be production and distribution, even cooking have headed by women. As urban populations become altered the nature of food. poorer, more of the food insecure will be found in iii. Social justice: Mass inequality appears in all the cities. aspects of the food system, both between and Food security is more vital of all the needs. Food within countries, regions and world.

References 1 Tufts Nutrition,2002.Discussion Paper 6,Tufts University 2 Delisle H, 1990. Patterns of urban food consumption in developing countries :Perspective from the 1980’s, FAO Rome 3 Urban food security & nutrition(http://www.fao/fcit/insec.asp 4 FAO, 1999. Urban food security and food marketing in Metropolitan Lahore, Pakistan. 5 FAO and All India Disaster Mitigation Institute, 2004. Participatory urban food & nutrition security assessment process. 6 Elliot V, 2000. Urban food security and vulnerability-Development & issues in Zimbabwe (working paper, November) 7 Food Security, Global Education (http//www.globaleducation.edna.edu.au/) 8 Nazli. Hina, 1998. Intra-household resource allocation, role of gender and rural food security: Issues from Pakistan. Paper presented in Technical Consultation on Intra-household dynamics and rural food security, FAO (RAP) Bangkok

9 IFPRI, Accra urban food security & nutrition study (http//www.ifpri.org/) 10 FAO, 2001. The State of Food Insecurity in the World. 11 FAO/UNDP, 2003, Nepal: Agricultural Policy and Strategies for poverty Alleviation & Food security. 12 Urban Resource Centre (www.urckarachi.org/popu.htm) 13 World Bank, 1995.Pakistan Poverty Assessment, September 25(Report #14397-Pak) 14 UNDP, 2003.Pakistan: National Human Development-Poverty, Growth & Governance 15 FAO, 2001. Special Report: FAO/WFP Crop & Food Supply Assessment Mission to Pakistan, July 11. 16 Food Insecurity in Rural Pakistan, WFP Pakistan. 17 FAO, The Spectrum of Malnutrition 18 FAO, Feeding the cities 19 Anwar, I and Awan J.A.2003. Nutritional Status comparison of rural with urban school children in Faisalabad district, Pakistan 20 Mougeot, Luca J.A. The concept of urban food security for self-reliant cities: Urban food production in a globalized South -Part 1(http://web.idrc.ca/es/ev-30582-201-1-DO_TOPIC.html) 21 Lang, Tim, Food Policy for the 21st century: Can it be both radical and reasonable(http://web.idrc.ca/es/ev-30626-201-1-DO_TOPIC.html)

11 VULNERABILITY ANALYSIS AND MAPPING (VAM) UNIT, WORLD FOOD PROGRAMME, PAKISTAN FOOD INSECURITY IN URBAN PAKISTAN Urbanization in Pakistan 2 CChhaapptteerr 22

Urbanization in Pakistan

2.1. Urbanization in Pakistan: Implication for Urban Food Security

Whereas, urbanization is essential in terms of Figure 2.1 Urbanization VS human development, for it helps accelerate economic develoment growth by creating new socio-economic avenues, it has been found that urbanization in developing Low human countries has also resulted in development-related development M edium human problems. For example, the benefits associated development with urbanization could be offset by concomitant High human increase in the concentration of urban development populations. Thus, the increase in population of 0 20406080 urban areas leads to higher demand in terms of the basic needs, civic infrastructures and services. patterns of urbanization in Pakistan, and reported It, at times, becomes difficult especially, for that urbanization in Pakistan had gone up from countries with limited resources, to cater 17.8 per cent in 1951 to 32.5 percent in 1998, effectively for such needs. recording an increase of 14.7 percent since the first Census after country won independence in Urbanization is closely linked to human 1947. The study under reference used census development and economic activity level and data, for district level changes, from 1981-98. It resultant income of the regions, as is depicted in reported that, from proportion of population figures 1-3. These figures would reveal that living in towns and cities, Pakistan was in the urbanization is more pronounced in areas where midst of gigantic urban increase, and the level of there is lower level of human development and urbanization of 32.5 percent in Pakistan was lower income. This trend is quite evident from viewed as highest among the South Asian Fig. 2.3, where one can see that in poorer regions Association for Regional Cooperation (SAARC) of the world urbanization is on higher side, member countries. According to the compared to the developed parts of the world. It Demographic Survey of Pakistan 2003 (Federal also shows that South Asia as a region is more Bureau of Statistics) the share of urban thickly urbanized compared to Europe and CIS. population has reached to 35.7%.

Figure 2.2 Urbanization VS income The study further reported that the rate of natural increase of total population had been lower than Low income that of urban population in every district of Pakistan. The higher average annual rate of

Middle income growth of urban population, therefore, was largely the result of migration, from rural to urban areas, particularly in the Punjab. High income

0 102030405060 With urban population increasing at 3.54 percent

As elsewhere, in the region, urban population in Figure 2.3 Urbanization by regions Pakistan has been growing fast over the period. In 2002, it was estimated that 33 percent of the total Central and Eastern Europe and the CIS population resided in the urban Pakistan. Sub-Saharan Africa Although the urban population has not increased So uth A sia Latin America and the Caribbean to the extent it was projected, the 1998 Census East Asia and the Pacific revealed that a large number of earlier rural Arab States communities were later characterized as urban, Least developed countries and had several urban attributes1. All developing countries 0 20406080100120 In this context, a study using percentage distribution and urban density index analyzed the

VULNERABILITY ANALYSIS AND MAPPING (VAM) UNIT, WORLD FOOD PROGRAMME, PAKISTAN 12 FOOD INSECURITY IN URBAN PAKISTAN Urbanization in Pakistan 2

Table 2.1 Difference in Growth Rate due to Migration Average Growth Average Growth Difference in Growth Rate due to Province Rate* Natural Rate* Migration Actual (3)=(1)- Urban Areas (1981-1998) (1984-1997) Percent (2) 1 2 3 4 Punjab 3.3 2.6 0.7 20.5 Sindh 3.5 2.7 0.8 22.9 NWFP 3.5 2.7 0.8 22.2 Balochistan 4.8 2.9 2 40.7 Pakistan 3.5 2.6 0.8 23.8 *.Intercensal growth rate during 1981-98 **. Average based on Pakistan Demographic Survey conducted during 1984-97 per year, concomitant development of civic provincial government expenditure during the infrastructure & services, like housing, 1980s. transportation, electricity, water, sewerage, 2.2 In-Migration sanitation and police services was needed to satisfy the requirements of urban populace. The Migration normally takes place from rural to limited urban infrastructure & services available, urban and from commercially underdeveloped to however, failed to cater the growing urban needs, commercially developed areas; hence a and thus slums emerged in the periphery of urban prominent feature of urbanization is constant settings i.e., periurban slums. inflow of migrants in search of employment, business, study and other livelihood The study data also suggested that Islamabad opportunities. Capital Territory (ICT) was the most urbanized administrative unit of the country in 1981 and it Population movement causes changes in the continued to be in that position till 1998, with an population growth rate of recipient district or urban index ratio of 584.08. It is important to region and also upsets the male/female ratio of note that the urban population in ICT grew at the area. Although in-migrants contribute towards the rate of 5.75 per cent per annum during the the economic activity, production rate and 1981-98. In 1998, Sindh was the most urbanized volume of output, they also place an extra stress province with 48.9 percent of the total provincial on existing social and physical infrastructure, in population living in urban areas with an urban particular, facilities and utilities such as housing, index ratio of 110.54 as against 104.04 of the transport, public space, electricity, water and fuel. Punjab. The least urbanized province with only There is additional burden on municipality 16.9 percent of the total population living in services due to higher generation of solid waste urban localities, with urban index ratio of 39.89, both at household and at industry level. was the NWFP. The percentages of urban population in Punjab and Balochistan were 31.3 The migration data in the Census conducted in and 23.3 percent respectively. It also revealed 1998 covers movement of population from one another important dimension of the levels of district to another in the same province, from one urbanization in Pakistan, that urban population of province to another and Pakistani emigrants. It three provinces viz., Punjab, Sindh and NWFP does not cover persons who changed their place grew at almost the same rate i.e., 3.31, 3.44 and of residence within their own district. 3.46 percent respectively between 1981 and 1998. There was also not much difference in the Estimated Contribution in Population Growth rate average annual growth of total population during due to Migration during the 1980s and 1990s is the study period, which was estimated at 2.55, depicted in table-2.12: 2.71 and 2.75 percent for Punjab, Sindh and NWFP respectively. Urban population of The above mentioned study further states that Balochistan witnessed fastest rate during 1981-98 urban areas of all the four provinces have 5-6 (4.91 percent) among the four provinces of the percent of population classified as recent country. This could be attributed due to increase migrants. Both urban and rural areas of in public sector employment due to increase in Islamabad have a fairly high percentage of the population classified as recent migrants. This is

VULNERABILITY ANALYSIS AND MAPPING (VAM) UNIT, WORLD FOOD PROGRAMME, PAKISTAN 13 FOOD INSECURITY IN URBAN PAKISTAN Urbanization in Pakistan 2 mainly due to Islamabad being the nation’s Among the reasons for migration, a large number capital where many people also move due to job of peoples migrate with family head, male transfers from provinces. It may be true for migrants seem to move in search of work, provincial capitals as well. In-migration in business or due to transfers whereas female Karachi, Lahore, Peshawar and Quetta reflects migrants move as a result of marriage. Out of higher percentage compared to other towns and total number of migrants for business and cities. Similarly, in-migration to industrial cities employment purpose across all districts, 60%- of Gujranwala and Faisalabad is higher than non- 100% are male whereas out of total number of industrial cities of the same size. migrants for marriage purpose, 95%-100% are female. Table 2.2 Proportion of Migrant Population to Total Migration from depressed areas to developed Urban Population 1998 % areas affects the socio-economic scenario at both In-Migrants places. Some of the issues are not visible to Total immediately or at the first sight but emerge in due Total Urban In- Urban District Population Migration Population course of time. Whereas big cities offer host of opportunities to incoming population, they also Islamabad 529180 312640 59.08 have problems in assimilating the additional Malir 660,466 301,085 45.59 population in the social and economic set up. Any Rawalpindi 1,788,273 635,542 35.54 new addition in the labour market affects the Lasbaila 115,424 36,137 31.31 scale of daily wages due to the free labour market Loralai 34,984 9,219 26.35 mechanism in the private sector. Availability of Karachi West 1,909,574 500,064 26.19 cheap labour on one-side cuts down the Peshawar 982816 257173 26.17 production cost but on the other side does not Karachi East 2,746,014 606,638 22.09 provide enough money in terms of wages for Karachi Central 2,277,931 501,306 22.01 consuming these products. Suppressed wages in Attock 271,092 58,897 21.73 turn shrink the consumer market leading to Karachi South 1,745,038 328,912 18.85 reduction in production and lay offs. Gujranwala 1,719,038 314,812 18.31 Jehlum 259,330 46,980 18.12 Secondly, in-migrants coming for the purpose of Vehari 335,432 60,075 17.91 work and business have to transfer the money Okara 514,408 89,598 17.42 back to their families still living at the original Lahore 5,209,088 890,427 17.09 place of residence. That takes a substantial part of Kohlu 9,665 1,557 16.11 money out of circulation in the host city. Faisalabad 2,318,433 364,018 15.7 From social point of view migration of male The percentage of urban in-migrants is 59.08 % whether single or married who move without for Islamabad, 45.59% for Malir (Karachi), their family causes many secondary issues that 35.54% for Rawalpindi, more than 26% for both need to be addressed in order to maintain gender Karachi West and Peshawar, 17% for Lahore and balance both in the recipient city and the original 15.70 % for Faisalabad. place of residence. Looking at Male/Female Ratio

Figure 2.4 Proportion of Migrant Population to Total Urban Population 7000000 Total Urban Population In-M igration 6000000

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ir i l d l la st st ra la m a a indi a e t lu ore M p r Ea ock h h Population o i e Kohlu al L i W Att J Vehari Okara alab w h ch ranwa La is Lasbaila a i Cen j Islamabad Peshawarr h Ra Gu Fa Ka rac Karac a Karachi South K Dis tr icts

VULNERABILITY ANALYSIS AND MAPPING (VAM) UNIT, WORLD FOOD PROGRAMME, PAKISTAN 14 FOOD INSECURITY IN URBAN PAKISTAN Urbanization in Pakistan 2 of Urban areas at district level, it appears that address it adequately. except in two cases i.e. Chakwal in Punjab and Ghizer in Northern Areas, the ratio of male to Some of the questions to be raised are: female is high ranging between 101:100 and x Are the opportunities for migrants in urban 141:100; in one case it is 187:100.3 areas real or false? x What are the push factors at the original place Obviously, in case of only male migration, the of migration and pull factors at the host city? family members left behind are women, children x How in-migrants are contributing towards and elderly. The wife, in this case, has to hold economic growth and productivity of the host the folk back home that puts her under city? tremendous pressure socially, economically and x What kind of additional social and physical administratively. The economic burden is infrastructure facilities are needed to somewhat lessen with the receipts of money from accommodate in-migrant population? the migrant worker, however, other tasks fully x What is the optimum capacity of a place, city or overwhelmed the women as transitory head of the region to absorb migrants? family. Women in this situation are responsible to x What does happen to families, particularly look after both the children and elders of the female members of the family left behind? family, perform daily household chores and x What are the sets of issues faced by male and maintain social relationships. female migrants at individual and community level? As far the social assimilation is concerned, there x Is there any policy on the issue of in-migration is a hesitation in the society to accept single male both rural-urban and urban-urban migration? when it comes to establishing social relationship, renting out residential property and making These questions partly take us to research a commercial contracts. It normally results in related problem of shortage of housing, house higher payments for goods and services in the ownership, urban slums and the homeless open market in particular, for housing that brings population within the context of habitat. distortion in the housing prices. Hiring migrant male without family in household jobs where All the major administrative units of the country rent-free housing is available is also not looked at have registered an increase in urban proportion of encouragingly. However, there are a number of the total population during 1981-98, with the elementary occupations where single male exception of Sialkot, Lahore, Tharparker, Karachi migrants adjust well, such as construction East, Bannu, Quetta, Pishin and Killa Abdullah. industry, transport sector, security services and These districts have recorded slight decrease in small business. their urban proportion of population in 1998 as against 1981. These changes could also be due to The issues related to In-Migration are not the definitional changes of an urban locality. thoroughly addressed at national level due to low Some localities adjacent to large urban centers importance attached to its impact on the society. might have been considered as rural in the 1998 It is recommended to conduct further census, compared to 1981 when they were treated investigation on this theme to substantiate the urban due to updating of delimitation of areas. In above assumptions and generate ideas on how to

Table 2.3 Top 10 most Populated Cities in Pakistan 2005 Provincial National Population Province Province Districts City Code Rank 2005 Rank S 1 SIND KARACHI KARACHI 11,873,812 1 P 2 PUNJAB LAHORE LAHORE 6,464,711 1 P 3 PUNJAB FAISALABAD FAISALABAD 2,569,693 2 P 4 PUNJAB RAWALPINDI RAWALPINDI 1,785,144 3 P 5 PUNJAB GUJRANWALA GUJRANWALA 1,590,150 4 P 6 PUNJAB MULTAN MULTAN 1,465,640 5 S 7 SIND HYDERABAD HYDERABAD 1,398,477 2 N 8 NWFP PESHAWAR PESHAWAR 1,232,765 1 C 9 ICT ISLAMABAD ISLAMABAD 783,165 1 B 10 BALOCHISTAN QUETTA QUETTA 748,198 1

VULNERABILITY ANALYSIS AND MAPPING (VAM) UNIT, WORLD FOOD PROGRAMME, PAKISTAN 15 FOOD INSECURITY IN URBAN PAKISTAN Urbanization in Pakistan 2

1998 Census for instance, the urban population of the major cities of the country having population Lahore district was 82.5 percent of the total as more than 1 million. Sialkot, Larkana, Hyderabad against 84.3 percent in 1981. This might be and Quetta fell into Group D in the order with because of earlier inclusion of some areas of urban density index ranging from 200.0 to 299.9. Lahore district as urban in 1981 that were later Quetta was the only major city of Balochistan as reclassified as rural in 1998. The average annual well as provincial headquarters with an urban growth rate of urban population of 105 districts density index of 211.19. In the second last Group of Pakistan during 1981-98 varied from 9.06 10 districts of Pakistan were included within percent (Jafarabad) a newly created district to urban density index 100.0 – 199.9. The 73 0.04 (Bannu). Out of the total 105, nine districts districts out of the total 98 analyzed, in the study, had average annual growth rate, of urban fell in Group F with urban density index ratio population, of more than 6 percent, whereas 26 below 99.94. were with less than 6 but more than 4 percent during the study period. In remaining 63 districts, comparable rates were of less than 4 Figure 2.5 CITIES POPULATION BY PROVINCE/REGION 2005 percent. ISLAMABAD 783165 N-1

NA 159 70 6 N-5 For a clearer picture of urbanization in Pakistan, FATA 15188 2 as reported in 1998 Census, urban density index N-5 AJK 503217 N-18 of every administrative unit was calculated, for N-43 the country it was a useful measure of the BALOCHISTAN 2159059 N-46 urbanization, by dividing the urban population NWFP 3829545 SINDH 18812004 N-150 of a region by its area. Urban density index for N-231 98 districts was categorized into six groups, PUNJAB 29038096 while 7 districts having no urban population 0 10000000 20000000 30000000 40000000 were excluded from the analysis. The Group A, in the analysis, comprised of the districts The Fig.2.5 suggests that this trend of province- Karachi central (32450.69), Karachi east wise urbanization is continue and the districts of (19544.24), Karachi south (14138.64), Lahore the Punjab province have relatively higher level (2894.59), Karachi west (2026.58), Peshawar of urbanization, followed by Sindh, NWFP, (780.0) and ICT (584.08). All of these were the Balochistan, ICT and Northern Areas. major urban centers of the country and justified to be in one group, because of their importance in With in Punjab (Fig.2.6) there are 41 cities as per national economy. Both in the past and in the 2005 estimates, with population of more than one present these administrative centers had been an hundred thousand (100,000), while population important urbanizing force. These districts with in the remaining major cities falls in the proved to be important cultural centers and range of 60,000-80,000- Fig- 2.7. principal hubs of learning over time. Gujranwala was the only district, which fell into Group B, Out of 499 cities of Pakistan 387(78%) cities fall with an urban density index of 471.13. In Group in the population bracket of 10,000 to 99,999, C, there were four districts viz., Rawalpindi, while in 45 population is below 100,000, while Faisalabad, Multan and Malir. All of these were exceeding one million in eight cities, table-2.4. Figure 2.6 PUNJAB- CITIES WITH 1-70 LAC POPULATION 2005 7000000

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VULNERABILITY ANALYSIS AND MAPPING (VAM) UNIT, WORLD FOOD PROGRAMME, PAKISTAN 16 FOOD INSECURITY IN URBAN PAKISTAN Urbanization in Pakistan 2

Table 2.4 Population of Cities in Pakistan Number of Towns No. of Towns with High Balochis Northern Islama Population Punjab NWFP Sindh tan Areas PAK FATA bad Total Below 1,000 - 1 - 1 - - - - 2 1,000 - 9,999 1 1 33 1 - 7 - - 43 10,000 - 24,999 62 9 61 19 2 6 2 - 161 25,000 - 49,999 78 18 29 11 2 2 2 - 142 50,000 - 99,999 49 8 15 9 1 1 1 - 84 100,000 - 199,999 22 6 6 1 - 2 - - 37 200,000 - 499,999 12 2 4 - - - - - 18 5,000,000 - 1,000,000 2 - - 1 - - - 1 4 Above 1 Million 5 1 2 - - - - - 8 Total: 231 46 150 43 5 18 5 1 499 PAK:Azad Jammu & Kashmir, FATA: Federally Administered Tribal Areas No Urban Areas inDistricts:NWFP:Buner,Shangla,Kohistan,BattagramBalochistan:Awaran,FATA:Bajour,Mohamand,Orakzai,S.Waziristan.

This clearly reflects that cities in Pakistan are emergence of urban slums, poorly designed and thickly populated. This situation is also clearly serviced urban satellites, and consequent upon depicted in Graphs at Annexure-1 to 9. Cities like that the issues related to sanitation, poor access to Lahore, Faisalabad, Rawalpindi, Gujranwala and potable water, diseases etc., lead unhygienic Multan are the most populated, in the same order, conditions that precipitate the food insecurity cities of Punjab province. situation in urban centers because of poor food absorption.

In Sindh on the other hand, Karachi has emerged Figure 2.8 FATA- CITIES POPULATION 2005 nd as a mega city, and Hyderabad as the 2 most 70000 populous city of the province. Similarly, 60000

Peshawar in NWFP and Quetta in Balochistan are 50000

the most populated cities of the respective R 40000 provinces. In national ranking Karachi is the 30000 highly populated city followed by Lahore, NUMBE Faisalabad, Rawalpindi, Gujranwala, Multan, 20000 Hyderabad, Peshawar, Islamabad and Quetta. 10 0 0 0

0 The size of cities of Pakistan, in terms of JAMRUD LANDI KOTAL SADDA PARACHINAR MIRAN SHAH population, is given in Annex-4. Rapid Although Pakistan registered reasonable urbanization in Pakistan poses immense economic growth rate, population increase had challenge to this developing country, where cities been around 3 percent for decades, and thus per in Pakistan are ill-equipped to deal with it in capita income remained relatively low. There is terms of civic infrastructure. As a result

Figure 2.7 PUNJAB- CITIES 20-50K POPULATION 2005

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VULNERABILITY ANALYSIS AND MAPPING (VAM) UNIT, WORLD FOOD PROGRAMME, PAKISTAN 17 FOOD INSECURITY IN URBAN PAKISTAN Urbanization in Pakistan 2 also a strong feeling that benefits of growth were Food safety and nutritional health-related not equitably shared among regions and concerns relate primarily to raw and 1 communities . This situation encouraged the processed foods. Consumer’s health is trend of urbanization, and as a result, the civic implicated because of lack of clean water for environment in urban areas was badly affected. washing of fruits & vegetables, Figur e 2.9 NORTHERN AREAS- CITIES contamination of foodstuffs with dust and POPULATION 2005 80000 airborne pollutants, poor hygiene practices, 70000 improper storage, deteriorating urban 60000 environments, and the food borne diseases 50000 such as typhoid. This aspect of urbanization, 40000 interfacing food security needs to understood, 30000 for the food eaten in such an unhealthy 20000

10 0 0 0 environment may not necessarily contribute

0 towards meeting daily food needs, as is Gilgit Skardu Chilas Gah Kuch Khaplu discussed in the chapter on food absorption. This situation is further complicated by growing demand for affordable convenient It is worth noting that even in marginalized areas; 6 the urban settings are growing exponentially as is food, by the workforce, both male & female . the case of FATA & NAs Figs. 2.8 & 2.9. Access to clean water is a fundamental issue, as 2.3. Implications of Urbanization for we would see in the chapter on food absorption, Urban Food Security closely linked to the urban food security, especially for the poor, who do not have access to Few Examples potable water. This aspect of food security is poorly understood and appreciated by the middle class in Pakistan6. Typhoid, hepatitis and related The few examples cited below emanate from host of problems have emerged because of this inability of the governments to respond to sole factor in urban Pakistan. As a result, urban growing urbanization, in terms of, for example, food security is affected adversely. health and food related infrastructure. A research conducted, in this regard, for the 2.3.1. Health & Productivity National Human Development Report6 has shown that ill-health is so widespread in Pakistan that it Rapid urbanization naturally results in an should now be regarded as a major national issue, increased demand for food in general and for in the context of poverty alleviation and certain types of food in particular. There are three economic development. The report suggested that broad concerns, in this regard, of Asian urban as much as 65 per cent of the poor population in consumers. The first relates to the rising cost of Pakistan was suffering from ill-health with the food, especially for the urban poor; the second poor, on average, being sick for three months of involves food safety and nutritional health of the year. This affects person’s productivity and food; and the third relates to the need for a thus income, as is discussed in the chapters on diversified food base, and quality of processed or food absorption and food access. value-added products to fill the demand for labor- saving foodstuffs. The rising cost of food in A large proportion of the middle class was also Asian cities is directly related to inefficient food reported to be suffering from ill-health and got supply & distribution system, and related locked into high cost health care, because of poor shortfalls such as in distribution infrastructure. social safety net. This resulted not only in lower Poor linkages between rural areas and cities result productivity and incomes, but also in to loss of in a high rate of food spoilage, resulting in a already low income due to expensive medical constricted food supply and higher food costs. care, provided by private sector for repeated and Improvements in distribution system and sometimes chronic illness. management of post-harvest losses through efficient technologies can thus help improve According to the study, three factors accounted 5 the situation . for 60 percent of the burden of disease in Pakistan, when measured in terms of life years

VULNERABILITY ANALYSIS AND MAPPING (VAM) UNIT, WORLD FOOD PROGRAMME, PAKISTAN 18 FOOD INSECURITY IN URBAN PAKISTAN Urbanization in Pakistan 2 lost: (i) communicable infectious diseases, (ii) high prevalence of disease. For children, women reproductive health problems, and (iii) nutritional and men, malnutrition leads to impaired deficiencies. Inspite of the fact that all of the immunity and high susceptibility to infection. three factors were preventable as well as curable, The data from the survey conducted for the the incidence of disease and mortality remained National Human Development Report, suggested high, as the disease prevention & control is very that the high prevalence of disease amongst those weak. who were slightly above the poverty line was a major factor in pushing them into poverty. Those This is indicative of high level of poverty who are already poor get pushed into deeper (responsible for poor nutritional health, and poverty as a result of loss of income and high unhealthy living conditions). Equally important is medical costs resulting from illness. The data the continued acute lack of preventive and showed that on average 65 per cent of the disease control infrastructure. The serious extremely poor were ill at the time of the survey inadequacies in preventive health include and had on average suffered from their current measures related to sanitation, safe drinking illness for 95 days. water, and reproductive health care for the women, and food safety regulations, with respect The NHSP data also showed that the poor to both raw and cooked food available outside the predominantly go to private medical household. practitioners. Many of them were poorly trained and had grossly inadequate diagnostic facilities. The study under reference also reports that Consequently, when the poor fall ill they suffer whereas curative health care system has been for a protracted period and get locked into a high expanded substantially during the last decade, the cost of medical treatment, which eroded whatever population per doctor has fallen from 2082 in few assets, they had, and pushed them into 1990 to 1372 in the year 2005, and the population indebtedness and deeper into vicious circle of per nurse has fallen from 6374 to 3155 over the poverty. same period. The fact that inspite of this expansion the incidence of disease remains high Infant mortality rates had declined, according to points to both inadequate coverage and poor the report, over the decade of the 1990s, although quality. they were still high compared to other low- income countries. The infant mortality rate (IMR) This aspect has also been discussed in the chapter in Pakistan declined from 122 per 1000 live on food absorption. births in 1991 to 79 per 1000 live births in 2005. Health data suggested that infants born to the According to the National Health Survey of least educated mothers have twice the risk of Pakistan (NHSP) there is a high prevalence of ill- dying within the first year after birth compared to health, particularly amongst women and children. women that are more educated. For example, in rural areas prevalence of fair plus poor health for females above 25 years is about However, it is noteworthy that since the 75 per cent, while for males in the same age percentage of uneducated women is much higher group it is about 45 per cent. The high prevalence amongst poor households, infant mortality rates of disease is also indicated by the fact that visits may be correlated not simply with the educational to a health care provider per person aged five status of the mother but also with poverty and years and above, is as high as six per year. An hence the inability of the mother to get adequate increasing proportion of the health care is now nutrition, prenatal and post natal care. being provided by the private sector, especially in urban Pakistan. The critical determinant of an infant’s survival and subsequent health is the nutrition status and Malnutrition is a major problem in Pakistan and health care received by the mother. In Pakistan is an important underlying factor in ill-health and where 40 per cent of the women are anemic and morbidity. For example for the children, protein almost 80 per cent deliver at home without energy malnutrition is an underlying cause of trained assistance, it is not surprising that both death in about one third of all deaths below five infant mortality and maternal morbidity years of age. For women inadequate intake of associated with pregnancy are amongst the energy, protein and micronutrients, compounded highest in Asia. (Maternal mortality rates are 300 by high fertility and unhygienic living conditions to 400 per 100,000 live births). associated with poverty, are major factors in the

VULNERABILITY ANALYSIS AND MAPPING (VAM) UNIT, WORLD FOOD PROGRAMME, PAKISTAN 19 FOOD INSECURITY IN URBAN PAKISTAN Urbanization in Pakistan 2

According to the study, the government had not amounts of animal products than their rural been able to achieve its immunization target rate counterparts do. Urbanites consume a more of 90 percent; although there has been a diversified diet and more micronutrients and significant improvement in the immunization rate animal proteins than rural residents do but with over the decade 1991 to 1999. The percentage of considerably higher intakes of refined children between 12 and 23 months who were carbohydrates, processed foods, and saturated and fully immunized increased from 37 percent to 49 total fat and lower intakes of fiber. percent. The immunization rates in children improved for both genders as well as rural and The Countries that have an urban population urban areas. According to PIHS data there is a share of 75 percent consume about 4 percentage strong correlation between income levels of points more energy from vegetable and animal fat household and immunization rates. For example, and 12 percentage points more energy from 75 percent of the children in the upper income sweeteners than countries with an urban quintile were fully immunized as against only 25 population share of 25 percent. This holds true percent in the lowest income quintile. even at low levels of gross national product (GNP). Related research has shown that lower- In view of the evidence provided in the report, it income countries are able now to afford far more was important that the government integrated its energy from fat than they could in the past at the health policy with the strategy of poverty same level of GNP. Thus, not only are urban diets alleviation. Five broad initiatives proposed in this changing, but they are changing at an earlier context are: stage of economic development.

(1) Improve the quality and coverage of Increasing incomes partially explain this turn preventive health facilities. (2) Improve the toward fattier foods and sweeteners, but there service delivery of basic health units where the also seems to be an upward shift in consumer frequent absence of doctors from duty and lack of demand for sweeteners and higher-fat products at medicines have made them largely ineffective at any given income level. Greater penetration of the moment. (3) Improve the hygiene standards, mass media and modern marketing approaches diagnostic facilities and professional quality of into the lives of urban residents may account for medical care at Tehsil level hospitals. (4) this shift in food choices. Little is understood, Establish at least one model hospital of though, about the impact of media and marketing international standards in each district. (5) on the nutrition changes in the urbanites. Launch a national campaign for: (i) Provision of Economic work that relies on income and price hygienic drinking water, (ii) Control of hazardous changes cannot account for these shifts in pesticides used on food grains and vegetables, behavior. (iii) Strict implementation of food adulteration laws and control of unhygienic food supplied by The ability to produce lower-cost foods that vendors, cafes and restaurants. contain oils and sweeteners has facilitated the transition as well. In the last half century, new Improved health of Pakistan’s population, technologies and new oilseed varieties, for through disease control and preventive & example, have made it much easier to create curative measures will be an important factor in high-quality; low-cost edible oils as alternatives improving productivity, incomes, alleviating to much more expensive animal fats. poverty and thus improving nutritional health & food security of in urban Pakistan. New technologies in work and leisure, along with shifting diets, have increased obesity levels 2.3.2. Food Demand & Consumption in the urban areas of developing countries. Body composition has changed in tandem with the Urban residents have vastly different lifestyles transformation of the pre-industrial agrarian than rural residents. These lifestyles create their economy into an industrial, urban one. As this own patterns of food demand and time allocation. transformation has accelerated, the service sector The consequences for diets, physical activity, and has grown rapidly, capital-intensive processes health have been enormous. The Urban residents have come to dominate industrial production, and obtain a much higher proportion of energy from time-allocation patterns have changed fats and sweeteners than those of rural residents, dramatically. Urban work now requires less even in the poorest areas of very low-income physical exertion and allows more leisure. countries. Most urban dwellers also eat greater Leisure activity has been transformed,

VULNERABILITY ANALYSIS AND MAPPING (VAM) UNIT, WORLD FOOD PROGRAMME, PAKISTAN 20 FOOD INSECURITY IN URBAN PAKISTAN Urbanization in Pakistan 2 particularly by changes in food preparation, security. For example, access to education that production, and processing and by the has close link with access to income revolutionary penetration of the mass media into opportunities, and thus to economic access to the developing world. Almost all Chinese food. households, for example, owned at least one working television set by 1997. References Changes in diet and physical activity have 1 Zaman, Arshad and Iffat Ara (2002), Rising Urbanization in Pakistan: accelerated the rate of increase in obesity in the Some Facts and Suggestion, the Journal, Sept. developing world. Trends in obesity are not limited to one region, country, or racial or ethnic 2 Study Paper titled ‘Migration Patterns and Differentials in Pakistan’ by M/S Mehtab S. Karim and Abu Nasar published in Population of group. In many cases, such as with women in Pakistan: An Analysis of 1998 Population and Housing Census by Egypt and South Africa and across ages and Pakistan Institute of Development Economics – PIDE, 2003 3 Gender related data, both quantitative and qualitative is difficult to sexes in Mexico, the lower- and middle-income obtain and report. It gives reason to believe that in some areas where countries have overweight levels that match those counting of women is not easy to do due to social taboos, accurate of the United States and exceed those of most information could not be obtained, hence gender ratio appears too high in the above analysis. European countries. Obesity levels are much 4 Shirazi, Sadar Ali, Patterns of urbanization in Pakistan: A higher in urban areas: in China and Indonesia demographic Appraisal, by Department of Geography adult obesity is twice as prevalent in urban areas 5 Hussain, Akmal (2003), Health & Poverty, Daily Times, Thursday, May 15 as it is in rural areas; in the Congo it is almost six 6 FAO, Technical Overview: The Challenge of Feeding Asian Cities times as prevalent. The Middle East, the Western 7 Popkin, Barry M (2000), Urbanization and the Nutrition Transition, Pacific, and Latin America have far higher levels IFPRI, August. of obesity than other developing regions. 8 Punjab development Statistics 2004- 05, Bureau of Statistics Government of the Punjab Lahore. 9 Sindh development Statistics 2004, Bureau of Statistics Planning and Higher-income populations in the developing Development Department of Sindh Karachi. 10 NWFP Development Statistics 2004 - 05, Bureau of Statistics world also have much higher levels of obesity. Planning and Development Department Government of NWFP. This relationship also held a century ago among European and North American populations, but 11 Development Statistics of Balochistan 2005, Bureau of Statistics Planning and Development Department. the reverse is now true: the poor in Europe and 12 District Census Report 1998 North America experience far higher levels of 13 Central Board of Revenue, Government of Pakistan 2001-02 obesity and diet-related chronic diseases than 14 House hold integrated Survey 2004-05 their rich counterparts. This reversal has occurred recently among urban Brazilian women and in 15 Pakistan Statistical Year Book 2006 Chile. 16 Economic Survey 2003-04

A range of changes in health have accompanied this nutrition transition. Most immediate among these seems to be the emerging epidemic of diabetes, stroke, and hypertension, all diet-related chronic diseases. The evidence from some Asian and Latin American countries is particularly worrying. The economic costs of diet-related non-communicable diseases in fact have surpassed the cost of malnutrition in China.

A unique issue emerging from this transition is the increasingly frequent double burden of under- nutrition and obesity in the same household. The prevalence of households with both overweight and underweight members in Brazil, for example, is 11 percent7. Thus, disparity in food demand and consumption among urbanites has inter alia food security implications.

Besides aforementioned issues, there are host of other socio-economic issues related to urbanization that have close interface with food

VULNERABILITY ANALYSIS AND MAPPING (VAM) UNIT, WORLD FOOD PROGRAMME, PAKISTAN 21 FOOD INSECURITY IN URBAN PAKISTAN Urbanization in Pakistan 2

Annexure - 1

NWFP- CITIES POPULATION 2005

1400000

1200000

1000000 R

800000

600000 N U M B E E B U M N 400000

200000

0

Annexure – 2

AJK- CITIES POPULATION 2005

121000 N U M B E 117835 101000 110013 81000

61000 60314 R

41000 42886 37251 22325 18832 12124 11900 11881 10678 8128 7930 7886 7822 6337 5208 3865 21000 1000 KOTLI BAGH HAJIRA HAJIRA MIRPUR MIRPUR CHIKAR CHIKAR SEHNSA KAHUTA DUDYAL DUDYAL BHIMBER FATEHPUR THAKIALA ABBASPUR ATHMUQAM ATHMUQAM ISLAMGARH ISLAMGARH PALLANDARI PALLANDARI RAWALAKOT HATTIAN BALA GARHI DOPATTA DOPATTA GARHI MUZAFFARABAD

Annexure 3 SINDH-CITIES WITH 1-120 LAC POPULATION 2005 14000000

12000000 11873812

10000000

8000000

6000000

4000000 1398477 423462 372525 235928 224384 184105 172015 141267 130167 123949 103963 2000000

0 S HI D R A H A D R U M UR R C BA KU N A H A PU D A P A A A K KA SH K AB R DA AD IR HY AR R U R B UR B KA O A A K DE S LA A P O I D KH LL Y AW IR AC SH N A H N M J TA O ND TA

VULNERABILITY ANALYSIS AND MAPPING (VAM) UNIT, WORLD FOOD PROGRAMME, PAKISTAN 22 FOOD INSECURITY IN URBAN PAKISTAN Urbanization in Pakistan 2

Annexure 4 Cities in Pakistan

180

160 167 140

Number of cities of Number 120

100 96 80 84 85

60

40 22 37

20 8

0

00 00 00 00 00 00 0 ,0 ,0 ,0 ,0 ,0 ,0 ,00 00 00 00 00 50 30 20 ,0 -8 -2 -1 1- 0- w 12 01 01 01 00 00 lo 0- ,0 ,0 ,0 0, 0, Be ,00 00 00 50 3 2 00 2 1 1,2 Population TOTAL CITIES = 499

Annexure - 5 SINDH- CITIES WITH 2-20K POPULATION 2005

25000

20000 19845 19791 19618 19192 18965 18744 18600 18515 18488 17957 17495 17439 17172 17046 16908 16673 16637 16409 16198 16111 16106 16010 16001 15877 15342 15000 15264 15256 14750 14430 14106 12948 12738 12582 12103 12006 11876 11821 11708 11373 10700 10596 10578 10425 10363 10155 10000 9980 9814 9755 9701 9682 9515 9487 9483 9381 9344 9275 9238 9056 8923 8878 8877 8777 8683 N U M B E R B E N U M 8393 7879 7849 7272 7070 7032 6748 6477 6470 5524 5507 5000 5148 3127 2865 2674

0

VULNERABILITY ANALYSIS AND MAPPING (VAM) UNIT, WORLD FOOD PROGRAMME, PAKISTAN 23 FOOD INSECURITY IN URBAN PAKISTAN Urbanization in Pakistan 2

Annexure – 6

SINDH- CITIES WITH 20-90K POPULATION 2005

100000

90000 89633 85525 84779 82273 80407

80000 79459 79229 77741 75472 70000 73048

60000 62903 59094 58664 57887 50000 54748 48918 48108 47869 46674 45203 40000 43674 38637 38321 37946 37872 37251 35833 35535 33730 33272 33219 33033 32040 31975 31973 31960 31875 31739 N U M R B E

30000 29454 28971 27923 27755 27152 25523 24792 23768 23728 22782 22648 20000 22410 22356 22176 22003 21814 21476 20883 20711 20580 20520 20212 10000 0 JOHI JOHI MITHI DIGRI DIGRI THUL THUL THERI THERI HALA HALA KOTRI MATLI KUNRI BADIN MORO ROHRI JHUDO JHUDO MEHAR GUDDU GUDDU KHIPRO BADAH GHOTKI GHOTKI GHARO GHARO WARAH KOT DIJI THATTA THATTA TALHAR TALHAR NAUKOT RANIPUR RANIPUR UBAURO GAMBAT PADIDAN SEHWAN DAHARKI DAHARKI UMERKOT KHANPUR NAUDERO NAUDERO SAKRAND SUJAWAL SANGHAR HINGORJA HINGORJA SETHARJA KANDIARO BHIT SHAH SITA ROAD PANO AQIL KANDHKOT GHAUSPUR RATODERO KASHMORE PIRJO GOTH GOTH PIRJO JAM TANDO NASIRABAD MEHRABPUR QAZI AHMED AHMED QAZI DHORONARO DHORONARO SHAHDADPUR SHAHDADPUR SHAHDAD KOT MIRPUR MATHELO MATHELO MIRPUR KAMBAR ALI KHAN SHAHPUR CHAKAR KHAIRPUR NATHANSHAH TANDO MUHAMMAD KHAN KOT GHULAM MUHAMMAD

Annexure - 7

BALOCHISTAN- CITIES POPULATION 2005 800000 700000 600000 500000 748198 400000 300000

200000 134921 94435 74358 71040 65556 62659 61469 61185 60282 50003 40329 40308 39693 35812 30249 28952 28587 28221 28014 27665 25135 20439 20040 20040 19851 19213 17867 17647 17407 16653 16359 15730 15613 14891 14837 14770 14068 13263 12892 12659 6893

100000 856 0 SIBI HUB HUB DUKI DUKI BELA ZHOB ZHOB ZEHRI BHAG MACH MACH PASNI PISHIN WADH UTHAL UTHAL JIWANI KALAT KOHLU KOHLU SURAB NUSHKI NUSHKI ZIARAT HARNAI HARNAI WINDER WINDER QUETTA QUETTA TURBAT CHITKAN CHITKAN DHADAR DHADAR KHARAN CHAMAN LORALAI ORMARA ORMARA GADDANI GADDANI GWADAR KHUZDAR KHUZDAR MASTUNG BARKHAN GANDAWA GANDAWA MUSAKHEL DALBANDIN DALBANDIN DERA BUGTI DERA SOHBATPUR MUSLIM BAGH KILLA SAIFULLAHKILLA DERA ALLAH YAR YAR ALLAH DERA USTA MOHAMMAD MOHAMMAD USTA N U M B E R N U M DERA MURAD JAMALI JAMALI MURAD DERA

VULNERABILITY ANALYSIS AND MAPPING (VAM) UNIT, WORLD FOOD PROGRAMME, PAKISTAN 24 FOOD INSECURITY IN URBAN PAKISTAN Food Absorption 6 Annexure – 8 & 9 PUNJAB- CITIES 9-20K POPULATION 2005

25000 19989

20000 19966 19842 19564 19333 19208 19205 19160 18728 18546 18408 18403 18253 17907 17887 17795 17662 17607 17539 17320 16956 16477 16334 16295 16188 15984 15821 15786 15746 15000 15506 14764 14588 14521 14408 14099 13886 13349 13311 13302 13034 12788 12597 12505 12318 11951 11466 10000 10917 9446

5000

0 R NUMBE

PUNJAB-CITIES 50-96K POPULATION 2005

120000

100000 95358 95181 91518 90090 89857 89842 88424 86745 85700 83936 80586 80000 79801 79613 76976 76887 76168 75695 75214 73337 73259 72844 72165 71740 71562 71246 70271 70138 68778 68274 66836 66772 65027 64190 63896 62106 60701 59404

60000 59005 56321 56188 54819 54304 53614 52824 51976 51644 51382 51193 50455 40000 N U M B E R 20000

0 FOOD INSECURITY IN URBAN PAKISTAN Food Availability 3 CChhaapptteerr 33

Food Availability

The Food Security in Rural Pakistan (2003)-FSA average production of key staple i.e. wheat, 2003, revealed that out of 120 districts, 74(62%) increased since 1993-94 from 11 million MT to suffered from, low through high to extreme level 18 million MT in 2006 in Punjab, it remained of food insecurity, on all food basis, in terms of almost stagnant in other three provinces. For production & consumption. Since, urban centers in Pakistan rely heavily on rural production of 2000-01 to 2005-06 000 mt food crops, for the food requirements; the state of food insecurity in rural Pakistan is further Average Net Availability 17571.8 compounded when it comes to the urban Consumption 2005 17620.6 Pakistan, as is discussed below: Deficit 48.7 In terms of demand of food, in urban Pakistan, example, according to the Agricultural Statistics wheat ranks number one, followed by rice and of Pakistan (2004-5), wheat production in NWFP then dairy & meat Figure 3.1. Figure 3.2 Food Shortfall Pakistan

Figure 3.1 Requirment of food in Urban Pakistan Wheat 9 (Million MT) Consumpt ion Requirement Gape Rice 8

Pulses 7

Mutton, 0.474 Milk, 2.893 Vegetable 6 Vegetable Beef, 0 .474 Ghee 5 Ghee, 0.618 Milk Chicken, 0 .474 Pulses, 0.371 Fish, 0.474 Mutton 4 Rice, 0.74 6 Fruitts, 2.439 Beef 3

Other, 6.2 Chicken 2 Vegetables, 2.439 Fish 1 Sugar, 0.848 Fruitts 0 Wheat , 7.82 4 Wheat Pulses M ilk B eef Fish V eget ables Vegetable -1 Food type s Sugar & Balochistan was in the range of 1064-1091 & 638-655 thousand tons, during 2002-2005 as The requirements for these food items in urban against Punjab & Sindh, where during the same areas have been estimated at 7.8, 6.2, 2.8 and period production fell in the range of 15355- 0.74 million MT per annum respectively. When 17375 & 2109-2509 thousand tons respectively. we contrast the food requirements with its The situation in NWFP and Balochistan remained average availability, the gap is more pronounced almost unimproved during the period. As a result, in case of wheat compared to other daily use food as reported in FSA 2003, 35(29%) districts in items Figure 3.2. Pakistan were highly deficit in wheat production in 2003. As can be seen from the Figure 3.3 whereas, the

Figure 3.3 Production of Wheat in Pakistan

19000 18000 19 9 3 - 9 4 170 0 0 19 9 4 - 9 5 16000 19 9 5- 9 6 150 0 0 19 9 6 - 9 7 14000 19 9 7- 9 8 000 MT 13000 19 9 8 - 9 9 12000 19 9 9 - 0 0 110 0 0 2000-01 10000 2001-02 9000 2002-03 8000 2003-04 70 00 2004-05 6000 50 00 2005-06 4000 3000 2000 10 0 0 0 Punjab Sindh N.W.F.P Balochistan Province

VULNERABILITY ANALYSIS AND MAPPING (VAM) UNIT, WORLD FOOD PROGRAMME, PAKISTAN 26 FOOD INSECURITY IN URBAN PAKISTAN Food Availability 3

An average availability of wheat flour, through 5. In Sindh, on the contrary it declined from 1682 own sources, was estimated at 17.5718 million thousand tons in 2000-1 to 1499 in 2004-5, while Mt, during period from 2000-2001 to 2005-6, as its production was even lower in 2001-2, when it against wheat demand of 17.6206 million MT, registered production level of 1159 thousand suggesting a net deficit of 0.0487 million MT. tons. In NWFP & Balochistan it remained However, Government of Pakistan has estimated stagnant in the range of 130 and 420 thousand production of wheat as 22.5 million MT during tons respectively, on average, during 2000-2005. 2006-07 with a surplus of 1.6 million MT. Nevertheless, good bumper crop of wheat during On stocks balance, there was a marginal increase 2006-07 was the result of good weather condition from 4807 thousand tons during 2000-1 to 5024 and proper rainfall. Such conditions are uncertain thousand tons, over five years time, since 2001. and may not repeat every year. As Pakistan exports rice, its availability for local consumption, with increasing population, and Since wheat is key contributor to daily caloric relatively static growth in production is intake in Pakistan, the deficit in wheat compromised. Needless to mention that growing requirement & demand, translates to caloric demand with increasing population and lesser shortfalls and thus to food insecurity. As availability has led to higher prices over years. mentioned in table-3.1, for urban areas, in 8(7%) This has impacted economic access to rice as a districts out of 112 average caloric intake falls in staple food. the range of 3501-4855 Kcal per person per day, while in 39(35%) districts, on the other extreme Compared to wheat, rice however contributes caloric intake is in the range of 1477-1800 Kcal relatively less, in terms of caloric intake, in per person per day. There are 89(80%) districts, Pakistan in general and in marginalized regions in where the average caloric intake is below the particular. For example, in Punjab its contribution standard Kcal required by healthy person. varies from zero Kcal (Attock & Chakwal) to 1669 Kcal (Hafizabad). This suggests that physical access to food i.e., food availability, inter alia, is one of the key Partially this disparity, in consumption among factors implicating food security in Pakistan in districts, reflects on local production capacity, for general and in urban Pakistan particular. rice is primarily produced in irrigated belts of Punjab and Sindh, and especially production of With regard to rice, milk & dairy products, relished variety, the basmati, is restricted to a few barring powder milk, and to some extent meat, districts including Sialkot, Gujranwala and the gap between actual requirements and Hafizabad. In Sindh, use of rice in daily diet in availability is not that big. Yet, in 2006, the quantitative terms is more common, as such its Government had to allow duty free imports of contribution towards daily caloric intake is on meat and live animals to stabilize the abnormal higher side compared to Punjab, and ranges from prices of these products in urban Pakistan. zero (Mirpur Khas & Tharparkar) to as high as 1923(Shikarpur). It is interesting to observe that Rice production, as per Agricultural Statistics of in some key agricultural areas, like Hafizabad in Pakistan (2004-5) remained almost static, around Punjab and Noshero Feroz in Sindh contribution 2500 thousand tons in Punjab during 2000-3, of both wheat & rice is quite significant towards while it increased to 2980 thousand tons in 2004- daily diet, in terms of caloric intake. This Table 3.1 Calories Consumption Per Capita Per Day in Urban Pakistan Number of Districts Calories Balochi Northern Islama Per Person Punjab NWFP Sindh stan Areas PAK FATA bad Total Extremely Low 4 3 6 22 2 - 2 - 39 Very Low 9 10 3 2 3 3 1 - 31 Low 9 1 6 - - 3 - - 19 Normal 7 6 1 1 - - - - 15

Sufficient 5 - 1 - - 1 - 1 8 Total: 34 20 17 25 5 7 3 1 112 Extremel:Low:1477 - 1799, Ver: Low: 1800 -1995, Low:2017 - 2305, Normal: 2465 - 3466, Sufficient: 3550-4855 PAK:Azad Jammu & Kashmir, FATA: Federally Administered Areas No Urban Areas in these Districts: NWFP:Buner, Shangla, Kohistan,Battagram Balochistan: Awaran,FATA: Bajour,Mohamand,Orikzai,S.Waziristan

VULNERABILITY ANALYSIS AND MAPPING (VAM) UNIT, WORLD FOOD PROGRAMME, PAKISTAN 27 FOOD INSECURITY IN URBAN PAKISTAN Food Availability 3 phenomenon guides us to the fact that local Balochistan, 359 Kcal (Gilgit) in NAs, 143 Kcal production and thus physical access to food or (Kotli) in PAK and 157 Kcal (Bajour) in FATA. availability is inter alia an important factor in In the mountainous region on northern Pakistan, terms of food security, in developing countries. it is almost the key staple. On all Pakistan basis it These countries will not afford to import food for contributes only 55.35 Kcal towards the daily diet want of foreign exchange, and have no choice but per capita. to produce their own food, if they want to be food secure. The aforementioned three staple crops, namely wheat, rice & maize collectively contribute 1117 On the contrary, in marginal land zones, like NAs Kcal per capita, on average, towards daily diet in & FATA, contribution of rice towards caloric Pakistan, and as such are the basis for food intake, as mentioned above, is insignificant security in Pakistan. ranging from zero in NAs to maximum of 147 Kcal (Kurram) in FATA. In PAK too its Production of other minor staples like Millet and consumption, and thus contribution towards daily Sorghum, yet other important contributors caloric intake is on lower side compared to towards daily diet, also remained stagnated Punjab and Sindh, and falls in the range of 3-19 around 150-200 thousand tons from 1987-2005. Kcal. This again is true reflection inter alia of Similarly, production of Barley, during this local production capacity, for PAK like NA’s & period, was also in the range of 90-150 thousand FATA has marginal land structure. Though tons. In net cereal terms, the production remained Balochistan also falls in marginal land zone of static around 26000 thousand tons from 2000-04, Pakistan, some of its districts have irrigated while it increased to 2905 thousand tons in 2004- lands, and are among rice producing areas of 05 (Agricultural Statistics of Pakistan, 2004-05). Pakistan. As such, rice contributes significantly This stagnation in the production, especially of in the daily diet and thus caloric intake in those subsistent crops, over two consecutive decades, districts. However, in general rice contributes less adversely affected food security in marginal areas in daily diet, in terms of calories, in Balochistan and of poor segment of the society in urban as compared to Punjab and Sindh. However, on Pakistan, for it could not keep pace with the average, rice contributes almost 232 Kcal per demand of growing population. capita per day on all Pakistan basis. Production of Grams stagnated around 500-550 Maize, a subsistent crop in Pakistan, as thousand tons since 1987, while that of Mash and mentioned above, is also an important staple, Masoor declined from 35 and 31 thousand tons in especially in marginal areas of almost all regions 1987 to 18 and 26 thousand tons respectively in of Pakistan. 2004-5. In sum, the net production of pulses remained in the bracket of 700-800 thousand tons Its production remained almost static from 1987- during the last two decades. Whereas, demand of 88 to 1994-95, and was in the range of 1100-1200 pulses in relative terms remained low during last thousand tons. Its production in areas, where it is two decades, but due to decline in domestic consumed the most like NWFP was almost static production the prices went up sharply during the around 750-800 thousand tons on average, during last 3 years and consequently, pulses were 1987-2005. It however, has increased on Pakistan iumported. Low-income group mainly used basis since1995-96, from 1504 thousand tons to pulses with bread as a major diet in the past in 2797 thousand tons in 2004-5 (Agricultural Pakistan. Thus static growth of pulses Statistics of Pakistan, 2004-5) on all Pakistan compromises food security of these basis, primarily because of growing demand by marginalized sections of the society, especially in maize oil manufacturers, who have also entered urban Pakistan, for poor in urban setting have no into contracts with farmers in some of the areas other substitute available. especially in Punjab. Since, pulses are routine diet item, for the poor Its contribution, therefore towards daily caloric and the marginalized in Pakistan, as mentioned intake is on lower side. For example, in Punjab its above; stagnation in their yield has led to increase contribution in terms of caloric intake registered in their prices over last few years. As a result, in maximum of 308 Kcal (Okara), while it 2006, Government was compelled to import contributes up to 642 kcal (Kohistan) in NWFP, 3 pulses to stabilize their prices. Kcal (Mirpur Khas) in Sindh, 23 Kcal (Loralai) in

VULNERABILITY ANALYSIS AND MAPPING (VAM) UNIT, WORLD FOOD PROGRAMME, PAKISTAN 28 FOOD INSECURITY IN URBAN PAKISTAN Food Availability 3

Sugar is yet another important contributor in terms of caloric intake, and makes a significant References share in the daily diets of especially middle and 1 Agricultural Census Punjab 2004, Government of Pakistan, below middle classes, who relish drinking tea to Statistical Division Agricultural Census Organization. make up caloric needs, with high level of sugar. 2 Punjab Development Statistics 2005, Bureau of Statistics Consumption of sugar per capita therefore, is Government of the Punjab. higher in Pakistan compared to many countries. 3 Agricultural Census Sindh 2004, Government of Pakistan, The prices of sugar in the country went up, Statistical Division Agricultural Census Organization registering a skyrocketing trend, this year, and 4 Sindh Development Statistics 2004, Bureau of Statistics again Government had to import sugar to Planning and Development department of Sindh , Karachi stabilize the prices and satisfy the local demand. 5 Agricultural Census Balochistan 2004, Government of Pakistan, The production of sugar in Pakistan was too Statistical Division Agricultural Census Organization. static around 45000 thousand tons over last 6 House Hold Integrated Survey (HIES) 2004-05, Federal Bureau of Statistics Government of Pakistan ,Statistical Division, decade. Given the fact that Pakistan is registered 7 Punjab Agricultural Statistics 2000 as Net Food Importing Developing Country 8 Sindh Agricultural Statistics 2000 (NFIDC) with the World Trade 9 Balochistan Agricultural Statistics 2000 Organization(WTO) and that it on an average 10 NWFP Agricultural Statistics 2000 imports 1-2 MT of wheat each year (with few 11 Pakistan Statistical Year Book 2006 exceptions), present import surge in sugar, pulses 12 Economic Survey 2003-04 and even milk signals worsening state of food security in general and urban food security in particular. This situation further accentuates, when one looks at the inadequate per capita income and increased rate of urbanization. Figure 3.4 Food Consumption in Urban Pakistan (Million MT)

B eef , Mutton, 0.2005128 0.0891168 Chicken, Fish, 0.0334188 V eget ab le Ghee, 0.1225356 0.3286182 Milk, 3.0021222 Fruitts, 0.6460968 Pulses, 0.2339316 Ot her, 3.007692 Vegetables, 2.2501992 Rice, 0.5681196 Wheat , 3.8765808 Sugar, 0 .0779 772

Wheat Rice Pulses V eget able Ghee

Milk Mutton B eef Chicken Fish Fruitts Vegetables Sugar

VULNERABILITY ANALYSIS AND MAPPING (VAM) UNIT, WORLD FOOD PROGRAMME, PAKISTAN 29 FOOD INSECURITY IN URBAN PAKISTAN Food Absorption 6

FOOD INSECURITY IN URBAN PAKISTAN Food Availability 3

Table 3.2 Calories Consumption per capita per day in Urban Areas of Pakistan 2005 Provincial Provincial Provincial Provincial Provincial Provincial National National National National District District District Rank Rank Rank Rank Rank Rank Rank Code Code Code

S U F F I C I E N T C ISLAMABAD 1 1 P Sialkot 4 2 P Sheikhupura 7 5 S Karachi 2 1 P Kasur 5 3 A Mirpur 8 1 P Jhelum 3 1 P Faisalabad 6 4

N O R M A L P Lahore 9 6 N Haripur 14 3 N Swabi 19 5 P Rawalpindi 10 7 B Quetta 15 1 P Rahim Yar 20 10 Khan S Hyderabad 11 2 P Mianwali 16 8 N Swat 21 6 N Peshawar 12 1 N Mardan 17 4 P D.G Khan 22 11 N Nowshera 13 2 P Multan 18 9 P Sahiwal 23 12

L O W A Muzaffarabad 24 2 P Hafizabad 31 17 S Thatta 38 7 P Sargoda 25 13 S Ghotki 32 4 S Badin 39 8 P Khushab 26 14 P Gujrat 33 18 P Chakwal 40 20 P Gujranwala 27 15 S Larkana 34 5 P Jhang 41 21 P Muzaffargarh 28 16 S Khairpur 35 6 A Bagh 42 4 S Sukkar 29 3 A Rawalakot 36 3 N Abbottabad 30 7 P Attock 37 19

V E R Y L O W A Kotli 43 5 N Bannu 54 8 N Kohat 65 12 B Killa Saifullah 44 2 P Bahawalpur 55 26 P Bahawalnagar 66 29 P Khanewal 45 22 N Charsadda 56 9 P Layyah 67 30 P Okara 46 23 P Pakpattan 57 27 NA Ghizer 68 3 P T.T.Singh 47 24 S Sanghar 58 10 N Malakand 69 13 NA Gilgit 48 1 S Jacobabad 59 11 N Mansehra 70 14 B Kharan 49 3 A Sudhnoti 60 7 N Lakki 71 15 S Dadu 50 9 NA Skardu 61 2 N Hangu 72 16 A Bhimber 51 6 N D.I.Khan 62 10 N Chitral 73 17 F Kurram 52 1 P Bhakkar 63 28 P Mandi Bahaud 53 25 N Tank 64 11 Din E X T R E M E L Y L O W N Lower Dir 74 18 B Gawader 87 4 B Mastung 100 15 N Karak 75 19 B Lasbela 88 5 B Jafarabad 101 16 N Upper Dir 76 20 B Turbat 89 6 B Zhob 102 17 P Vehari 77 31 S Shikarpur 90 15 B Bolan 103 18 S Nawabshah 78 12 B Kohlu 91 7 B Kalat 104 19 P Lodhran 79 32 B Panjgur 92 8 B Killa Abdullah 105 20 S Noushero Feroze 80 13 B Ziarat 93 9 B Pishin 106 21 NA Diamer 81 4 B Barkhan 94 10 B Sibi 107 22 NA Ghanche 82 5 F N.Waziristan 95 3 B Khuzdar 108 23 P Narowal 83 33 B Chagai 96 11 B Musa Khel 109 24 F Khyber 84 2 B Nasirabad 97 12 B Dera Bugti 110 25 P Rajanpur 85 34 B Jhal Magsi 98 13 S Umerkot 111 16 S Mirpurkhas 86 14 B Loralai 99 14 S Tharparkar 112 17

P: Punjab, S: Sindh, N:NWFP, C: Capital, B: Balochistan, NA: Northern Area, A:Azad Jammu & Kashmir, F: Federally Administered Areas National Rankings are from 1 to 112, 1 being the worst and 112 the best. Provincial Rankings depend on the number of districts per province.

VULNERABILITY ANALYSIS AND MAPPING (VAM) UNIT, WORLD FOOD PROGRAMME, PAKISTAN 31 FOOD INSECURITY IN URBAN PAKISTAN Gender and Food Security 4 CChhaapptteerr 44

Gender and Food Security

The term ‘Gender’ is used by sociologists to Women make 47.13% of urban population in describe all the attributes, roles, activities and Pakistan whereas urban sex ratio is 112.15 responsibilities of men or women, which are according to the District Census conducted in socially learnt. Different cultures form different 1998. social expectations about what behaviors and activities are appropriate for men vs women and Pakistan ranks low in many gender related human boys vs girls and what rights, resources and development indicators. It ranks at 120 among power they should or may possess. These 146 countries on Gender Development Index expectations are socially constructed roles of (GDI) that includes literacy, combined primary, women and men, or gender roles, and may secondary and tertiary gross enrolment, mortality change over time1. indicators and share in total income.

Table 4.1 Sex Ratio Pakistan and Provinces Province/Area Census 1998 2001-2002 2003-2004 Pakistan 108 107 105 Rural 106 106 104 Urban 112 110 108 Punjab 110 105 103 Sindh 113 113 112 NWFP 113 104 99 Balochistan 118 113 109 Source: i. District Census Report 1998 ii. Labour Force Survey of Pakistan 2003-04

Keeping the above concept in sight, an attempt is This section looks at the following key indicators made to analyze the situation of women as one of regarding Gender and Development to assess the the most vulnerable groups of population in the state of affaires in general and vulnerability of perspective of gender and development, using women as a group in particular: disaggregated data available from various data sources. Since reporting on women statistics is o Sex Ratio in Urban Pakistan not easy due to social constraint in obtaining o Labour Force Participation Rate complete and accurate information, the analysis o Literacy Rate cannot provide a comprehensive overview. It thus, touches only upon some key issues to 4.1. Sex Ratio in Urban Pakistan initiate a discourse on the theme of gender in relation to poverty and food insecurity. The overall sex ratio in Pakistan was reported as 108 and urban sex ratio as 112 in the Census of

Table 4.2 Gender and Development – Sex Ratio in Urban Population - 1998 Balochista Punjab Sindh NWFP n FANA PAK FATA ICT Total Urban Population 23,019,000 14,840,000 2,994,000 1,569,000 126,200 349,868 85,000 529,000 Male Population 12,071,000 7,905,000 1,589,000 850,000 65,717 175,569 46,000 291,000

Female Population 10,948,000 6,935,000 1,405,000 719,000 60,483 174,300 39,000 238,000 Sex Ratio 110.26 113.99 113.10 118.22 108.65 100.73 117.95 122.27

Source :( Pakistan Statistical Year Book 2004) PAK,FANA (PAK Statistical Year Book 1998)

VULNERABILITY ANALYSIS AND MAPPING (VAM) UNIT, WORLD FOOD PROGRAMME, PAKISTAN 32 FOOD INSECURITY IN URBAN PAKISTAN Gender and Food Security 4

Figure 4.1 Gender and Development - Sex Ratio in Urban assessed. An important aspect of mainstream Pakistan social science research, which leads to a

ICT 116.24 misconception of the economic status of women, is that conventional statistical categories do not FANA 108.65 take account of the specific role of women.3 AJK 100.73

Balochis tan 114.61 The reasons for this huge gap between male and female labor participation rate are many. To cite a NWFP 105.02 few: Sindh 112.24 o lack of opportunities for education, skills Punjab 107.23 Sex Ratio training and employment; o social restraint on mobility; o 1998 which came down to 105 and 108, lack of participation in family decision respectively, in 2003-2004. Across provinces, making; Balochistan had the highest sex ratio of 118 in o parental neglect and preference for male 1998, which stands at 109 now. The sex ratio child as bread earner of the family; reversed in NWFP, which came dwon from 113 o lack of personal security and risk of sexual to 99. All the provices have showed a decrease in harassment at work place; o sex ratio. However, Sindh province still has a non-acknowledgement of labor; o highest sex ratio as compared to other provinces. engagement in low paid or unpaid work. As per the latest Labour Force Survey of Pakistan, Sindh has a ratio of 112. On the other Table 4.4 hand, NWFP has a ratio of 99. The reasons for Unpaid Family Workers Province this change have not been investigated. Code District Male% Female% Change in sex ratio in urban areas could be N Malakand 8.5 30.6 attributed to only male in-migration, female out B Gwadar 2.93 32.54 migration due to marriage as well as maternal and P Vehari 4.5 33 female child mortality rate in urban areas. Some B Nasirabad 12.13 41.67 of these issues are covered in the forthcoming S Hyderabad 4.91 41.7 sections. P Multan 5.8 42.8 N Nowshera 1.9 48.6 4.2. Labour Force Participation Rate B Sibbi 7.81 50.06 S Sanghar 4.88 64.25 The Pakistan Economic Survey 2003-2004 S Badin 7.95 75.48 mentions that the female labour force participation rate is far less compared to the male A brief analysis of workers in unpaid participation rate and as such, their participation employment shows that more women than men 2 in economic activities is also low. are engaged in unpaid labor. The table-4.4 enlists ten districts across Pakistan with female unpaid Table 4.3 family workers with 30% or higher rate. Badin Labour Force Participation Rate – Urban has an extreme situation where female unpaid (2003-04) family workers count for more than 75% of total Crude (CAR) Refined (RAR) Activity Rate Activity Rate working female. Sanghar in Sindh, Sibbi in Both Sexes 29.2 39.2 Balochistan and Nowshera in NWFP, have a rate Male 49.8 67.1 of more than 45%. Female 7 9.4 Figure 4.2 Unpaid Family Workers Source: Labour Force Survey 2003-2004 80 70 Male%

‘Inspite of the fact that women of poor s Female% households do engage in productive labour and 60 play a vital role in the economic and social life of 50 40 our society, yet they continue to be perceived as 30 marginal to our society. Apart from culture 20 specific biases, there are also trans-cultural 10 0 Percentage Worker to Total i n reasons for the bias against women, which are ar r a and bad ltan er bbi k u Si ira sh Badi ala Veha erabad M rooted, in the analytical framework within which Gwad d w Sanghar M Nas o the economic contribution of individuals is Hy N Districts w ith High Percentage of Unpaid Female Family Workers

VULNERABILITY ANALYSIS AND MAPPING (VAM) UNIT, WORLD FOOD PROGRAMME, PAKISTAN 33 FOOD INSECURITY IN URBAN PAKISTAN Gender and Food Security 4 The gulf between the male and female labour newborn babies being born motherless.2 participation rate needs to be narrowed down through devising policies and programmes that 4.4. Social Development in Primary should focus on enhancing economic and social Education and Primary Health indicators for women and providing protection against exploitation as well as improvement in The state of Social Indicators, in particular on reporting mechanism to obtain accurate and Education, Health and Gender Equality in complete information on the situation of women. Pakistan is a matter of concern both at national and international level due to recent slip in the 4.3. Social Indicators on Primary ranking. The latest UN Report on Human Education and Primary Health Development ranks Pakistan at No. 142 down from No. 135 among a list of 210 countries. According to the Pakistan Economic Survey 2003-2004, Gender disparity in primary and Gender inequality starts from the very beginning secondary education exists in low-income of childhood and is demonstrated in parental, countries. The gender gap, on average, stood at family and societal preference for male child in 11 percentage points at the primary level and 19 providing opportunities for education, percentage points at the secondary level. The gap nourishment, health care, distribution of is widest in Asian and the Middle Eastern household responsibility and inheritance countries. Eliminating gender gaps in basic education is the corner stone of the government’s Figure 4.3 Percentage of Urban Population policy for social development in general and Under 10 Years of Age education in particular. Less than 20% 25 21-25%

26-30% 20 Table 4.5 31-35% 15 36-40%

Literacy Rate - Urban Pakistan 2004-05 10

No. of District 5 Total Male Female 0 Punjab Sindh NWFP Balochistan FANA AJK ICT

69% 78% 59% Province Source: Pakistan Social and Living Standard Measurement Survey 2004-05 decisions. It is also demonstrated in placing responsibility on male or female child for certain The government has a policy framework in place tasks at a certain age. The social attitudes towards to advance gender equality in education through gender equality have started to change. Hence, it Education Sector Reforms (ESR) and Education is now considered useful to look at disaggregated For All (EFA) Programmes.’ data on social indicators to assess change in the context of gender equality. Two important Similarly, according to the Pakistan Economic aspects of Primary Education and Primary Health Survey 2003-2004, the human development Care are, thus, included in this section. indicators for Pakistan particularly health are still low despite the fact that progress has been made The ratio of child population under the age of 10 in recent years. While, mortality has been in urban Pakistan is 26.98 % with 26.24 % male decreasing and fertility has shown a significant and 27.80% female. It implies that population in decline over the recent years, the crude death rate this age group forms more than a quarter of total (CDR) of Pakistan is estimated at 8.1 (per urban population with particular primary health thousand) in 2003-2004. Maternal mortality care needs such as immunization, proper ranges from 350-400 per hundred thousand, per nourishment to help in growth and safe living year leading to about seventeen thousand environment with protection against physical and Table 4.6 Ratio of Urban Population under 10 Years of Age 1998 Number of Districts Balochis Northern Islama Range Punjab NWFP Sindh PAK FATA Total tan Area bad Less than 20% - - - - - 4 - - 4 21-25% 7 2 1 1 - - - 1 12 26-30% 23 8 7 2 5 2 - - 47 31-35% 4 9 9 16 - 1 1 - 40 36-40% - 1 - 6 - - 2 - 9 Total 34 20 17 25 5 7 3 1 112

VULNERABILITY ANALYSIS AND MAPPING (VAM) UNIT, WORLD FOOD PROGRAMME, PAKISTAN 34 FOOD INSECURITY IN URBAN PAKISTAN Gender and Food Security 4 social hazards including abuse, violence and 4.5. Primary Education indulgence in street life. Primary Education is the foundation of learning The percentage of urban child population by age for both girls and boys. It is a basic human right groups is as follows: and a top priority in the realm of child rights and 00-04 13.00% development. It is the first opportunity for social 05-09 13.98% interaction beyond the protective environment of 10-15 13.10% the household and family. Primary Education 15-19 11.28% gives a start to building learning capacities and understanding the world of knowledge that goes a A province-wise overview of ratio of urban long way in shaping the personality, attitudes and Population under 10 years of age is given in table intellectual direction of a child. 4.6. Main issues are the availability of primary The variation at district level shows that there are education, access of eligible population aged 5-9 9 districts with 36-40% of population under the both male and female and acceptable quality of age of 10 which makes it imperative to pay education. attention to their needs in areas of health and education in those districts. Six of these districts The availability is verified by the number of are located in Balochistan, two in FATA and one primary schools physically existing in a district in NWFP. and also being functional, having necessary equipment, staff and physical facilities needed by Table 4.7 the children of particular age and sex. Access is a Districts with Under 10 Years Population more complex matter as it not only entails between 35-40% 1998 affordability in financial terms but also social Province Under 10 Year Code District Pop 35 - 40 % norms that hinder access of girls to primary education. Hence, gender analysis of participation N Lower Dir 35.53 in primary education is a good tool to assess the B Nasirabad 35.57 accessibility to primary education. Quality of B Kharan 35.66 B Pangur 35.85 education is assessed by looking at the B Killa Saifullah 36.82 availability and quality of teachers, curriculum NA Ghizer 37.4 contents, teaching environment and applicability B Musa Khail 39.45 of education to practical life.

The national level data collection does not A sub-group of this population between 5-9 years include all the above aspects in one set of of age is identified as prospected primary school information and therefore, many different sources goers. The following sections look into the of information are to be consulted to develop a aspects of health and education for children’s realistic picture of primary education in Pakistan. groups below the age of 10, between 5 and 9 and For the purpose of this study, National Education below the age of 19. Management Information System at the Education Planning and Management Wing has

Table 4.8 Primary Education in Urban Pakistan - NEMIS 2004-05 Main Indicator Punjab Sindh NWFP Balochistan PAK FANA Islamabad Total Female Schools 2364 1402 515 282 60 18 - 4641 Male Schools 1927 1644 702 674 20 14 - 4981 Mixed School 0 1718 0 0 0 48 62 1828 Total 4291 4764 1217 956 80 80 62 11450 Female Teachers 10765 19262 3226 1103 98 149 960 35563 Male Teachers 9913 18036 4260 2076 46 71 - 34402 Total 20678 37298 7486 3179 144 220 960 69965 Female Enrolment 527694 399140 89607 57468 6661 5595 20542 1106707 Male Enrolment 498670 431936 124503 86240 5184 3225 22870 1172628 Total 1026364 831076 214110 143708 11845 8820 43412 2279335

VULNERABILITY ANALYSIS AND MAPPING (VAM) UNIT, WORLD FOOD PROGRAMME, PAKISTAN 35 FOOD INSECURITY IN URBAN PAKISTAN Gender and Food Security 4 been used as the main source of information. It enrolment ratio is 94%. There are 6.11 teachers includes data on education across country per school and 32.58 students per teacher. PAK covering four provinces, PAK, FANA, FATA has the highest, i.e., 3:1 female-male ratio of and Islamabad Capital Territory. schools and 2:1 female-male ratio of primary school teachers whereas female students’ This study is focused on urban Pakistan and enrolment is reported to be 128% of male’s includes information on overall situation of enrolment. primary education in respect of: o Number of Primary Schools 4.6. Distribution of Mixed Schools o Number of Primary School Teachers o Enrolment The practice of Mixed Primary Education o Teachers/Student and Teacher/Schools System4 that offers learning possibilities to both Ratio girls and boys is also reported in the NEMIS o Sex Disaggregated data on the above 2004-05. It seems to be socially acceptable in indicators certain regions as seen from the ratio of mixed schools to total number of schools in respective The national statistics on Primary School areas. Education in Urban Pakistan is given in table-4.8. The Mixed Primary Education System is According to information, total number of practiced at three regions i.e. the Province of primary schools is 11,450, total number of Sindh and Federally Administered Northern teachers is 69,965 and the total enrolment is Areas in both rural and urban settings and in ICT. 2,279,335. The female/male ratio of primary In Sindh and FANA, in total four districts have school is 93:100. There are 6.11 teachers per less than 20% mixed schools, nine 21-40% mixed school whereas each teacher is responsible for schools, five between 41-60%, two between 61- 32.58 students. 80% and one district has above 81% share of mixed schools. However, there are variations at the provincial level. Islamabad has highest number of teachers per school i.e. 15.48, Sindh is placed next with Table 4.10 7.83 teachers per school, NWFP has 6.15, Punjab Mixed Schools 4.82, Balochistan 3.33, FANA 2.75 and PAK 1.8 Number of Districts FANA Sindh Total teachers per school. On the other hand, PAK has Range Urban Urban Urban highest student / teacher ratio i.e. 82 students per teacher, Punjab 50, Balochistan and Islamabad Less than 20% 0 4 4 45, NWFP 29, Sindh 22 and NAs have 40 21-40% 2 7 9 students per teacher. 41-60% 0 5 5 61-80% 2 0 2 As far as female-male ratio is concerned, female- 81-100% 1 0 1 male ratio excluding mixed school is 93%, Total 5 16 21 female-male teachers’ ratio is 103% and In Islamabad Capital Territory (Urban), there are Table 4.9 62 mixed-schools and no separate boy’s or girl’s School Statistics of Pakistan - NEMIS 2004-05 schools in the primary education sector according Teacher Student/ to NEMIS 2004-2005 report. Main F/ M per Teacher Indicators Total Ratio school Ratio Female Mixed schools reflect both resource constraints to Schools 4641 have separate girls and boys schools as well as Male Schools 4981 social acceptance for co-education at primary Mixed School 1828 level. Total 11450 0.93 6.11 32.58 Female Teachers 35563 Male Teachers 34402 Total 69965 1.03 Female Enrolment 1106707 Male Enrolment 1172628 Total 2279335 0.94

VULNERABILITY ANALYSIS AND MAPPING (VAM) UNIT, WORLD FOOD PROGRAMME, PAKISTAN 36 FOOD INSECURITY IN URBAN PAKISTAN Gender and Food Security 4 4.7. Gender Gap in Primary Education Poonch, Bagh and Muzaffarabad in PAK have ratio ranging between 300-650%.

Regarding female/male primary school teachers ratio, lowest ranking is once again recorded in Pishin, Balochistan with only 2% female/male ratio of primary school teachers. Dera Bugti, Killah Abdullah, Killa Saifullah, Bolan and Panjgur rank at 7% to 18%.

Female enrolment statistics in urban Balochistan in the districts Dera Bugti, Pangur, Pishin, Awaran show low female/male ratio ranging between 13% to 18%. However, altogether 34 districts of Pakistan, PAK and FANA have a ratio of more than 100%, which is very encouraging. The district level female/male ratio of primary Highest ratio is noted in two remote areas of schools, primary school teachers and the Battagram and Kohistan in NWFP i.e. 4.9:1 and enrolment varies from province to province. The 9.9:1 respectively. details are contained in the table 4.12.

Table 4.11 Gender Gap in Literacy Rate in Urban Pakistan 2004-05 Number of Districts Gender Gap Northern (Percentage) Punjab NWFP Sindh Balochistan Areas PAK FATA Islamabad Total 7 - 19 8 1 1 - - - - 1 11 20 - 29 16 1 - - 1 7 - - 25 30 - 49 9 6 10 7 4 - - - 36 50 - 79 1 12 6 15 - - 2 - 36 80 - 84 - - - 3 - - 1 - 4 Total 34 20 17 25 5 7 3 1 112 PAK:Azad Jammu & Kashmir, FATA: Federally Administered Tribal Areas No Urban Areas in these Districts:NWFP:Buner,Shangla,Kohistan,BattagramBalochistan:Awaran,FATA:bajour,Mohamand,Orakzai,S.Waziristan

Districts in both Balochistan and NWFP seem to rank low whereas districts in PAK, Sindh and 4.8 Gender Gap in Literacy Rate Punjab as well as ICT (Islamabad) seem to rank high on the selected indicator. Ratio of female Literacy rate is one of the important indicators of primary schools to male primary school is only human development. The gender gap in literacy 3% in Pishin, 9%in Killa Abdullah, 15% in determines the level of social development of Pangur and 17% in Killa Saifullah in Balochsitan. individual sex. The narrow the literacy gap the narrow the deprivation between male and female.

VULNERABILITY ANALYSIS AND MAPPING (VAM) UNIT, WORLD FOOD PROGRAMME, PAKISTAN 37 FOOD INSECURITY IN URBAN PAKISTAN Gender and Food Security 4

Islamabad has the lowest gender gap in literacy rate as 7.4% while the highest gap is in Khyber Agency as 84%. Forty districts are having gap of 50% and above and majority of these are in Balochistan, NWFP and FATA. The lower literacy gap is recorded in 11 districts, where 8 districts are in Punjab. The highest literacy gap of 80-84% is recorded in 4 districts, three in Balochistan and one in FATA.

Gender gap is a good instrument for measuring soio-economic development. Areas with low economic development, in most of the cases, have wider gender gap.

VULNERABILITY ANALYSIS AND MAPPING (VAM) UNIT, WORLD FOOD PROGRAMME, PAKISTAN 38 FOOD INSECURITY IN URBAN PAKISTAN Gender and Food Security 4

VULNERABILITY ANALYSIS AND MAPPING (VAM) UNIT, WORLD FOOD PROGRAMME, PAKISTAN 41 FOOD INSECURITY IN URBAN PAKISTAN Gender and Food Security 4

References

1 An excerpt from ‘Mainstreaming a Gender Perspective into Vulnerability Analysis and Mapping in line with the WFP Gender Policy 2003-2007’

2 Pakistan Economic Survey 2003-2004 3 Poverty Alleviation in Pakistan by Dr. Akmal Hussain 4 Mixed schools teachers and enrolment distinction was not given in the set of data and therefore could not be included in the complete analysis 5 Punjab Development Statistics 2004-05, Bureau of Statistics Government of the Punjab. 6 Sindh Development Statistics 2004, Bureau of Statistics Planning and Development department of Sindh , Karachi

7 Development Statistics of Balochistan 2005, Bureau of Statistics Planning and Development Department.

8 NWFP Development Statistics 2005, Bureau of Statistics Planning and Development Department Government of NWFP. 9 House Hold Integrated Economic Survey (HIES) 2004-05 10 Centeral Board of Revenue, Government of Pakistan 2001-02 11 District Census Report 1998 12 Pakistan Statical Year Book 2006 13 Pakistan Education Statistics 2004-05, Ministry of Education Government of Pakistan, National Education Management Information System 14 Pakistan School Education Statistics 2003-04, National Education Management Information System (NEMIS), Ministry of Education Government of Pakistan. 15 FATA Development Statistics 2005, Bureau of Statistics Planning & Development Department Government of NWFP. 16 Pakistan Social and Living Standreds Measurment Survey 2004-05 (PLSM), Government of Pakistan, Statistical Division Federal Bureau of Statistics. 17 Labour Force Survey 2003-04, Statistical Division Federal Bureau of Statistic Government of Pakistan.

VULNERABILITY ANALYSIS AND MAPPING (VAM) UNIT, WORLD FOOD PROGRAMME, PAKISTAN 40 FOOD INSECURITY IN URBAN PAKISTAN Gender and Food Security 4

Table 4.12 Primary Education in Urban Pakistan – NEMIS 2004-05 Teacher Per Teacher Main Indicator Punjab F/M Ratio School Student Ratio Female Schools 2364 1.23 4.82 49.64 Male Schools 1927 Mixed School 0 Total 4291 Female Teachers 10765 1.09 Male Teachers 9913 Total 20678 Female Enrolment 527694 1.06 Male Enrolment 498670 Total 1026364 Main Indicator Sindh Female Schools 1402 0.85 7.83 22.28 Male Schools 1644 Mixed School 1718 Total 4764 Female Teachers 19262 1.07 Male Teachers 18036 Total 37298 Female Enrolment 399140 0.92 Male Enrolment 431936 Total 831076 Main Indicator NWFP Female Schools 515 0.73 6.15 28.60 Male Schools 702 Mixed School 0 Total 1217 Female Teachers 3226 0.76 Male Teachers 4260 Total 7486 Female Enrolment 89607 0.72 Male Enrolment 124503 Total 214110 Main Indicator Balochistan Female Schools 282 0.42 3.33 45.21 Male Schools 674 Mixed School 0 Total 956 Female Teachers 1103 0.53 Male Teachers 2076 Total 3179 Female Enrolment 57468 0.67 Male Enrolment 86240 Total 143708 Main Indicator PAK Female Schools 60 3.00 1.80 82.26 Male Schools 20 Mixed School 0 Total 80

VULNERABILITY ANALYSIS AND MAPPING (VAM) UNIT, WORLD FOOD PROGRAMME, PAKISTAN 41 FOOD INSECURITY IN URBAN PAKISTAN Gender and Food Security 4

Female Teachers 98 2.13 Male Teachers 46 Total 144 Female Enrolment 6661 1.28 Male Enrolment 5184 Total 11845 Main Indicator FANA Female Schools 18 1.29 2.75 40.09 Male Schools 14 Mixed School 48 Total 80 Female Teachers 149 2.10 Male Teachers 71 Total 220 Female Enrolment 5595 1.73 Male Enrolment 3225 Total 8820 Main Indicator ICT Female Schools - - 15.48 45.22 Male Schools - Mixed School 62 Total 62 Female Teachers 960 - Male Teachers 0 Total 960 Female Enrolment 20542 Male Enrolment 22870 Total 43412

VULNERABILITY ANALYSIS AND MAPPING (VAM) UNIT, WORLD FOOD PROGRAMME, PAKISTAN 42 FOOD INSECURITY IN URBAN PAKISTAN Food Access 5 CChhaapptteerr 55

Food Access

Economic access to food is the function of host of in the range of Rs. 6,000-21,000 (USD100-350), factors that contribute to financial well-being of while there are 31(22%) districts, where per the household that in turn enables the household capita income is in-between Rs. 6,000 - 10,000 to secure food, in terms of quantity, quality & (USD 100-180). wholesomeness. Figure 5.1 Percentage of Income Shares In Urban-Rural Areas 1996-97 60 Urban Rural

The urban centers of the countries have to 50 depend for their food either on the local production or on the imported food. In some 40 30 countries home gardens and backyard Percent production, like poultry farming, do contribute 20 towards household food consumption. In urban 10

Pakistan, it is mainly food from rural areas, along 0 with produce of peri-urban farm settings, that meet the demand of urban populace, along with some imported food that caters the need of upper class and at times of the middle class. When translated into the provincial context, 21 (62%) out of 34 in Punjab, 14 out of 20 (70%) in Given that economic access is primarily the NWFP, 15 out of 17 (88%) in Sindh, 24 out of 25

Table 5.1 Per Capita Income in Pakistan Number of Districts Level of Per Capita Income Balochis Northern Islama (Rs.) Punjab NWFP Sindh tan Areas PAK FATA bad Total 10,001-21,000 7 - 1 - - 1 - 1 10 6,001-10,000 6 6 1 1 - 1 - - 15 5,501-6,000 8 1 6 - - 1 - - 16 5,001-5,500 6 3 3 2 2 4 1 - 21 4,000-5,000 7 10 6 22 3 - 2 - 50 Total: 34 20 17 25 5 7 3 1 112 PAK:Azad Jammu & Kashmir, FATA: Federally Administered Tribal Areas No Urban Areas in these Districts:NWFP:Buner,Shangla,Kohistan,BattagramBalochistan:Awaran,FATA:Bajour,Mohamand,Orakzai,S.Waziristan function of income as per capita income is a (96%) in Balochistan, 5 out of 5 (100%) in NAs, useful indicator to determine the purchasing 5 out of 7 (71%) in PAK, and 3 out of 3 (100%) power of the households. In 87(78%) out of 112 in FATA have per capita income below 100 districts per capita income is below Rs.6, 000 i.e., USD. 100 USD/per person, and in only 25 districts it is Figure 5.2 Income of Urban Population by source in Pakistan In the poverty level context, the per capita 60 income in 87(78%) out of 121 districts is below

50 100 USD. When translated into regional context 100% of the populations in regions like FATA & 40 NA’s falls in this bracket and almost 88% of the 30 population of Balochistan province falls in the 20 same category. With this level of poverty, reliable Percentage Income 10 economic access to quality food is rather impossible. 0 1996-97 1998-99 2000-2001 Y e a r

Wage and Salaries Non-Agri Activities Property Among the top 10 (9%) out of 112 districts, Owner Occupied Dwelling Social Isurance Benifits Gift and Assistance Foreign remittances where the per capita income is in the upper bracket, i.e., USD 100-350, Islamabad-the

VULNERABILITY ANALYSIS AND MAPPING (VAM) UNIT, WORLD FOOD PROGRAMME, PAKISTAN 43 FOOD INSECURITY IN URBAN PAKISTAN Food Access 5 Federal Capital is at # 1, while Rawalpindi is at to other provinces/regions, while in Mirpur #10. While other 6 districts namely Karachi (PAK) it is primarily because of the remittances from overseas of PAK nationals. Sialkot, Table 5.2 Faisalabad & Lahore (Punjab), and Karachi Top 10 Districts Based on Highest Per Capita (Sindh) are the industrial base, and contributes a Income great deal to this end. While in the later two S.N Prov. District Rank o Code districts, which are also provincial capitals where 1 C ISLAMABAD 1 public sector employment is equally important. 2 S Karachi 2 Jhelum (Punjab) and Mirpur (PAK) have 3 P Jhelum 3 contributions towards this end primarily from 4 P Sialkot 4 5 P Kasur 5 foreign remittances. The remaining districts like 6 P Faisalabad 6 Kasur and Sheikupura have an income mix both 7 P Sheikhupura 7 from agriculture & industry, while in Rawalpindi 8 A Mirpur 8 9 P Lahore 9 it is mainly public sector employment and 10 P Rawalpindi 10 industry that contributes towards relatively better C: Capital, S: Sindh, P: Punjab, A: Azad Jammu & Kashmir per capita income. (Sindh), Jhelum (Punjab), Sialkot (Punjab), Kasur (Punjab), Faisalabad (Punjab), Sheikupura It is however, worth noting that even in these top (Punjab), Mirpur (PAK) and Lahore (Punjab) ten districts, in terms of per capita income, the

Composite Indicators of Urban Food Insecurity Table 5.3 Livelihood Access In Urban Pakistan Number of Districts Livelihood Punja NWF Balochi Northern Islamab Access b P Sindh stan Areas PAK FATA ad Total Extremely Low - 2 1 11 2 - 3 - 19 Very Low 2 7 4 11 1 - - - 25 Low 13 2 10 2 2 3 - - 32 Poor 10 6 - 1 - 3 - - 20 Moderate 9 3 2 - - 1 - 1 16 Total: 34 20 17 25 5 7 3 1 112 Extremely Low:0.647 - 0.780, Very Low: 0.570 - 0.629, Low: 0.509 - 0.556, Poor: 0.460 - 0.508, Moderate: 0.180 - 0.455 PAK:Azad Jammu & Kashmir, FATA: Federally Administered Tribal Areas No Urban Areas in these Districts:NWFP:Buner,Shangla,Kohistan,BattagramBalochistan:Awaran,FATA:Bajour,Mohamand,Orakzai,S.Waziristan have per capita income ranking at 2, 3, 4, 5, 6, 7, income range of 100-350 USD, is not reasonable 8 & 9 respectively among the top ten. This to meet the food security conditions. situation reveals that one district each from Sindh i.e.Karachi, and PAK i.e., Mirpur, fall in this Food security for the urban poor is closely related bracket, while remaining 8 belong to the Punjab to their purchasing capacity in terms of income, province. This could be explained by relatively which in turn relies on their ability to earn a better standing of the Punjab province in terms of respectable income for themselves and their infrastructure, agricultural land under cultivation, industrial base and skilled manpower compared

Table 5.4 Adult Literate (Total) in Urban Pakistan (2004-05) Number of Districts Literate (Total) Balochis Northern Islama % Punjab NWFP Sindh tan Areas PAK FATA bad Total 16-30 - - - 2 - - - - 2 31-40 - 1 - 3 - - 2 - 6 41-50 1 4 4 11 1 - - - 21 51-60 9 8 7 5 - - 1 - 30 61-70 14 5 5 4 3 5 - - 36 71-80 10 2 1 - - 2 - - 15 81-91 - - - - 1 - - 1 2 Total: 34 20 17 25 5 7 3 1 112 PAK:Azad Jammu & Kashmir, FATA: Federally Administered Tribal Areas No Urban Areas in these Districts:NWFP:Buner,Shangla,Kohistan,BattagramBalochistan:Awaran,FATA:bajour,Mohamand,Orakzai,S.Waziristan

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families. Hence, viable livelihood means for the sector workers with declining or unstable urban poor ought to be seen as a food security incomes and those dependent on “over-crowded” issue. Table no. 5.3 guides to this fact. It shows informal sector activities. that in 76 (67%) districts out of 112, access to livelihood is quite limited, ranging from low This unfortunate situation could be understood in through very low to extremely low levels. its true perspective, in terms of poverty of opportunities, implying access to employment, The most vulnerable urban groups, in this regard, education and health etc. In the literacy context, are the marginalized and poor segments of the situation is no better than what we have seen above in terms of per capita income. For example in 59 (53%) out of 112 districts the literacy rate is 60% or below, and with in that in 21 (19%) districts it is between 41-50%. Balochistan stands for the lowest literacy rate now. This implies that roughly half of the urban population has limited access to education, and its particularly true for marginal areas like Balochistan, NWFP, NAs and FATA.

Disintegrating the literacy in to the gender perspective, in 12 (11%) out of 112 districts, the female literacy rate is 20% or below. Balochistan and FATA are hosting majority of these districts. This is the case of urban area, which has maximum facilities and comratatively, educated society, like the unemployed, migrants, single people are residing here, someone can think mothers with dependent children, senior citizens about the rural area situation, which hosts 67% of & pensioners with out family support, disabled, the population. indigenous people, ethnic minorities, formal

Table 5.5 Adult Literate (Male) in Urban Pakistan (2004-05) Number of Districts Literate (Total) Northern Islama % Punjab NWFP Sindh Balochistan Areas PAK FATA bad Total 20-50 - - - 2 2 - - - 4 51-70 8 6 4 12 1 - 2 - 33 71-80 19 9 10 7 1 1 1 - 48 81-90 7 5 3 4 1 6 - - 26 91-94 ------1 1 Total: 34 20 17 25 5 7 3 1 112 PAK:Azad Jammu & Kashmir, FATA: Federally Administered Tribal Areas No Urban Areas in these Districts:NWFP:Buner,Shangla,Kohistan,BattagramBalochistan:Awaran,FATA:bajour,Mohamand,Orakzai,S.Waziristan

VULNERABILITY ANALYSIS AND MAPPING (VAM) UNIT, WORLD FOOD PROGRAMME, PAKISTAN 47 FOOD INSECURITY IN URBAN PAKISTAN Food Access 5 This gender aspect of literacy is important, to This level of illiteracy in turn translates into poor understand especially the women’s role towards employment and also low productivity per income generation, for women constitute 51% of person, as could be seen from the table-5.7. the population, implying half of the urban segment in Pakistan. In 108(96%) out of 112 The table-5.7 also testifies this situation.

Table 5.6 Adult Literate (Female) in Urban Pakistan (2004-05) Number of Districts Literate (Total) Balochi Northern Islam % Punjab NWFP Sindh stan Areas PAK FATA abad Total Below 10 - - - 1 - - - - 1 10-20 - - - 8 1 - 2 - 11 21-35 1 10 6 10 2 - 1 - 30 36-55 15 8 10 6 2 - - - 41 56-70 16 2 - - - 7 - - 25 71-80 2 - 1 - - - - - 3 80-87 ------1 1 Total: 34 20 17 25 5 7 3 1 112 PAK:Azad Jammu & Kashmir, FATA: Federally Administered Tribal Areas No Urban Areas in these Districts:NWFP:Buner,Shangla,Kohistan,BattagramBalochistan:Awaran,FATA:bajour,Mohamand,Orakzai,S.Waziristan districts of Pakistan the female literacy rate is Whereas, all 112 (100%) districts of Pakistan 70% or below, while in 83 (74%) the literacy rate face unemployment, from low to extremely is 55% or below. This implies that illiteracy in higher level, with 90 (80%) out of 112 falling in female is far more pronounced compared to the the range of high to extremely high male folk, and when it comes to the provinces & unemployment zone. This reflects extremely low regions, especially Balochistan, NAs and FATA level of employment in urban Pakistan. The the situation gets worsened. For example, in FATA 100% female fall in below 35% literacy bracket, while 76% in Balochistan, 50% in

situation becomes even worse, when it gets to the marginalized areas, like Balochistan province, NAs & FATA, where 100% districts fall in the NWFP and 50% in NAs have the same situation. Table 5.7 Unemployment Ratio in Urban Areas of Pakistan 2005 Number of Districts

Unemployment Baloch Northern Islam Ratio Punjab NWFP Sindh istan Areas PAK FATA abad Total Extremely High 3 6 3 15 1 3 3 - 34 Very High 15 5 5 9 1 2 - - 37 High 7 1 6 1 3 1 - - 19 Medium 3 7 1 - - 1 - - 12 Low 6 1 2 - - - - 1 10 Total: 34 20 17 25 5 7 3 1 112 PAK:Azad Jammu & Kashmir, FATA: Federally Administered Areas No Urban Areas in these Districts: NWFP:Buner, Shangla, Kohistan,Battagram Balochistan: Awaran,FATA:Bajour,Mohamand,Orakzai,S.Waziristan

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VULNERABILITY ANALYSIS AND MAPPING (VAM) UNIT, WORLD FOOD PROGRAMME, PAKISTAN 52 FOOD INSECURITY IN URBAN PAKISTAN Food Access 5 high to extremely high unemployment bracket. territory and is adversely affected by urban growth. 5.1. Habitat - Shelter for All The second UN Conference on Human Zafar H. Ismail in his article ‘Karachi: Planning Settlements (Habitat II) that took place in and Managing for Urban Development’ writes Istanbul in June 1996 adopted an agenda that and quotes as follows: ’The rapid growth of cities envisages the evolution of healthy, safe, equitable and the resulting stresses and strains will continue and sustainable human settlements through better to be a major focus of attention in most management in both economic and social context. developing countries, including Pakistan. Pakistan is signatory to the Habitat agenda and According to projections, there would be an recognizes housing as a basic human need; yet additional 18 million urban residents in Pakistan millions of people are still struggling to have a roof over their head.

According to the 1998 Census, the total number of housing units, throughout the country was 19.3 million, 67.7% housing was in rural areas and 32.3% in urban areas. It comprised of 39% kachha houses, 40% semi pukka and 21% pukka houses. It is estimated that there is a back-log of 5.5 million housing units. 1

The urban population of Pakistan is facing not only shortage of housing but also homelessness. Homelessness is of three kinds. One is that of the portion of resident population who donot own house. Second kind of homelessness is of slum dwellers, mostly migrants who settle on public by the turn of the century of which Karachi is property in the outskirts of large cities creating projected to draw 4 million. Housing these new Kachi Abadis and survive on low paid jobs in the residents, creating the jobs that they need to informal sector and households in the centre of support themselves, maintaining the environment the city. Third kind is of those who are without in which they live, providing transport systems shelter in their hometown due to abject poverty. that can move them from one place to another This segment of population lives on street and and administering the city where they will reside ekes out a living mostly through day labour, will be a major challenge but one which must be begging or other informal ways of earnings. met (Khan1987). Children make a considerable part of the Hence, in this part of the study, homelessness is population. looked at from these three angles: o House Ownership o Slums Dwelling/Kachhi Abadis o Homelessness/Street Dwelling

Homelessness is the result of imbalances in the distribution of opportunities, income and resources across population and geographical

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FOOD INSECURITY IN URBAN PAKISTAN Food Access 5 5.2. House Ownership administration in keeping even a minimum standard of living that ensures paid jobs, House ownership is as much a matter of availability as affordability. The percentage of Figure 5.3 Ownership of Household in Urban Areas house ownership in urban areas is as follows: Total Household (000) 3500 Household Unit s Owned (000)

3000

According to the information, overall ownership 2500 of house units comes to 69% whereas there is 2000 some variation across provinces and regions. 1500

PAK has the highest number of owned house 1000 units whereas Islamabad has the lowest number. 500 Islamabad being the capital city has public 0 housing facility that is being provided to Punjab Sindh NWFP Balochistan AJK FANA* ICT Government employees on subsidized terms for provision of facilities such as clean drinking the duration of active employment. water, utilities, schooling for children of slum dwellers, health care for expectant mothers and One third of urban population is without owned safety from crime. houses and using either rented or rent free

Table 5.8 House Ownership in Urban Areas - 1998 Total House Units House Units Owned % Province (No.s) (No.s) Houses Owned Punjab 3,200,934 2,336,347 72.99 Sindh 2,171,403 1,410,515 64.96 NWFP 368,748 234,721 63.65 Balochistan 195,162 139,508 71.48 PAK 48,887 36,284 74.22 FANA* 11,674 7,973 68.30 ICT 86,575 30,057 34.72 FATA 8,608 5,563 64.63 Total 6091991 4200968 68.96 Information on Ghizer and Ghanche in FANA are not included Source: Pakistan Statistical Year Book 2004 housing. A small proportion is homeless without Access and legal title to land and housing is any shelter as elaborated later in the study. critical for the poor and the asset-less to survive in the urban setting and secure sustainable 5.3. Slums Dwelling / Kachhi Abadis livelihood including food security.

Emergence of slums or kachhi abadis is attributed Slums or Kachi Abadis are illegal settlements to the inadequacy of housing sector to address the whose dwellers do not hold title to land. As a demand for low coast housing. In this regard, it result any investment in building houses on is noted in ‘Pakistan National Report on the public land considered a waste due to risk of Implementation of Habitat Agenda 2001 “the eviction by the municipal authorities. Hence this current housing backlog in the country has group of population is highly vulnerable in terms remained at over two million units, which is of housing assets and investment. Tenure Rights likely to grow about 500.000 units every year. is considered a critical aspect of sustainable While the bulk of the demand comes from the livelihood as defined by DFID. lower income groups, the sites and services schemes have so far remained short of providing DFID’s approach attaches general security to five plots at affordable prices to them. These groups major factors where, Tenure Rights is one of are therefore constrained to turn to opportunities them. These are: offered by the squatter settlements, (khachi o Income Stream abadis) and informal land subdivisions. o Tenure Rights o Basic education and skills training The appearance of slums around large cities and o Savings schemes and sometimes right in the heart of the city as is the o Community support systems case with Karachi, Islamabad and other metropolitan cities, pose a challenge to city

VULNERABILITY ANALYSIS AND MAPPING (VAM) UNIT, WORLD FOOD PROGRAMME, PAKISTAN 53 FOOD INSECURITY IN URBAN PAKISTAN Food Access 5 The question of security comes after survival that little girls are still required to baby sit younger is based on the right of people to food, shelter, siblings. Youth, however, needs to be directed as employment, education and health care. 2 their energies are being wasted in some cases in playing cards and wandering around instead of There is not sufficient qualitative information or learning skills and getting into more challenging empirical evidence to assess the proportionate occupations to enhance their earning share of residents or migrant settlers of kachhi opportunities to improve the quality of life. abadis and what is the nature of food insecurity in People (in these kachhi abadis) aspire to progress this group of population. However, a recent through education, skills training and small survey of four kachhi abadis in Islamabad by enterprise.’ Plan International, an international NGO, verifies the assumption that the slum dwellers are 5.4. Homelessness / Street Dwelling deprived of basic means of livelihood that places them among the most vulnerable groups of The worst kind of deprivation is homelessness. population in the context of poverty and food The poorest of the poor, homeless population has insecurity. 3 not shelter and dwells on the streets, pathways, railway stations, parks, empty plots or any place It reads ‘Urban poverty and sustainable found under the sun to spend the night. Although livelihood situation is precarious. Communities the homeless are small both in absolute number located in the centre of the city have access to and in percentage to total population, their utilities like electricity, water, paved streets, vulnerability makes them food insecure and transport and markets, but due to the uncertain dependent on the society for their living. legal status of urban slums (Khachi abadis) people are not able to invest either in house The table below reflects that some 0.076% of building or environment. Communities living in urban population is without any kind of shelter. It proximity of the city lack part of the above consists of men and women of all ages. Street infrastructure. Majority of the population is life is economically and socially dangerous, in engaged in menial jobs with low salary scales, particular for children, women and elderly. such as sanitation workers with CDA, gardeners, These people have to put up with starvation and masons, hawkers and wage labor. aggression from undesirable elements, drug pushers and criminals who pray on this Natural capital is deficient in urban communities vulnerable section of the society. as land is scarce and livestock keeping is not allowed. There is also air pollution due to heavy There is no formal system to house this traffic and on going construction. Rain streams population except some non-governmental trusts are flooded during monsoon endangering the life such as Edhi Trust, Ansar Burni Foundation and a and habitat of people in the slums. few other welfare organizations. The most vulnerable among this population is children who Positive aspects are that children have are dangerously exposed to all kinds of social opportunity to get education and have exposure to abuse. developed facilities of the Capital City. Women are mobile and active in economic life, though UNICEF, in its publication ‘Creating a

Table 5.9 Homeless Population In Urban Pakistan - 1998 Homeless Districts with No Total Urban Urban Homeless Population to Homeless Population Population Total Population Population Province (No.s) (No.s) (% ) (No.s) Punjab 23,019,025 17,695 0.077 0 Sindh 14,839,862 13,856 0.093 1 NWFP 2,994,084 682 0.023 4 Balochistan 1,568,780 374 0.024 16 PAK 371,974 180 0.048 2 FANA* 69,356 14 0.020 1 Islamabad 529,180 64 0.012 NA Total 43,392,261 32,865 0.076 24 Information Only on Ghizer and Ghanche in FANA are included Source: District Census Reports 1998

VULNERABILITY ANALYSIS AND MAPPING (VAM) UNIT, WORLD FOOD PROGRAMME, PAKISTAN 54 FOOD INSECURITY IN URBAN PAKISTAN Food Access 5 Protective Environment for Children in Pakistan’ The poor employment rates then translates into draws attention to this particular fact. It reads. even poorer access to quality life, such as better ‘Although there are no official data regarding shelter in the form of bricked & plastered or

Table 5.10 Proportion of Kacha Houses in Urban Pakistan Number of Districts Population in Baloch Northern Islama Kacha Punjab NWFP Sindh PAK FATA Total istan Areas bad Houses (%) 0.6 - 8.7 14 2 3 1 - 2 - 1 23 8.8 - 22.7 14 6 4 - 1 1 - - 26 22.8 - 43.9 6 7 8 2 - 3 2 - 28 44.0 - 69.7 - 5 2 14 1 1 1 - 24 69.8 & Above - - - 8 3 - - - 11 Total: 34 20 17 25 5 7 3 1 112 PAK:Azad Jammu & Kashmir, FATA: Federally Administered Tribal Areas No Urban Areas in these Districts:NWFP:Buner,Shangla,Kohistan,BattagramBalochistan:Awaran,FATA:Bajour,Mohamand,Orakzai,S.Waziristan street children, it is thought their numbers are Pacca houses, as against semi-Pacca (bricked but relatively low because of the traditional family not plastered) and the mud or Kaccha houses. The model where two or three generations live table no.5.10 clearly supports this argument, as in together and children without one or both parents 35(31%) out of 112 districts, 44% and above are cared for by other family members. While the population has no access to bricked houses. In the number of children living on the streets may be provincial & regional context Balochistan has the limited, the number of children working on the highest number of districts within this braket. streets is much higher and they face many Even thickly populated provinces like Punjab & problems, such as exploitation, different forms of Sindh have many urban areas with above 22% of abuse and vulnerability to drug or substance population livening in su-standard houses with abuse. poor sanitation and other facilities. This is one of the reasons that there are sizeable urban slums in The few studies available on street children show the mega cities of these two provinces. that abuse and exploitation by parents or members of the extended family are the main A sizable population also lives in semi-Pacca and reasons which force a child leave home. Once on Kacha houses as is evident from the table no.5.11 the street, children are subject to violence, and 5.12. torture, sexual abuse and exploitation. The majority do not have access to shelter, adequate Add to this mix, the access to the electricity and nutrition, health care or education.’ one finds that almost 60% of the households in 112 districts are without electricity connection, The above situation calls for an unconventional implying that they do not have access, on one approach to address the issues related to shelter- hand to food preservation through refrigeration less and homeless population in the context of and on the other, their living places are not well- food insecurity and not just for promoting the lit. The later is one of the factors that helps breed housing sector investment and building a certain microbes and unhealthy living, and thus helps set number of housing units. vicious circle of disease, poverty and hunger. Table 5.11 Population in Semi-Pacca Houses In Urban Pakistan Number of Districts Population in Sami-Pacca Baloch Northern Islam Houses (%) Punjab NWFP Sindh istan Areas PAK FATA abad Total 0.6 - 2.7 6 3 1 3 2 1 - - 16 2.8 - 7.6 14 10 1 6 1 4 2 1 39 7.7 - 16.9 11 4 12 10 1 2 - - 40 17.0 - 31.3 3 1 2 6 1 - - - 13 31.4 & Above - 2 1 - - - 1 - 4 Total: 34 20 17 25 5 7 3 1 112 PAK:Azad Jammu & Kashmir, FATA: Federally Administered Tribal Areas No Urban Areas in these Districts: NWFP:Buner, Shangla, Kohistan,Battagram Balochistan: Awaran,FATA:Bajour,Mohamand,Orakzai,S.Waziristan

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Table 5.12 Households Without Electricity Connection in Urban Pakistan 2004-05 Number of Districts HH Without Electricity Connection Balochi Northern Islama (%) Punjab NWFP Sindh stan Areas PAK FATA bad Total 0.5 - 2.5 15 13 3 5 - 5 - - 41 2.6 - 4.5 9 3 6 7 1 1 - 1 28 4.6 - 6.5 7 2 3 2 1 1 - - 16 6.6 - 8.5 1 - 1 1 - - 2 - 5 8.6 - 10.5 1 2 - 1 - - - - 4 10.6 - 20.5 1 - - 7 - - - - 8 20.6 - 50.5 - - 4 - - - - - 4 50.6 - 70.5 - - - 1 3 - - - 4 70.6 - 99.0 - - - 1 - - 1 - 2 34 20 17 25 5 7 3 1 112 PAK:Azad Jammu & Kashmir, FATA: Federally Administered Tribal Areas No Urban Areas in these Districts:NWFP:Buner,Shangla,Kohistan,BattagramBalochistan:Awaran,FATA:Bajour,Mohamand,Orakzai,S.Waziristan

Needless to emphasize that poor shelter and References civic 1 National Housing Policy 2001; Pakistan Economic Survey facilities become breeding place for diseases, 2003-04. 2 Poor People’s Priorities, Urban Livelihoods – a publication that has, besides productivity per person, a close edited by Carole Rakodi with Tony Lloyd-Jones and published interface with food absorption. by Earthscan Publications Ltd. UK 2002. 3 Sustainable Livelihood Analysis by Plan International December 2004. It has been discussed at length in chapter on 4 Punjab Development Statistics 2004-05, Bureau of Statistics food absorption that poor sanitation facilities, Government of the Punjab, Lahore. such as in Kacha and semi Pacca houses, 5 Development Statistics of Sindh 2004, Bureau of Statistics compromise food safety & food absorption and Planning and Development department of Sindh Karachi. thus implicate food security in urban Pakistan. 6 NWFP Development Statistics 2005, Bureau of Statistics Planning and Development Department Government of NWFP. In sum, given that urban centers do not produce their own food, barring some peri-urban 7 Pakistan Statistical Year Book 2006. farming, coupled with low level of income 8 Economic Survey 2003-04. especially in terms of access to opportunities, 9 PLSM, Pakistan Social and Living Standreds Measurement Survey 2004-05 and thus increasing urban poverty, along with 10 Important District Wise Socio-Economic Indicators of NWFP poor urban civic infrastructure and increasing 2005, Bureau of Statistics Planning & Development Department urbanization all compound the urban food Government of NWFP insecurity situation in Pakistan.

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Table 5.13 Livelihood Access Index in Urban Pakistan Provincial Provincial Provincial Provincial Provincial Provincial National National National National District District District Rank Rank Rank Rank Rank Rank Rank Code Code Code

E X T R E M E L Y L O W B Musa Khel 1 1 B Khuzdar 8 4 N Upper Dir 15 2 S Tharparkar 2 1 B Panjgur 9 5 NA Ghanche 16 2 B Killa Abdullah 3 2 B Kharan 10 6 B Nasirabad 17 10 NA Diamer 4 1 B Bolan 11 7 F N.Waziristan 18 3 B Jhal Magsi 5 3 N Malakand 12 1 B Barkhan 19 11 F Kurram 6 1 B Jafarabad 13 8 F Khyber 7 2 B Dera Bugti 14 9 V E R Y L O W B Pishin 20 12 B Kohlu 29 17 B Kalat 38 22 P Lodhran 21 1 B Killa Saifullah 30 18 NA Ghizer 39 3 N Tank 22 3 N Karak 31 6 S Noushero Feroze 40 3 B Gawader 23 13 S Umerkot 32 2 N Charsadda 41 8 B Ziarat 24 14 B Chagai 33 19 S Jacobabad 42 4 N Hangu 25 4 B Sibi 34 20 N Swabi 43 9 N Lower Dir 26 5 N Lakki 35 7 S Sukkar 44 5 B Lasbela 27 15 P Rajanpur 36 2 B Mastung 28 16 B Turbat 37 21 L O W S Badin 45 6 N Chitral 56 10 S Khairpur 67 14 S Dadu 46 7 S Shikarpur 57 11 S Mirpurkhas 68 15 B Zhob 47 23 A Bagh 58 2 P Muzaffargarh 69 12 P Bhakkar 48 3 P Jhang 59 6 P Khanewal 70 13 S Larkana 49 8 P Mianwali 60 7 P Bahawalpur 71 14 A Sudhnoti 50 1 P Layyah 61 8 A Rawalakot 72 3 S Thatta 51 9 P Bahawalnagar 62 9 P Okara 73 15 S Ghotki 52 10 S Sanghar 63 12 N Bannu 74 11 P Khushab 53 4 S Nawabshah 64 13 NA Skardu 75 4 P Hafizabad 54 5 P Pakpattan 65 10 NA Gilgit 76 5 B Loralai 55 24 P Vehari 66 11 P O O R B Quetta 77 25 P Sargoda 84 20 P D.G Khan 91 22 N Swat 78 12 A Muzaffarabad 85 4 P Multan 92 23 P T.T.Singh 79 16 A Kotli 86 5 N Mansehra 93 16 N Kohat 80 13 N Mardan 87 14 P Gujranwala 94 24 P Narowal 81 17 A Bhimber 88 6 P Sahiwal 95 25 Rahim Yar P Khan 82 18 P Chakwal 89 21 N Peshawar 96 17 Mandi Bahaud P Din 83 19 N D.I.Khan 90 15 M O D E R A T E P Attock 97 26 N Abbottabad 103 20 P Sialkot 109 33 N Nowshera 98 18 S Hyderabad 104 16 S Karachi 110 17 P Gujrat 99 27 A Mirpur 105 7 P Jhelum 111 34 N Haripur 100 19 P Faisalabad 106 30 C Islamabad 112 1 P Sheikhupura 101 28 P Lahore 107 31 P Kasur 102 29 P Rawalpindi 108 32 P: Punjab, S: Sindh, N:NWFP, C: Capital, B: Balochistan, NA: Northern Area, A:Azad Jammu & Kashmir, F: Federally Administered Areas National Rankings are from 1 to 112,1 being the worst and 112 the best. Provincial Rankings depend on the number of districts per province.

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Table 5.14 Adult Literate (Total) in Urban Pakistan 2004-05 Provincial Provincial Provincial Provincial Provincial Provincial National National National District District District Rank Rank Rank Rank Rank Rank Rank Code Code Code

16-30 PERCENT B Musa Khel 1 1 B Dera Bugti 2 2 31 - 40 PERCENT B Qilla Abdullah 3 3 B Khuzdar 5 4 F Khyber 7 2 F Kurram 4 1 N Charsada 6 1 B Kohlu 8 5 41 -50 PERCENT B Nasirabad 9 6 B Jafarabad 16 12 N Nowshera 23 3 B Barkhan 10 7 P Lodhran 17 1 N Swabi 24 4 S Thatta 11 1 S Larkana 18 2 N Malakand 25 5 B Kalat 12 8 B Ziarat 19 13 S Jaccobabad 26 3 B Jhal Magsi 13 9 B Lasbilla 20 14 S Umer kot 27 4 B Gwadar 14 10 B Bolan 21 15 B Kharan 28 16 B Panjgur 15 11 N Tank 22 2 NA Diamer 29 1 51 - 60 PERCENT N Upper Dir 30 6 P Bhakhar 40 2 P Muzaffar Garh 50 6 B Chaghi 31 17 P Khushab 41 3 P Rajanpur 51 7 B Ketch 32 18 S Tharparkar 42 6 P Vehari 52 8 N Lakki Marwat 33 7 P Bahawalpur 43 4 P Mianwali 53 9 N Hangu 34 8 S Khairpur 44 7 N Swat 54 11 N Mardan 35 9 P Okara 45 5 N Mansehra 55 12 F N.Waziristan 36 3 S Nawabshah 46 8 P Hafizabad 56 10 N Lower Dir 37 10 S Dadu 47 9 N Karak 57 13 S Ghotki 38 5 B Loralai 48 20 S Sanghar 58 10 B Pashin 39 19 B Qilla Saifullah 49 21 S Badin 59 11 61 - 70 PERCENT P Kasur 60 11 NA Skardu 72 3 N D.I.Khan 84 18 P Multan 61 12 A Sudhnoti 73 1 NA Ghanche 85 4 N Peshawar 62 14 N Chitral 74 17 P Layyah 86 21 S Shikarpur 63 12 B Mastung 75 23 A Bhimber 87 2 B Zhob 64 22 P Bahawalnager 76 15 A Muzaffarabad 88 3 N Bannu 65 15 P D.G.khan 77 16 P Narowal 89 22 N Kohat 66 16 B Sibbi 78 24 P Sheikhupura 90 23 Rahim Yar S Hyderabad 67 13 P Khan 79 17 S Sukkur 91 16 NA Gilgit 68 2 P Sargodha 80 18 B Quetta 92 25 Nowshero P Jhang 69 13 S Feroze 81 15 A Mirpur 93 4 P Khanewal 70 14 P Faisalabad 82 19 P T.T.Singh 94 24 S Mir Pur Khas 71 14 P Pakpatten 83 20 A Kotli 95 5 71 -80 PERCENT A Bagh 96 6 P Jehlum 101 28 P Lahore 106 32 Mandi P Gujranwala 97 25 P Bahuddin 102 29 N Abbottabad 107 20 P Gujrat 98 26 P Attock 103 30 P Chakwal 108 33 A Rawalakot 99 7 N Haripur 104 19 P Rawalpindi 109 34 P Sahiwal 100 27 P Sialkot 105 31 S Karachi 110 17 81 - 91 PERCENT NA Ghizer 111 5 C Islamabad 112 1 P: Punjab, S: Sindh, N:NWFP, C: Capital, B: Balochistan, NA: Northern Area, A:Azad Jammu & Kashmir, F: Federally Administered Areas National Rankings are from 1 to 112,1 being the worst and 112 the best. Provincial Rankings depend on the number of districts per province.

VULNERABILITY ANALYSIS AND MAPPING (VAM) UNIT, WORLD FOOD PROGRAMME, PAKISTAN 46 FOOD INSECURITY IN URBAN PAKISTAN Food Access 5

Table 5.15 Adult Literate (Male) in Urban Pakistan 2004-05 National Rank National Rank National Rank Provincial Provincial Provincial Provincial Provincial Provincial District District District Rank Rank Rank Rank Code Code Code

20 - 50 PERCENT B Musa Khel 1 1 NA Ghanche 3 2 B Dera Bugti 4 2 NA Diamer 2 1 51 - 70 PERCENT Qilla B Abdullah 5 3 B Lasbilla 16 9 S Larkana 27 3 S Thatta 6 1 B Jhal Magsi 17 10 F Khyber 28 2 NA Ghizer 7 3 B Barkhan 18 11 N Nowshera 29 4 N Charsada 8 1 S Umer kot 19 2 P Okara 30 4 B Kohlu 9 4 P Bahawalpur 20 2 P Hafizabad 31 5 B Khuzdar 10 5 N Malakand 21 2 P Kasur 32 6 F Kurram 11 1 B Pashin 22 12 P Multan 33 7 B Ziarat 12 6 B Nasirabad 23 13 S Jaccobabad 34 4 B Gwadar 13 7 B Bolan 24 14 N Mardan 35 5 B Kalat 14 8 N Tank 25 3 N Mansehra 36 6 P Lodhran 15 1 P Bhakhar 26 3 P Rajanpur 37 8 71 - 80 PERCENT B Chaghi 38 15 B Qilla Saifullah 54 21 P Mianwali 70 21 B Kharan 39 16 N Peshawar 55 10 P Sargodha 71 22 B Panjgur 40 17 P D.G.khan 56 13 S Shikarpur 72 11 N Upper Dir 41 7 P Khushab 57 14 S Sanghar 73 12 B Ketch 42 18 S Ghotki 58 8 N Bannu 74 13 B Jafarabad 43 19 S Nawabshah 59 9 P Gujranwala 75 23 Rahim Yar N Hangu 44 8 P Khan 60 15 S Dadu 76 13 P Jhang 45 9 P Sheikhupura 61 16 N Kohat 77 14 P Vehari 46 10 P Khanewal 62 17 P Narowal 78 24 S Tharparkar 47 5 S Mir Pur Khas 63 10 P Sahiwal 79 25 S Badin 48 6 F N.Waziristan 64 3 S Khairpur 80 14 B Loralai 49 20 N Lakki Marwat 65 11 NA Gilgit 81 4 N Swabi 50 9 N Lower Dir 66 12 N Swat 82 15 Muzaffar P Garh 51 11 P Bahawalnager 67 18 P T.T.Singh 83 26 P Faisalabad 52 12 P Gujrat 68 19 P Sialkot 84 27 S Hyderabad 53 7 P Pakpatten 69 20 A Sudhnoti 85 1 81 - 90 PERCENT Nowshero B Mastung 86 22 B Sibbi 95 24 S Feroze 104 17 N Chitral 87 16 N Haripur 96 18 P Rawalpindi 105 33 Mandi P Layyah 88 28 P Bahuddin 97 31 A Rawalakot 106 5 P Lahore 89 29 S Karachi 98 16 A Bagh 107 6 P Jehlum 90 30 A Mirpur 99 2 A Kotli 108 7 B Quetta 91 23 A Bhimber 100 3 N Karak 109 19 N D.I.Khan 92 17 A Muzaffarabad 101 4 N Abbottabad 110 20 S Sukkur 93 15 B Zhob 102 25 P Chakwal 111 34 NA Skardu 94 5 P Attock 103 32 91 - 94 PERCENT C Islamabad 112 1 P: Punjab, S: Sindh, N:NWFP, C: Capital, B: Balochistan, NA: Northern Area, A:Azad Jammu & Kashmir, F: Federally Administered Areas National Rankings are from 1 to 112,1 being the worst and 112 the best. Provincial Rankings depend on the number of districts per province.

VULNERABILITY ANALYSIS AND MAPPING (VAM) UNIT, WORLD FOOD PROGRAMME, PAKISTAN 47 FOOD INSECURITY IN URBAN PAKISTAN Food Access 5

Table 5.16 Adult Literate (Female) in Urban Pakistan 2004-05 Provincial Provincial Provincial Provincial Provincial Provincial National National National District District District Rank Rank Rank Rank Rank Rank Code Code Code Code

Below 10 PERCENT B Musa Khel 1 1 10 - 20 PERCENT F Khyber 2 1 B Panjgur 6 5 B Kohlu 10 7 B Barkhan 3 2 F Kurram 7 2 B Jafarabad 11 8 B Nasirabad 4 3 B Qilla Abdullah 8 6 B Khuzdar 12 9 B Dera Bugti 5 4 NA Diamer 9 1 21 - 35 PERCENT B Kalat 13 10 B Gwadar 23 15 N Malakand 33 8 B Kharan 14 11 B Bolan 24 16 S Ghotki 34 3 N Charsada 15 1 N Lakki Marwat 25 3 S Umer kot 35 4 B Jhal Magsi 16 12 B Chaghi 26 17 N Hangu 36 9 F N.Waziristan 17 3 N Tank 27 4 S Thatta 37 5 NA Ghanche 18 2 N Nowshera 28 5 B Ziarat 38 19 S Jaccobabad 19 1 S Larkana 29 2 S Khairpur 39 6 N Lower Dir 20 2 N Swabi 30 6 P Lodhran 40 1 B Zhob 21 13 N Upper Dir 31 7 N Mardan 41 10 B Ketch 22 14 B Lasbilla 32 18 NA Ghizer 42 3 36 - 55 PERCENT N Karak 43 11 N Bannu 57 14 S Hyderabad 71 14 P Khushab 44 2 S Nowshero Feroze 58 11 NA Skardu 72 4 N Swat 45 12 P Muzaffar Garh 59 5 N D.I.Khan 73 18 B Pashin 46 20 P Rajanpur 60 6 S Mir Pur Khas 74 15 S Tharparkar 47 7 S Shikarpur 61 12 P Khanewal 75 11 S Dadu 48 8 S Badin 62 13 B Quetta 76 25 B Loralai 49 21 B Mastung 63 24 P Bahawalnager 77 12 B Qilla Saifullah 50 22 P Vehari 64 7 P Layyah 78 13 P Mianwali 51 3 N Kohat 65 15 P Kasur 79 14 P Bhakhar 52 4 N Peshawar 66 16 P Multan 80 15 S Nawabshah 53 9 N Mansehra 67 17 P Jhang 81 16 N Chitral 54 13 P Bahawalpur 68 8 S Sukkur 82 16 S Sanghar 55 10 P Okara 69 9 NA Gilgit 83 5 B Sibbi 56 23 P Hafizabad 70 10 56 - 70 PERCENT Rahim Yar P Khan 84 17 A Muzaffarabad 93 2 P Sahiwal 101 29 P D.G.khan 85 18 P Mandi Bahuddin 94 25 A Mirpur 102 5 P Sargodha 86 19 P Attock 95 26 P Gujrat 103 30 P T.T.Singh 87 20 A Kotli 96 3 N Haripur 104 20 P Pakpatten 88 21 A Bhimber 97 4 A Bagh 105 6 A Sudhnoti 89 1 P Gujranwala 98 27 P Chakwal 106 31 P Faisalabad 90 22 P Jehlum 99 28 P Rawalpindi 107 32 P Narowal 91 23 N Abbottabad 100 19 A Rawalakot 108 7 P Sheikhupura 92 24 71 - 80 PERCENT P Lahore 109 33 S Karachi 110 17 P Sialkot 111 34 80 & above PERCENT C Islamabad 112 1 P: Punjab, S: Sindh, N:NWFP, C: Capital, B: Balochistan, NA: Northern Area, A:Azad Jammu & Kashmir, F: Federally Administered Areas National Rankings are from 1 to 112,1 being the worst and 112 the best. Provincial Rankings depend on the number of districts per province.

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Table 5.17 Unemployment Ratio in Urban Pakistan National Rank National Rank National Rank Provincial Provincial Provincial Provincial Provincial Provincial District District District District Rank Rank Rank Rank Code Code Code Code

E X T E R M E L Y H I G H S Tharparkar 1 1 B Khuzdar 13 6 P Mianwali 25 2 B Musa Khel 2 1 A Bagh 14 1 N Upper Dir 26 4 B Killa Abdullah 3 2 B Ziarat 15 7 A Sudhnoti 27 3 F N.Waziristan 4 1 P Lodhran 16 1 B Quetta 28 13 F Kurram 5 2 N Karak 17 2 N Hangu 29 5 F Khyber 6 3 B Bolan 18 8 B Barkhan 30 14 S Sukkar 7 2 B Mastung 19 9 B Kalat 31 15 Noushero B Kharan 8 3 B Chagai 20 10 S Feroze 32 3 NA Diamer 9 1 B Jhal Magsi 21 11 N Lower Dir 33 6 B Panjgur 10 4 N Tank 22 3 P Rajanpur 34 3 B Pishin 11 5 B Gawader 23 12 N Malakand 12 1 A Rawalakot 24 2 V E R Y H I G H S Dadu 35 4 A Kotli 48 5 P Bahawalnagar 61 15 A Muzaffarabad 36 4 P Bhakkar 49 7 B Loralai 62 22 N Swabi 37 7 B Sibi 50 19 B Zhob 63 23 S Umerkot 38 5 B Turbat 51 20 B Nasirabad 64 24 B Jafarabad 39 16 P Khushab 52 8 P Khanewal 65 16 B Lasbela 40 17 P D.G Khan 53 9 N Chitral 66 9 Mandi Bahaud N Lakki 41 8 S Jacobabad 54 7 P Din 67 17 S Larkana 42 6 P Rahim Yar Khan 55 10 N Haripur 68 10 NA Ghanche 43 2 P Muzaffargarh 56 11 P Sargoda 69 18 B Dera Bugti 44 18 B Kohlu 57 21 N Swat 70 11 P Sheikhupura 45 4 P Chakwal 58 12 S Ghotki 71 8 P Hafizabad 46 5 P Vehari 59 13 P Layyah 47 6 P Bahawalpur 60 14 H I G H P Sahiwal 72 19 P Jhang 79 23 N Kohat 86 12 P Kasur 73 20 S Thatta 80 10 S Mirpurkhas 87 11 NA Skardu 74 3 P Pakpattan 81 24 S Badin 88 12 P Narowal 75 21 A Bhimber 82 6 S Khairpur 89 13 B Killa Saifullah 76 25 P T.T.Singh 83 25 S Sanghar 90 14 P Multan 77 22 NA Ghizer 84 4 S Shikarpur 78 9 NA Gilgit 85 5 M E D I U M P Okara 91 26 P Gujrat 95 27 P Attock 99 28 N Mansehra 92 13 S Nawabshah 96 15 N Abbottabad 100 17 N Bannu 93 14 N Mardan 97 15 N Peshawar 101 18 A Mirpur 94 7 N Charsadda 98 16 N D.I.Khan 102 19 L O W P Jhelum 103 29 P Faisalabad 107 31 P Rawalpindi 111 34 N Nowshera 104 20 S Karachi 108 17 C Islamabad 112 1 S Hyderabad 105 16 P Lahore 109 32 P Gujranwala 106 30 P Sialkot 110 33 P: Punjab, S: Sindh, N:NWFP, C: Capital, B: Balochistan, NA: Norther Area, A:Azad Jammu & Kashmir, F: Federaly Administered Areas National Rankings are from 1 to 112,1 being the worst and 112 the best. Provincial Rankings depend on the number of districts per province.

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Table 5.18 Population in Kacha Houses in Urban Pakistan Provincial Provincial Provincial Provincial Proincial Proincial Proincial Proincial National National National National District District District Rank Rank Rank Rank Rank Rank Rank Code Code Code

69.8 - 96.55 PERCENT B Jhal Magsi 1 1 B Kalat 5 5 NA Ghizer 9 2 B Musa Khel 2 2 B Barkhan 6 6 B Turbat 10 8 B Kharan 3 3 B Khuzdar 7 7 NA Diamer 11 3 Killa B Saifullah 4 4 NA Ghanche 8 1 44.0 - 69.7 PERCENT B Kohlu 12 9 B Panjgur 20 16 N Upper Dir 28 4 B Chagai 13 10 B Killa Abdullah 21 17 S Shikarpur 29 1 B Bolan 14 11 NA Skardu 22 4 B Gawader 30 20 B Nasirabad 15 12 N Chitral 23 1 S Khairpur 31 2 B Loralai 16 13 N Lakki 24 2 A Kotli 32 1 F Khyber 17 1 N Karak 25 3 B Dera Bugti 33 21 B Zhob 18 14 B Sibi 26 18 N Charsadda 34 5 B Mastung 19 15 B Jafarabad 27 19 B Pishin 35 22 22.8 - 439 PERCENT S Larkana 36 3 P Layyah 46 3 P Bhakkar 56 5 N D.I.Khan 37 6 F Kurram 47 3 N Lower Dir 57 9 S Jacobabad 38 4 P Muzaffargarh 48 4 P Bahawalpur 58 6 P Lodhran 39 1 S Noushero Feroze 49 7 B Quetta 59 23 S Umerkot 40 5 A Rawalakot 50 2 N Bannu 60 10 P Rajanpur 41 2 S Dadu 51 8 B Lasbela 61 24 N Malakand 42 7 A Sudhnoti 52 3 N Mardan 61 11 F N.Waziristan 43 2 A Bagh 53 4 N Kohat 63 12 S Tharparkar 44 6 S Ghotki 54 9 N Hangu 45 8 S Sukkar 55 10 8.8 - 22.7 PERCENT P D.G Khan 64 7 P Mianwali 73 13 S Badin 82 13 N Swabi 65 13 S Nawabshah 74 11 P Jhang 83 16 P Khanewal 66 8 S Sanghar 75 12 N Swat 84 18 N Peshawar 67 14 P Rahim Yar Khan 76 14 S Mirpurkhas 85 14 P Vehari 68 9 N Mansehra 77 16 P Khushab 86 17 P Multan 69 10 N Nowshera 78 17 P Chakwal 87 18 P Pakpattan 70 11 NA Gilgit 79 5 P T.T.Singh 88 19 N Tank 71 15 P Bahawalnagar 80 15 P Hafizabad 89 20 P Okara 72 12 A Muzaffarabad 81 5 0.6 - 8.7 PERCENT A Bhimber 90 6 C ISLAMABAD 98 1 P Sialkot 106 30 P Kasur 91 21 P Narowal 99 24 P Faisalabad 107 31 P Attock 92 22 B Ziarat 100 25 P Lahore 108 32 S Hyderabad 93 15 P Sargoda 101 25 A Mirpur 109 7 P Sahiwal 94 23 P Jhelum 102 26 P Rawalpindi 110 33 Mandi Bahaud N Haripur 95 19 P Sheikhupura 103 27 P Din 111 34 S Thatta 96 16 P Gujrat 104 28 S Karachi 112 17 N Abbottabad 97 20 P Gujranwala 105 29 P: Punjab, S: Sindh, N:NWFP, C: Capital, B: Balochistan, NA: Norther Area, A:Azad Jammu & Kashmir, F: Federaly Administered Areas National Rankings are from 1 to 112,1 being the worst and 112 the best. Provincial Rankings depend on the number of districts per province.

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Table 5.19 Population in Semi Pacca Houses Provincial Provincial Provincial Provincial Provincial Provincial National National National District District District Rank Rank Rank Rank Rank Rank Rank Code Code Code

31.4 - 66.15 PERCENT F Kurram 1 1 S Thatta 3 1 N Swat 2 1 N Karak 4 2 17.0 - 31.3 PERCENT S Badin 5 2 B Panjgur 10 3 N Tank 15 3 B Dera Bugti 6 1 B Pishin 11 4 S Tharparkar 16 3 B Lasbela 7 2 B Mastung 12 5 P Layyah 17 3 P T.T.Singh 8 1 B Gawader 13 6 NA Diamer 9 1 P Rahim Yar Khan 14 2 7.7 - 16.9 PERCENT P Khanewal 18 4 P Bahawalpur 32 9 B Turbat 46 11 B Loralai 19 7 N D.I.Khan 33 4 B Jafarabad 47 12 P Rajanpur 20 5 S Shikarpur 34 9 S Larkana 48 14 P Bahawalnagar 21 6 P Muzaffargarh 35 10 B Killa Saifullah 49 13 S Ghotki 22 4 B Killa Abdullah 36 10 N Lower Dir 50 6 Noushero S Feroze 23 5 S Jacobabad 37 10 S Mirpurkhas 51 15 P Jhang 24 7 P Bhakkar 38 11 NA Ghanche 52 2 B Quetta 25 8 S Khairpur 39 11 B Kohlu 53 14 B Nasirabad 26 9 N Lakki 40 5 B Kalat 54 15 P Faisalabad 27 8 S Sukkar 41 12 N Malakand 54 7 S Dadu 28 6 P Sahiwal 42 12 A Kotli 56 2 S Nawabshah 29 7 P Okara 43 13 B Bolan 57 16 S Umerkot 30 8 S Sanghar 44 13 A Rawalakot 31 1 P Pakpattan 45 14 2.8 - 7.6 PERCENT B Sibi 58 17 P Multan 71 20 P Attock 84 23 P Mianwali 59 15 B Zhob 72 20 N Upper Dir 85 14 A Muzaffarabad 60 3 P Khushab 73 21 F Khyber 86 3 P Vehari 61 16 A Mirpur 74 4 NA Skardu 87 3 P D.G Khan 62 17 B Chagai 75 21 A Bhimber 88 6 P Jhelum 63 18 F N.Waziristan 76 2 N Swabi 89 15 B Barkhan 64 18 P Chakwal 77 22 N Mardan 90 16 N Bannu 65 8 N Hangu 78 11 P Narowal 91 24 N Chitral 66 9 B Kharan 79 22 P Kasur 92 25 S Hyderabad 67 16 C ISLAMABAD 80 1 P Sargoda 93 26 Mandi Bahaud P Lodhran 68 19 A Bagh 81 5 P Din 94 27 B Khuzdar 69 19 N Kohat 82 12 P Lahore 95 28 N Abbottabad 70 10 N Mansehra 83 13 N Charsadda 96 17 0.6 - 2.7 PERCENT S Karachi 97 17 NA Gilgit 103 5 N Haripur 109 20 P Gujrat 98 29 P Sialkot 104 31 B Musa Khel 110 24 NA Ghizer 99 4 A Sudhnoti 105 7 P Gujranwala 111 34 P Sheikhupura 100 30 P Rawalpindi 106 32 B Ziarat 112 25 N Peshawar 101 18 B Jhal Magsi 107 23 N Nowshera 102 19 P Hafizabad 108 33 P: Punjab, S: Sindh, N:NWFP, C: Capital, B: Balochistan, NA: Northern Area, A:Azad Jammu & Kashmir, F: Federally Administered Areas National Rankings are from 1 to 112,1 being the worst and 112 the best. Provincial Rankings depend on the number of districts per province.

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Table 5.20 Household without Electricity Connection in Urban Pakistan Provincial P Provincial Provincial Provincial Provincial N National National District District District District rov Rank Rank Rank Rank Rank Rank a Code Code Code Code ti i ona nc i a l l

70.6 - 99.0 PERCENT B Musa Khel 1 1 F Kurram 2 1 50.6- 70.5 PERCENT NA Ghanche 3 1 B Panjgur 5 2 NA Diamer 6 3 NA Ghizer 4 2 20.6 - 50.5 PERCENT S Tharparkar 7 1 S Badin 9 3 S Thatta 10 4 S Umerkot 8 2 10.6 - 20.5 PERCENT B Kohlu 11 3 B Jhal Magsi 14 6 B Khuzdar 17 9 B Dera Bugti 12 4 B Kharan 15 7 P Khushab 18 1 B Chagai 13 5 B Jafarabad 16 8 8.6 - 10.5 PERCENT B Pishin 19 10 N Malakand 21 1 N Upper Dir 22 2 P Bahawalpur 20 2 6.6 - 8.5 PERCENT B Barkhan 23 11 F Khyber 25 3 S Shikarpur 27 5 F N.Waziristan 24 2 P Lodhran 26 3 4.6 - 6.5 PERCENT P Okara 28 4 P D.G Khan 34 6 N Mansehra 39 4 S Khairpur 29 6 B Gawader 35 13 P Vehari 40 8 N Chitral 30 3 P Bhakkar 36 7 P Khanewal 41 9 P Jhang 31 5 NA Skardu 37 4 S Hyderabad 42 8 S Jacobabad 32 7 A Muzaffarabad 38 1 P Bahawalnagar 43 10 B Lasbela 33 12 2.6 - 4.5 PERCENT S Ghotki 44 9 P Rajanpur 54 14 P Lahore 63 18 P Muzaffargarh 45 11 C Islamabad 55 1 S Karachi 64 14 P Rahim Yar Khan 46 12 P Multan 56 15 NA Gilgit 65 5 S Sanghar 47 10 N Kohat 57 6 B Nasirabad 66 17 P Mianwali 48 13 P Sheikhupura 58 16 B Kalat 67 18 B Turbat 49 14 B Loralai 59 15 P Kasur 68 19 S Mirpurkhas 50 11 B Mastung 60 16 B Bolan 69 19 Noushero S Nawabshah 51 12 S Feroze 61 13 B Quetta 70 20 A Sudhnoti 52 2 P Jhelum 62 17 N Abbottabad 71 7 N D.I.Khan 53 5 0.5 - 2.5 PERCENT S Sukkar 72 15 P Layyah 86 25 P Mandi Bahaud Din 100 30 A Bagh 73 3 P T.T.Singh 87 26 N Haripur 101 16 S Dadu 74 16 N Nowshera 88 9 P Pakpattan 102 31 B Killa Saifullah 75 21 P Chakwal 89 27 B Killa Abdullah 103 25 B Sibi 76 22 P Gujrat 90 28 N Lakki 104 17 P Sargoda 77 20 A Mirpur 91 4 P Attock 105 32 P Rawalpindi 78 21 P Gujranwala 92 29 N Hangu 106 18 N Charsadda 79 8 N Karak 93 10 N Mardan 107 19 B Zhob 80 23 N Swat 94 11 P Sialkot 108 33 B Ziarat 81 24 N Lower Dir 95 12 A Kotli 109 6 P Faisalabad 82 22 N Tank 96 13 N Swabi 110 20 S Larkana 83 17 A Rawalakot 97 5 A Bhimber 111 7 P Hafizabad 84 23 N Bannu 98 14 P Narowal 112 34 P Sahiwal 85 24 N Peshawar 99 15 P: Punjab, S: Sindh, N:NWFP, C: Capital, B: Balochistan, NA: Northern Area, A:Azad Jammu & Kashmir, F: Federally Administered Areas National Rankings are from 1 to 112,1 being the worst and 112 the best. Provincial Rankings depend on the number of districts per province.

VULNERABILITY ANALYSIS AND MAPPING (VAM) UNIT, WORLD FOOD PROGRAMME, PAKISTAN 52 FOOD INSECURITY IN URBAN PAKISTAN Food Absorption 6 CChhaapptteerr 66

Food Absorption

Quality healthy food is a basic need of life, stage and to get timely medical help including ensuring growth & development and sustaining immunization. life, and of enjoyment. For normal human growth & development, a sustained availability, both in 6.2. Immunization of Children under 10 physical and economic terms, of balanced food in years of age adequate quantity and quality is essential. Under & malnutrition can both lead to host of health Immunization is an important aspect of health, in related problems. Similarly, contaminated and particular for children below the age of 10 years. poor quality food may also cause diseases, Parental negligence due to unawareness, lack of interfering proper digestion, absorption & access to health facilities and/or lack of resources assimilation of food. In this backdrop, along with can cause irreparable damage to the health of food availability and economic access to food, children. food absorption is equally important, in terms of food security, as is discussed below: One glaring example is of disability among children, affected by polio at an early age and The issues related to food-borne disease are could not get adequate medical help on time. spread from the food production places through Although detailed information on the issue is not its distribution to consumption. Scores of food- available, it is assumed that limbs disability in borne diseases and health hazards stem from Pakistan is mostly caused due to polio, accidents cultivation, harvesting, processing, distribution or child abuse including corporal punishment at and consumption practices. One could add to this schools. mix problems emanating from contaminants, pesticides, chemicals residues and ‘junk food. Children under the age of 10 form more than a quarter of the population. The status of The issue of food-borne diseases and thus of poor immunization of this population group in the four food absorption has a close interface with provinces of Pakistan, PAK and Islamabad poverty. In this context there is a need to Capital Territory is given in table-6.1. understand this link, especially in the context of Millennium Development Goals (MDGs). According to the above information, out of total population below 10 years, 37.37% male and 6.1. Health 34.42% female are vaccinated whereas some 2.43% male and 2.41% female remained out of This section looks at two key issues related to coverage. Besides, immunization status of 12% children: Immunization and Children with male and 11% female population could not be Disability. The reason to select these two issues is reported due to lack of information in the 1998 that children’s health at an early stage need Census. Immunization is administered for the special attention and care. Child mortality and protection against seven deadly diseases i.e.: disability is largely caused due to negligence of o Measles parents to identify health problem at an early Table 6.1 Immunization Status in Urban Pakistan 1998 Number of Districts Immunization Status Punjab Sindh NWFP Balochistan PAK ICT Total % Total Population by Immunization ( Below 10 Years) 5957639 3752993 924678 778848 70770 125057 11609985 Vaccinated Male % 40.94 37.61 34.46 34.46 39.45 37.3 224.22 37.37 Vaccinated Female % 38.64 34.8 31.35 30.51 37.11 34.1 206.51 34.42 Not Vaccinated Male % 1.91 1.74 3.67 4.53 1.03 1.7 14.58 2.43 Not Vaccinated Female % 1.9 1.73 3.54 4.17 0.9 2.2 14.44 2.41 Not Known Male % 8.5 12.27 14.24 13.6 11.68 12.4 72.69 12.12 Not Known Female % 8.09 11.82 12.74 12.73 9.69 12.3 67.37 11.23 Total 100 100 100 100 100 100 600 99.97

VULNERABILITY ANALYSIS AND MAPPING (VAM) UNIT, WORLD FOOD PROGRAMME, PAKISTAN FOOD INSECURITY IN URBAN PAKISTAN Food Absorption 6 o B.C.G. (Bacillus of Calmette and Guerin) Table - 6.2 o Polio Disability Population Analysis (National Basis) o D.P.T. (Diphtheria, Pertussis and Tetanus) 2002 o D.T. (Diphtheria and Tetanus) Male Female Total % o T.T. (Tetanus Toxiod) Total o 68,873,686 63,478,593 132,352,279 H.B.V (Hepatitis B Vaccine) Population

Population 6.3. Disability among Children and Youth of the 1,918,705 1,374,450 3,293,155 2.49 in Urban Pakistan Disabled Ref: GOP, Ministry of Women’s Development, Social Welfare and Special Education – The issue of disability is to be seen in the context Pakistan’s Special People Opportunities and Challenges 2002 of personal health and socio-economic well-being framework to address their needs. of the individual, the family and the society. Care for special persons is a shared responsibility. The 6.4. Incidence of Disability United Nations declared 1981 as the International Year of the Disabled, which brought about The Disability Population Analysis conducted by awareness on the issue. A Decade of Disability the Ministry of Women’s Development Social (1992-2002) was earmarked by the UNESCAP to Welfare and Special Education in 2002 on advocate, encourage and undertake measures to national basis indicates that the incidence of address the needs of special people by its member disability in Pakistan is 2.49%. Information on states. the specific nature of disabilities is also given in the following table. According to an estimate by the United Nations, about 500 million people i.e. 7-8% are faced with Table-6.3 defines 43.33% cases of disability as health conditions that mar their ability to lead a ‘Others’, which could mean that the health normal life without support. In Pakistan 2.49% conditions of a significant segment of special population is affected with disability. persons are not identified. This fact is further evidenced from an analysis of data provided in This study includes two main aspects on the 1998 District Census Report on Disabled Table 6.3 Type of Disability (National Basis) 2002 Disability Male Female Total % a. Blind 146039 119369 265408 8.06 b. Deaf & Mute 138238 105448 243686 7.4 c. Crippled 382262 243523 625785 19 d. Insane 119645 91209 210854 6.4 e. Mentally Retarded 134887 115297 250184 7.6 Having more than one f. 140285 130166 270451 8.21 disability g. Other 857362 569438 1426800 43.33 Ref: GOP, Ministry of Women’s Development, Social Welfare and Special Education – Pakistan’s Special People Opportunities and Challenges 2002 Disability: Incidence of Disability and Population. The situation analysis of children and Institutional Support with relevant information youth aged 6-19 in Urban Pakistan given in the on the national, provincial and district level next section shows that except in two cases, the scenario with special focus on children and youth unidentified disabilities of special persons range (aged 6-19) with disability and institutional from 4.88 in Bagh, PAK to 99.52% in Kohlu, Balochistan. Figure 6.1 Ratio of Urban Population with Disability 25

Less t han 0.50% The province-wise incidence of disability in 20 0.51-1.00% population above the age of 10 shows that 1.01-1.50% 15 1. 51- 2 . 0 0 % Punjab, being the largest and most populated M ore t han 2% province has 21 districts with an incidence of 10 disability between 0.51-1.00 percent. NWFP is

5 facing this situation in 12 and Balochistan in 9 districts. All four provinces and PAK have at 0 Punjab Sindh NWFP Balochistan NA AJK ICT least one district with more than 2% incidence of

Province disability among this group of population.

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Table 6.4 Ratio of Urban Population 10 years and above with Disability – Province wise Number of Districts Balochista Northern Range Punjab NWFP Sindh PAK ICT Total n Areas Less than 0.50% 5 2 9 12 2 2 1 33 0.51-1.00% 21 12 5 9 1 2 - 50 1.01-1.50% 5 4 2 3 2 2 - 18 1.51-2.00% 2 1 - - - 0 - 3 More than 2% 1 1 1 1 - 1 - 5 Total 34 20 17 25 5 7 1 109 3 Districts of FATA are not included At district level, the worst situation exists in systematic education, rehabilitation and Karachi East that has the highest number as well mainstreaming in the society to secure their as highest ratio of PWD as seen in the table future and realize their potential to lead a normal below. There is a need to further probe reasons life. for this situation to devise appropriate mechanism to address it. In order to ascertain institutional capacity of the country to address particular needs of children Table 6.5 and youth with disability aged 6-19, it is Population 10 Years and Above - 10 Districts with Lowest Disability Incidence important to look at the existing situation across Prov. No. of board. Code District Population PWDs* % B Loralai 25296 21 0.08 The first drawback is lack of complete B Dera Bugti 10412 13 0.12 information regarding type of disabilities that exist and the reasons causing these disabilities B Pangur 13661 20 0.15 among certain groups of population. With P Rawalpindi 1351156 2010 0.15 B Killa abdollah 37520 59 0.16 insufficient information and unawareness on S Thatta 87895 147 0.17 health conditions of special persons, it is difficult S Mirpur Khas 215318 379 0.18 for the concerned authorities to plan appropriate N Peshawar 694207 1423 0.2 health and rehabilitation programmes that could S Larkana 375033 769 0.21 address the need of persons with disability in S Jaccobabad 232790 529 0.23 general and children with disability in particular. Hence, the capability of this group of population People that belong to this group are to secure livelihood and food is compromised. (supposedly)1 engaged in study, work, employment and other means of livelihood in Table 6.6 order to contribute to the well-being of their Population 10 Years and Above - 10 Districts families and their own development. They are with Highest Disability Incidence Prov. No. of the bread earners, consumers and service District Population % providers in the market they are operating in. Code PWDs* N Swabi 122692 1594 1.3 Their role as valuable citizens of the society is to N Karak 18234 248 1.36 be fully realized by creating conducive living and B Gwadar 67,816 991 1.46 working conditions for them as to reduce their P Khoshab 165,259 2765 1.67 Rahim Yar P 428,046 7717 1.8 vulnerability for food insecurity. Khan N Tank 23817 473 1.99 6.5. Institutional Support System for PAK Poonch 40,953 848 2.07 B Jhal Magsi 5,374 112 2.08 Children with Disability P Chakwal 98,686 2208 2.24 N Malakand 28283 772 2.73 The second group i.e children between the ages S Karachi East 2080800 61196 2.94 of 6 and 19, is identified specifically in order to see if their needs are being addressed through the The concerned authorities are also not able, in such a case, to guide and help the families with special children and youth on how to bring them 1 Keeping in mind the lack of social apathy towards PWD and systematic assimilation in education and employment, it is felt that up and address their day to day needs. Such their vulnerabilities are to be emphasised and addressed with families are faced with a dual problem of dedication and commitment at both organizational and societal allocating extra family resources to the care of levels.

VULNERABILITY ANALYSIS AND MAPPING (VAM) UNIT, WORLD FOOD PROGRAMME, PAKISTAN 55 FOOD INSECURITY IN URBAN PAKISTAN Food Absorption 6 special person and also being deprived of his/her contribution to the well being of the family. Table 6.7 Special Education Institutions in Public Sector - GOP MWDSW & SE Pub 2002 All disabilities are not caused by birth or inheritance; some are the result of lack of medical g and social care of mother during pregnancy and ment ment No. of No. of No. of cation cation Year of of Year District District enrolled students awaitin unprofessional handling of the process of child Students Establish Centre/lo birth as well as neglect in having timely immunization of infants and children under the Bahawalpur 1 1986-87 66 age of five. Some of these problems can be fairly Rahim Yar Khan 1 1986-87 73 controlled or lessened by providing better Mother-Child Care at the local level and D. G. Khan 1 1986-87 60 extending the immunization coverage to 100%. Faisalabad 1 1986-87 339 Jhang 1 Hence, Immunization is included in this chapter Gujranwala 1 1986-87 59 1986-87 as one of the two main aspects of child health Gujrat 2 1992-93 34 care. Lahore 4 1992-93 70 Okara 1 1986-87 65 6 Regarding the existing institutional facilities for Sheikupura 1 1986-87 89 those identified with specific disability, the total Multan 1 1986-87 78 number of institutions in the public sector as Sahiwal 2 1986-87 47 reported in the Ministry of Women Development, Jehlum 1 1986-87 70 15 Social Welfare and Special Education publication Rawalpindi 1 1986-87 40 16 is 56 in which 3210 students are enrolled and 414 Sargodah 1 1986-87 102 are on waiting list. These institutions are located D.I. Khan 1 1986-87 47 across country i.e. 20 in Punjab, 10 in Sindh, 9 in Kohat 1 4 NWFP, 4 in Balochistan, 1 in PAK, 1 in Northern Peshawar 3 1986-87 105 3 Areas and 11 in Islamabad. Most of these Charsadda 1 Mardan 1 50 institutions are located in large cities and towns. Swat 1 The capacity of these institutions is also far Abbottabad 1 44 120 below the need of disabled population. The Sukkar 1 1986-87 61 students enrolled in these institutions are between Nawabshah 1 1986-87 83 0.30% to 17% except in the case of Islamabad Larkana 1 1986-87 71 6 and Gilgit where the percentage is 56% and 29 % Mirpur Khas 1 1986-87 68 respectively. Some 414 students are on waiting Dadu 1 1986-87 73 list for enrollment. Hyderabad 1 1986-87 67 1986-87 Karachi 4 371 100 These institutions are addressing many types of 1992-93 Quetta 2 1982-83 51 20 disabilities, which may not be commensurate Sibbi 1 4 with the percentage of incidence given in the Khuzdar 1 table above. However, the distribution is as Gilgit 1 1986-87 46 follows: Muzaffarbad 1 1986-87 66 1982-83 1986-87 Institutions for addressing: Islamabad 11 1992-93 815 120 o Hearing Impaired 10 56 Total: 3210 414 o Mentally Retarded 10 which are run on grants and donations from o Physically Retarded 14 philanthropist, welfare societies, non-profit o Visually Impaired 9 organizations and international agencies. Their o Vocational Training 10 services and facilities include: o Special Education 1 o Library/Resource Centre 1 x Institutions for Hearing Impaired (32) o Braille Press 1 x Institutions for Multiple Disabilities (39) x Institutions for Mentally Retarded Children Fully recognizing the budgetary constraints on (29). resources in the public sector, a number of initiatives are taken to establish Special Most of these facilities are located in Karachi, Education Institutions in the Private Sector, Lahore, Islamabad, Peshawar, Faisalabad and

VULNERABILITY ANALYSIS AND MAPPING (VAM) UNIT, WORLD FOOD PROGRAMME, PAKISTAN 56 FOOD INSECURITY IN URBAN PAKISTAN Food Absorption 6 other big towns as per the list provided in the 2003-04. However, exact allocation is not above mentioned publication of the Ministry of mentioned in the National Budget given in Women’s Development Social Welfare and Pakistan Economic Survey 2003-04. Special Education. Based on the above information, it is noted that Table 6.8 there is a strong need to devise adequate policies Addressing Disability in Children and Youth (6-19 years) Eligible for Enrolment and programs for addressing the issue of disability, in particular among children and youth

2 and creating awareness in the society to mobilize national support for successful implementation of with with % of No. of Worse (CWD) enrolled enrolled Students Students reported Enrolled Better to Children Situation Situation aged 6-19 aged 6-19 Disability Disability these policies. The government and people have Students to Total CWD District to jointly commit to take up the issue of Islamabad 1459 815 55.86 1 assimilating special persons into the mainstream Gilgit 156 46 29.49 2 society and mobilize resources for the purpose. Peshawar 611 105 17.18 3 The issue is not to be considered in isolation as it Mirpur Khas 602 68 11.3 4 is cutting across all the sectors from proper Jehlum 825 70 8.48 5 health care to the right of dignified means of Abbottabad 556 44 7.91 6 living and disenfranchisement. Sahiwal 662 47 7.1 7 Larkana 1083 71 6.56 8 D.I. Khan 772 47 6.09 9 A few areas to be covered in the policies and Malir 6309 371 5.88 10 programs are: Mardan 1034 50 4.84 11 Okara 1504 65 4.32 12 x Providing systematic and low cost health D. G. Khan 1526 60 3.93 13 care for mother and child and ensuring 100% Sargodah 3673 102 2.78 14 coverage of immunization of infants and Hyderabad 3389 67 1.98 15 children under the age of five to lessen the Nawabshah 4609 83 1.8 16 incidence of disability due to neglect in these Bahawalpur 3666 66 1.8 17 two important areas; Quetta 3492 51 1.46 18 Providing appropriate health care of special Multan 5856 78 1.33 19 x Faisalabad 25985 339 1.3 20 persons according to physical and non- Gujranwala 5602 59 1.05 21 physical needs for medication, rehabilitation Sukkar 6795 61 0.9 22 and attitude building that brings Dadu 8376 73 0.87 23 independence to leading well-functional life Rawalpindi 5117 40 0.78 24 and lessens physical and emotional stress; Sheikupura 16246 89 0.55 25 x Establishing health insurance facilities for Rahim Yar Khan 14876 73 0.49 26 special persons and their families to cover the Gujrat 11353 34 0.3 27 cost of their treatment, rehabilitation and Lahore 23584 70 0.3 28 maintenance; Source: District Census Reports 1998 and MOWDSW&SE Publication x Creating social, economic and political integration of special persons to protect basic Another key issue is of mobility and facilitation human rights such as education, facilitation of day to day functioning of special persons at for learning skills, dignified means of public places, such as schools, offices, parking earning, and the disenfranchisement; sites, roads crossings, shopping malls and means x Creating enabling environment for mobility of travel. in public physical infrastructure such as schools, offices, parking sites, roads General attitude towards special persons has just crossings, shopping malls as part of town started to change due to advocacy campaigns and planning and means of travel; awareness-raising with regard to their positive x Creating avenues for income generation traits and universal responsibility to assimilate beyond 1% quota in employment in the special persons into mainstream of daily life. public sector. It needs some thinking on the part of providers of services in the financial The budget for Special Education is expected to sector and marketing support systems. For be part of the PSDP budget which has decreased example, micro financing of cooperatives that from 2.9% of GDP in 2001-02 to 2.8% of GDP in facilitate skills training of special persons leading to production of marketable goods.

2 PWD: People with Disability

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x Facilitating social integration through health has been the focus of much debate and marriage and adoption of homeless persons planning, progress in terms of reaching major with disability; targets has been painfully slow. Some of the x Establishing factories for producing highest rates of mother and infant mortality are in equipment and supporting gadgets for special the south Asian region. Pakistan, in particular, persons, especially with limbs disabilities; has one of the highest rates of under 5 mortality x Acquiring technology from other countries and malnutrition in the region. Much of this high for facilitating medical and non medical and interactable mortality relates to deaths within treatment for the special persons; the newborn period. While there is little x Developing social attitudes through population-based information on maternal awareness-raising for equal opportunities to mortality, available data indicate that maternal special persons in all walks of life. mortality rates are high and also intransigent to change. Nations that take care of the weak segments of society become socially strong, emotionally Figure: 6.2 healthy and rich in terms of human resources that ensures a secure future for the coming MDG nutrition targets for Pakistan generations.

6.6. The MDGs, Food Absorption and Food Security:

The Millennium Development Goals (MDGs) adopted at the September 2000 United Nations Summit are a set of numerical and time-bound targets that express key elements of human development. They include inter alia halving income-poverty and hunger; achieving universal primary education and gender equality; reducing Given widespread poverty and malnutrition in under-five mortality by two thirds and maternal the country, it is also not surprising that some of mortality by three quarter; reversing the spread of these indicators have actually worsened over the HIV/AIDS; and halving the proportion of people last decade1. without access to safe water. These targets are to be achieved by 2015, from their level in 1990. Figure: 6.3 There are eight broad level goals, which are measured using 48 indicators. Of these 48 indicators, ten have specific targets, which are associated with the broad level goals. In addition, many countries have developed their own specific indicators and targets related to specific MDG targets. Of the MDG health & food security-related targets the most pertinent are goals related to maternal and child health and nutrition. The latter is tied to a general strategy of poverty reduction and overall improvement in nutrition through alleviation of hunger. The goal numbered six relates to reduction in the burden of malaria, HIV/AIDS and other diseases such tuberculosis.

Simple measurement of progress towards the MDG targets is based on looking at average rates of improvement and trends.

There is, unfortunately, little awareness of MDG targets in Pakistan, and while maternal and child

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Table 6.9 Millennium Development Goals, Targets and Indicators MDGs and MDG Targets Global perspective Indicators for Pakistan Goal 1: Eradicate Extreme Poverty and Hunger Proportion of population below the calorie based basic needs poverty line Poverty gap ratio (incidence x depth of Halve, between 1990 and 2015, the More than a billion people still live on poverty) proportion of population living on less than a less than US$1 a day: sub-Saharan Africa, Share of the poorest quintile (lowest dollar a day Latin America and the Caribbean, and 20%) in national consumption Halve, between 1990 and 2015 the proportion parts of Europe and Central Asia are Prevalence of underweight children of people who suffer from hunger falling short of the poverty target. (under five years of age) Proportion of population below minimum level of dietary energy consumption Goal 2: Achieve Universal Primary Education As many as 113 million children do not Net primary enrolment ratio Ensure that, by 2015, children everywhere, attend school, but the target is within Proportion of pupils starting grade 1 boys and girls alike, will be able to finish a reach. India, for example, should have 95 who reach grade 5 full course of primary schooling percent of its children in school by 2005. Literacy rate of 15-24 year olds Goal 3: Promote Gender Equality and Empower Women Ratio of girls to boys in primary, Two-thirds of illiterates are women, and secondary and tertiary education the rate of employment among women is Ratio of literate females to males of 15- Eliminate gender disparity in primary and two-thirds that of men. The proportion of 24 years secondary education preferably by 2005 and seats in parliaments held by women is Share of women in wage employment to all levels of education no later than 2015 increasing, reaching about one third in in the non-agricultural sector Argentina, Mozambique and South Proportion of seats held by women in Africa. national parliament Goal 4: Reduce Child Mortality Under-five mortality rate Infant mortality rate Proportion of fully immunized children 12-23 months Every year nearly 11 million young Proportion of under 1 year children children die before their fifth birthday, immunized against measles Reduce by two thirds, between 1990 and mainly from preventable illnesses, but Prevalence of under weight children 2015, the under-five mortality rate that number is down from 15 million in (under 5 years of age) 1980. Proportion of children under five who suffered from diarrhea in the last 30 days and received ORT Lady Health Workers’ coverage of target population Goal 5: Improve Maternal Health Maternal mortality ratio Proportion of births attended by skilled birth attendants In the developing world, the risk of dying Contraceptive prevalence rate Reduce by three-quarters, between 1990 and in childbirth is one in 48, but virtually all Total fertility rate 2015, the maternal mortality ratio countries now have safe motherhood Proportion of women 15-49 years who programs. had given birth during last 3 years, who had attended at least one antenatal care consultation Goal 6: Combat HIV/AIDS, Malaria and Other Diseases HIV prevalence among 15-24 year old pregnant women HIV prevalence among vulnerable Have halted by 2015, and begun to reverse, group (e.g., active sexual workers) Forty million people are living with HIV, the spread of HIV/AIDS Proportion of population in malaria risk including five million newly infected in areas using effective malaria prevention 2001. Countries like Brazil, Senegal, Have halted by 2015, and begun to reverse, and treatment measures Thailand and Uganda have shown that the the incidence of malaria and other major Incidence of tuberculosis per 100,000 spread of HIV can be stemmed. diseases population Proportion of TB cases detected and cured under DOTS (Directly Observed Treatment Short Course) Goal 7: Ensure Environmental Sustainability Integrate the principles of sustainable More than one billion people lack access Proportion of land area covered by development into country policies and to safe drinking water and more than two forest programs and reverse the loss of billion lack sanitation. During the 1990s, Land area protected to maintain environmental resources however, nearly one billion people gained biological diversity Halve, by 2015, the proportion of people access to safe water and the same number GDP per unit of energy use (as a proxy without sustainable access to safe drinking to sanitation. for energy efficiency)

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water No. of vehicles converted to CNG Have achieved, by 2020, a significant Sulphur content in high speed diesel (as improvement in the lives of at least 100 a proxy for ambient air quality) million slum dwellers Proportion of population (urban and rural) with sustainable access to a safe (improved) water source

Proportion of urban population with access to improved sanitation Proportion of 'katchi abadees' regularized Develop a global partnership for development Many developing countries spend more Targets: on debt service than on social services. • Develop further an open trading and New aid commitments made in the first financial system that includes a commitment half of 2002 could mean an additional to good governance, development and $12 billion per year by 2006. poverty reduction – nationally and internationally • Address the least developed countries’ special needs, and the special needs of landlocked and small island developing States • Deal comprehensively with developing countries’ debt problems • Develop decent and productive work for youth • In cooperation with pharmaceutical companies, provide access to affordable essential drugs in developing countries • In cooperation with the private sector, make available the benefits of new technologies – especially information and communications technologies. Millennium Development Goal 4: To Reduce Child Mortality by 2/3 by 2015 Target 5 Reduce by two-thirds, between 1990 and 2015, the under-five mortality rate 2005/06 2011 2015 Indicators Definitions 1990/91 2001/02 PRSP Perspective MDG Targets Plan Targets No. of deaths in children under Under-five five years of age 140 105 80 65 52 mortality rate per thousand live births No. of deaths in children under 1 Infant mortality rate year of age per 120 77 63 50 40 thousand live births Proportion of Prevalence of under children <5 years weight children who are 49% 37% 34% 28% 10% (under 5 years of underweight for age) their age No. of mothers dying due to complications of Maternal mortality pregnancy and 550 350 280 180 140 ratio delivery per 100,000 live births Proportion of deliveries Proportion of births attended by attended by skilled 18% 24% 26% >50% 90% skilled health birth attendants personnel (MOs, midwives, LHVs) Potential low-cost interventions that may improve maternal and child health in Pakistan at health system level Barriers or Strength of Potential impact or Relative ease of Intervention remaining issues before evidence effect size implementation nation-wide implementation

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Nutrition education Impact on reduction to improve of iodine deficiency Nutrition education is time consuming and Moderately ease for balanced energy- 80-100% labor intensive. Could be integrated with I promotion of protein intake and Reduction in other sectors e.g. education, family iodized salt use promotion of intake perinatal mortality planning using mass media. of iodized salt demonstrated Established Tetanus toxoid x 2 efficacy > 95% for administration I Relatively easy Public education and awareness the prevention of during pregnancy neonatal tetanus Maternal malaria 25% reduction in prevention and LBW and reduction Requires functional Selective benefit only in malaria endemic treatment (bed nets I in perinatal health systems areas and/or presumptive mortality therapy) Recognition of Despite misgivings, high-risk pregnancy up to 50% Development of core indicators and and timely reduction of Difficult outside of targeted training programs. referrals) II maternal mortality functional health Linkages needed between health providers (previous perinatal demonstrated in systems and first level facilities deaths, recognition functioning health of danger signs) system settings Intra-partum care of 15% reduction in mother including Difficult in areas perinatal Despite barriers and difficulties, must be facilitation of where skilled birth I complications and an absolute goal for health systems in skilled birth attendants are 4% reduction in South Asia attendance and sparse maternal deaths clean birth Regular iron folate While effect size or and maternal low reduction in rates of dose vitamin A iron deficiency administration anemia difficult to Regular availability and quality of tablets estimate but Compliance may be are key. Commensurate need for public II significant variable education and an integrated program of reduction in nutrition education maternal mortality has been demonstrated. Clear evidence of Promotion of No major barriers to widespread impact on mortality Counseling skills exclusive I application. Especially required in early and morbidity required breastfeeding infancy reduction Improved complementary Unlike Appropriate feeding strategies complementary complementary result in an average feeding the Must be integrated with the overall feeding of infants I 0.35 Z score promotion and use nutrition education program is paramount & use of iodized increment and of iodized salt is salt improvement in relatively easy survival rates Diarrheal disease management Significant (including Must be scaled up within health systems evidence of benefit appropriate feeding I Easy to implement with assured availability of ORS and on morbidity and and antibiotic use drugs mortality for dysentery) & ORT Community management of ARI leads to 24- Acute respiratory ARI recognition 27% reduction in Requires better “hands-on” training illness recognition I and treatment by all cause under 5 programs for community health workers and management CHWs is feasible mortality and 36- 42% in pneumonia mortality Promotion and Impact on health administration of Cold chain and vaccine availability remain I outcomes well Easy childhood EPI issues established vaccinations Benefits of skin-to- Care of the Low skin care or Easy but Some cultural barriers exist to skin to skin I Birth Weight infant appropriate early supervision needed care in South Asia care established Evidence of impact Recognition of on neonatal Moderately difficult Strong demand for domiciliary or village serious neonatal I mortality of 50% to train community based care in rural settings. Further illness, stabilization (76% on sepsis health workers evidence needed in health system settings and referral related mortality) if

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injectable antibiotics provided to community health workers Provision of Efficacy (over contraceptives and 98%) of depot- No significant barriers to their inclusion in I Easy injectable depot Provera® well primary care programs contraceptives established Established efficacy of health Health education, and nutrition Communication skills required. especially hand I education in several Feasible Limitations of restricted messages and washing studies , although media rates of success vary Level of Evidence I Established evidence (both efficacy and effectiveness) II Intermediate evidence (efficacy but not effectiveness) Table III Under-5 deaths from specific causes preventable through listed interventions (Estimates from year 2000) Preventable under-five deaths Disease or Under-five deaths Percent of total Number Percent condition in 2000 under-five deaths Diarrhea 131021 23.20% 106848 82% Pneumonia 137871 24.40% 105150 76% Measles 4070 0.70% 1970 49% Malaria 1016 0.04% 186 80% Neonatal 200591 35.50% 94622 47% Asphyxia 62183 10% 24338 39% Pre-maturity 70207 12% 38000 54% Severe infections 32094 5% 27124 85% Tetanus 10030 2% 5160 51% TOTAL 565277 339166 60%

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Table 6.10 Doctors (MBBS And Above)Per 20000 Population In Pakistan Number of Districts No. of Balochist Northern Islamaba Doctors Punjab NWFP Sindh an Areas PAK FATA d Total 0.5 - 0.9 9 - - 4 1 - - - 14 1.0 - 1.5 19 3 - 5 2 - - - 29 1.6 - 2.0 6 6 1 5 2 2 1 - 23 2.1 - 2.5 - 5 2 6 - 5 - 1 19 2.6 - 4.0 - 4 7 3 - - 2 - 16 4.1 - 7.0 - 1 6 1 - - - - 8 7.1 - 10.0 - 1 1 1 - - - - 3 Total: 34 20 17 25 5 7 3 1 112 PAK:Azad Jammu & Kashmir, FATA: Federally Administered Areas No Urban Areas in these Districts:NWFP:Buner,Shangla,Kohistan,BattagramBalochistan:Awaran,FATA:Bajour,Mohamand,Orakzai,S.Waziristan This state of affairs reflects inter alia on the The policy focus is also an issue, for addressing health security situation in Pakistan. There are basic issues like hygiene, sanitation, safe water several reasons for the poor performance of the supply and the environment, at times one is health sector in Pakistan, that include caught in a therapeutic rather than a preventive overarching issues of overall budgetary and promotional mode. It is critical to link the allocations for health, health policy frameworks, MDG target process to sectors other than health, miniscule social sector investments and resilient including inter alia food security, in order to poverty. However, a closer look indicates that address the issue holistically. In particular, the even where investments have been made in the critical link of health, development and economic public sector for primary care, the quality of prosperity must be underscored. In this context, it services is poor. It is estimated that over 70% of is crucial that social spending especially health- all health related care seeking is from the private related public allocations, including inter alia on sector and of approximately US $16 per capita food safety and public health, be regarded as an spending on health; the government spends only investment rather than an expense. This will US$ 4. Although, on paper one finds that there is provide underpinnings to the efforts aiming at health care infrastructure in the country, with poverty alleviation, and shall also help address basic health units linked to rural health centers food absorption related aspects of food security. and Tehsil/sub-Tehsil hospitals, the quality of care and staff within this health system is very In this backdrop, when one looks at the health poor. This function is particularly significant in services structure in Pakistan, one finds that the area of maternal and newborn care, and is number of medical doctors per twenty-thousand compounded in many instances by poor population in majority of districts in Pakistan is governance, staff absenteeism, lack of essential lower than what is actually required. For example medicines and transparency in the delivery table-6.10 would reveal that there are 66 (59%) system. districts out of 112 in Pakistan where less than 2 medical doctors are available per 20,000 people.

Table 6.11 Lady Health Visitors Per 20000 Population In Pakistan Number of Districts No. of Balochist Northern Islamab LHVs Punjab NWFP Sindh an Areas PAK FATA ad Total 0.05 -0.20 - - 9 2 - - - 1 12 0.21 - 0.50 3 1 8 4 - 2 1 - 19 0.51 - 0.80 16 6 - 8 1 - 1 - 32 0.81 - 1.00 11 7 - 6 1 1 1 - 27 1.01 - 1.50 4 5 - 2 3 4 - - 18 1.51 - 2.50 - 1 - 1 - - - - 2 2.51 - 3.56 - - - 2 - - - - 2 Total: 34 20 17 25 5 7 3 1 112 PAK:Azad Jammu & Kashmir, FATA: Federally Administered Areas No Urban Areas in these Districts:NWFP:Buner,Shangla,Kohistan,BattagramBalochistan:Awaran,FATA:Bajour,Mohamand,Orakzai,S.Waziristan

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VULNERABILITY ANALYSIS AND MAPPING (VAM) UNIT, WORLD FOOD PROGRAMME, PAKISTAN FOOD INSECURITY IN URBAN PAKISTAN Food Absorption 6 This situation get worsened when it comes to food absorption and food access, which in turn Punjab & NAs, where 34 & 5 districts (100%) compromises food security. respectively fall in this category. Compared to Punjab, in Balochistan 56% districts are in this A large proportion of the middle class, according category. There is only one district out of 112 in to the study under reference, was also reported to Pakistan where number of medical doctors be suffering from ill health and got locked into exceeds 8 per 20,000 population, while 3 districts high cost health care, because of poor social are having doctors in the range of 7.1-10. safety net. This resulted not only in lower productivity and income, but also in loss of The situation is even worse, in case of the already low income due to expensive medical paramedics as could be seen from table-6.11 for care, provided by private sector for repeated and in 90(80%) districts out of 112 number of LHVs sometimes chronic illness.

Table 6.12 Nurses Per 20000 Population In Pakistan Number of Districts No. of NWF Balochis Northern Islama Nurses Punjab P Sindh tan Areas PAK FATA bad Total No - - - 4 - - - - 4 0.04 - 0.25 13 3 2 6 - - - - 24 0.26 - 0.45 10 8 2 10 - 2 - - 32 0.46 - 0.65 3 2 4 2 - 1 - - 12 0.66 - 1.00 8 2 4 1 3 2 2 - 22 1.01 - 2.00 - 3 5 1 2 1 1 - 13 2.01 - 5.00 - 1 - - - 1 - - 2 5.01 - 6.00 - 1 - 1 - - - - 2 6.01 & Above ------1 1 Total: 34 20 17 25 5 7 3 1 112 PAK:Azad Jammu & Kashmir, FATA: Federally Administered Areas No Urban Areas in these Districts:NWFP:Buner,Shangla,Kohistan,BattagramBalochistan:Awaran,FATA:Bajour,Mohamand,Orakzai,S.Waziristan is less than or closer to one per 20,000 According to the study, three factors accounted population. for 60 percent of the burden of disease in Pakistan, when measured in terms of life years And when it comes to nursing staff table no. 6.12 lost: (i) Communicable infectious diseases; (ii) one finds that in 94(84%) districts of Pakistan Reproductive health problems; and (iii) the number of nurses per 20000 is less than or Nutritional deficiencies. Inspite of the fact that all equal to one, and situation is extremely miserable of the three factors were preventable as well as for example, in Balochistan where 4 disticts curable, the incidence of disease and mortality have no nurse at all. About 24 districts have only remained high, for the disease prevention & one nurse per 80,000 and above population. control is very weak. Nutritional deficiencies, which have been identified as one of the three The poor access to medical service, leads to ill- factors responsible for the ill-health inter alia health especially among the poor and results from poor state of food security in general marginalized who can’t afford private treatment. and food absorption in particular. A research, in this regard, conducted, for the National Human Development Report (NDHR), This situation of ill-health and poverty interfacing referred to in the chapter on urbanization, has food insecurity, sets in a vicious circle of poverty, shown that ill health is so widespread in Pakistan as discussed below: that it should now be regarded as a major national issue, in the context of poverty alleviation and 6.7. The Disease & Poverty: economic development. The report suggested that as much as 65 percent of the poor population in In the context of MDGs, it is important to Pakistan was suffering from ill health with the emphasize that hunger, disease and poverty poor, on average, being sick for three months of alternate with each other (FAS-2003). For the year. This affects person’s productivity and example, an IFPRI report says that death rates for thus income, as is discussed in the chapters on infectious diseases, such as diarrhea, measles, and

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VULNERABILITY ANALYSIS AND MAPPING (VAM) UNIT, WORLD FOOD PROGRAMME, PAKISTAN FOOD INSECURITY IN URBAN PAKISTAN Food Absorption 6 tuberculosis—and for infant mortality among Such issues can be addressed by appropriate urban poor children in developing countries can policy dispensation in urban areas. For example, be upto100 times higher than those for urban through empowerment at grass root level, children in industrialized countries. The World communities can be involved in local Bank calculated that in 1998 acute respiratory governance, urban development and thus can diseases (about 111 million years of life lost) and address the aforementioned issues effectively. diarrheal diseases (about 94 million years of life lost) were the world's major health problems, and Food security as discussed in earlier chapters, they were concentrated in urban areas of implies, food: developing countries. Malaria, for example represents a significant health problem in urban ƒ Accessible to all, Asia including Pakistan. The challenge is to ƒ Adequate quantitatively and qualitatively eliminate the breeding ground for factors according to the physiological needs of responsible for this vicious circle, as discussed individual population with reasonable but below: assured surplus at any one point of time, ƒ Appropriate and safe, 6.8. Poor Sanitation &Contamination ƒ Affordable by all, and ƒ Acceptable to all. Pollution because of industrial affluent and poor civic facilities complicates the situation and adds In addition, followings provide underpinning to to health risks. Urban satellites in developing food security paradigm: countries, like Karachi, Lahore, Faisalabad, to x Access to adequate and appropriate name few, are also industrial hubs and thus attract information and knowledge, to all leading to the poor labor for jobs. The health-related the community’s healthy food behavior, problems in these cities have closer connection x Research and surveillance for appropriate with dirty industrial development. For example, food policy decisions and actions, and in May 2006 many people in Ghulam x Enforcement of regulatory systems to protect Mohammad Abad- a part of urban Faisalabad, the people and consumers from deceptive Gujranwala & Sheikupura succumbed to gastro- fraud related to food products. intestinal diseases because of poor sanitation, and

Composite Indicators of Urban Food Insecurity Table 6.13 Health and Sanitation in Urban Pakistan Number of Districts Health & Sanitation Balochis Northern Islama Composite Punjab NWFP Sindh tan Areas PAK FATA bad Total Extremely Poor 13 7 8 8 3 2 - - 41 Very Poor 11 4 4 6 - 3 3 - 31 Moderately Poor 7 4 2 7 1 1 - - 22 Poor 2 2 3 2 - - - - 9 Reasonable 1 3 - 2 1 1 - 1 9 Total: 34 20 17 25 5 7 3 1 112 PAK:Azad Jammu & Kashmir, FATA: Federally Administered Areas No Urban Areas in these Districts:NWFP:Buner,Shangla,Kohistan,BattagramBalochistan:Awaran,FATA:Bajour,Mohamand,Orakzai,S.Waziristan contamination issues. The authorities blamed 6.10. Food handling, processing, & Water & Sanitation Agency (WASA) for poor cooking Practices management (Daily The News, 27th May, 2006) Poor and improper handling, processing, 6.9. Socio-economic & political storage, distribution and cooking practices Environment not only affect nutritional value of food but also the food aesthetics and taste. The social-economic and political environment also influences rural public health. Socio- Food can also be contaminated during economic inequality in urban areas of developing processing, handling, distribution and even countries has implications for health in general and food safety and food security in particular. during cooking and serving. Microbial

VULNERABILITY ANALYSIS AND MAPPING (VAM) UNIT, WORLD FOOD PROGRAMME, PAKISTAN FOOD INSECURITY IN URBAN PAKISTAN Food Absorption 6 contamination because of unhygienic argument advanced earlier that food in Pakistan is practices, and poor quality of water & exposed to contamination, from farm fields storage, coupled with environmental through processing & storage to consumption, contamination, and compounded by chemical which compromises effective food absorption. residues, additives & preservatives in food all pose threat to public health. Lack of education, especially in the area of food hygiene and eating habits, and poor food safety regulations, and ineffective enforcement in developing countries contribute a great deal to this effect. Poor sewerage facilities and lack of access to potable drinking water further complicate things. Similarly, lack of Good Agricultural Practices (GAP) and rational therapeutics in veterinary medicine in most of the developing countries leads to contamination of food in agricultural fields and helps build residues in food chain.

Lack of cool chain facilities also affects shelf life of products and at times deteriorates its quality, especially of perishable commodities like milk, meat and fish. Food poisoning and gastro- enteritis related issues like one encountered in 2006 summer in some of the big cities of Pakistan stem from such an environment.

Following case studies amply substantiate the

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6.11. Case Study 1: Wastewater Use in Pakistan: The Cases of Haroonabad and Faisalabad 2

Untreated wastewater is used for irrigation in over 80% of all Pakistani communities with a population of over 60%. The absence of a suitable alternative water source, wastewater’s high nutrient value, reliability, and its proximity to urban markets are the main reasons for its use. Two case studies in Pakistan studied the impact of untreated wastewater use on health, environment, and income. The results showed a high increase in hookworm infections among wastewater users and a clear over-application of nutrients through wastewater. Heavy metal accumulation in soil over a period of 30 years was minimal in Haroonabad, a small town with no industry, but showed initial signs of excess levels in soil and plant material in Faisalabad, a city with large-scale industry.. The lack of financial resources at municipal and provincial levels for wastewater treatment calls for other measures to reduce the negative impact of untreated wastewater use on health and environment, for example to manage groundwater, regular (canal) irrigation water, and wastewater conjunctively, and regular deworming treatment of those exposed to wastewater.

Pakistan has a population of over 150 million and is one of the few countries that are almost completely dependant on a single river system for all its agricultural water demands. The Indus River and its tributaries provide water to over 16 million hectares of land, situated in the mainly arid and semi-arid zones of the country. A rapidly growing population, saline groundwater, a poorly performing irrigation distribution system, and recurrent droughts have led to increased water shortages. Under these conditions, the use of untreated urban wastewater for agriculture has become a common and widespread practice.

Preliminary results from a countrywide survey in the four main provinces showed that untreated wastewater was used in 50 out of 60 visited urban centers, which affected food safety in these cities. The three main reasons for the use of wastewater were the high salinity of groundwater, recent droughts that have led to a decline in groundwater tables, and the nutrient value of wastewater. Other important reasons were the proximity of urban markets and the reliability of wastewater, which unlike regular irrigation water is not subjected to a rotational schedule. In more than half of the visited cities, some sort of fee was paid by farmers to either the municipality or the local wastewater utility for the use of wastewater. For example, in the city of Quetta, 212 farmers cultivating 800 ha collectively paid US$ 12,000/annum for the right to use wastewater. This was 2.5 times more than the fee for regular irrigation water. Land rent in all cities reflected the importance of wastewater with the rent for land that had access to wastewater being at least double and in some cases up to six times that of land without access to wastewater. In the city of Quetta, the average annual rent for land with access to wastewater was US$ 940/ha, compared to US$ 170/ha for land irrigated by fresh water. It is worth mentioning that around Quetta the sewage water irrigates vegetable fields, with long term implications for food safety and thus public health. 6.12.1 Haroonabad

The town of Haroonabad is located on the edge of the Cholistan desert, in southern Punjab province, close to the Indian border. In 1998 the population was 63,000 (Population Census Organization, 2001) and apart from the small-scale seasonal, cotton-related industrial activities such as washing and ginning (separation of seeds and fibre), there was no major industry in the town. The arid climate, with an annual average rainfall of 160 mm, potential evaporation of 2500 mm, and temperatures ranging from 0°C in January to 48°C in July, make agriculture without irrigation virtually impossible. Shortly after the construction of a sewerage system in 1965, farmers started using untreated wastewater pumped from the newly constructed disposal station for irrigation. In 1979, more pumps were installed in and around the town to dispose of blocked wastewater, after the sewerage system had collapsed because of heavy monsoon rains. This resulted in the development of more wastewater-irrigated sites. Currently there are three main sites with a total irrigated area of over 130 ha. The main crops grown with wastewater are vegetables (in particular cauliflower) cotton, and fodder. 6.12.2 Faisalabad

The city of Faisalabad has a population of just over 2 million and is the third largest city in Pakistan. Centrally located in the heart of the Punjab province it was founded in 1900 as an agricultural market town, but has since then rapidly developed into a major agro-based industrial centre. Over 150 different industrial units have been identified by the local Water and Sanitation Agency (WASA), most of which are involved in such cotton processing tasks as washing, bleaching, dying and weaving.

The use of wastewater for agriculture was common, a survey showed that at least nine different sites could be identified, differing in size from a few ha to almost 1,000 ha. Two main sites can be distinguished, the Narwala Road site and the Channel 4 site. Farmers at the first site used wastewater of primarily domestic origin, while farmers at the latter site used a mixture of industrial and domestic wastewater. Common crops at both sites were fodder, wheat, cotton and vegetables (cauliflower, spinach, and aubergine). The aquifer underlying the city was highly saline and could not be used as a source of irrigation or drinking water. Temperatures ranged from 48°C to – 4°C, while annual rainfall has varied between 198 mm and 615 mm over the last 40 years.

6.13. Water Quality, Crops and Cropping Intensities

Wastewater used for irrigation in Haroonabad and at both sites in Faisalabad was not fit for unrestricted irrigation according

VULNERABILITY ANALYSIS AND MAPPING (VAM) UNIT, WORLD FOOD PROGRAMME, PAKISTAN FOOD INSECURITY IN URBAN PAKISTAN Food Absorption 6 to microbiological guidelines set by the World Health Organization (WHO) Health Guidelines for the Use of Wastewater in Agriculture and Aquaculture (WHO, 1989). However, the WHO guidelines state that the guidelines can be relaxed when vegetables are eaten cooked, and in this case, the main vegetables cultivated, cauliflower, spinach and aubergine, are almost exclusively eaten cooked. The high values of electrical conductivity and total nitrogen loads of the wastewater placed medium restrictions on the use of this wastewater for agricultural production as its use could result in limited crop growth and hence yield reductions. Table 6.14 During the course of the studies farmers Water quality parameters of wastewater used for mentioned that they were limited in their choice irrigation in Haroonabad and at the Narwala and Channel of crops, though some crops considered unsuitable by one farmer were grown by 4 sites in Faisalabad, Pakistan. another. There seemed to be a consensus among FAO and Faisalabad farmers that such root crops as carrots, radishes, WHO Narwala Channal onions and potatoes were unsuitable for Parameter Unit guidelines Haroonabad Road 4 wastewater irrigation, because as a result of their Electrical foul smell, poor color, and in the case of carrot conductivity (EC) ds/m < 3 4.4 3.1 5.8 and radish, the development of several short, not Faecal single straight roots, these could not be sold in coliform Count/100 the local market. The main crops grown were (FC) ml 1000 6.3 x 102 > 1025 > 1025 fodder sorghum (Sorghum bicolor), cauliflower, Helminth eggs Number/1 < 1 100 763 spinach, cotton, wheat, tomatoes and aubergine. Sodium The number of crops grown on the same land adsorption each year on wastewater-irrigated sites in ratio (SAR) < 9 4.5 6.3 16.9 Total Faisalabad and Haroonabad was three, compared nitrogen (N) mg/1 < 30 78.3 41.6 35.7 to less than two grown in fields irrigated with Total freshwater. Phosphorus (P) mg/1 8.6 6 5.7 Total The over-application of wastewater was potassium reflected in low irrigation performance, as over- (K) mg/1 34.7 20 35.1 application of wastewater led to high percolation Manganese (Ensink et al., 2002). In addition, the nitrogen (Mn) mg/1 0.20 0.07 0.14 Chromium ratio results for both Haroonabad and (Cr) mg/1 0.10 0.23 0.05 Faisalabad, indicated a significant ‘inefficient’ over-application of nitrogen (Table 6.14). This Lead (Pb) mg/1 5.00 0.04 0.24 resulted in high levels of nitrates, nitrites and Nickel (Nl) mg/1 0.20 0.14 0.03 Escherchia coli in groundwater under the Copper (Cu) mg/1 0.20 0.35 0.09 wastewater-irrigated sites. These levels of Cobalt (Co) mg/1 0.05 0.06 0.08 nitrates, nitrites and E. coli would be of concern Cadmium if groundwater were to be used for drinking (Cd) mg/1 0.01 0.01 0 water purposes [World Health Organization Iron (Fe) mg/1 5.00 0.22 0.16 (WHO) Guidelines for drinking-water quality] Zinc (Zn) mg/1 2.00 N.D 0.14 (WHO, 1993) but the natural salinity of this groundwater has prevented such use.

The results for Haroonabad indicate that because the pH of the soils analyzed ranged from 7.72–8.30, the levels of copper (Cu), nickel (Ni), lead (Pb), and chromium (Cr) are within European Economic Community (EEC) maximum permissible (MP) levels (Table 6.14). No MP levels are established for cobalt (Co) and manganese (Mn). However, a significant accumulation of Pb and Cu can be observed within the top 0–15 cm of the 100% wastewater-irrigated soil profiles (Table 6.14). In contrast, Ni, Co, Cr and Mn remained relatively uniform irrespective of depth with mean (n=6) concentrations of Ni 30.2 (±0.4), Co 12.3 (±0.5), Cr 56.3 (±9.5) and Mn Table 6.15 256.3 (±18.4) mg/ kg (Table 6.15). Total nitrogen (TN) application, nitrogen ratios and total amount of wastewater applied to cauliflower in Haroonabad and As with the 100% wastewater-irrigated field, Pb and Cu Faisalabad, Pakistan. levels were elevated at the soil surface (0–5 cm) of the TN/cropping Total Water conjunctively irrigated field (Table 6.16). However, the season Nitrogen applied surface accumulation of Pb and Cu was restricted to 0–5 (kg/ha) ratio* (%) (mm) cm soil depth compared to 0–15 cm for the 100% Haroonabad 546 440 314 wastewater-irrigated field. It is suggested that the Faisalabad 192 160 321 elevated levels of Pb could be attributable to deposition *Nitrogen ratio: Total Napplied x 100% from petrol fumes as the 100% irrigated wastewater site Recommended N is located next to the central bus station. Other metal concentrations remain relatively uniform with depth with mean (n=6) concentrations of Ni 26.9 (±1.1), Co 12.4 (±0.9), Cr 46.5 (±4.6) and Mn 231.9 (±12.5) mg/kg. a Sampling depth in parentheses. b Standard deviation in parentheses and it a laicized. c The range of European Economic Community (EEC) maximum permissible (MP) levels for Pb, Cu and Ni given in Table 6.16 correspond to soil pH.

The lower value given corresponds to a soil pH < 5.5 and the higher value a soil pH >7.0. In contrast, both soil Pb and Cu in the Hakra 4/R (freshwater-irrigated) fields were significantly lower than in the

VULNERABILITY ANALYSIS AND MAPPING (VAM) UNIT, WORLD FOOD PROGRAMME, PAKISTAN 88 FOOD INSECURITY IN URBAN PAKISTAN Food Absorption 6 wastewater-irrigated plots (Table 6.16). In addition, no surface accumulation of Pb or Cu was observed. In comparison to the wastewater-irrigated plots, levels of Ni, Co, Mn and Cr remained relatively uniform irrespective of soil depth.

In Faisalabad, during April–May 2002 soil and wheat samples were collected from pre-selected fields at 1-km intervals

Table 6.16 Vertical distribution of heavy metal concentrations in soil (mg/kg) at varying soil depths in relation to type of irrigation water used at three sites in Pakistan. Concentration (mg/kg) at various soil depths* Type of irrigation water Pb Pb Cu Cu Ni Co Mn Cr 100% wastewater (0-15 cm)* (15-90 cm) (0-15 cm) (15-90 cm) (0-90 cm) (0-90 cm) (0-90 cm) (0-90 cm) 19.4 9.2 86.9 71.1 12.3 256.3 256.3 56 (2.3) (1.2) (1.4) (2.4) (0.4) (18.4) (18.4) (9.5) Conjunctive use (0-5 cm) (5-90 cm) (0-90 cm) (5-90 cm) (0-90 cm) (0-90 cm) (0-90 cm) (0-90 cm) 13.4 6.4 77.3 58.7 26.9 12.4 231.9 46.5 (2.0) (1.1) (0.9) (12.5) (4.6) Freaswater (Hakra (0-90 cm) (0-90 cm) (0-90 cm) (0-90 cm) (0-90 cm) (0-90 cm) 4/R) 7.9 21.9 22.5 11.2 185.7 64.2 (1.7) (4.4) (3.3) (1.0) (16.1) (11.0) EEC MP levels 50-300 50-140 30-75 100-150 along the length of Channel 4 to evaluate the impact of wastewater use on soil heavy metal accumulation. As a control, samples were also collected from fields receiving freshwater irrigation from the Dhudi Wala Minor. The results indicated that for both the Channel 4 and Dhudi Wala Minor irrigated fields, soil Cd, Pb, Zn, Ni, Cr, and Cu concentrations are all below EEC MP levels irrespective of sampling site (Table 6.17). However, elevated levels of Zn were observed at the 0.2 and 1.3 km sampling locations with values of 90.6 mg/kg at 0.2 km and 92.6 mg/kg at 1.3 km. In addition, elevated levels of Cd were observed between the 1–3 km sampling site with a mean Cd value of 0.40 ± 0.03 mg/kg compared to a mean Cd concentration of 0.14 ± 0.04 mg/kg for the 4–9 km sampling site. Lead, Cr, Ni, and Cu concentrations were relatively uniform irrespective of sampling site and irrigation source.

The wheat grain results indicate trace (<0.05 mg/kg) concentrations of Pb, Cr, and Ni in grain, which reflected the relative immobility of these elements in soils and translocation in the plant. Wheat grain Cu and Zn concentrations for both the Channel 4 and Dhudi Wala Minor irrigated fields were at concentrations indicative of optimum yields (Wells et al., 1996). The wheat grain Cd concentrations exceed the Joint FAO/WHO Expert Committee on Food Additives (JECFA) Codex Committee on Food Additives and Contaminants (CCFAC) draft provisional maximum level (ML) for Cd in wheat grain of 0.1 mg/kg (Codex Alimentarius Commission, 2002). However, Chaney et al. (1996) suggested that a Cd:Zn ratio of <1.5% effectively provides protection against Cd-induced health impacts. For the Channel 4 and Dhudi Wala Minor wheat samples, the Cd:Zn ratio ranged from 0.28–1.05%. Health risks are therefore effectively prevented at this time.

In summary, with the exception of the surface accumulation of Pb and Cu in 100% wastewater and conjunctively irrigated fields in Haroonabad (Table 6.16) heavy metal accumulation in Haroonabad was of minor concern. However, monitoring programs should be established and the source of contamination confirmed and managed to prevent soil Cu and Pb reaching levels that may prove toxic to crop growth and soil biological functions. In Faisalabad the source of Cd contamination should be identified and managed, monitoring soil and edible portions of crops is essential to ensure protection of the food chain from elevated levels of Cd.

6.14 Health Impact

6.14.1. Intestinal nematodes

Preliminary results from a health survey in Faisalabad and a completed study in Haroonabad showed similar trend, suggesting that wastewater farmers had a 4 to 5 fold higher risk of hookworm infection than a group of non-wastewater users. There was no difference in risk of hookworm infection between children of wastewater farmers and children of non- wastewater irrigators.

Studies in Mexico identified Ascaris lumbricoides as the main source of intestinal nematode infections among wastewater farmers and their children. Although A. lumbricoides eggs were found in large numbers in wastewater, the studies in Faisalabad and Haroonabad showed very low prevalence of A. lumbricoides among wastewater farmers and their children for as yet unexplained reasons. a Values in mg/kg ± 1t Standard deviation. b Range of concentration given in parentheses and italicized. Vector studies in Haroonabad and Faisalabad revealed that wastewater stabilization ponds and other wastewater bodies favored the breeding of Anopheles and Culex mosquitoes. Within the wastewater-irrigated zones, each vector species was found to be associated with specific breeding site types and environmental characteristics. The presence of potential vectors of human diseases such as malaria, filariasis, West Nile fever, and Japanese encephalitis indicated that wastewater systems could contribute to vector-borne disease risks in addition to other associated health risks among poor human communities that depend on wastewater use for their livelihoods. However, this potential role of wastewater stabilization ponds to serve as breeding sites for mosquito vectors of human disease has received little attention. Poorly managed wastewater treatment ponds have thick emergent vegetation and floating solid waste along their margins. The vegetation and floating waste offer

VULNERABILITY ANALYSIS AND MAPPING (VAM) UNIT, WORLD FOOD PROGRAMME, PAKISTAN 89 FOOD INSECURITY IN URBAN PAKISTAN Food Absorption 6 ideal habitats for the breeding of mosquitoes by attracting them to Table 6.17 oviposit and also by providing them with protection against Soil and wheat grain heavy metal concentrations predators. The creation of such perennial water bodies close to (mg/kg) in relation to irrigation source, Faisalabad, large urban areas in an arid environment could pose a significant Pakistan. health risk for communities living around such treatment Dhudi wala schemes. Metal Sample type Channel 4 Minor Cd Soil (0-20 cm) 023±0.13* 0.21±0.00 (0.08-0.44)* (0.21-0.21) Untreated wastewater irrigation thus poses serious health risks that cannot be ignored. While the risks to consumers may not be Wheat grain 0.16±0.04 0.11±0.00 excessive, as most vegetables grown in land irrigated with (0.10-0.23) (0.11-0.12) wastewater are eaten cooked, the risks to farmers practicing flood Pb Soil (0-20 cm) 10.5±1.7 11.6±0.1 irrigation cannot be ignored. The studies in Faisalabad and (8.5-15.2) (11.5-11.6) Haroonabad show a 5-fold increase in the risk of hookworm Trace<0.05 Trace<0.05 infection among wastewater farmers. However many of these Wheat grain farmers have no other option or do not want to use other water. Zn Soil (0-20 cm) 50.8±15.2 44.5±4.8 This was illustrated by some farmers in Faisalabad who had (32.1-92.6) (41.2-47.9) access to treated and untreated wastewater but opted for the 28.0±9.4 29.6±4.8 untreated (black) wastewater as it was considered less saline and better for their crops. (15.0-47.9) (41.2-47.9) Cr Soil (0-20 cm) 26.3±3.4 24.1±1.8 Although the use of wastewater is likely to become increasingly (20.7-35.4) (22.8-25.4) important for Pakistan as a combined strategy for water Trace<0.05 Trace<0.05 conservation and pollution prevention, management of this Wheat grain resource is in the hands of local farmers and municipalities. There Ni Soil (0-20 cm) 33.8±4.1 35±0.98 seems to be little awareness of the risks involved in the use of (27.1-40.4) (34.5-35.9) untreated wastewater among local municipalities where the Wheat grain Trace<0.05 Trace < 0.05 opinion of many is that ‘the farmer knows best’. Cu Soil (0-20 cm) 21.6±2.3 22.8±0.09 It is unlikely that Pakistan will be able to treat all wastewater (17.18-28.30) (22.70-22.83) currently used by farmers up to WHO guideline standards. Wheat grain 6.5±1.1 6.0±0.04 Enforcement of crop restrictions will deprive many farming (5.6-10.2) (6.0-6.0) Table 6.18 families of their livelihoods and there is therefore a need Hookworm prevalence among wastewater-irrigating to look at options other than full wastewater treatment or farmers and their children compared to a group of the enforcement of crop restrictions. The need for ways unexposed farmers, laborers and their children at two to reduce health and environmental risks while at the locations in Pakistan. same time safeguarding positive impacts on household Hookworm Prevalence income is evident. The WHO guidelines offer such other 95% Odds Confidence options as partial treatment for irrigation of vegetables Exposed (%) Unexposed (%) ratio Interval eaten cooked, as is predominately the case here, and the Haroonabad use of deworming medication, which could be 75 (51/68) 41 (48/118) 4.4 2.3-8.5 Adult appropriate for the economic and environmental Children (age < 13) 20(26/130) 21 (55/261) 0.9 0.6-1.6 situation prevailing in Pakistan. Although these Faisalabad 15(24/165) 3 (7/243) 5.7 4.9-6.6 strategies have not been implemented, as full wastewater Adult treatment has always been considered the norm, Children (age <13) 6 (18/305) 5 (26/478) 1.1 0.7-1.8 deworming campaigns, with or without partial wastewater treatment, could potentially be very successful, as they have shown to be in programs established for school Fig. 6.4 Total cost and gross margin ('000 Rs/ha) for children (UNICEF, 1998). a wastewater farmer and a regular canal water farmer in Haroonabad, Pakistan (Rs.58 = US$1). Encouraging farmers to wear footwear and other protective gear, such as gloves and long trousers, has been suggested as a possible additional measure to protect farmer health. Many farmers might consider footwear and gloves impractical and uncomfortable under field conditions, and therefore the acceptability of such an intervention needs to be investigated prior to its implementation. The above study clearly reflects that access to safe drinking water is a key issue, in terms of food safety/absorption, in Pakistan. While the situation in terms of access to sanitation facilities is equally dismal.

VULNERABILITY ANALYSIS AND MAPPING (VAM) UNIT, WORLD FOOD PROGRAMME, PAKISTAN 90 FOOD INSECURITY IN URBAN PAKISTAN Food Absorption 6 6.15. Access to Safe Potable Water because of size of the population in the province coupled with higher number of urban settings Safe Potable water is the key to good healh. compared to other provinces/areas. In FATA, it is Unfrotunately, majority of the population is not primarily due to overall poor infrastructure. aware of the waterborne diseases and level of investment at government as well as community The aforementioned evidence and discussion level is very low. In 31 out of 112(28%) districts, leads us to conclude that poor health above 65% of the urban population has no access infrastructure, unhealthy living conditions, lack to safe drinking water, while in 17 districts less of good agricultural practices, poor enforcement than 25% of the population has access to safe of food safety implicate food absorption. potable water. Surprisingly, 6 districts, majority Consequently, because of inadequate food in Punjab, more than 85% of the population have availability and poor food access & absorption, no access to safe drinking water. net caloric intake is low in urban Pakistan, as could be seen from the table-6.20. For example, In the provincial context, more than 65% of the there are only eight districts out of 112, where urban population in 15 districts out of 34 in caloric intake falls in the range of 3501-4855 Punjab has no access to safe drinking water. Kcal/person, while in 39 districts, on the other

Table 6.19 Households Without Safe Drinking Tap Water in Urban Pakistan 2004-05 Number of Districts Households Without Safe Drinking Baloch Northern Islama Water (%) Punjab NWFP Sindh istan Areas PAK FATA bad Total 1 - 15 3 5 1 10 - - - 1 20 16 - 30 2 5 4 6 - 2 - - 19 31 - 45 7 2 2 5 3 1 1 - 21 46 - 65 7 4 3 3 1 1 2 - 21 66 - 75 6 2 3 1 - 2 - - 14 76 - 85 4 1 4 - 1 1 - - 11 86 - 92 5 1 ------6 34 20 17 25 5 7 3 1 112 PAK:Azad Jammu & Kashmir, FATA: Federally Administered Areas No Urban Areas in these Districts:NWFP:Buner,Shangla,Kohistan,BattagramBalochistan:Awaran,FATA:Bajour,Mohamand,Orakzai,S.Waziristan Comparable figures for NWFP, Sindh, extreme caloric intake is in the range of 1477- Balochistan, PAK and FATA are, 4 out of 20, 1800 Kcal/person, which is far below the caloric 7 out of 17, 1 out of 25, 3 out of 7 respectively. threshold of 2350 Kcal/per person/day. There are Even in the ICT, the best-planned township in the 65 districts, where the caloric intake is in between country has 9% population without safe drinking these two extremes, and falls in the bracket of water. In summary, in only 20 out of 112 (18%) 1801-3500 K Cal. /person. In 89 districts the districts 85-95% population has access to safe caloric intake, on average, is below the normal water, and in the remaining 92 districts 16-92% rate. Majority of these districts are in Balochistan of households are without safe drinking water. and FATA and followed by Sindh. The poor access to water in Punjab is primarily Composite Indicators of Urban Food Insecurity Table 6.20 Food Consumption in Kcal per cu in Urban Pakistan Number of Districts Calories Baloch Northern PA Islamab Per cu Punjab NWFP Sindh istan Areas K FATA ad Total Extremely Low 4 3 6 22 2 - 2 - 39 Very Low 9 10 3 2 3 3 1 - 31 Low 9 1 6 - - 3 - - 19 Normal 7 6 1 1 - - - - 15 Sufficient 5 - 1 - - 1 - 1 8 Total: 34 20 17 25 5 7 3 1 112 PAK:Azad Jammu & Kashmir, FATA: Federally Administered Areas No Urban Areas in these Districts:NWFP:Buner,Shangla,Kohistan,BattagramBalochistan:Awaran,FATA:Bajour,Mohamand,Orakzai,S.Waziristan

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VULNERABILITY ANALYSIS AND MAPPING (VAM) UNIT, WORLD FOOD PROGRAMME, PAKISTAN FOOD INSECURITY IN URBAN PAKISTAN Food Absorption 6 6.16. Cultural Diversity and People’s Table 6.21 Preferences Distribution of Main Races and Tribes in Number of Districts Culture is a refined state of perceptions, manners and tastes prevalent at a particular time and place whereas civilization is an advanced stage of PAK Total Sindh Sindh NWFP social development. Cultural norms that sprout Punjab Balochistan from various past civilizations do also lead to Tribe forming new future civilizations. Arian 15 2 1 18 Ansari 2 2 Dr. R.A Shah, Former Vice Chancellor and Awan 11 2 2 15 Professor Emeritus, University of Sindh in his Baloch 10 4 1 9 24 book on Education and Teacher Education in Bhatti 3 3 Pakistan writes,’ Culture is what an intra Brahvi 6 6 integrated group of people inherits from its Chandio 2 2 forebears as a result of established customs and 2 2 traditions and continued through years and Dogar Gujar 13 2 5 20 sometimes centuries of practice.’ He further Hizmatgar 2 2 elaborates, ‘A society’s culture is deep rooted not Jamali 1 1 2 only in the thoughts and ideas of its individuals 1 4 5 but also in their emotions and aspirations. Jamote 2 2 Culture of a people is manifested in the ways the Janjua people talk, dress, eat, think, bring up their Jat 18 3 1 3 25 children, earn their livelihood, build their Jatoi 1 2 1 4 monuments, govern their state, satisfy their Junejo 2 2 aesthetic sense, worship, enjoy the auspicious Kakar 1 6 7 ceremonial occasions, and bury the dead…’ Kathia 3 3 Khaggas 2 2 In this study, three key aspects of Pakistani Kharral 3 3 Culture are included; these are: Khattak 3 1 4 i. Cultural Diversity and Ethnicity reflected Khokhar 2 2 by Races and Tribes in Pakistan. Khosa 5 5 ii. Main Food Preferences of People in the Laghari 3 3 context of food security and food Lashari 2 1 1 4 sovereignty. Magsi 2 2 iii. Media Choices for Knowledge, Mari 2 2 4 Information and Entertainment. Memon 6 6 Mengal 3 3 Mohammads/ 6.17. Cultural Diversity and Ethnicity 1 5 6 Muhammad reflected by Races and Tribes in Pakistan Mughal 4 1 5 Pathan 10 2 12 12 1 1 Pakistan is a unique society made up of many Qureshi 14 2 2 diverse races and tribes. The cultural diversity Raisani Rajput 17 2 3 22 and ethnicity in Pakistan reflects a rich historical Rind 3 3 background that endowed it with a vast treasure 4 4 of heritage from civilizations that flourished here Shahwani Sheikh 1 4 5 in the past. It has created a dynamic nation with Sial 2 2 tremendous capacity to absorb external influence Soomra/Soom 5 5 while maintaining its indigenous culture. On the ro other hand, this diversity, at times, becomes the Sudhan 4 4 cause of conflict in the society. Syed 19 6 7 7 3 42 Tarpur 3 3 Historically, Pakistan has been the home of Tareen 1 3 4 immigrants from around the world including Watto 4 4 Dravidians, Aryans, Persians, Arabs, Turks, Total 162 57 20 59 21 319

VULNERABILITY ANALYSIS AND MAPPING (VAM) UNIT, WORLD FOOD PROGRAMME, PAKISTAN FOOD INSECURITY IN URBAN PAKISTAN Food Absorption 6 Greeks, Mughal and Afghans. These races got According to this brief analysis, 319 instances of socially assimilated in local tribes through presence of two or more major races and tribes intermarriages and an exchange of customs and are noted in districts, i.e., 162 instances in traditions as well as sharing land and means of Punjab, 57 in Sindh, 20 in NWFP, 59 in livelihood to make this place their habitat over Balochistan and 21 in PAK. This multi-ethnic centuries. and multi-cultural social scenario adds to the dynamics that create inter-cultural harmony at the While mapping the presence and influence of national level, which is at times broken by ethnic races and tribes in Pakistan, one finds examples conflicts. of both concentration and dispersion of certain races with their unique culture across country. Generally, the “Last Name” on documents of Table-6.21 shows an interesting overview. personal identification and reference invokes an interest when two people meet and interact for Prominent among the races with large spread the first time. Knowing your roots establishes across the country are Arian, Awan, Baluch, foundation for a secured and trusting relationship. Gujar, Jat, Pathans, Rjputs, Qureshi and Syeds. At its best, it brings people into tribal and ethnic Other major races include Bruhvi, Jamote, Kakar, networks for gaining social strength and Khoso, Mohammads, Mughal, Shahwani, Sheikh, supporting each other. At the worst, it ends up Soomro, Tareen and Wattoo. Some tribes are excluding other perfectly eligible parties from present in all four provinces and PAK whereas joining the network to narrow down its others are present in two or three provinces. development basis and social benefits. There are also examples of concentration in one place such as Achakzai, Ahmedzai, Raisani and Social networking is part of human development Mengal in Balochistan; Marwat, Tanoli and dynamics. Noam Chompsky has been quoted to Tarkheli in NWFP; Bhatti, Dogar and Janjua in say in one of his conversation with a lead Punjab; Sudhan in PAK and Chandio Khuros and journalist, ‘There are things you can do in groups Talpur in Sindh. you can’t do by yourself. In fact, that is true of the most advances in sciences, very little is done These tribes represent distinct cultures, which are individually. It is usually done in groups by easily observed in their daily life. The languages, collective action and interchange and critique and dialects, dresses, food, jewelry, display of challenge…’ hospitality, sports, folklore and festivities, all have some peculiarities that distinguish one Let us not forget that this is not the only aspect culture from the other. Although people maintain that keeps the society intact, economic and their core cultural , they are adaptable to new political forces play an important role in setting ideas. An exchange of customs and traditions is the norms for peace and harmony in emerging constantly taking place among people. This civilizations. interaction affects the dynamics of the society and helps forming contemporary civilization of 6.18. Food Preferences of People Pakistan. The food preferences mentioned by people in the Urban societies are closely linked with their rural District Census conducted in 1998 do not give counterparts due to the reason that most of the information about inter- and intra-family people have originally come from rural consumption and distribution of food, nor do they background. Even after having lived for a relate to the nutritional requirement of people considerable time in large cities, people go back across age and gender. to the village to spend the last part of their life and desire to be buried in their family graveyard. Information simply gives an idea of main food Some large cities like Karachi and Islamabad preferred by people as a cultural norm. There could be considered an exception due to their may be some exceptions to the rule. The study cosmopolitan profile. includes whole of Pakistan as no distinct choices have been reported in the Census, which is the The table below reflects distribution of races and source of information in this case. tribes in the number of districts in all four provinces and PAK. Karachi and Islamabad are The Census Report of Pakistan 1998 describes,’ not included due to their peculiar cosmopolitan Pattern of the North-West Frontier is to eat well. nature. Their diet consisting of, in addition to wheat and

VULNERABILITY ANALYSIS AND MAPPING (VAM) UNIT, WORLD FOOD PROGRAMME, PAKISTAN 94 FOOD INSECURITY IN URBAN PAKISTAN Food Absorption 6 maize bread, rich mutton provided by the fat- Milk and milk products are a frequent choice tailed sheep and luscious fruits in which the with a score of 28. However, preference for Egg province abounds. Punjabis eat less meat but are seems under reported. Vegetable including Salad exceedingly fond of milk products. Milk, butter are a common part of food in 49 districts. Fruits and curd form a good percentage of their daily are sparingly consumed as seen from a low score diet. They quench their thirst with skimmed milk, of 3. of which they drink large quantities diluted with water. The Sindhis resemble Punjabis in their Complete table on Food Preferences is attached dietary habits, the difference being mainly in the to provide an overall view of preferences across way of cooking. The Balochis are more akin to country. Pathans, through they differ from them in habits and outlook on life.’ The Census Report, There is also outdoor dietary culture that prevails however, remained short of describing the in cities of Pakistan. It includes a large menu of Table 6.22 choices ranging from local varieties of Pakistani Distribution of Food Choices - in Number of food to Chinese, Thai, Continental cuisine and Districts Fast Food stalls. There is no specific information available on food choices across gender and age. Food Item Count Common Products3 Bajra (Millet) 4 Social Preferences in Food is a major concern at Jawar 7 the international level these days. Whereas Food Maize 16 Maize Cake Security protects the right to access, affordability Rice 60 Boiled Rice and absorption of food, Food Sovereignty Pulao concerns itself with people’s right to have safe, Wheat 62 Chapati nutritious and culturally appropriate food and to food producing resources to sustain themselves Chpri Roti Bread and their societies. It echoes high at the mandate While Bread of organizations advocating ecologically friendly Egg* 3 agriculture. Dal and Pulses 28 Beef* 6 Curry** It is for the planners to understand the food Chicken 11 Tikka preferences of each district and develop ideas on Meat 51 Sajji how to preserve socio-culturally appropriate food Fish 19 and advocate change in food preferences for Milk 23 Lassi, Chach and Curd health and nutritional purposes and also to ensure Butter, Desi Ghee equitable inter and intra family access and Vegetable 49 absorption of food. (including Salad) Fruits* 3 Source: District Census Reports 1998 6.19. Media Choices for Knowledge, difference in habits and outlook on life. Some Information and Entertainment similarities are noted in social attitudes regarding The third part of this chapter sheds light on media girl’s education, acknowledgement of women choices of people for knowledge, information and work and contribution towards building the entertainment. Four mediums are selected for the society as mentioned in other relevant chapters. study; these are Newspaper, Radio, Television and Cinema.

The analysis given below informs that both wheat Table 6.23 and rice have equal score of preference as some Percentage of Household that Subscribe to: 60 districts consume rice and 62 consume wheat Number of Districts as their staple food. Other grains i.e. Maize, Household Jawar and Millet are also consumed to some (%) Newspaper Television Radio extent. 1%-20% 13 9 30 21%-40% 73 21 49 41%-60% 22 55 23 Among livestock produce, Meat is preferred in 51 61%-80% 1 23 7 districts while Chicken, Fish and Beef is 81%-100% 0 1 0 preferred in 11, 19 and 6 districts, respectively. Total 109 109 109 61.11% 81.55% Karachi 73.81% Highest Islamabad Central Pangur 1.71% 1.97% 11.81% 3 * Use of beef, Egg and Fruit seem to be not fully captured. Lowest Khudzar Musa Khail Sahiwal ** Curry is produced from Beef, Mutton, Chicken, Vegetables. 3 Districts of FATA are not included

VULNERABILITY ANALYSIS AND MAPPING (VAM) UNIT, WORLD FOOD PROGRAMME, PAKISTAN 95 FOOD INSECURITY IN URBAN PAKISTAN Food Absorption 6 and sources of public information. From an analysis it emerges that Radio is still the common medium, in particular in less developed Table-6.24 lists 13 districts with less than 20% areas whereas TV is more preferred in large household subscription of newspaper and 8 cities. Newspaper readership is low. It is districts with more than 50% household understood that with low literacy rate, there is no subscription of newspaper. The first list includes possibility to increase the reading habit among 6 districts in Balochistan. 6 in NWFP and one in the people. There are few public libraries in the Punjab, whereas the second list includes one country with limited membership that reflects the culture of audio-visual medium to seek district in Balochistan i.e. Ziarat with an absolute knowledge and information, which is quick but number of 63 out of total 116 households, 4 unfortunately not lasting. Table 6.25 Districts with More than 50% Subscription of 6.20. Newspaper Readership Newspaper at Household Level Total Newspaper readership is common among Number of Household educated urban families in large cities. The Prov. Househo Subscribing Census Report 1998 provides information on the Code District ld Newspaper % number of households that subscribe newspaper. S Shikarpur 19985 10070 50.39 Karachi Table 6.24 S South 264245 134410 50.87 Districts with Less than 20% Subscription of PAK Kotli 5653 2962 52.4 Newspaper at Household Level B Ziarat 116 63 54.31 Household PAK Bagh 2888 1616 55.96 Total Subscribin Prov. Number of g S Karachi East 399465 229246 57.39 Code District Household Newspaper % Karachi B Khuzdar 17440 299 1.71 S Central 333744 193806 58.07 B Musa Khail 1522 120 7.88 ICT Islamabad 86575 52906 61.11 B Jhal Magsi 1014 120 11.83 B Kohlu 921 130 14.12 districts in Sindh, 2 in PAK and the capital city of N Swabi 23321 3469 14.88 Islamabad. Lakki N Marwat 5162 821 15.9 The highest percentage of household N Charsadda 24804 4130 16.65 P Khoshab 35768 6344 17.74 newspaper subscription is in Islamabad, i.e., B Sibbi 6722 1225 18.22 61.11% and the lowest in Khuzdar, N Lower Dir 4492 842 18.74 N Tank 3474 671 19.31 Balochistan 1.71%. This state of affairs is N Mardan 34625 6756 19.51 reflective of the development in the sector of B Nasirabad 4863 961 19.76 education, literacy and public information by means of print media. An overview across In order to arrive at the number of readers and provinces is given in the table-6.26. future scope of newspaper readership, both the population growth rate and literacy ratio is to be 6.21. Radio considered. But the basic issue is about the right of people to information and legal and Radio has been very popular all over Pakistan commercial viability of print media to sustain that before the introduction of Television in early right. This fact is also true for other mass media 1960s. It has been and is still fairly listened to in Table 6.26 Percentage of Household Subscribing Newspaper Number of Districts Northern Range Punjab NWFP Sindh Balochistan Areas PAK ICT Total 1%- 20% 1 6 - 6 - - - 13 21%-40% 30 12 11 16 3 1 - 73 41%-60% 3 2 6 3 2 6 - 22 61%-80% ------1 1 81%-100% ------Total 34 20 17 25 5 7 1 109 3 Districts of FATA are not included

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Table 6.27 Percentage of Household Subscribing Radio Number of Districts Northern Range Punjab NWFP Sindh Balochistan Areas PAK ICT Total 1%- 20% 25 5 - - - - - 30 21%-40% 9 12 16 11 1 - - 49 41%-60% - 3 1 10 4 4 1 23 61%-80% - - - 4 - 3 - 7 81%-100% ------Total 34 20 17 25 5 7 1 109 3 Districts of FATA are not included villages and small towns by a large number of Figure 6.5 Household with Radio Subscription people of all ages, sex and social backgrounds. It 25 1%- 20% holds a special attraction to rural communities, 21%-40% 41%-60% 20 61%-80% Table 6.28 81%-100% Districts with Less than 15% Subscription of 15 Radio at Household Level Total % of 10

No of Households Houses ofNo. District Prov. Houses that have that have 5 Code District (Urban) Radio Radio 0 P Sahiwal 42249 4988 11.81 Punjab Sindh NWFP Balochistan N.A AJK ICT P Khoshab 35768 4393 12.28 P Kasur 74565 9532 12.78 P Pakpattan 26424 3393 12.84 The lowest ranking district is Sahiwal in Punjab P Sheikupura 113703 16475 14.49 P Okara 71620 10576 14.77 with 11.81% houses that have radio subscription housewives, students, elderly and traders. With whereas the highest percentage of radio listeners the expansion of this medium to educational and is found in Pungur in Balochistan with a entertainment programmes besides news, youth is percentage of 73.81. particularly attracted to it. Despite its ease of mobility and access such as in the case of a 6.22. Television transistor radio, car radio and computerized audio Television has invaded urban households faster systems, Radio is loosing its charm to urban than any other medium of information and audiences. entertainment. It seems to have superceded all other media, especially in providing good quality The tables-6.27 confirm the above point of view. entertainment to people from all walks of life. Accordingly, only 25 districts in Punjab and 5 in Public preference in urban areas for this medium NWFP have less than or up to 20% household is quite high. According to this analysis, the Table 6.29 highest viewer-ship of TV is in Karachi i.e. Districts with More than 60% Subscription of 81.55%. Radio at Household Level Total No % of of Household Houses Prov Houses s that have that have Code District (Urban) Radio Radio Figure 6.6 Households with TV Subscription B Loralai 3505 2178 62.14 20 N Upper Dir 2740 1711 62.45 1%-20% 18 PAK Sudhooti 1969 1235 62.72 21%-40% 16 41%-60% 61%-80% PAK Bagh 2888 1835 63.54 14 81%-100% PAK Poonch 6718 4341 64.62 12 B Turbat 12617 8288 65.69 10 Killa 8 B abdollah 4950 3599 72.71 6 B Pangur 3055 2255 73.81 4 2 subscribing to Radio. On the other hand this 0 medium is still regarded high in Balochistan and Punjab Sindh NWFP Balochistan N.A AJK ICT PAK where 10 districts and 4 districts have shown more than 40% and 4 and 3 districts more than 60% subscription respectively.

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Table 6.30 Percentage of Household Subscribing TV Number of Districts

Balochist Northern Islamaba Range Punjab NWFP Sindh an Areas PAK d Total 1%-20% - 1 1 5 2 - - 9 21%-40% 2 5 2 12 - - - 21 41%-60% 20 13 8 7 3 3 1 55 61%-80% 12 1 5 1 - 4 - 23 81%-100% - - 1 - - - - 1 Total 34 20 17 25 5 7 1 109 3 Districts of FATA are not included However, Balochistan has two districts Musa There are number of cinemas across the country Khel and Killa Saifullah with TV subscription of with fairly large seating capacity. However, lower than 10% of households. actual number of cine goers could not be ascertained. For a society with high illiteracy rate, both radio and TV are a blessing to keep people informed Highest number of cinemas i.e. 42 is located in and aware of new developments. The Karachi, next is Lahore with 37 cinemas, then introduction to Television helped in providing Gujranwala, Faisalabad and Multan with 31, 26 information, education and entertainment to a and 17 cinemas respectively. large section of the society who are not inclined or capable to enjoy newspaper reading. The above analysis includes 111 district 4 .There are many other interesting aspects of social life in Table 6.31 Districts with less than 15% Household Pakistan that could be researched to add more subscribing to TV knowledge and understanding on the subject. Pro Total No People make choices both in individual capacity . of Household % of Houses and at the family and society level. The overall Co Houses s that have that have de District (Urban) TVs TV development scenario plays a big role in guiding B Musa Khail 1522 30 1.97 and facilitating people to constantly prioritize Killa their livelihood needs. In places where there is B Saifullah 3205 319 9.95 NA Ghizer 1211 161 13.29 lack of social, physical, financial and political infrastructure, it is not possible to meet these priorities. People cannot be blamed for being Television is a strong medium to influence unhealthy, uninformed or socially vulnerable if public opinion on social, economic and they are denied the right to make their choices political issues. Its utility, however, in and realize them. enhancing adult literacy and public In conclusion, this study only tries to highlight awareness on issues in the country is not fully harnessed. Table 6.32 District wise Number of Cinemas 6.23. Cinema Cinemas No. of District None 31 Cinema is one of the common outdoor 1-5 46 entertainments for the people of Pakistan. Despite 6-10 8 the fact that it has faced fierce competition from 11-15 6 cable TV and Video systems in the last two 16-20 2 decade, it is still striving to hold its place as a 21-25 0 medium to show and watch talking movies. The main attraction in this choice is not only its Big 26-30 1 Screen, but also the opportunity to get out of the 31-35 1 36-40 1 house and spend a few pleasant moments with Over 40 1 family and friends away from daily hardship. Total 97 Therefore, it is more popular among the working Average capacity ranges from 80 seats to 1100 seats class, students, and youth and for certain type of 4 movies among children. Four districts of NWFP and one of Balochistan are not included in this analysis being total rural. Two of FANA and all FATA agencies are not included due to insufficient information on the subject.

VULNERABILITY ANALYSIS AND MAPPING (VAM) UNIT, WORLD FOOD PROGRAMME, PAKISTAN 98 FOOD INSECURITY IN URBAN PAKISTAN Food Absorption 6 the plight of the weak and the vulnerable in the society in the prevailing socio-cultural background, in particular the state of women and children, persons with disability, homeless population and migrants that are constantly swarming large cities in search of livelihood, quality education for their children, access to better medical care and urban facilities to ease the hardships of life.

In the absence of social safety net for the poor and the weak, the society is exposed to the danger of food insecurity and perpetual poverty. On one side, there is lack of systematic efforts to identify and address the particular vulnerabilities of these groups; on the other, there is lack of general apathy among people to assimilate them in the mainstream social network to protect their absorption is a country wide phenomina, which right to food. affected all the four provinces including FATA, Table 6.33 NAs and PAK. About 24 districts fall in the Districts with Highest Number of Cinemas “extremely low” food absorption category, where Seating one-forth are in Punjab, one-forth in NWFP and District No. of cinemas Capacity two-third in FATA. Karachi 42 33179 Lahore 37 23867 The food absorption situation is worse in 74 Gujranwala 31 16067 districts (66%) of urban Pakistan. Urban parts of Faisalabad 26 16468 FATA and NAs are 100% insecure, while Sindh Multan 17 12068 has 70% insecure urban areas.

6.24. Food Absorption This means that health related indicators are very low in most of the urban areas, especially in Based on the major indicators, a composite FATA, NAs and Sindh. Female literacy rate, indicator was developed to assess the overall gender gap, unhygienic water are the main causes situation about food absorption. In many cases, of low food absorption, while inadequate and the food absorption insecurity exists in a wide expensive health facilities have further range of population and extended geographical aggravated the situation. area. The causes are wide spread and even in the most urbanized areas like Karachis, it is on increase.

Unlike food availability and aceess, the food

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Composite Indicators of Urban Food Insecurity Table 6.34 Food Absorption in Urban Pakistan Number of Districts Food Northern Absorption Punjab NWFP Sindh Balochistan Areas PAK FATA Islamabad Total Extermely Low 6 5 4 5 2 - 2 - 24 Very Low 11 5 3 9 3 - 1 - 32 Low 5 2 5 3 - 3 - - 18 Normal 5 4 1 4 - 1 - - 15 Reasonable 7 4 4 4 - 3 - 1 23 Total 34 20 17 25 5 7 3 1 112 PAK:Azad Jammu & Kashmir, FATA: Federally Administered Areas No Urban Areas in these Districts:NWFP:Buner,Shangla,Kohistan,BattagramBalochistan:Awaran,FATA:Bajour,Mohamand,Orakzai,S.Waziristan

social security for low paid or unpaid workers and thus a major segment of the population is denied the health facilities. It should be noted that preventive measures, mass mobilization and communities’ involvement can The government should invest adequately in the play a vital role in minimising risk of low food health protection sector before it is too late. A absorption. compreshenvie strategy for quality water needs to be developed and coordinated with all mucipal On the other hand health services are not coping and town committees. with the increase in population of urban areas due to high rate of migration. The privatization of health services by the government and expensive private sector medicare is beyond the reach of many urban dwellers and they prefer to find cheap ways of treatment. However, in such cases poor urban people ignore minor problems at initial stage. There is no health insuarance or

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References

1 Zulfiqar A. Bhutta, The Aga Khan University Hospital, Karachi, Pakistan.

2 Ensink, Jeroen H.J, Simmons, R.W. and Hoek, Wim van der, Wastewater Use in Pakistan: The Cases of Haroonabad and Faisalabad, International Water Management Institute (IWMI)

3 District Census Report 1998 4 PSLM Pakistan Social and Living Standreds Measurements Survey 2004-05 5 Punjab Development Statistics 2004-05 6 Sindh Development Statistics 2004 7 NWFP Development Statistics 2005, Bureau of Statistics Planning & Development Department Government of Pakistan 8 FATA Development Statistics 2005, Bureau of Statistics Planning & Development Department Government of NWFP 9 Pakistan Statictical Year Book 2006, Government of Pakistan Statistics Division,Federal Bureau of Statistics 10 Important Dictrict Wise Socio- Economic Indicators of NWFP 2005, Bureau ofStatistics Planniong & Development Department Government of NWFP

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Table 6.35 Number of Doctors (MBBS and Above) per 20000 Population in Pakistan Provincial Provincial Provincial Proincial Proincial Proincial Proincial National National National District District District District Rank Rank Rank Rank Rank Rank Code Code Code Code

0.5 - 2 PERCENT P Multan 1 1 P Okara 24 18 S Tharparkar 47 1 B Barkhan 2 1 P Sargoda 25 19 P Khushab 48 31 P Faisalabad 3 2 NA Ghizer 26 3 NA Skardu 49 4 NA Ghanche 4 1 P D.G Khan 27 20 A Kotli 50 2 P Muzaffargarh 5 3 P Lodhran 28 21 N Mansehra 51 4 Mandi Bahaud P Rawalpindi 6 4 P Din 29 22 N Nowshera 52 5 B Khuzdar 7 2 P Bahawalnagar 30 23 B Panjgur 53 10 P Bahawalpur 8 5 P Rajanpur 31 24 B Mastung 54 11 P Pakpattan 9 6 P Sheikhupura 32 25 B Chagai 55 12 B Nasirabad 10 3 P Narowal 33 26 P Chakwal 56 32 P Rahim Yar Khan 11 7 P Layyah 34 27 N Mardan 57 6 P Kasur 12 8 N Upper Dir 35 1 NA Gilgit 58 5 P Lahore 13 9 B Killa Abdullah 36 5 B Jhal Magsi 59 13 P Hafizabad 14 10 B Dera Bugti 37 6 N Charsadda 60 7 P Vehari 15 11 P Gujrat 38 28 N Lakki 61 8 P Khanewal 16 12 N Swabi 39 2 P Bhakkar 62 33 P Sialkot 17 13 B Bolan 40 7 P Jhelum 63 34 P Gujranwala 18 14 B Kharan 41 8 N Tank 64 9 NA Diamer 19 2 N Haripur 42 3 F Khyber 65 1 P T.T.Singh 20 15 P Mianwali 43 29 B Kalat 66 14 B Musa Khel 21 4 B Jafarabad 44 9 N Lower Dir 67 10 P Jhang 22 16 P Attock 45 30 P Sahiwal 23 17 A Rawalakot 46 1 21. - 4.0 PERCENT B Loralai 68 15 N Malakand 80 14 F Kurram 92 2 B Kohlu 69 16 B Zhob 81 20 S Sanghar 93 5 N Karak 70 11 S Jacobabad 82 2 N Kohat 94 17 B Pishin 71 17 S Ghotki 83 3 N Swat 95 18 N Hangu 72 12 A Bhimber 84 6 S Mirpurkhas 96 6 A Muzaffarabad 73 3 A Bagh 85 7 F N.Waziristan 97 3 Noushero A Sudhnoti 74 4 N Chitral 86 15 S Feroze 98 7 A Mirpur 75 5 B Lasbela 87 21 S Khairpur 99 8 B Killa Saifullah 76 18 B Sibi 88 22 S Karachi 100 9 C ISLAMABAD 77 1 N D.I.Khan 89 16 N Bannu 78 13 S Umerkot 90 4 B Gawader 79 19 B Turbat 91 23 4.1 - 6.0 PERCENT S Sukkar 101 10 S Shikarpur 104 13 N Abbottabad 107 19 S Badin 102 11 S Larkana 105 14 S Thatta 103 12 S Dadu 106 15 6.1 – 8 PERCENT B Quetta 108 24 S Nawabshah 110 17 B Ziarat 111 25 S Hyderabad 109 16 8.1 & Above PERCENT N Peshawar 112 20 P: Punjab, S: Sindh, N:NWFP, C: Capital, B: Balochistan, NA: Norther Area, A:Azad Jammu & Kashmir, F: Federaly Administered Areas National Rankings are from 1 to 112,1 being the worst and 112 the best. Provincial Rankings depend on the number of districts per province.

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Table 6.36 Number of LHV's per 20000 Population in Pakistan Provincial Provincial Provincial Provincial Provincial Provincial National National National District District District Rank Rank Rank Rank Rank Rank Rank Code Code Code

0.05 - 0.20 PERCENT

S Jacobabad 1 1 S Tharparkar 5 3 S Umerkot 9 7

B Kharan 2 1 S Karachi 6 4 C ISLAMABAD 10 1 S Ghotki 3 2 S Shikarpur 7 5 S Sukkar 11 8 B Khuzdar 4 2 S Larkana 8 6 S Nawabshah 12 9 0.21 - 0.50 PERCENT

S Sanghar 13 10 B Turbat 20 3 B Killa Saifullah 26 5

A Bhimber 14 1 S Mirpurkhas 21 15 A Bagh 27 2 Noushero S Feroze 15 11 S Dadu 22 16 N Peshawar 28 1

S Hyderabad 16 12 B Jhal Magsi 23 4 B Dera Bugti 29 6 S Khairpur 17 13 S Badin 24 17 P Multan 30 2

S Thatta 18 14 F Khyber 25 1 P Muzaffargarh 31 3 P Lahore 19 1 0.51 - 0.80 PERCENT

P Gujranwala 32 4 F N.Waziristan 43 2 N Swabi 54 5 Killa B Abdullah 33 7 P D.G Khan 44 7 B Jafarabad 55 14

B Musa Khel 34 8 P Rawalpindi 45 8 P Kasur 56 14 B Kohlu 35 9 P Rajanpur 46 9 P Sheikhupura 57 15 NA Ghizer 36 1 B Quetta 47 12 P Vehari 58 16 P Faisalabad 37 5 B Pishin 48 13 P Khanewal 59 17

B Zhob 38 10 P Rahim Yar Khan 49 10 N Kohat 60 6 B Panjgur 39 11 P Layyah 50 11 P Sahiwal 61 18 N Nowshera 40 2 P Sialkot 51 12 N Karak 62 7 P Bahawalpur 41 6 N Swat 52 4 P Pakpattan 63 19 N Mardan 42 3 P Jhang 53 13 0.81 - 1.00 PERCENT N Charsadda 64 8 N D.I.Khan 73 10 B Loralai 82 17 P Lodhran 65 20 P Hafizabad 74 25 F Kurram 83 3 P Okara 66 21 N Malakand 75 11 N Lower Dir 84 13 P Mianwali 67 22 P Gujrat 76 26 B Chagai 85 18

P T.T.Singh 68 23 B Nasirabad 77 15 B Kalat 86 19 Mandi Bahaud NA Diamer 69 2 P Narowal 78 27 P Din 87 29

P Attock 70 24 N Bannu 79 12 P Bahawalnagar 88 30 N Hangu 71 9 B Lasbela 80 16 N Mansehra 89 14 A Rawalakot 72 3 P Sargoda 81 28 B Gawader 90 20 1.01 - 1.50 PERCENT NA Gilgit 91 3 B Bolan 97 21 N Upper Dir 103 18 P Bhakkar 92 31 NA Ghanche 98 4 B Sibi 104 22 A Mirpur 93 4 A Kotli 99 5 N Tank 105 19 N Abbottabad 94 15 N Lakki 100 16 P Chakwal 106 34

P Khushab 95 32 N Haripur 101 17 A Muzaffarabad 107 6 P Jhelum 96 33 NA Skardu 102 5 A Sudhnoti 108 7 1.51 - 2.50 PERCENT N Chitral 109 20 B Mastung 110 23 2.51 - 3.56 PERCENT B Barkhan 111 24 7 B Ziarat 112 25 7 P: Punjab, S: Sindh, N:NWFP, C: Capital, B: Balochistan, NA: Northern Area, A:Azad Jammu & Kashmir, F: Federally Administered Areas National Rankings are from 1 to 112,1 being the worst and 112 the best. Provincial Rankings depend on the number of districts per province.

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Table 6.37 Number of Nurses per 20000 Population in Pakistan Provincial Provincial Provincial Provincial Provincial Provincial Provincial National National National National District District District Rank Rank Rank Rank Rank Rank Rank Code Code Code

NO B Barkhan 1 1 B Jhal Magsi 3 3 B Bolan 2 2 B Musa Khel 4 4 0.04 -0.25 PERCENT Rahim Yar B Killa Abdullah 5 5 P Faisalabad 13 5 P Khan 21 9 B Khuzdar 6 6 P Hafizabad 14 6 P Muzaffargarh 22 10 P Multan 7 1 N Hangu 15 1 B Panjgur 23 10 Mandi Bahaud P Din 8 2 B Pishin 16 9 P Pakpattan 24 11 B Lasbela 9 7 S Umerkot 17 1 P Okara 25 12 P Rawalpindi 10 3 P Kasur 18 7 S Tharparkar 26 2 B Mastung 11 8 P Narowal 19 8 N Upper Dir 27 3 P Bahawalpur 12 4 N Haripur 20 2 P Khanewal 28 13 0.26 -0.45 PERCENT B Zhob 29 11 P Jhang 40 17 P D.G Khan 51 20 N Tank 30 4 B Chagai 41 15 N Chitral 52 9 N Lower Dir 31 5 B Kalat 42 16 B Kharan 53 20 P Vehari 32 14 P Sheikhupura 43 18 P Bahawalnagar 54 21 B Killa Saifullah 33 12 S Jacobabad 44 3 P T.T.Singh 55 22 N Swabi 34 6 B Kohlu 45 17 A Rawalakot 56 1 N Karak 35 7 B Dera Bugti 46 18 P Rajanpur 57 23 P Gujranwala 36 15 N Lakki 47 8 A Bagh 58 2 P Lodhran 37 16 S Ghotki 48 4 N Charsadda 59 10 B Loralai 38 13 P Gujrat 49 19 N Nowshera 60 11 B Jafarabad 39 14 B Turbat 50 19 0.46 - 0.65 PERCENT P Sialkot 61 24 B Gawader 65 22 N Mansehra 69 12 P Layyah 62 25 S Thatta 66 6 N Malakand 70 13 S Dadu 63 5 A Bhimber 67 3 S Sanghar 71 8 B Sibi 64 21 S Badin 68 7 P Sahiwal 72 26 0.66 - 1.00 PERCENT P Attock 73 27 N D.I.Khan 81 15 A Muzaffarabad 89 5 P Chakwal 74 28 B Nasirabad 82 23 NA Diamer 90 3 Noushero S Feroze 75 9 P Bhakkar 83 31 S Khairpur 91 12 S Shikarpur 76 10 S Mirpurkhas 84 11 F Khyber 92 2 N Mardan 77 14 NA Skardu 85 1 P Jhelum 93 33 P Lahore 78 29 NA Gilgit 86 2 P Mianwali 94 34 P Khushab 79 30 P Sargoda 87 32 A Kotli 80 4 F Kurram 88 1 1.01 - 2.00 PERCENT S Karachi 95 13 F N.Waziristan 100 3 S Hyderabad 104 17 N Bannu 96 16 N Swat 101 17 N Kohat 105 18 S Larkana 97 14 S Sukkar 102 15 B Ziarat 106 24 A Mirpur 98 6 S Nawabshah 103 16 NA Ghanche 107 5 NA Ghizer 99 4 2.01 - 5.00 PERCENT A Sudhnoti 108 7 N Abbottabad 109 19 5.01 - 6.00 PERCENT B Quetta 110 25 N Peshawar 111 20 6.01 & Above PERCENT C ISLAMABAD 112 1 P: Punjab, S: Sindh, N:NWFP, C: Capital, B: Balochistan, NA: Northern Area, A:Azad Jammu & Kashmir, F: Federally Administered Areas National Rankings are from 1 to 112,1 being the worst and 112 the best. Provincial Rankings depend on the number of districts per province.

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Table 6.38 Health and Sanitation in Urban Pakistan Provincial Provincial Provincial Provincial Provincial Provincial National National National National District District District District Rank Rank Rank Rank Rank Rank Rank Code Code Code

E X T R E M E L Y P O O R

B Khuzdar 1 1 P Mandi Bahaud Din 15 5 N Charsadda 29 5 NA Ghizer 2 1 P Rajanpur 16 6 N Upper Dir 30 6 B Musa Khel 3 2 N Mardan 17 2 P Khanewal 31 10

S Tharparkar 4 1 S Noushero Feroze 18 2 B Jhal Magsi 32 6 B Panjgur 5 3 N Hangu 19 3 B Nasirabad 33 7 P Layyah 6 1 P Bhakkar 20 7 P Sargoda 34 11 NA Ghanche 7 2 B Lasbela 21 4 N Nowshera 35 7 A Rawalakot 8 1 S Khairpur 22 3 B Kohlu 36 8

P Muzaffargarh 9 2 N Malakand 23 4 S Shikarpur 37 6 NA Diamer 10 3 S Ghotki 24 4 P Chakwal 38 12 P Hafizabad 11 3 P Jhang 25 8 S Umerkot 39 7 N Swabi 12 1 P Lodhran 26 9 S Larkana 40 8

P Okara 13 4 B Killa Saifullah 27 5 P Mianwali 41 13 A Sudhnoti 14 2 S Jacobabad 28 5 V E R Y P O O R P Khushab 42 14 P Sheikhupura 53 17 P Jhelum 64 23 P Kasur 43 15 P Narowal 54 18 B Gawader 65 11

B Turbat 44 9 P Rahim Yar Khan 55 19 A Muzaffarabad 66 5 B Mastung 45 10 P Bahawalpur 56 20 B Jafarabad 67 12 S Badin 46 9 S Sanghar 57 11 S Thatta 68 12 N D.I.Khan 47 8 N Mansehra 58 10 P Vehari 69 24 N Swat 48 9 A Bhimber 59 4 B Bolan 70 13 A Bagh 49 3 P Faisalabad 60 21 B Dera Bugti 71 14

S Dadu 50 10 P Multan 61 22 F N.Waziristan 72 3 P T.T.Singh 51 16 F Kurram 62 2 F Khyber 52 1 N Lower Dir 63 11 M O D E R A T E L Y P O O R P Gujrat 73 25 B Loralai 81 17 N Lakki 89 15 N Kohat 74 12 B Barkhan 82 18 B Sibi 90 20

P D.G Khan 75 26 N Karak 83 14 P Bahawalnagar 91 30 N Chitral 76 13 P Sahiwal 84 29 P Attock 92 31 B Kalat 77 15 NA Skardu 85 4 B Pishin 93 21

P Pakpattan 78 27 B Killa Abdullah 86 19 S Nawabshah 94 14 P Gujranwala 79 28 A Kotli 87 6 B Kharan 80 16 S Sukkar 88 13 P O O R P Sialkot 95 32 B Ziarat 98 23 P Rawalpindi 101 33 B Chagai 96 22 S Hyderabad 99 16 N Haripur 102 16 S Karachi 97 15 S Mirpurkhas 100 17 N Peshawar 103 17 R E A S O N A B L E NA Gilgit 104 5 N Tank 107 19 P Lahore 110 34 N Bannu 105 18 A Mirpur 108 7 B Quetta 111 25 B Zhob 106 24 N Abbottabad 109 20 C Islamabad 112 1 P: Punjab, S: Sindh, N:NWFP, C: Capital, B: Balochistan, NA: Northern Area, A:Azad Jammu & Kashmir, F: Federally Administered Areas National Rankings are from 1 to 112,1 being the worst and 112 the best. Provincial Rankings depend on the number of districts per province.

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Table 6.39 Food Absorption in Urban Pakistan Provincial Provincial Provincial Provincial Provincial Provincial National National National District District District Rank Rank Rank Rank Rank Rank Code Code Code Code

E X T E R M E L Y L O W B Musa Khel 1 1 NA Diamer 9 1 P Bhakkar 17 3 B Dera Bugti 2 2 N Charsadda 10 2 P Khanewal 18 4 N Swabi 3 1 F Khyber 11 2 P Layyah 19 5 F Kurram 4 1 P Muzaffargarh 12 2 P Jhang 20 6 S Ghotki 5 1 NA Ghanche 13 2 N Mardan 21 4 S Jacobabad 6 2 B Barkhan 14 4 S Khairpur 22 3 P Lodhran 7 1 B Nasirabad 15 5 S Larkana 23 4 B Kohlu 8 3 N Malakand 16 3 N Nowshera 24 5 V E R Y L O W P Vehari 25 7 NA Ghizer 36 3 B Kalat 47 10 P Bahawalpur 26 8 N Upper Dir 37 6 B Killa Saifullah 48 11 B Khuzdar 27 6 P Multan 38 13 P Rahim Yar Khan 49 16 P Okara 28 9 P Mandi Bahaud Din 39 14 B Kharan 50 12 B Jafarabad 29 7 S Umerkot 40 5 NA Skardu 51 5 F N.Waziristan 30 3 NA Gilgit 41 4 B Bolan 52 13 P Khushab 31 10 S Shikarpur 42 6 N Karak 53 9 P Hafizabad 32 11 P Sargoda 43 15 B Killa Abdullah 54 14 P Mianwali 33 12 N Hangu 44 7 P Gujranwala 55 17 B Jhal Magsi 34 8 N D.I.Khan 45 8 N Lower Dir 56 10 B Panjgur 35 9 S Noushero Feroze 46 7 L O W S Tharparkar 57 8 P Rajanpur 63 19 S Nawabshah 69 12 S Sanghar 58 9 B Lasbela 64 16 N Lakki 70 11 A Mirpur 59 1 P Pakpattan 65 20 P Kasur 71 21 S Thatta 60 10 S Badin 66 11 A Muzaffarabad 72 3 P Narowal 61 18 A Kotli 67 2 P Faisalabad 73 22 B Turbat 62 15 B Chagai 68 17 N Tank 74 12 N O R M A L B Pishin 75 18 N Mansehra 80 14 P Attock 85 25 P T.T.Singh 76 23 B Zhob 81 20 N Chitral 86 16 P Sheikhupura 77 24 B Loralai 82 21 P Sahiwal 87 26 B Gawader 78 19 A Bhimber 83 4 S Dadu 88 13 N Kohat 79 13 N Swat 84 15 P Gujrat 89 27 S U F F I C I E N T B Mastung 90 22 S Hyderabad 98 16 P Lahore 106 33 A Bagh 91 5 P Rawalpindi 99 30 P Jhelum 107 34 P D.G Khan 92 28 A Sudhnoti 100 6 B Quetta 108 25 P Bahawalnagar 93 29 P Sialkot 101 31 N Peshawar 109 19 S Mirpurkhas 94 14 P Chakwal 102 32 S Karachi 110 17 B Sibi 95 23 A Rawalakot 103 7 N Abbottabad 111 20 S Sukkar 96 15 N Haripur 104 18 C ISLAMABAD 112 1 N Bannu 97 17 B Ziarat 105 24 P: Punjab, S: Sindh, N:NWFP, C: Capital, B: Balochistan, NA: Norther Area, A:Azad Jammu & Kashmir, F: Federally Administered Areas National Rankings are from 1 to 112,1 being the worst and 112 the best. Provincial Rankings depend on the number of districts per province.

VULNERABILITY ANALYSIS AND MAPPING (VAM) UNIT, WORLD FOOD PROGRAMME, PAKISTAN 108 FOOD INSECURITY IN URBAN PAKISTAN Food Insecurity in Urban Pakistan 7 CChhaapptteerr 77 Food Insecurity in Urban Pakistan

Right to food is acknowledged in a number of times, have physical and economic access to international Conventions, including the 1948 sufficient, safe and nutritious food to meet their International Bill of Human Rights (UN 1985), dietary needs and food preferences for an active the International Covenant on Economic, Social and healthy life” namely food availability, access & Cultural Rights (UN 1966) and the Convention and absorption. on the Rights of the Child (UN 1989). Similarly, other international declarations, like World Based on the composite indicator of food Declaration on Nutrition (adopted in Rome in availability, access and absorption, 94 out of 112 1992), the Declaration on Social Development (84%) districts in urban Pakistan, are food (adopted at the World Social Summit in 1995) insecure, as is illustrated in the table-7.1. and Rome Declaration on Food Security (FAO, 1996) affirm the right of every one to have access It is disturbing to note that 39 out of 112 (35%) to safe and nutritious food- consistent with the urban district settings in Pakistan rank extremely right to adequate food and the fundamental right low in food security, while 56 (50%) are in the of every one to be free from hunger. range of low to very low.

Food security is thus an important objective of In the provincial context, in the highly populated every nation, now formalized in the ‘Rome province namely Punjab, only 9 districts out of 34 Declaration’ adopted by 186 countries at the (26%) have adequate level of food security, while World food Summit [WFS] in 1996. The WFS the remaining 25 (74%) districts are food Rome Declaration sets Millennium Development insecure, with in the range of low to extremely Goals [MDGs] with following target; low. While, 19 (56%) districts are highly food insecure, being in the bracket of very low to We pledge our political will and our common and extremely low. In NWFP 5 districts (25%) are national commitment to achieving food security extremely food insecure and 11 (55%) are very for all, and to an on going effort to eradicate insecure. In Sindh, figures in the same sequence hunger in all countries, with an immediate view are 6 (35%) and 9 (53%) districts respectively, to reducing the number of undernourished people while in Balochistan these are in the order of 20 to half of their present level no later than 2015. (80%) and 4 (16%) out of 25 districts respectively. The FSA-2006, based on the empirical evidence discussed in earlier chapter, concludes based on In the relatively less populated, yet more composite indexing of three dimensions of food marginalized regions, like PAK, 6 (86%), NAs security, as per its definition, 5(100%), FATA 3 (100%) of districts are having food insecure urban areas. “Food Security exists when all people, at all

Table 7.1 Food Insecurity in Urban Pakistan Number of Districts Food Security Balochis Northern Islama Level Punjab NWFP Sindh tan Areas PAK FATA bad Total Extremely Low 2 5 6 20 3 - 3 - 39 Very Low 17 11 9 4 1 4 - - 46 Low 6 1 - - 1 2 - - 10 Normal 4 3 1 1 - - - - 9 Sufficient 5 - 1 - - 1 - 1 8 Total: 34 20 17 25 5 7 3 1 112 PAK:Azad Jammu & Kashmir, FATA: Federally Administered Areas No Urban Areas in these Districts:NWFP:Buner,Shangla,Kohistan,BattagramBalochistan:Awaran,FATA:Bajour,Mohamand,Orakzai,S.Waziristan

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When translated in to caloric intake terms, then as low, compared to Nasirabad. This situation mentioned in earlier Chapter, and depicted in reflects on the marginal status of land in Gawadar table-6.2 in 8 (7%) districts out of 112 caloric compared to relatively fertile agricultural land in intake falls in the range of 3501-4855 Nasirabad.

According to Pakistan’s economic Survey 2005- 6, there was an increase of only 0.4% in wheat production during 2005-6 compared to the last year.

Since growth in wheat production is not enough to meet its demand, with growing population, its availability has naturally been compromised.

With regard to rice, dairy products, barring powder milk, and to some extent meat, the gap

Kcal/person, while in 45 (40%) districts, on the other extreme caloric intake is in the range of 1477-1800Kcal/person. This level of caloric intake measures against threshold of 2350 Kcal translates in to an acute state of urban food insecurity in this proportion of urban population.

between actual requirements and availability, is not that big. Yet, in 2006, the Government had to allow duty free imports of meat and live animals to stabilize the rocketing prices of these products in urban Pakistan.

In Sindh, use of rice in daily diet is more common, as such, its contribution towards daily In Balochistan this disparity gets further widened, caloric intake is on higher side compared to for there are places, like Gawadar where Punjab. It is interesting to observe that in some contribution of wheat to caloric intake is very key agricultural areas, like Hafizabad in Punjab and Noshero Feroz in Sindh contribution of both

Composite Indicators of Urban Food Insecurity Table 7.2 Food Consumption in Kcal per cu in Urban Pakistan Number of Districts Calories NWF Sind Balochis Northern Islamab Per cu Punjab P h tan Areas PAK FATA ad Total Extremely Low 4 3 6 22 2 - 2 - 39 Very Low 9 10 3 2 3 3 1 - 31 Low 9 1 6 - - 3 - - 19 Normal 7 6 1 1 - - - - 15 Sufficient 5 - 1 - - 1 - 1 8 Total: 34 20 17 25 5 7 3 1 112 Extremely Low:1477 - 1799, Very Low: 1800 -1995, Low:2017 - 2305, Normal: 2465 - 3466, Sufficient: 3550-4855 PAK:Azad Jammu & Kashmir, FATA: Federally Administered Areas No Urban Areas in these Districts:NWFP:Buner,Shangla,Kohistan,BattagramBalochistan:Awaran,FATA:Bajour,Mohamand,Orakzai,S.Waziristan

VULNERABILITY ANALYSIS AND MAPPING (VAM) UNIT, WORLD FOOD PROGRAMME, PAKISTAN FOOD INSECURITY IN URBAN PAKISTAN Food Insecurity Urban in Pakistan 7 wheat & rice is quite significant in daily diet in Maize, a subsistent crop in Pakistan, as terms of caloric intake. This phenomenon guides mentioned above, is also an important staple, us to the fact that local production and thus especially in marginal areas of almost all regions availability is a key factor in food security, where of Pakistan. In Punjab its contribution in terms of countries lack financial means to import food. caloric intake registers maximum of 308 Kcal (Okara), while it contributes up to 642 Kcal On the contrary, in marginal land zones, like NAs (Kohistan) in NWFP, 3 Kcal (Mirpur Khas) in & FATA, contribution of rice towards caloric Sindh, 23 Kcal (Loralai) in Balochistan, 359 intake is insignificant, ranging from zero in NAs (Gilgit) in NAs, 143 Kcal(Kotli) in PAK and 157 to a maximum of 147 Kcal (Kurram) in FATA. Kcal (Bajour) in FATA. While on all Pakistan basis, it contributes 55.35 Kcal towards the daily diet per capita.

The aforementioned three staple crops, namely wheat, rice & maize thus collectively contribute 1117 Kcal per capita towards daily diet in Pakistan.

Where as, demand of pulses, in relative terms, is low i.e. 0.371 million MT, compared to cereals, these are mainly used by low-income group, in

This again is true reflection of inter alia local production capacity of this marginal land area. However, Balochistan is a marginal land zone too, some of its districts are irrigated and are among rice producing areas of Pakistan. As such, rice contributes significantly in the daily diet and thus caloric intake in these districts of their daily diet. An increase in prices of pulses Balochistan. However, in general rice contributes in Pakistan has been registered. In 2006, less towards daily diet in terms of caloric intake Government was compelled to import pulses to in Balochistan, compared to Punjab and Sindh, stabilize the prices. Sugar is yet another for it contributes almost zero to daily caloric important contributor in terms of caloric intake, intake in as many as 16 districts. However, it and makes a significant share in the daily diets of contributes almost 232 Kcal per capita on all especially middle and below middle classes. Pakistan basis. Consumption of sugar per capita is higher in Pakistan compared to many countries. The prices of sugar in the country went up, registering a

VULNERABILITY ANALYSIS AND MAPPING (VAM) UNIT, WORLD FOOD PROGRAMME, PAKISTAN 110 FOOD INSECURITY IN URBAN PAKISTAN Food Insecurity Urban in Pakistan 7 skyrocketing trend, this year, and again Government had to import large quantity of sugar to stabilize the prices and satisfy the local demand.

Low production of sugarcane crop inter alia is one of the factors responsible for lower level of sugar availability and its higher prices. According to the Pakistan Economic Survey 2005-6, sugarcane production in Pakistan has decreased by 6.2% during 2005-6,declining from 47.25 million MT in 2004-5 to 44.30 million MT in 2005-6. Given the fact that Pakistan is registered as Net Food Importing Developing Country (NFIDC) with the World Trade Organization (WTO) and that it on an average imports 1-2 MT of wheat each year, present import surge in sugar, pulses and even milk powder signals worsening state of food security in general and urban food security in particular. This situation is not surprising, when one looks at the growth of agricultural sector, which has declined to 2.5 percent in 2005-6, compared to 6.7% during 2004-5(Pakistan Economic Survey, 2005-6).

VULNERABILITY ANALYSIS AND MAPPING (VAM) UNIT, WORLD FOOD PROGRAMME, PAKISTAN 111 FOOD INSECURITY IN URBAN PAKISTAN Food Insecurity in Urban Pakistan 7

Table 7.3 Food Insecurity in Urban Pakistan National Rank National Rank National Rank Provincial Provincial Provincial Provincial Provincial Provincial District District District Rank Rank Rank Code Code Code Code

E X T R E M E L Y L O W B Musa Khel 1 1 B Kharan 14 8 B Kalat 27 17 F Kurram 2 1 B Mastung 15 9 B Jafarabad 28 18 NA Diamer 3 1 N Karak 16 1 S Shikarpur 29 4 NA Ghizer 4 2 S Umerkot 17 2 N Hangu 30 3 B Panjgur 5 2 B Dera Bugti 18 10 F N.Waziristan 31 3 NA Ghanche 6 3 B Barkhan 19 11 B Chagai 32 19 S Tharparkar 7 1 B Bolan 20 12 P Rajanpur 33 1 B Jhal Magsi 8 3 B Turbat 21 13 S Khairpur 34 5 B Khuzdar 9 4 B Killa Abdullah 22 14 P Lodhran 35 2 B Kohlu 10 5 B Lasbela 23 15 B Gawader 36 20 F Khyber 11 2 S Jacobabad 24 3 N Malakand 37 4 B Killa Saifullah 12 6 B Loralai 25 16 S Noushero Feroze 38 6 B Nasirabad 13 7 N Upper Dir 26 2 N Lakki 39 5 V E R Y L O W P Layyah 40 3 N D.I.Khan 56 9 N Kohat 72 13 N Charsadda 41 6 P Okara 57 7 P Pakpattan 73 14 B Pishin 42 21 A Sudhnoti 58 1 S Nawabshah 74 13 N Chitral 43 7 A Rawalakot 59 2 A Bagh 75 4 B Sibi 44 22 P Bahawalpur 60 8 S Sukkar 76 14 P Bhakkar 45 4 P Jhang 61 9 P Bahawalnagar 77 15 S Badin 46 7 S Sanghar 62 12 P Mandi Bahaud Din 78 16 S Ghotki 47 8 P Khushab 63 10 P Chakwal 79 17 B Zhob 48 23 N Swabi 64 10 N Mardan 80 14 NA Skardu 49 4 P T.T.Singh 65 11 N Mansehra 81 15 N Lower Dir 50 8 N Swat 66 11 P Mianwali 82 18 S Thatta 51 9 A Kotli 67 3 N Bannu 83 16 S Larkana 52 10 B Ziarat 68 24 S Mirpurkhas 84 15 P Muzaffargarh 53 5 N Tank 69 12 P Rahim Yar Khan 85 19 P Khanewal 54 6 P Hafizabad 70 12 S Dadu 55 11 P Vehari 71 13 L O W A Bhimber 86 5 N Nowshera 90 17 P Gujrat 94 24 P Narowal 87 20 P Attock 91 22 P D.G Khan 95 25 P Sargoda 88 21 NA Gilgit 92 5 A Muzaffarabad 89 6 P Multan 93 23 N O R M A L P Gujranwala 96 26 N Peshawar 99 19 S Hyderabad 102 16 P Sahiwal 97 27 B Quetta 100 25 P Kasur 103 28 N Abbottabad 98 18 N Haripur 101 20 P Sheikhupura 104 29 B E T T E R A Mirpur 106 7 P Lahore 109 33 C Islamabad 112 1 P Rawalpindi 107 31 P Sialkot 110 34 P Jhelum 108 32 S Karachi 111 17 P: Punjab, S: Sindh, N:NWFP, C: Capital, B: Balochistan, NA: Northern Area, A:Azad Jammu & Kashmir, F: Federally Administered Areas National Rankings are from 1 to 112,1 being the worst and 112 the best. Provincial Rankings depend on the number of districts per province.

VULNERABILITY ANALYSIS AND MAPPING (VAM) UNIT, WORLD FOOD PROGRAMME, PAKISTAN FOOD INSECURITY IN URBAN PAKISTAN Food Insecurity in Urban Pakistan 7

Table 7.4 Food Consumption in Kcal per cu in Urban Pakistan Prove: Code Prove: Code Prove: Code Provincial Provincial Provincial National National National District District District Rank Rank Rank rank rank rank

S U F F I C I E N T C Islamabad 1 1 P Sialkot 4 2 P Sheikhupura 7 5 S Karachi 2 1 P Kasur 5 3 A Mirpur 8 1 P Jhelum 3 1 P Faisalabad 6 4 N O R M A L P Lahore 9 6 N Haripur 14 3 N Swabi 19 5 P Rawalpindi 10 7 B Quetta 15 1 P Rahim Yar Khan 20 10 S Hyderabad 11 2 P Mianwali 16 8 N Swat 21 6 N Peshawar 12 1 N Mardan 17 4 P D.G Khan 22 11 N Nowshera 13 2 P Multan 18 9 P Sahiwal 23 12 L O W A Muzaffarabad 24 2 P Hafizabad 31 17 S Thatta 38 7 P Sargoda 25 13 S Ghotki 32 4 S Badin 39 8 P Khushab 26 14 P Gujrat 33 18 P Chakwal 40 20 P Gujranwala 27 15 S Larkana 34 5 P Jhang 41 21 P Muzaffargarh 28 16 S Khairpur 35 6 A Bagh 42 4 S Sukkar 29 3 A Rawalakot 36 3 N Abbottabad 30 7 P Attock 37 19 V E R Y L O W A Kotli 43 5 N Bannu 54 8 N Kohat 65 12 B Killa Saifullah 44 2 P Bahawalpur 55 26 P Bahawalnagar 66 29 P Khanewal 45 22 N Charsadda 56 9 P Layyah 67 30 P Okara 46 23 P Pakpattan 57 27 NA Ghizer 68 3 P T.T.Singh 47 24 S Sanghar 58 10 N Malakand 69 13 NA Gilgit 48 1 S Jacobabad 59 11 N Mansehra 70 14 B Kharan 49 3 A Sudhnoti 60 7 N Lakki 71 15 S Dadu 50 9 NA Skardu 61 2 N Hangu 72 16 A Bhimber 51 6 N D.I.Khan 62 10 N Chitral 73 17 F Kurram 52 1 P Bhakkar 63 28 P Mandi Bahaud Din 53 25 N Tank 64 11 E X T E R M E L Y L O W N Lower Dir 74 18 B Gawader 87 4 B Mastung 100 15 N Karak 75 19 B Lasbela 88 5 B Jafarabad 101 16 N Upper Dir 76 20 B Turbat 89 6 B Zhob 102 17 P Vehari 77 31 S Shikarpur 90 15 B Bolan 103 18 S Nawabshah 78 12 B Kohlu 91 7 B Kalat 104 19 P Lodhran 79 32 B Panjgur 92 8 B Killa Abdullah 105 20 S Noushero Feroze 80 13 B Ziarat 93 9 B Pishin 106 21 NA Diamer 81 4 B Barkhan 94 10 B Sibi 107 22 NA Ghanche 82 5 F N.Waziristan 95 3 B Khuzdar 108 23 P Narowal 83 33 B Chagai 96 11 B Musa Khel 109 24 F Khyber 84 2 B Nasirabad 97 12 B Dera Bugti 110 25 P Rajanpur 85 34 B Jhal Magsi 98 13 S Umerkot 111 16 S Mirpurkhas 86 14 B Loralai 99 14 S Tharparkar 112 17 P: Punjab, S: Sindh, N:NWFP, C: Capital, B: Balochistan, NA: Northern Area, A:Azad Jammu & Kashmir, F: Federally Administered Areas National Rankings are from 1 to 112,1 being the worst and 112 the best. Provincial Rankings depend on the number of districts per province.

VULNERABILITY ANALYSIS AND MAPPING (VAM) UNIT, WORLD FOOD PROGRAMME, PAKISTAN FOOD INSECURITY IN URBAN PAKISTAN Annexure

Annexure - 10 Population of Cities in Pakistan 2005 Provincial Population PROVINCIAL NATIONAL Code PROVINCE DISTRICT CITY 2005 RANK RANK S SIND KARACHI KARACHI 11,873,812 1 1 P PUNJAB LAHORE LAHORE 6,464,711 1 2 P PUNJAB FAISALABAD FAISALABAD 2,569,693 2 3 P PUNJAB RAWALPINDI RAWALPINDI 1,785,144 3 4 P PUNJAB GUJRANWALA GUJRANWALA 1,590,150 4 5 P PUNJAB MULTAN MULTAN 1,465,640 5 6 S SIND HYDERABAD HYDERABAD 1,398,477 2 7 N NWFP PESHAWAR PESHAWAR 1,232,765 1 8 C ISLAMABAD ISLAMABAD ISLAMABAD 783,165 1 9 B BALOCHISTAN QUETTA QUETTA 748,198 1 10 P PUNJAB BAHAWALPUR BAHAWALPUR 571,976 6 11 P PUNJAB SARGODHA SARGODHA 552,428 7 12 P PUNJAB SIALKOT SIALKOT 483,841 8 13 S SIND SUKKUR SUKKUR 423,462 3 14 S SIND LARKANA LARKANA 372,525 4 15 P PUNJAB SHEIKHUPURA SHEIKHUPURA 371,546 9 16 P PUNJAB JHANG JHANG 346,582 10 17 P PUNJAB OKARA OKARA 312,168 11 18 P PUNJAB RAHIM YAR KHAN RAHIM YAR KHAN 308,147 12 19 P PUNJAB GUJRAT GUJRAT 307,365 13 20 N NWFP MARDAN MARDAN 303,075 2 21 P PUNJAB KASUR KASUR 296,019 14 22 P PUNJAB RAWALPINDI WAH CANTT 249,270 15 23 P PUNJAB DERA GHAZI KHAN DERA GHAZI KHAN 246,352 16 24 P PUNJAB SAHIWAL SAHIWAL 238,507 17 25 S SIND NAWABSHAH NAWABSHAH 235,928 5 26 N NWFP SWAT MINGORA 230,886 3 27 S SIND MIRPUR KHAS MIRPUR KHAS 224,384 6 28 P PUNJAB JHELUM JHELUM CANTT 213,499 18 29 P PUNJAB JHANG CHINIOT 203,094 19 30 P PUNJAB VEHARI BUREWALA 195,482 20 31 P PUNJAB RAHIM YAR KHAN SADIQABAD 194,530 21 32 P PUNJAB GUJRANWALA KAMOKE 194,291 22 33 S SIND JACOBABAD JACOBABAD 184,105 7 34 S SIND SHIKARPUR SHIKARPUR 172,015 8 35 P PUNJAB MUZAFFARGARH MUZAFFARGARH 171,890 23 36 P PUNJAB RAHIM YAR KHAN KHANPUR 162,184 24 37 P PUNJAB HAFIZABAD HAFIZABAD 161,590 25 38 N NWFP KOHAT KOHAT 159,272 4 39 P PUNJAB KHANEWAL KHANEWAL 159,017 26 40 P PUNJAB SHEIKHUPURA MURIDKE 152,871 27 41 P PUNJAB TOBA TEK SINGH GOJRA 143,277 28 42 S SIND DADU DADU 141,267 9 43 P PUNJAB FAISALABAD JARANWALA 136,659 29 44 B BALOCHISTAN KHUZDAR KHUZDAR 134,921 2 45 P PUNJAB BAHAWALNAGAR BAHAWALNAGAR 134,840 30 46 P PUNJAB MANDI BAHAUDDIN MANDI BAHUDDIN 133,042 31 47 P PUNJAB PAKPATTAN PAKPATTAN 132,087 32 48 S SIND SANGHAR TANDO ADAM 130,167 10 49 P PUNJAB BAHAWALPUR AHMADPUR EAST 128,957 33 50 N NWFP ABBOTTABAD ABBOTTABAD 128,850 5 51 S SIND KHAIRPUR KHAIRPUR 123,949 11 52 P PUNJAB BAHAWALNAGAR CHISHTIAN 123,906 34 53 P PUNJAB SIALKOT DASKA 123,284 35 54 p PUNJAB VEHARI VEHARI 121,254 36 55 N NWFP SWABI SWABI 118,708 6 56 P PUNJAB TOBA TEK SINGH KAMALIA 118,280 37 57 A PAK MIRPUR MIRPUR 117,835 1 58 P PUNJAB GUJRANWALA WAZIRABAD 115,074 38 59 P PUNJAB MUZAFFARGARH KOT ADDU 112,435 39 60 A PAK MUZAFFARABAD MUZAFFARABAD 110,013 2 61 P PUNJAB KHUSHAB KHUSHAB 107,141 40 62 N NWFP NOWSHERA NOWSHERA 106,134 7 63 P PUNJAB CHAKWAL CHAKWAL 105,972 41 64 S SIND HYDERABAD TANDO ALLAHYAR 103,963 12 65 N NWFP D. I. KHAN DERA ISMAIL KHAN 103,651 8 66 N NWFP CHARSADDA CHARSADDA 101,966 9 67 P PUNJAB BAHAWALPUR HASILPUR 95,358 42 68 P PUNJAB MIANWALI MIANWALI 95,181 43 69 B BALOCHISTAN LASBELA HUB 94,435 3 70 P PUNJAB ATTOCK ATTOCK 91,518 44 71 P PUNJAB RAWALPINDI TAXILA 90,090 45 72 P PUNJAB PAKPATTAN ARIF WALA 89,857 46 73 P PUNJAB LEIAH LEIAH 89,842 47 74 S SIND JACOBABAD KANDHKOT 89,633 13 75 P PUNJAB LODHRAN LODHRAN 88,424 48 76 P PUNJAB SHEIKHUPURA KOT ABDUL MALIK 86,745 49 77 P PUNJAB BHAKKAR BHAKKAR 85,700 50 78

VULNERABILITY ANALYSIS AND MAPPING (VAM) UNIT, WORLD FOOD PROGRAMME, PAKISTAN 114 FOOD INSECURITY IN URBAN PAKISTAN Annexure

S SIND DADU KOTRI 85,525 14 79 S SIND BADIN BADIN 84,779 15 80 P PUNJAB SAHIWAL CHICHAWATNI 83,936 51 81 N NWFP LOWER DIR TEMERGARA 83,311 10 82 S SIND LARKANA SHAHDAD KOT 82,273 16 83 P PUNJAB SHEIKHUPURA FAROOQABAD 80,586 52 84 S SIND SUKKUR PANO AQIL 80,407 17 85 P PUNJAB GUJRAT KHARIAN 79,801 53 86 P PUNJAB LODHRAN KAHROR PACCA 79,613 54 87 S SIND LARKANA KAMBAR ALI KHAN 79,459 18 88 S SIND HYDERABAD TANDO MUHAMMAD KHAN 79,229 19 89 S SIND SANGHAR SHAHDADPUR 77,741 20 90 P PUNJAB KHANEWAL MIAN CHANNU 76,976 55 91 P PUNJAB RAJANPUR JAMPUR 76,887 56 92 P PUNJAB BAHAWALNAGAR HAROONABAD 76,168 57 93 P PUNJAB SHEIKHUPURA FEROZEWALA 75,695 58 94 S SIND NAUSHAHRO FEROZE MORO 75,472 21 95 N NWFP BANNU BANNU 75,220 11 96 P PUNJAB GUJRAT JALALPUR JATTAN 75,214 59 97 B BALOCHISTAN KILLA ABDULLAH CHAMAN 74,358 4 98 P PUNJAB SARGODHA BHALWAL 73,337 60 99 P PUNJAB OKARA DEPALPUR 73,259 61 100 S SIND GHOTKI GHOTKI 73,048 22 101 P PUNJAB TOBA TEK SINGH TOBA TEK SINGH 72,844 62 102 P PUNJAB NAROWAL NAROWAL 72,165 63 103 P PUNJAB KASUR PATTOKI 71,740 64 104 P PUNJAB RAWALPINDI GUJAR KHAN 71,562 65 105 P PUNJAB VEHARI MAILSI 71,246 66 106 B BALOCHISTAN KECH TURBAT 71,040 5 107 P PUNJAB MULTAN SHUJABAD 70,271 67 108 P PUNJAB FAISALABAD SUMMUNDRI 70,138 68 109 NA NA Gilgit Gilgit 69,780 1 110 P PUNJAB SHEIKHUPURA SANGLA HILL 68,778 69 111 P PUNJAB KASUR PHOOL NAGAR 68,274 70 112 HAVELI LAKHA P PUNJAB OKARA WASAWEWALA 66,836 71 113 P PUNJAB SHEIKHUPURA NANKANA SAHIB 66,772 72 114 B BALOCHISTAN SIBI SIBI 65,556 6 115 P PUNJAB GUJRAT LALA MUSA 65,027 73 116 N NWFP CHARSADDA SHABQADAR 64,814 12 117 P PUNJAB NAROWAL SHAKARGARH 64,190 74 118 P PUNJAB RAJANPUR RAJANPUR 63,896 75 119 N NWFP MARDAN TAKHT BHAI 63,126 13 120 S SIND SANGHAR SANGHAR 62,903 23 121 B BALOCHISTAN NASIRABAD DERA MURAD JAMALI 62,659 7 122 P PUNJAB JHANG SHORKOT 62,106 76 123 B BALOCHISTAN GWADAR GWADAR 61,469 8 124 B BALOCHISTAN JAFFARABAD USTA MOHAMMAD 61,185 9 125 N NWFP MANSEHRA MANSEHRA 60,817 14 126 P PUNJAB OKARA HUJRA SHAH MUQEEM 60,701 77 127 N NWFP MALAKAND PROTECTED AREA BAT KHELA 60,684 15 128 A PAK POONCH RAWALAKOT 60,314 3 129 B BALOCHISTAN JAFFARABAD DERA ALLAH YAR 60,282 10 130 P PUNJAB SIALKOT SAMBRIAL 59,404 78 131 S SIND SUKKUR ROHRI 59,094 24 132 P PUNJAB GUJRANWALA GHAKKHAR 59,005 79 133 S SIND GHOTKI MIRPUR MATHELO 58,664 25 134 S SIND BADIN MATLI 57,887 26 135 F FATA KHYBER AGENCY JAMRUD 57,213 1 136 N NWFP HARIPUR HARIPUR 57,189 16 137 P PUNJAB KHANEWAL KABIRWALA 56,321 80 138 P PUNJAB JHELUM DINA 56,188 81 139 P PUNJAB SIALKOT PASRUR 54,819 82 140 S SIND LARKANA RATODERO 54,748 27 141 P PUNJAB MUZAFFARGARH JATOI 54,304 83 142 N NWFP CHITRAL CHITRAL 54,240 17 143 P PUNJAB SHEIKHUPURA SHAH KOT 53,614 84 144 P PUNJAB GUJRANWALA QILA DEDAR SINGH 52,824 85 145 P PUNJAB BHAKKAR DARYA KHAN 51,976 86 146 P PUNJAB JHANG CHENAB NAGAR 51,644 87 147 P PUNJAB KASUR CHUNIAN 51,382 88 148 P PUNJAB ATTOCK KAMRA CANTT. 51,193 89 149 P PUNJAB GUJRANWALA ALIPUR CHATTA 50,455 90 150 B BALOCHISTAN ZHOB ZHOB 50,003 11 151 P PUNJAB ATTOCK HASAN ABDAL 49,843 91 152 P PUNJAB KHUSHAB HADALI 49,836 92 153 P PUNJAB LAHORE KAHNA NAU 49,822 93 154 P PUNJAB CHAKWAL TALA GANG 49,711 94 155 P PUNJAB DERA GHAZI KHAN TAUNSA 49,514 95 156 P PUNJAB KHUSHAB JAUHRABAD 48,992 96 157 S SIND HYDERABAD HALA 48,918 28 158 P PUNJAB KASUR KOT RADHA KISHAN 48,128 97 159 S SIND DADU SEHWAN 48,108 29 160 S SIND GHOTKI DAHARKI 47,869 30 161 P PUNJAB OKARA BASIRPUR 46,892 98 162

VULNERABILITY ANALYSIS AND MAPPING (VAM) UNIT, WORLD FOOD PROGRAMME, PAKISTAN 115 FOOD INSECURITY IN URBAN PAKISTAN Annexure

S SIND THATTA THATTA 46,674 31 163 P PUNJAB KASUR MUSTAFAABAD 45,625 99 164 P PUNJAB KHANEWAL ABDUL HAKIM 45,206 100 165 S SIND LARKANA BADAH 45,203 32 166 N NWFP SWABI TOPI 45,106 18 167 P PUNJAB RAHIM YAR KHAN LIAQUAT PUR 44,268 101 168 P PUNJAB FAISALABAD TANDLIANWALA 44,176 102 169 S SIND UMER KOT UMERKOT 43,674 33 170 P PUNJAB GUJRANWALA NOWSHERA VIRKAN 43,301 103 171 P PUNJAB GUJRANWALA LUDHEWALA WARRAICH 43,286 104 172 A PAK KOTLI KOTLI 42,886 4 173 P PUNJAB SHEIKHUPURA NARANG 42,802 105 174 N NWFP LAKKI MARWAT LAKKI MARWAT 42,767 19 175 P PUNJAB BAHAWALNAGAR FORTABBAS 41,958 106 176 N NWFP UPPER DIR DIR 41,837 20 177 P PUNJAB MANDI BAHAUDDIN MALAKWAL 41,797 107 178 P PUNJAB LEIAH CHOWK AZAM 41,668 108 179 P PUNJAB OKARA RENALA KHURD 41,398 109 180 N NWFP SWABI TORDHER 41,260 21 181 N NWFP TANK TANK 41,081 22 182 P PUNJAB FAISALABAD CHAK JHUMRA 41,017 110 183 P PUNJAB SARGODHA KOT MOMAN 40,805 111 184 N NWFP HARIPUR KHALABAT 40,754 23 185 P PUNJAB MIANWALI KUNDIAN 40,558 112 186 B BALOCHISTAN GWADAR PASNI 40,329 12 187 B BALOCHISTAN LORALAI LORALAI 40,308 13 188 P PUNJAB JHELUM KHEWRA 40,306 113 189 P PUNJAB GUJRAT SARAI ALAMGIR 40,283 114 190 N NWFP HANGU HANGU 40,127 24 191 F FATA KHYBER AGENCY LANDI KOTAL 39,865 2 192 P PUNJAB LODHRAN DUNYAPUR 39,841 115 193 P PUNJAB MUZAFFARGARH ALIPUR 39,838 116 194 P PUNJAB RAHIM YAR KHAN ZAHIRPIR 39,821 117 195 B BALOCHISTAN KHARAN KHARAN 39,693 14 196 P PUNJAB MULTAN JALALPUR PIRWALA 39,437 118 197 P PUNJAB ATTOCK PINDI GHEB 39,178 119 198 S SIND JACOBABAD THUL 38,637 34 199 P PUNJAB SHEIKHUPURA SHARKPUR 38,488 120 200 N NWFP ABBOTTABAD HAVELIAN 38,406 25 201 P PUNJAB FAISALABAD KHURIANWALA 38,336 121 202 S SIND LARKANA NAUDERO 38,321 35 203 P PUNJAB SARGODHA SAHIWAL 38,167 122 204 S SIND NAUSHAHRO FEROZE MEHRABPUR 37,946 36 205 S SIND JACOBABAD KASHMORE 37,872 37 206 P PUNJAB SARGODHA BHERA 37,689 123 207 N NWFP KARAK KARAK 37,596 26 208 S SIND DADU MEHAR 37,251 38 209 A PAK BAGH BAGH 37,251 5 210 N NWFP NOWSHERA RISALPUR CANTT 37,125 27 211 P PUNJAB GUJRAT DINGA 37,046 124 212 N NWFP NOWSHERA PABBI 36,814 28 213 P PUNJAB TOBA TEK SINGH PIR MAHAL 36,772 125 214 N NWFP NOWSHERA JEHANGIRA 36,769 29 215 P PUNJAB MUZAFFARGARH CHOWK SARWAR SHAHEED 36,710 126 216 NA NA Skardu/Baltistan Skardu 36,252 2 217 P PUNJAB SHEIKHUPURA KHANGAH DOGRAN 36,211 127 218 P PUNJAB HAFIZABAD PINDI BHATTIAN 36,164 128 219 P PUNJAB ATTOCK HAZRO 35,996 129 220 P PUNJAB BAHAWALPUR KHAIRPUR TAMEWALI 35,918 130 221 S SIND DADU KHAIRPUR NATHAN SHAH 35,833 39 222 B BALOCHISTAN CHAGAI NUSHKI 35,812 15 223 P PUNJAB FAISALABAD MAMOON KANJAN 35,569 131 224 P PUNJAB LAHORE RAIWIND 35,551 132 225 S SIND KHAIRPUR PIRJO GOTH 35,535 40 226 P PUNJAB RAJANPUR FAZILPUR 35,161 133 227 P PUNJAB SHEIKHUPURA MANANWALA JODH SINGH 34,908 134 228 P PUNJAB HAFIZABAD SUKHEKE 34,143 135 229 P PUNJAB ATTOCK FATEH JANG 34,106 136 230 P PUNJAB JHANG LALIAN 33,896 137 231 S SIND NAWABSHAH SAKRAND 33,730 41 232 N NWFP SWABI ZAIDA 33,552 30 233 S SIND JACOBABAD GHAUSPUR 33,272 42 234 S SIND KHAIRPUR GAMBAT 33,219 43 235 S SIND DADU SITA ROAD 33,033 44 236 N NWFP HANGU TALL 32,797 31 237 S SIND HYDERABAD TANDO JAM 32,040 45 238 S SIND KHAIRPUR SETHARJA 31,975 46 239 S SIND MIRPUR KHAS DIGRI 31,973 47 240 S SIND LARKANA NASIRABAD 31,960 48 241 S SIND JACOBABAD GUDDU 31,875 49 242 S SIND SANGHAR KHIPRO 31,739 50 243 P PUNJAB BAHAWALNAGAR MINCHINABAD 30,865 138 244 P PUNJAB MIANWALI LIAQUATABAD 30,303 139 245 B BALOCHISTAN KALAT KALAT 30,249 16 246 F FATA KURRAM AGENCY SADDA 30,053 3 247

VULNERABILITY ANALYSIS AND MAPPING (VAM) UNIT, WORLD FOOD PROGRAMME, PAKISTAN 116 FOOD INSECURITY IN URBAN PAKISTAN Annexure

N NWFP CHARSADDA TANGI 29,632 32 248 P PUNJAB FAISALABAD DIJKOT 29,540 140 249 P PUNJAB JHANG GARH MAHARAJA 29,525 141 250 P PUNJAB KHANEWAL JAHANIAN 29,517 142 251 S SIND GHOTKI UBAURO 29,454 51 252 P PUNJAB KHUSHAB MITHA TIWANA 29,343 143 253 N NWFP CHARSADDA UTMANZAI 29,050 33 254 P PUNJAB MANDI BAHAUDDIN PHALIA 28,987 144 255 S SIND THATTA SUJAWAL 28,971 52 256 B BALOCHISTAN DERA BUGTI DERA BUGTI 28,952 17 257 P PUNJAB KHANEWAL TULAMBA 28,626 145 258 B BALOCHISTAN PANJGUR CHITKAN 28,587 18 259 P PUNJAB SARGODHA JHAWARIAN 28,358 146 260 B BALOCHISTAN MASTUNG MASTUNG 28,221 19 261 P PUNJAB KASUR KHUDIAN 28,139 147 262 P PUNJAB BAHAWALPUR YAZMAN 28,125 148 263 P PUNJAB LEIAH KAROR LAL ESAN 28,070 149 264 P PUNJAB SHEIKHUPURA SAFDARABAD 28,048 150 265 P PUNJAB RAHIM YAR KHAN TRINDA SAWAI KHAN 28,019 151 266 B BALOCHISTAN KILLA SAIFULLAH MUSLIM BAGH 28,014 20 267 S SIND MIRPUR KHAS JHUDO 27,923 53 268 P PUNJAB BAHAWALPUR SAMASATTA 27,875 152 269 S SIND UMER KOT KUNRI 27,755 54 270 B BALOCHISTAN PISHIN PISHIN 27,665 21 271 P PUNJAB SARGODHA SILLANWALI 27,507 153 272 P PUNJAB RAHIM YAR KHAN KOT SAMABA 27,392 154 273 P PUNJAB BAHAWALPUR UCH SHARIF 27,387 155 274 P PUNJAB BAHAWALNAGAR DONGA BONGA 27,222 156 275 P PUNJAB JHELUM PIND DADAN KHAN 27,183 157 276 S SIND NAUSHAHRO FEROZE KANDIARO 27,152 55 277 P PUNJAB BHAKKAR KALUR KOT 27,080 158 278 P PUNJAB SHEIKHUPURA WARBURTON 26,793 159 279 P PUNJAB RAWALPINDI MURREE 26,789 160 280 N NWFP SWABI NAWAN KILLI 26,778 34 281 P PUNJAB MIANWALI DAUD KHEL 26,772 161 282 P PUNJAB GUJRAT KUNJAH 26,379 162 283 P PUNJAB BAHAWALNAGAR FAQIRWALI 26,100 163 284 P PUNJAB HAFIZABAD JALALPUR BHATTIAN 25,685 164 285 S SIND KHAIRPUR KOT DIJI 25,523 56 286 P PUNJAB KASUR RAJA JANG 25,482 165 287 NA NA Diamir Chilas 25,404 3 288 AMANGARH INDUSTRIAL N NWFP NOWSHERA AREA 25,379 35 289 P PUNJAB SIALKOT CHIWINDA 25,249 166 290 B BALOCHISTAN LASBELA BELA 25,135 22 291 P PUNJAB NAROWAL ZAFARWAL 25,075 167 292 P PUNJAB JHANG AHMED PUR SIAL 25,007 168 293 S SIND DADU JOHI 24,792 57 294 P PUNJAB SIALKOT JAMKE CHEEMA 24,534 169 295 P PUNJAB GUJRANWALA EMINABAD 24,363 170 296 N NWFP ABBOTTABAD NAWAN SHEHR 24,132 36 297 P PUNJAB RAWALPINDI KAHUTA 24,072 171 298 S SIND THARPARKAR MITHI 23,768 58 299 S SIND SHIKARPUR KHANPUR 23,728 59 300 P PUNJAB SAHIWAL KAMIR 23,651 172 301 P PUNJAB MUZAFFARGARH KHANGARH 23,539 173 302 N NWFP NOWSHERA AKORA KHATTAK 23,079 37 303 N NWFP LAKKI MARWAT SARAI NAURANG 23,037 38 304 S SIND SANGHAR SHAHPUR CHAKAR 22,782 60 305 P PUNJAB ATTOCK JAND 22,685 174 306 P PUNJAB KASUR KANGANPUR 22,683 175 307 S SIND KHAIRPUR THERI 22,648 61 308 S SIND KHAIRPUR HINGORJA 22,410 62 309 S SIND KHAIRPUR RANIPUR 22,356 63 310 A PAK BHIMBER BHIMBER 22,325 6 311 P PUNJAB RAJANPUR DAJAL 22,249 176 312 S SIND BADIN TALHAR 22,176 64 313 P PUNJAB SARGODHA FAROOQA 22,026 177 314 P PUNJAB SIALKOT KOTLI LOHARAN 22,018 178 315 S SIND MIRPUR KHAS NAUKOT 22,003 65 316 S SIND NAUSHAHRO FEROZE PADIDAN 21,814 66 317 P PUNJAB LODHRAN DHANOTE 21,734 179 318 N NWFP D. I. KHAN KULACHI 21,507 39 319 S SIND LARKANA WARAH 21,476 67 320 P PUNJAB MULTAN QADIRPUR RAN 21,445 180 321 P PUNJAB KHANEWAL MAKHDOOM PUR PAHORAN 20,903 181 322 S SIND NAWABSHAH QAZI AHMED 20,883 68 323 P PUNJAB OKARA AHMADABAD 20,833 182 324 S SIND MIRPUR KHAS KOT GHULAM MUHAMMAD 20,711 69 325 S SIND THATTA GHARO 20,580 70 326 S SIND UMER KOT DHORONARO 20,520 71 327 B BALOCHISTAN KHUZDAR WADH 20,439 23 328 S SIND HYDERABAD BHIT SHAH 20,212 72 329 P PUNJAB JHELUM MANGLA CANTT 20,059 183 330 B BALOCHISTAN LASBELA UTHAL 20,040 24 331

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B BALOCHISTAN MUSAKHEL MUSAKHEL 20,040 25 332 P PUNJAB RAJANPUR KOT MITHAN 19,989 184 333 P PUNJAB NAROWAL BADDOMALHI 19,966 185 334 B BALOCHISTAN KHUZDAR ZEHRI 19,851 26 335 S SIND DADU RADHAN 19,845 73 336 P PUNJAB RAHIM YAR KHAN AHMEDPUR LUMMA 19,842 186 337 S SIND HYDERABAD MATIARI 19,791 74 338 N NWFP KOHAT LACHI 19,727 40 339 S SIND DADU BHAN 19,618 75 340 P PUNJAB LEIAH FATEHPUR 19,564 187 341 P PUNJAB ATTOCK GHUR GHUSHTI 19,333 188 342 B BALOCHISTAN GWADAR JIWANI 19,213 27 343 P PUNJAB SARGODHA PHULARWAN 19,208 189 344 P PUNJAB MUZAFFARGARH SHEHR SULTAN 19,205 190 345 S SIND BADIN GOLARCHI 19,192 76 346 P PUNJAB GUJRAT SHADIWAL 19,160 191 347 S SIND BADIN TANDO GHULAM ALI 18,965 77 348 A PAK SUDHNOTI PALLANDARI 18,832 7 349 S SIND NAUSHAHRO FEROZE NAUSHAHRO FEROZE 18,744 78 350 P PUNJAB MANDI BAHAUDDIN MANGAT 18,728 192 351 S SIND KHAIRPUR FAQIRABAD 18,600 79 352 P PUNJAB MIANWALI ISAKHEL 18,546 193 353 S SIND NAUSHAHRO FEROZE THARUSHAH 18,515 80 354 S SIND NAWABSHAH DAUR 18,488 81 355 P PUNJAB JHELUM SOHAWA 18,408 194 356 P PUNJAB KHUSHAB NOUR THAL 18,403 195 357 P PUNJAB SARGODHA SHAHPUR SADDAR 18,253 196 358 S SIND SHIKARPUR LAKHI 17,957 82 359 P PUNJAB SIALKOT BHOPALWALA 17,907 197 360 P PUNJAB OKARA SADDAR GOGERA 17,887 198 361 B BALOCHISTAN CHAGAI DALBANDIN 17,867 28 362 P PUNJAB GUJRANWALA SODHRA 17,795 199 363 P PUNJAB CHAKWAL CHOA SAIDAN SHAH 17,662 200 364 B BALOCHISTAN BOLAN MACH 17,647 29 365 P PUNJAB BHAKKAR JANDANWALA 17,607 201 366 P PUNJAB MUZAFFARGARH DERA DIN PANAH 17,539 202 367 S SIND DADU THANO BULA KHAN 17,495 83 368 S SIND SANGHAR SINJHORO 17,439 84 369 B BALOCHISTAN LASBELA WINDER 17,407 30 370 P PUNJAB MIANWALI KALABAGH 17,320 203 371 S SIND UMER KOT CHHORE OLD 17,172 85 372 S SIND SANGHAR JHOL 17,046 86 373 P PUNJAB HAFIZABAD KALEKE 16,956 204 374 S SIND LARKANA DOKRI 16,908 87 375 S SIND THATTA CHUHAR JAMALI 16,673 88 376 B BALOCHISTAN LASBELA GADDANI 16,653 31 377 S SIND HYDERABAD SAEED ABAD 16,637 89 378 P PUNJAB JHANG BHAWANA 16,477 205 379 S SIND KHAIRPUR PIRYALOI 16,409 90 380 N NWFP D. I. KHAN PAHAR PUR 16,406 41 381 B BALOCHISTAN KOHLU KOHLU 16,359 32 382 P PUNJAB MIANWALI KAMAR MASHANI 16,334 206 383 P PUNJAB RAJANPUR ROJHAN 16,295 207 384 S SIND NAUSHAHRO FEROZE BHIRIA ROAD 16,198 91 385 P PUNJAB MIANWALI HARNOLI 16,188 208 386 S SIND MIRPUR KHAS TANDO JAN MUHAMMAD 16,111 92 387 S SIND BADIN TANDO BAGO 16,106 93 388 S SIND SHIKARPUR GARHI YASIN 16,010 94 389 S SIND NAWABSHAH DAULAT PUR 16,001 95 390 P PUNJAB BHAKKAR DULLEWALA 15,984 209 391 S SIND SHIKARPUR MADEJI 15,877 96 392 P PUNJAB VEHARI JALLA JEEM 15,821 210 393 P PUNJAB GUJRANWALA RASULNAGHAR 15,786 211 394 P PUNJAB KHANEWAL SARAI SIDHU 15,746 212 395 B BALOCHISTAN GWADAR ORMARA 15,730 33 396 B BALOCHISTAN BOLAN DHADAR 15,613 34 397 P PUNJAB SARGODHA MIANI 15,506 213 398 S SIND JACOBABAD GARHI KHAIRO 15,342 97 399 S SIND SHIKARPUR CHAK 15,264 98 400 S SIND SUKKUR KANDHRA 15,256 99 401 B BALOCHISTAN KALAT SURAB 14,891 35 402 B BALOCHISTAN BOLAN BHAG 14,837 36 403 B BALOCHISTAN JHAL MAGSI GANDAWA 14,770 37 404 P PUNJAB BAHAWALNAGAR MANDI SADIQ GANJ 14,764 214 405 S SIND KHAIRPUR KHUHRA 14,750 100 406 P PUNJAB KHUSHAB QUAIDABAD 14,588 215 407 N NWFP MANSEHRA BAFFA 14,539 42 408 P PUNJAB VEHARI TIBBA SULTANPUR 14,521 216 409 S SIND KHAIRPUR SOBHODERO 14,430 101 410 P PUNJAB SARGODHA SHAHPUR 14,408 217 411 NA NA Ghizer Gah Kuch 14,352 4 412 F FATA KURRAM AGENCY PARACHINAR 14,131 4 413 S SIND DADU THERI MOHABAT 14,106 102 414 P PUNJAB SHEIKHUPURA JINDIALA SHER KHAN 14,099 218 415 B BALOCHISTAN BARKHAN BARKHAN 14,068 38 416

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NA NA Ghanche Khaplu 13,918 5 417 P PUNJAB NAROWAL QILA SOBHA SINGH 13,886 219 418 P PUNJAB MANDI BAHAUDDIN QADIRABAD 13,349 220 419 P PUNJAB JHANG BAGH 13,311 221 420 P PUNJAB GUJRANWALA DHONKAL 13,302 222 421 B BALOCHISTAN KILLA SAIFULLAH KILLA SAIFULLAH 13,263 39 422 P PUNJAB SIALKOT KALASWALA 13,034 223 423 S SIND HYDERABAD CHAMBAR 12,948 103 424 B BALOCHISTAN JAFFARABAD SOHBATPUR 12,892 40 425 P PUNJAB VEHARI KARAMPUR 12,788 224 426 S SIND NAUSHAHRO FEROZE BHIRIA 12,738 104 427 B BALOCHISTAN SIBI HARNAI 12,659 41 428 P PUNJAB RAWALPINDI DAULTALA 12,597 225 429 S SIND THARPARKAR ISLAMKOT 12,582 105 430 P PUNJAB MULTAN MAKHDOOM RASHID 12,505 226 431 P PUNJAB SARGODHA LILLIANI 12,318 227 432 A PAK MIRPUR ISLAMGARH 12,124 8 433 S SIND LARKANA MIRO KHAN 12,103 106 434 N NWFP KOHAT SHAKARDARA 12,077 43 435 S SIND MIRPUR KHAS MIRWAH 12,006 107 436 P PUNJAB ATTOCK SANJWAL CANTT 11,951 228 437 A PAK MIRPUR DUDYAL 11,900 9 438 A PAK POONCH HAJIRA 11,881 10 439 S SIND SANGHAR SARHARI 11,876 108 440 S SIND HYDERABAD NASARPUR 11,821 109 441 S SIND THARPARKAR DIPLO 11,708 110 442 P PUNJAB BHAKKAR MANKERA 11,466 229 443 S SIND THATTA DARO 11,373 111 444 P PUNJAB KHUSHAB NOWSHERA 10,917 230 445 S SIND SANGHAR KHADRO 10,700 112 446 A PAK KOTLI SEHNSA 10,678 11 447 F FATA NORTH WAZIRISTAN AGENCY MIRAN SHAH 10,620 5 448 S SIND JACOBABAD TANGWANI 10,596 113 449 S SIND DADU SANN 10,578 114 450 S SIND NAWABSHAH SHAHPUR JAHANIA 10,425 115 451 S SIND SANGHAR BERANI 10,363 116 452 S SIND GHOTKI ADALPUR 10,155 117 453 N NWFP HANGU DOABA 10,141 44 454 S SIND KHAIRPUR PACCA CHANG 9,980 118 455 S SIND JACOBABAD BUXAPUR 9,814 119 456 S SIND KHAIRPUR THARI MIRWAH 9,755 120 457 S SIND JACOBABAD KARAMPUR 9,701 121 458 S SIND THATTA JATI 9,682 122 459 S SIND DADU PHULJI 9,515 123 460 S SIND NAWABSHAH BANDHI 9,487 124 461 S SIND SHIKARPUR RUSTAM 9,483 125 462 P PUNJAB SIALKOT BEGOWALA 9,446 231 463 S SIND KHAIRPUR KUMB 9,381 126 464 S SIND NAUSHAHRO FEROZE DARYA KHAN MARI 9,344 127 465 S SIND BADIN KHOSKI 9,275 128 466 S SIND THATTA MIRPUR BATHORO 9,238 129 467 S SIND UMER KOT SAMARO 9,056 130 468 S SIND KHAIRPUR BOZDAR WADA 8,923 131 469 S SIND BADIN RAJO KHANANI 8,878 132 470 S SIND THATTA MIRPUR SAKRO 8,877 133 471 S SIND SUKKUR BAGERJI 8,777 134 472 S SIND KHAIRPUR KARUNDI 8,683 135 473 S SIND HYDERABAD ODEROLAL STATION 8,393 136 474 A PAK MUZAFFARABAD ATHMUQAM 8,128 12 475 A PAK KOTLI FATEHPUR THAKIALA 7,930 13 476 A PAK MUZAFFARABAD HATTIAN BALA 7,886 14 477 S SIND LARKANA GARELLO 7,879 137 478 S SIND BADIN KADHAN 7,849 138 479 A PAK POONCH ABBASPUR 7,822 15 480 S SIND SANGHAR KANDIYARI 7,272 139 481 S SIND NAWABSHAH JAM SAHIB 7,070 140 482 S SIND HYDERABAD KHYBER 7,032 141 483 B BALOCHISTAN LORALAI DUKI 6,893 42 484 S SIND UMER KOT PITHORO 6,748 142 485 S SIND BADIN KARIO GHANWAR 6,477 143 486 S SIND UMER KOT NABISAR 6,470 144 487 A PAK MUZAFFARABAD GARHI DOPATTA 6,337 16 488 S SIND SANGHAR JAM NAWAZ ALI 5,524 145 489 S SIND UMER KOT SHADIPALI 5,507 146 490 A PAK MUZAFFARABAD CHIKAR 5,208 17 491 S SIND HYDERABAD BULRI 5,148 147 492 A PAK BAGH KAHUTA 3,865 18 493 S SIND THATTA KETI BUNDER 3,127 148 494 N NWFP NOWSHERA CHERAT CANTT. 2,986 45 495 S SIND SANGHAR TANDO MITHA KHAN 2,865 149 496 S SIND SANGHAR PERUMAL 2,674 150 497 B BALOCHISTAN ZIARAT ZIARAT 856 43 498 N NWFP ABBOTTABAD MURREE GALLIES CANTT 373 46 499 P: Punjab, S: Sindh, N:NWFP, C: Capital, B: Balochistan, NA: Northern Area, A:Azad Jammu & Kashmir, F: Federally Administered Areas National Rankings are from 1 to 112,1 being the worst and 112 the best. Provincial Rankings depend on the number of districts per province.

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Annexure - 11 Per Capita Income in Urban Pakistan

Prove: Code District National Rank Provincial Rank C ISLAMABAD 1 1 S Karachi 2 1 P Jhelum 3 1 P Sialkot 4 2 P Kasur 5 3 P Faisalabad 6 4 P Sheikhupura 7 5 A Mirpur 8 1 P Lahore 9 6 P Rawalpindi 10 7 S Hyderabad 11 2 N Peshawar 12 1 N Nowshera 13 2 N Haripur 14 3 B Quetta 15 1 P Mianwali 16 8 N Mardan 17 4 P Multan 18 9 N Swabi 19 5 P Rahim Yar Khan 20 10 N Swat 21 6 P D.G Khan 22 11 P Sahiwal 23 12 A Muzaffarabad 24 2 P Sargoda 25 13 P Khushab 26 14 B Killa Saifullah 27 2 P Gujranwala 28 15 B Kharan 29 3 P Muzaffargarh 30 16 S Sukkar 31 3 P Hafizabad 32 17 S Ghotki 33 4 S Larkana 34 5 S Khairpur 35 6 A Rawalakot 36 3 P Attock 36 18 S Thatta 38 7 S Badin 39 8 P Chakwal 40 19 P Jhang 41 20 F Kurram 42 1 A Bagh 43 4 A Kotli 44 5 P Khanewal 45 21 P Okara 45 22 P T.T.Singh 47 23 NA Gilgit 48 1 B Gawader 49 4 B Lasbela 50 5 P Gujrat 51 24 B Turbat 52 6 S Dadu 53 9 A Bhimber 54 6 P Mandi Bahaud Din 55 25 N Bannu 56 7

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F Khyber 57 2 P Bahawalpur 58 26 N Charsadda 59 8 P Pakpattan 60 27 S Sanghar 61 10 S Jacobabad 62 11 A Sudhnoti 63 7 NA Skardu 63 2 N D.I.Khan 65 9 B Kohlu 66 7 B Panjgur 67 8 P Bhakkar 67 28 B Ziarat 69 9 N Tank 69 10 B Barkhan 71 10 N Kohat 72 11 P Bahawalnagar 73 29 N Abbottabad 74 12 B Chagai 75 11 P Layyah 75 30 B Nasirabad 77 12 B Jhal Magsi 78 13 NA Ghizer 78 3 N Malakand 80 13 N Mansehra 81 14 N Lakki 82 15 N Hangu 82 16 B Loralai 84 14 N Chitral 85 17 B Mastung 86 15 B Jafarabad 87 16 N Lower Dir 88 18 B Zhob 89 17 B Bolan 89 18 B Kalat 91 19 B Killa Abdullah 91 20 N Karak 91 19 B Pishin 94 21 B Sibi 95 22 B Khuzdar 96 23 B Musa Khel 97 24 N Upper Dir 97 20 B Dera Bugti 99 25 P Vehari 100 31 P Lodhran 101 32 S Nawabshah 101 12 S Noushero Feroze 103 13 NA Diamer 104 4 NA Ghanche 104 5 P Narowal 106 33 P Rajanpur 107 34 S Mirpurkhas 108 14 F N.Waziristan 109 3 S Shikarpur 110 15 S Umerkot 111 16 S Tharparkar 112 17 PAK:Azad Jammu & Kashmir, FATA: Federally Administered Tribal Areas No Urban Areas in theseDistricts:NWFP:Buner,Shangla,Kohistan,BattagramBalochistan:Awaran,FATA:Bajour,Mohamand,Orakzai,S.Waziristan.

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Annexure - 12 No. of Towns by Population in Pakistan Pop Pop of Pop of Pop of Pop of Pop of Pop of Pop of Pop of of towns towns towns towns Towns Towns Towns Towns towns 1,000 10,000 25,000 50000 100000 200,000 500,000 above Prove: below ------1 S.No. Code District 1,000 9,999 24,999 49,999 99,999 199,999 499999 1,000,000 million P U N J A B 1 P Bahawalnagar 1 4 1 2 2 P Bahawalpur 4 1 1 1 3 P Rahim Yar Khan 1 4 2 1 4 P D.G Khan 1 1 5 P Layyah 1 2 1 6 P Muzaffargarh 3 2 1 2 7 P Rajanpur 3 1 2 8 P Faisalabad 5 1 1 1 9 P Jhang 2 3 2 2 10 P T.T.Singh 1 1 2 11 P Gujranwala 4 2 3 2 1 12 P Gujrat 1 3 3 1 13 P Hafizabad 1 3 1 14 P Mandi Bahaud Din 2 2 1 15 P Narowal 2 1 2 16 P Sialkot 1 4 1 2 1 1 17 P Kasur 1 4 3 1 18 P Lahore 2 1 19 P Okara 2 2 3 1 20 P Sheikhupura 1 6 6 1 1 21 P Khanewal 2 3 2 1 22 P Lodhran 1 1 2 23 P Multan 2 1 1 1 24 P Pakpattan 1 1 25 P Sahiwal 1 1 1 26 P Vehari 3 1 2 27 P Attock 3 4 2 28 P Chakwal 1 1 1 29 P Jhelum 2 2 1 1 30 P Rawalpindi 2 1 2 1 1 31 P Bhakkar 3 1 2 32 P Khushab 3 3 1 33 P Mianwali 4 3 1 34 P Sargoda 6 5 1 1 1 N W F P 35 N Tank 1 36 N D.I.Khan 2 1 37 N Lakki 1 1 38 N Bannu 1 39 N Karak 1 40 N Kohat 2 1 41 N Hangu 1 2 42 N Peshawar 1 43 N Nowshera 1 1 4 1 44 N Charsadda 2 1 1 45 N Mardan 1 1 46 N Swabi 4 1 47 N Swat 1 48 N Malakand 1 49 N Lower Dir 1 50 N Upper Dir 51 N Chitral 1 1 52 N Mansehra 1 1 53 N Abbottabad 1 1 1 1 54 N Haripur 1 1 S I N D H 55 S Khairpur 5 7 4 1 56 S Ghotki 1 2 2 57 S Jacobabad 2 2 4 1 1 58 S Sukkar 1 1 2 1 59 S Shikarpur 1 5 1

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60 S Nawabshah 2 4 1 1 61 S Noushero Feroze 1 5 2 1 62 S Larkana 1 3 3 3 1 63 S Sanghar 4 6 1 2 1 64 S Mirpurkhas 4 2 1 65 S Tharparkar 3 66 S Umerkot 4 2 2 67 S Dadu 1 6 4 1 1 68 S Hyderabad 3 5 2 1 1 1 69 S Badin 4 4 2 70 S Thatta 4 3 2 71 S Karachi 1 B A L O C H I S T A N 72 B Quetta 1 73 B Pishin 1 74 B Killa Abdullah 1 75 B Chagai 1 1 76 B Zhob 1 77 B Loralai 1 1 78 B Killa Saifullah 1 1 79 B Sibi 1 1 80 B Ziarat 1 81 B Dera Bugti 1 82 B Kohlu 1 83 B Nasirabad 1 84 B Kalat 1 1 85 B Mastung 1 86 B Khuzdar 2 87 B Lasbela 3 1 1 1 88 B Kharan 1 89 B Turbat 1 90 B Panjgur 1 91 B Gawader 2 1 1 92 B Barkhan 1 93 B Bolan 3 94 B Jafarabad 1 95 B Jhal Magsi 1 96 B Musa Khel 1 N O R T H E R N A R E A S 97 NA Diamer 1 98 NA Gilgit 1 99 NA Ghanche 1 100 NA Ghizer 1 101 NA Skardu 1 A Z A D J A M U & K A S H M I R 102 A Muzaffarabad 4 1 103 A Bagh 1 1 104 A Rawalakot 1 1 1 105 A Mirpur 2 1 106 A Bhimber 1 107 A Sudhnoti 1 108 A Kotli 1 1 1 F A T A 109 F Khyber 1 1 110 F Kurram 1 1 111 F N.Waziristan 1 C A P I T A L 112 c ISLAMABAD 1 PAK:Azad Jammu & Kashmir, FATA: Federally Administered Tribal Areas No Urban Areas in theseDistricts:NWFP:Buner,Shangla,Kohistan,BattagramBalochistan:Awaran,FATA:Bajour,Mohamand,Orakzai,S.Waziristan.

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Annexure - 13 Food Insecurity in Urban Pakistan 2006 Provincial Provincial Provincial Provincial Provincial Provincial Provincial Provincial National National National National District District District District Rank Rank Rank Rank Code Code Code Code Code Rank Rank Rank Rank

Punjab Balochistan NWFP Sindh P Rajanpur 33 1 B Musa Khel 1 1 N Karak 16 1 S Tharparkar 7 1 P Lodhran 35 2 B Panjgur 5 2 N Upper Dir 26 2 S Umerkot 17 2 P Layyah 40 3 B Jhal Magsi 8 3 N Hangu 30 3 S Jacobabad 24 3 P Bhakkar 45 4 B Khuzdar 9 4 N Malakand 37 4 S Shikarpur 29 4 P Muzaffargarh 53 5 B Kohlu 10 5 N Lakki 39 5 S Khairpur 34 5 P Khanewal 54 6 B Killa Saifullah 12 6 N Charsadda 41 6 S Noushero Feroze 38 6 P Okara 57 7 B Nasirabad 13 7 N Chitral 43 7 S Badin 46 7 P Bahawalpur 60 8 B Kharan 14 8 N Lower Dir 50 8 S Ghotki 47 8 P Jhang 61 9 B Mastung 15 9 N D.I.Khan 56 9 S Thatta 51 9 P Khushab 63 10 B Dera Bugti 18 10 N Swabi 64 10 S Larkana 52 10 P T.T.Singh 65 11 B Barkhan 19 11 N Swat 66 11 S Dadu 55 11 P Hafizabad 70 12 B Bolan 20 12 N Tank 69 12 S Sanghar 62 12 P Vehari 71 13 B Turbat 21 13 N Kohat 72 13 S Nawabshah 74 13 P Pakpattan 73 14 B Killa Abdullah 22 14 N Mardan 80 14 S Sukkar 76 14 P Bahawalnagar 77 15 B Lasbela 23 15 N Mansehra 81 15 S Mirpurkhas 84 15 Mandi Bahaud 10 P Din 78 16 B Loralai 25 16 N Bannu 83 16 S Hyderabad 2 16 11 P Chakwal 79 17 B Kalat 27 17 N Nowshera 90 17 S Karachi 1 17 P Mianwali 82 18 B Jafarabad 28 18 N Abbottabad 98 18 Northern Areas Rahim Yar P Khan 85 19 B Chagai 32 19 N Peshawar 99 19 NA Diamer 3 1 P Narowal 87 20 B Gawader 36 20 N Haripur 101 20 NA Ghizer 4 2

P Sargoda 88 21 B Pishin 42 21 FATA NA Ghanche 6 3 P Attock 91 22 B Sibi 44 22 F Kurram 2 1 NA Skardu 49 4 P Multan 93 23 B Zhob 48 23 F Khyber 11 2 NA Gilgit 92 5 P Gujrat 94 24 B Ziarat 68 24 F N.Waziristan 31 3 P D.G Khan 95 25 B Quetta 100 25 Capital P Gujranwala 96 26 PAK C Islamabad 112 1 P Sahiwal 97 27 A Sudhnoti 58 1 P Kasur 103 28 A Rawalakot 59 2 P Sheikhupura 104 29 A Kotli 67 3 P Faisalabad 105 30 A Bagh 75 4 P Rawalpindi 107 31 A Bhimber 86 5 P Jhelum 108 32 A Muzaffarabad 89 6 P Lahore 109 33 A Mirpur 106 7 P Sialkot 110 34 Extremely Food Insecure Very Food Insecure Food Insecure Moderately Secure Reasonably Secure

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Annexure - 14 Food Insecurity Ranking in Urban Pakistan 2006 Population Po Po Provincial Provincial Provincial Ranking National Ranking National Ranking National District District District Urban Urban Urban Urban Code Code Code p p ulation ulation % % % %

Extremely Insecure B Musa Khel 10 1 B Kharan 14 14 B Kalat 16 27 F Kurram 6 2 B Mastung 15 15 B Jafarabad 22 28 NA Diamer 8 3 N Karak 7 16 S Shikarpur 25 29 NA Ghizer 10 4 S Umerkot 15 17 N Hangu 21 30 B Panjgur 10 5 B Dera Bugti 10 18 F N.Waziristan 2 31 NA Ghanche 15 6 B Barkhan 8 19 B Chagai 19 32 S Tharparkar 4 7 B Bolan 14 20 P Rajanpur 15 33 B Jhal Magsi 8 8 B Turbat 17 21 S Khairpur 23 34 B Khuzdar 31 9 B Killa Abdullah 15 22 P Lodhran 15 35 B Kohlu 11 10 B Lasbela 41 23 B Gawader 58 36 F Khyber 14 11 S Jacobabad 26 24 N Malakand 10 37 B Killa Saifullah 15 12 B Loralai 13 25 S Noushero Feroze 18 38 B Nasirabad 17 13 N Upper Dir 4 26 N Lakki 10 39 Very Insecure P Layyah 13 40 N D.I.Khan 14 56 P Vehari 16 71 N Charsadda 19 41 P Okara 24 57 N Kohat 27 72 B Pishin 6 42 A Sudhnoti 4 58 P Pakpattan 14 73 N Chitral 11 43 A Rawalakot 13 59 S Nawabshah 28 74 B Sibi 33 44 P Bahawalpur 28 60 A Bagh 6 75 P Bhakkar 16 45 P Jhang 23 61 S Sukkar 53 76 S Badin 17 46 S Sanghar 23 62 P Bahawalnagar 19 77 S Ghotki 17 47 P Khushab 26 63 P Mandi Bahaud Din 16 78 B Zhob 16 48 N Swabi 19 64 P Chakwal 13 79 NA Skardu 13 49 P T.T.Singh 19 65 N Mardan 21 80 N Lower Dir 7 50 N Swat 14 66 N Mansehra 5 81 S Thatta 11 51 A Kotli 8 67 P Mianwali 21 82 S Larkana 30 52 B Ziarat 2 68 N Bannu 8 83 P Muzaffargarh 13 53 N Tank 15 69 S Mirpurkhas 33 84 P Khanewal 18 54 P Hafizabad 28 70 P Rahim Yar Khan 20 85 S Dadu 23 55 Less Insecure A Bhimber 4 86 N Nowshera 26 90 P Gujrat 27 94 P Narowal 13 87 P Attock 22 91 P D.G Khan 14 95 P Sargoda 29 88 NA Gilgit 23 92 A Muzaffarabad 12 89 P Multan 43 93 Moderately Secure P Gujranwala 52 96 B Quetta 74 100 P Sheikhupura 28 104 P Sahiwal 16 97 N Haripur 12 101 N Abbottabad 18 98 S Hyderabad 52 102 N Peshawar 48 99 P Kasur 23 103 Reasonably Secure P Faisalabad 44 105 P Jhelum 31 108 S Karachi 94 111 A Mirpur 34 106 P Lahore 82 109 C Islamabad 66 112 P Rawalpindi 54 107 P Sialkot 26 110 1- Being the most Food Insecure

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Annexure - 15 Composite indicators of Urban Food Security 1 2 3 4 5 Prov Food Affordability Health & Discrimination ince Index Housing Livelihood Sanitation Index S. Cod Food (Kcal) Index Access index Index Gender Gap No. e District Consumption Composite Composite Composite Literacy ratio 1 P Bahawalnagar 0.374 0.237 0.533 0.581 0.126 2 P Bahawalpur 0.387 0.272 0.522 0.658 0.165 3 P Rahim Yar Khan 0.533 0.246 0.503 0.658 0.152 4 P D.G Khan 0.524 0.183 0.472 0.611 0.071 5 P Layyah 0.374 0.28 0.533 0.798 0.211 6 P Muzaffargarh 0.436 0.276 0.524 0.775 0.181 7 P Rajanpur 0.364 0.317 0.591 0.75 0.211 8 P Faisalabad 0.817 0.108 0.383 0.645 0.164 9 P Jhang 0.419 0.215 0.539 0.732 0.163 10 P T.T.Singh 0.402 0.208 0.506 0.671 0.225 11 P Gujranwala 0.437 0.044 0.466 0.609 0.072 12 P Gujrat 0.426 0.05 0.442 0.614 0.108 13 P Hafizabad 0.427 0.109 0.548 0.77 0.177 14 P Mandi Bahaud Din 0.393 0.053 0.502 0.758 0.167 15 P Narowal 0.365 0.069 0.504 0.658 0.061 16 P Sialkot 0.871 0.04 0.317 0.56 0.153 17 P Kasur 0.823 0.094 0.43 0.686 0.193 18 P Lahore 0.714 0.045 0.376 0.405 0.059 19 P Okara 0.403 0.209 0.518 0.759 0.208 20 P Sheikhupura 0.769 0.072 0.433 0.661 0.114 21 P Khanewal 0.403 0.27 0.522 0.717 0.206 22 P Lodhran 0.368 0.294 0.625 0.73 0.242 23 P Multan 0.545 0.169 0.47 0.64 0.112 24 P Pakpattan 0.382 0.213 0.53 0.609 0.176 25 P Sahiwal 0.508 0.136 0.461 0.602 0.063 26 P Vehari 0.369 0.188 0.529 0.628 0.178 27 P Attock 0.425 0.081 0.455 0.58 0.233 28 P Chakwal 0.419 0.119 0.488 0.704 0.18 29 P Jhelum 0.937 0.079 0.297 0.632 0.164 30 P Rawalpindi 0.703 0.032 0.344 0.517 0.105 31 P Bhakkar 0.377 0.243 0.555 0.744 0.261 32 P Khushab 0.449 0.193 0.55 0.691 0.285 33 P Mianwali 0.583 0.178 0.535 0.694 0.319 34 P Sargoda 0.463 0.085 0.499 0.714 0.141 35 N Tank 0.376 0.196 0.625 0.488 0.347 36 N D.I.Khan 0.381 0.291 0.488 0.677 0.212 37 N Lakki 0.371 0.368 0.593 0.586 0.373 38 N Bannu 0.39 0.167 0.518 0.497 0.272 39 N Karak 0.37 0.465 0.601 0.605 0.438 40 N Kohat 0.375 0.154 0.506 0.613 0.277 41 N Hangu 0.371 0.209 0.619 0.744 0.404 42 N Peshawar 0.622 0.127 0.46 0.498 0.242 43 N Nowshera 0.605 0.11 0.454 0.711 0.338 44 N Charsadda 0.385 0.276 0.58 0.723 0.322 45 N Mardan 0.557 0.167 0.493 0.746 0.303 46 N Swabi 0.534 0.166 0.572 0.761 0.355 47 N Swat 0.528 0.316 0.507 0.676 0.269 48 N Malakand 0.373 0.25 0.666 0.739 0.261 49 N Lower Dir 0.371 0.202 0.615 0.635 0.364 50 N Upper Dir 0.37 0.336 0.655 0.719 0.286 51 N Chitral 0.371 0.352 0.542 0.61 0.333 52 N Mansehra 0.372 0.141 0.47 0.648 0.145 53 N Abbottabad 0.427 0.085 0.422 0.464 0.173 54 N Haripur 0.602 0.069 0.434 0.503 0.199 55 S Khairpur 0.425 0.403 0.526 0.74 0.253 56 S Ghotki 0.427 0.261 0.553 0.736 0.319 57 S Jacobabad 0.381 0.304 0.576 0.726 0.452 58 S Sukkar 0.432 0.226 0.57 0.587 0.232 59 S Shikarpur 0.343 0.377 0.541 0.707 0.226 60 S Nawabshah 0.368 0.191 0.53 0.579 0.212 61 S Noushero Feroze 0.366 0.274 0.58 0.745 0.266 62 S Larkana 0.425 0.298 0.555 0.695 0.236

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63 S Sanghar 0.382 0.195 0.533 0.656 0.224 64 S Mirpurkhas 0.361 0.15 0.525 0.534 0.171 65 S Tharparkar 0.304 0.415 0.77 0.8 0.324 66 S Umerkot 0.321 0.372 0.595 0.704 0.325 67 S Dadu 0.396 0.258 0.556 0.672 0.251 68 S Hyderabad 0.655 0.102 0.415 0.535 0.111 69 S Badin 0.424 0.347 0.556 0.684 0.271 70 S Thatta 0.425 0.394 0.553 0.629 0.197 71 S Karachi 0.955 0.039 0.302 0.543 0.078 72 B Quetta 0.589 0.222 0.508 0.313 0.215 73 B Pishin 0.332 0.391 0.629 0.579 0.189 74 B Killa Abdullah 0.332 0.455 0.731 0.599 0.241 75 B Chagai 0.336 0.511 0.595 0.559 0.173 76 B Zhob 0.332 0.357 0.556 0.489 0.366 77 B Loralai 0.333 0.432 0.543 0.607 0.336 78 B Killa Saifullah 0.405 0.573 0.608 0.727 0.199 79 B Sibi 0.332 0.369 0.594 0.582 0.235 80 B Ziarat 0.338 0.034 0.62 0.539 0.458 81 B Dera Bugti 0.332 0.458 0.66 0.622 0.29 82 B Kohlu 0.341 0.465 0.608 0.709 0.374 83 B Nasirabad 0.335 0.439 0.652 0.714 0.237 84 B Kalat 0.332 0.46 0.588 0.61 0.231 85 B Mastung 0.333 0.454 0.608 0.685 0.272 86 B Khuzdar 0.332 0.531 0.684 0.826 0.188 87 B Lasbela 0.361 0.399 0.609 0.744 0.242 88 B Kharan 0.399 0.521 0.674 0.608 0.377 89 B Turbat 0.359 0.429 0.59 0.685 0.309 90 B Panjgur 0.339 0.757 0.679 0.8 0.005 91 B Gawader 0.361 0.527 0.62 0.631 0.014 92 B Barkhan 0.338 0.49 0.647 0.606 0.283 93 B Bolan 0.332 0.446 0.668 0.627 0.274 94 B Jafarabad 0.333 0.382 0.666 0.631 0.227 95 B Jhal Magsi 0.335 0.641 0.698 0.717 0.212 96 B Musa Khel 0.332 0.945 0.78 0.816 0.175 97 NA Diamer 0.365 0.773 0.731 0.773 0.08 98 NA Gilgit 0.401 0.101 0.509 0.497 0.208 99 NA Ghanche 0.365 0.777 0.652 0.796 0.053 100 NA Ghizer 0.373 0.731 0.581 0.822 0.159 101 NA Skardu 0.381 0.352 0.515 0.601 0.303 102 A Muzaffarabad 0.475 0.136 0.498 0.631 0.199 103 A Bagh 0.416 0.17 0.54 0.672 0.18 104 A Rawalakot 0.425 0.213 0.519 0.777 0.164 105 A Mirpur 0.731 0.052 0.391 0.486 0.156 106 A Bhimber 0.396 0.065 0.489 0.647 0.176 107 A Sudhnoti 0.381 0.163 0.554 0.758 0.176 108 A Kotli 0.411 0.288 0.498 0.592 0.215 109 F Khyber 0.364 0.383 0.686 0.666 0.516 110 F Kurram 0.395 0.933 0.688 0.638 0.382 111 F N.Waziristan 0.336 0.236 0.651 0.614 0.474 112 C Islamabad 1 0.097 0.18 0.202 0.135

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Annexure 16 Correlations of Major Indicators

HH without Gender HH without Semi- Both HH Food (Kcal) Kacha safe Hospital Gap- electricity Kacha Kacha+semi Unemployment Income Illeterate without consumption houses potable Beds Literacy connection houses kacha toilets water Ratio

Food (Kcal) consumption 1 -.236(*) -.540(**) -.203(*) -.568(**) -.454(**) .976(**) -.520(**) -.378(**) -0.156 .392(**) -.325(**) HH without electricity connection 1 .406(**) .366(**) .503(**) .401(**) -.212(*) .559(**) .497(**) .230(*) -0.118 -0.162 Kacha houses 1 0.048 .934(**) .497(**) -.492(**) .702(**) .658(**) -0.009 -0.148 .274(**) Semi-Kacha houses 1 .403(**) .230(*) -.202(*) .252(**) 0.019 0.101 -0.071 0.136 Both Kacha+semi kacha 1 .538(**) -.524(**) .734(**) .609(**) 0.028 -0.161 .300(**) Unemployment 1 -.438(**) .580(**) .368(**) 0.103 -0.161 .325(**) Income 1 -.485(**) -.370(**) -0.18 .491(**) -.307(**) Illeterate 1 .646(**) 0.156 -.261(**) .360(**) HH without toilets 1 0.099 -0.079 0.136 HH without safe potable water 1 -.344(**) -0.034 Hospital Beds 1 -0.075 Gender Gap-Literacy Ratio 1 * Correlation is significant at the 0.05 level (2-tailed). ** Correlation is significant at the 0.01 level (2-tailed).

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Annexure - 17 Household Without Toilet Facilities in Urban Pakistan 2004-05 Provincial Provincial Provincial Provincial Provincial Provincial National National National District District District Rank Rank Rank Rank Rank Rank Rank Code Code Code

B Musa Khel 1 1 N Swat 39 6 P Gujrat 77 26 NA Ghanche 2 1 N Swabi 40 7 S Thatta 78 12 NA Ghizer 3 2 P Hafizabad 41 6 S Sukkar 79 11 NA Diamer 4 3 P Jhang 42 7 B Loralai 80 13 B Kohlu 5 2 P Mandi Bahaud Din 43 8 B Mastung 81 15 A Sudhnoti 6 1 B Lasbela 44 10 B Ziarat 82 14 B Jafarabad 7 3 N Mansehra 45 8 P Sahiwal 83 30 A Rawalakot 8 2 P Muzaffargarh 46 11 S Hyderabad 84 13 A Muzaffarabad 9 3 P Bhakkar 47 12 B Kalat 85 16 NA Skardu 10 4 P Bahawalpur 48 10 B Bolan 86 17 N Mardan 11 1 P Sargoda 49 13 P D.G Khan 87 28 B Dera Bugti 12 4 N Karak 50 9 N Abbottabad 88 14 B Quetta 13 5 B Khuzdar 51 11 P Lahore 89 29 N Kohat 14 2 P Bahawalnagar 52 9 N D.I.Khan 90 15 S Umerkot 15 1 P Khanewal 53 14 P Sheikhupura 91 32 F N.Waziristan 16 1 N Tank 54 10 P Kasur 92 31 A Bhimber 17 4 P Vehari 55 15 P Chakwal 93 33 A Kotli 18 5 P Mianwali 56 17 N Peshawar 94 17 F Khyber 19 2 N Nowshera 57 11 N Lakki 95 16 S Larkana 20 2 P Attock 58 16 B Chagai 96 18 NA Gilgit 21 5 S Shikarpur 59 5 S Karachi 97 14 A Bagh 22 6 P Multan 60 20 C Islamabad 98 1 F Kurram 23 3 S Badin 61 6 B Zhob 99 19 B Panjgur 24 6 P Rajanpur 62 18 S Noushero Feroze 100 15 A Mirpur 25 7 B Nasirabad 63 12 P Rawalpindi 101 34 S Tharparkar 26 3 P Sialkot 64 19 B Pishin 102 20 N Upper Dir 27 3 N Bannu 65 12 B Turbat 103 23 N Malakand 28 4 S Ghotki 66 7 N Haripur 104 18 P Khushab 29 1 S Jacobabad 67 8 B Kharan 105 22 P Lodhran 30 2 P Rahim Yar Khan 68 21 B Killa Abdullah 106 21 B Barkhan 31 7 S Mirpurkhas 69 9 S Nawabshah 107 16 S Khairpur 32 4 P Faisalabad 70 22 N Charsadda 108 20 B Killa Saifullah 33 8 P T.T.Singh 71 23 S Sanghar 109 17 N Chitral 34 5 S Dadu 72 10 N Hangu 110 19 P Okara 35 3 N Lower Dir 73 13 B Gawader 111 25 B Jhal Magsi 36 9 P Layyah 74 24 B Sibi 112 24 P Jhelum 37 4 P Gujranwala 75 25 P Narowal 38 5 P Pakpattan 76 27 P: Punjab, S: Sindh, N:NWFP, C: Capital, B: Balochistan, NA: Northern Area, A:Azad Jammu & Kashmir, F: Federally Administered Areas National Rankings are from 1 to 112,1 being the worst and 112 the best. Provincial Rankings depend on the number of districts per province.

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Annexure - 18 Household without Safe Drinking Tap Water in Urban Pakistan 2004-05 Provincial Provincial Provincial Provincial Provincial Provincial National National National District District District Rank Rank Rank Rank Rank Rank Code Code Code Code

P Layyah 1 1 N Nowshera 39 7 P Rawalpindi 77 30 P Jhang 2 2 P Sheikhupura 40 20 S Sukkar 78 14 Mandi Bahaud P Din 3 3 F N.Waziristan 41 1 S Dadu 79 15 P Khanewal 4 4 A Bhimber 42 4 A Rawalakot 80 6 N Swabi 5 1 P Faisalabad 43 21 B Pishin 81 23 P Muzaffargarh 6 5 P T.T.Singh 44 22 N Lower Dir 82 16 S Ghotki 7 1 S Sanghar 45 8 B Kalat 83 9 A Mirpur 8 1 B Killa Saifullah 46 24 B Turbat 84 10 S Shikarpur 9 2 S Badin 47 9 N Peshawar 85 17 P Bhakkar 10 6 B Musa Khel 48 3 S Mirpurkhas 86 16 NA Gilgit 11 1 F Kurram 49 2 B Bolan 87 11 S Larkana 12 3 N Hangu 50 8 A Sudhnoti 88 7 P Hafizabad 13 7 S Umerkot 51 10 N Haripur 89 24 S Khairpur 14 4 N Upper Dir 52 9 P D.G Khan 90 31 P Lodhran 15 9 A Bagh 53 5 B Kharan 91 12 P Okara 16 8 F Khyber 54 3 N Chitral 92 18 N D.I.Khan 17 2 P Kasur 55 23 N Tank 93 19 P Multan 18 12 P Gujrat 56 24 N Lakki 94 20 P Gujranwala 19 11 P Sahiwal 57 25 N Swat 95 21 P Bahawalpur 20 10 P Attock 58 26 B Loralai 96 13 S Jacobabad 21 5 P Rajanpur 59 27 P Bahawalnagar 97 32 P Sargoda 22 14 N Karak 60 10 P Lahore 98 33 P Vehari 23 13 S Thatta 61 11 N Abbottabad 99 22 B Dera Bugti 24 1 B Jhal Magsi 62 25 B Chagai 100 14 N Malakand 25 3 B Nasirabad 63 4 S Karachi 101 17 S Noushero Feroze 26 6 N Kohat 64 11 B Quetta 102 15 N Mardan 27 4 NA Ghizer 65 12 B Mastung 103 16 A Kotli 28 2 NA Ghanche 66 13 B Panjgur 104 17 S Nawabshah 29 7 B Jafarabad 67 5 B Gawader 105 18 A Muzaffarabad 30 3 NA Diamer 68 14 C Islamabad 106 26 P Mianwali 31 16 S Hyderabad 69 12 B Killa Abdullah 107 19 P Rahim Yar Khan 32 15 B Barkhan 70 6 B Sibi 108 20 P Narowal 33 17 P Sialkot 71 28 P Jhelum 109 34 N Charsadda 34 5 B Khuzdar 72 7 B Ziarat 110 21 P Khushab 35 18 P Chakwal 73 29 B Zhob 111 22 NA Skardu 36 6 S Tharparkar 74 13 N Bannu 112 23 P Pakpattan 37 19 N Mansehra 75 15 B Kohlu 38 2 B Lasbela 76 8 P: Punjab, S: Sindh, N:NWFP, C: Capital, B: Balochistan, NA: Norther Area, A:Azad Jammu & Kashmir, F: Federaly Administered Areas National Rankings are from 1 to 112,1 being the worst and 112 the best. Provincial Rankings depend on the number of districts per province.

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Annexure-19 Household without Electricity Connection in Urban Pakistan 2004-05 Provincial Provincial Provincial Provincial Provincial Provincial National National National District District District District Rank Rank Rank Rank Rank Rank Code Code Code Code

B Musa Khel 1 1 N Mansehra 39 4 P Sargoda 77 20 F Kurram 2 1 P Vehari 40 8 P Rawalpindi 78 21 NA Ghanche 3 1 P Khanewal 41 9 N Charsadda 79 8 NA Ghizer 4 2 S Hyderabad 42 8 B Zhob 80 23 B Panjgur 5 2 P Bahawalnagar 43 10 B Ziarat 81 24 NA Diamer 6 3 S Ghotki 44 9 P Faisalabad 82 22 S Tharparkar 7 1 P Muzaffargarh 45 11 S Larkana 83 17 S Umerkot 8 2 P Rahim Yar Khan 46 12 P Hafizabad 84 23 S Badin 9 3 S Sanghar 47 10 P Sahiwal 85 24 S Thatta 10 4 P Mianwali 48 13 P Layyah 86 25 B Kohlu 11 3 B Turbat 49 14 P T.T.Singh 87 26 B Dera Bugti 12 4 S Mirpurkhas 50 11 N Nowshera 88 9 B Chagai 13 5 S Nawabshah 51 12 P Chakwal 89 27 B Jhal Magsi 14 6 A Sudhnoti 52 2 P Gujrat 90 28 B Kharan 15 7 N D.I.Khan 53 5 A Mirpur 91 4 B Jafarabad 16 8 P Rajanpur 54 14 P Gujranwala 92 29 B Khuzdar 17 9 C Islamabad 55 1 N Karak 93 10 P Khushab 18 1 P Multan 56 15 N Swat 94 11 B Pishin 19 10 N Kohat 57 6 N Lower Dir 95 12 P Bahawalpur 20 2 P Sheikhupura 58 16 N Tank 96 13 N Malakand 21 1 B Loralai 59 15 A Rawalakot 97 5 N Upper Dir 22 2 B Mastung 60 16 N Bannu 98 14 B Barkhan 23 11 S Noushero Feroze 61 13 N Peshawar 99 15 Mandi Bahaud F N.Waziristan 24 2 P Jhelum 62 17 P Din 100 30 F Khyber 25 3 P Lahore 63 18 N Haripur 101 16 P Lodhran 26 3 S Karachi 64 14 P Pakpattan 102 31 S Shikarpur 27 5 NA Gilgit 65 5 B Killa Abdullah 103 25 P Okara 28 4 B Nasirabad 66 17 N Lakki 104 17 S Khairpur 29 6 B Kalat 67 18 P Attock 105 32 N Chitral 30 3 P Kasur 68 19 N Hangu 106 18 P Jhang 31 5 B Bolan 69 19 N Mardan 107 19 S Jacobabad 32 7 B Quetta 70 20 P Sialkot 108 33 B Lasbela 33 12 N Abbottabad 71 7 A Kotli 109 6 P D.G Khan 34 6 S Sukkar 72 15 N Swabi 110 20 B Gawader 35 13 A Bagh 73 3 A Bhimber 111 7 P Bhakkar 36 7 S Dadu 74 16 P Narowal 112 34 NA Skardu 37 4 B Killa Saifullah 75 21 A Muzaffarabad 38 1 B Sibi 76 22 P: Punjab, S: Sindh, N:NWFP, C: Capital, B: Balochistan, NA: Northern Area, A:Azad Jammu & Kashmir, F: Federally Administered Areas National Rankings are from 1 to 112,1 being the worst and 112 the best. Provincial Rankings depend on the number of districts per province.

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Annexure-20 Population in Kacha Houses in Urban Pakistan Provincial Provincial Provincial Provincial Provincial Provincial National National National District District District Rank Rank Rank Rank Rank Rank Code Code Code Code

B Jhal Magsi 1 1 P Lodhran 39 1 N Mansehra 77 16 B Musa Khel 2 2 S Umerkot 40 5 N Nowshera 78 17 B Kharan 3 3 P Rajanpur 41 2 NA Gilgit 79 5 B Killa Saifullah 4 4 N Malakand 42 7 P Bahawalnagar 80 15 B Kalat 5 5 F N.Waziristan 43 2 A Muzaffarabad 81 5 B Barkhan 6 6 S Tharparkar 44 6 S Badin 82 13 B Khuzdar 7 7 N Hangu 45 8 P Jhang 83 16 NA Ghanche 8 1 P Layyah 46 3 N Swat 84 18 NA Ghizer 9 2 F Kurram 47 3 S Mirpurkhas 85 14 B Turbat 10 8 P Muzaffargarh 48 4 P Khushab 86 17 NA Diamer 11 3 S Noushero Feroze 49 7 P Chakwal 87 18 B Kohlu 12 9 A Rawalakot 50 2 P T.T.Singh 88 19 B Chagai 13 10 S Dadu 51 8 P Hafizabad 89 20 B Bolan 14 11 A Sudhnoti 52 3 A Bhimber 90 6 B Nasirabad 15 12 A Bagh 53 4 P Kasur 91 21 B Loralai 16 13 S Ghotki 54 9 P Attock 92 22 F Khyber 17 1 S Sukkar 55 10 S Hyderabad 93 15 B Zhob 18 14 P Bhakkar 56 5 P Sahiwal 94 23 B Mastung 19 15 N Lower Dir 57 9 N Haripur 95 19 B Panjgur 20 16 P Bahawalpur 58 6 S Thatta 96 16 B Killa Abdullah 21 17 B Quetta 59 23 N Abbottabad 97 20 NA Skardu 22 4 N Bannu 60 10 C ISLAMABAD 98 1 N Chitral 23 1 B Lasbela 61 24 P Narowal 99 24 N Lakki 24 2 N Mardan 61 11 B Ziarat 100 25 N Karak 25 3 N Kohat 63 12 P Sargoda 101 25 B Sibi 26 18 P D.G Khan 64 7 P Jhelum 102 26 B Jafarabad 27 19 N Swabi 65 13 P Sheikhupura 103 27 N Upper Dir 28 4 P Khanewal 66 8 P Gujrat 104 28 S Shikarpur 29 1 N Peshawar 67 14 P Gujranwala 105 29 B Gawader 30 20 P Vehari 68 9 P Sialkot 106 30 S Khairpur 31 2 P Multan 69 10 P Faisalabad 107 31 A Kotli 32 1 P Pakpattan 70 11 P Lahore 108 32 B Dera Bugti 33 21 N Tank 71 15 A Mirpur 109 7 N Charsadda 34 5 P Okara 72 12 P Rawalpindi 110 33 B Pishin 35 22 P Mianwali 73 13 P Mandi Bahaud Din 111 34 S Larkana 36 3 S Nawabshah 74 11 S Karachi 112 17 N D.I.Khan 37 6 S Sanghar 75 12 S Jacobabad 38 4 P Rahim Yar Khan 76 14 P: Punjab, S: Sindh, N:NWFP, C: Capital, B: Balochistan, NA: Northern Area, A:Azad Jammu & Kashmir, F: Federally Administered Areas National Rankings are from 1 to 112,1 being the worst and 112 the best. Provincial Rankings depend on the number of districts per province.

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Annexure-21 Population in Semi Pacca Houses in Urban Pakistan Provincial Provincial Provincial Provincial Provincial Provincial National National National District District District Rank Rank Rank Rank Rank Rank Rank Code Code Code Code

F Kurram 1 1 S Khairpur 39 11 P Chakwal 77 22 N Swat 2 1 N Lakki 40 5 N Hangu 78 11 S Thatta 3 1 S Sukkar 41 12 B Kharan 79 22 N Karak 4 2 P Sahiwal 42 12 C ISLAMABAD 80 1 S Badin 5 2 P Okara 43 13 A Bagh 81 5 B Dera Bugti 6 1 S Sanghar 44 13 N Kohat 82 12 B Lasbela 7 2 P Pakpattan 45 14 N Mansehra 83 13 P T.T.Singh 8 1 B Turbat 46 11 P Attock 84 23 NA Diamer 9 1 B Jafarabad 47 12 N Upper Dir 85 14 B Panjgur 10 3 S Larkana 48 14 F Khyber 86 3 B Pishin 11 4 B Killa Saifullah 49 13 NA Skardu 87 3 B Mastung 12 5 N Lower Dir 50 6 A Bhimber 88 6 B Gawader 13 6 S Mirpurkhas 51 15 N Swabi 89 15 P Rahim Yar Khan 14 2 NA Ghanche 52 2 N Mardan 90 16 N Tank 15 3 B Kohlu 53 14 P Narowal 91 24 S Tharparkar 16 3 B Kalat 54 15 P Kasur 92 25 P Layyah 17 3 N Malakand 54 7 P Sargoda 93 26 Mandi Bahaud P Khanewal 18 4 A Kotli 56 2 P Din 94 27 B Loralai 19 7 B Bolan 57 16 P Lahore 95 28 P Rajanpur 20 5 B Sibi 58 17 N Charsadda 96 17 P Bahawalnagar 21 6 P Mianwali 59 15 S Karachi 97 17 S Ghotki 22 4 A Muzaffarabad 60 3 P Gujrat 98 29 S Noushero Feroze 23 5 P Vehari 61 16 NA Ghizer 99 4 P Jhang 24 7 P D.G Khan 62 17 P Sheikhupura 100 30 B Quetta 25 8 P Jhelum 63 18 N Peshawar 101 18 B Nasirabad 26 9 B Barkhan 64 18 N Nowshera 102 19 P Faisalabad 27 8 N Bannu 65 8 NA Gilgit 103 5 S Dadu 28 6 N Chitral 66 9 P Sialkot 104 31 S Nawabshah 29 7 S Hyderabad 67 16 A Sudhnoti 105 7 S Umerkot 30 8 P Lodhran 68 19 P Rawalpindi 106 32 A Rawalakot 31 1 B Khuzdar 69 19 B Jhal Magsi 107 23 P Bahawalpur 32 9 N Abbottabad 70 10 P Hafizabad 108 33 N D.I.Khan 33 4 P Multan 71 20 N Haripur 109 20 S Shikarpur 34 9 B Zhob 72 20 B Musa Khel 110 24 P Muzaffargarh 35 10 P Khushab 73 21 P Gujranwala 111 34 B Killa Abdullah 36 10 A Mirpur 74 4 B Ziarat 112 25 S Jacobabad 37 10 B Chagai 75 21 P Bhakkar 38 11 F N.Waziristan 76 2 P: Punjab, S: Sindh, N:NWFP, C: Capital, B: Balochistan, NA: Northern Area, A:Azad Jammu & Kashmir, F: Federally Administered Areas National Rankings are from 1 to 112,1 being the worst and 112 the best. Provincial Rankings depend on the number of districts per province.

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Annexure-22 Population in Both Kacha and Semi Kacha Houses in Urban Population Provincial Provincial Provincial Provincial Provincial Provincial National National National District District District District Rank Rank Rank Rank Rank Rank Code Code Code Code

B Jhal Magsi 1 1 P Rajanpur 39 1 N Kohat 77 13 F Kurram 2 1 S Jacobabad 40 4 N Mardan 78 14 NA Diamer 3 1 S Tharparkar 41 5 P Multan 79 16 B Killa Saifullah 4 2 N Charsadda 42 7 P Mianwali 80 17 B Kharan 5 3 S Umerkot 43 6 N Swabi 81 15 N Karak 6 1 B Lasbela 44 23 N Peshawar 82 16 B Musa Khel 7 4 P Layyah 45 2 A Muzaffarabad 83 5 B Kalat 8 5 S Thatta 46 7 S Mirpurkhas 84 15 B Panjgur 9 6 S Badin 47 8 N Mansehra 85 17 NA Ghanche 10 2 P Lodhran 48 3 P Sahiwal 86 18 B Barkhan 11 7 S Noushero Feroze 49 9 P Khushab 87 19 B Khuzdar 12 8 S Ghotki 50 10 N Nowshera 88 18 B Loralai 13 9 P Muzaffargarh 51 4 P Chakwal 89 20 B Mastung 14 10 S Dadu 52 11 NA Gilgit 90 5 B Turbat 15 11 A Rawalakot 53 2 P Faisalabad 91 21 B Nasirabad 16 12 N Malakand 54 8 S Hyderabad 92 16 B Kohlu 17 13 B Quetta 55 24 N Abbottabad 93 19 NA Ghizer 18 3 F N.Waziristan 56 3 A Bhimber 94 6 B Dera Bugti 19 14 N Hangu 57 9 P Attock 95 22 B Bolan 20 15 P Khanewal 58 5 P Kasur 96 23 B Chagai 21 16 P Bahawalpur 59 6 P Jhelum 97 24 B Killa Abdullah 22 17 P Bhakkar 60 7 P Hafizabad 98 25 B Gawader 23 18 S Sukkar 61 12 C ISLAMABAD 99 1 B Zhob 24 19 N Tank 62 10 A Mirpur 100 7 B Pishin 25 20 P Rahim Yar Khan 63 8 P Narowal 101 26 F Khyber 26 2 P T.T.Singh 64 9 N Haripur 102 20 N Lakki 27 2 N Lower Dir 65 11 P Sargoda 103 27 NA Skardu 28 4 N Bannu 66 12 P Sheikhupura 104 28 B Jafarabad 29 21 A Bagh 67 3 P Gujrat 105 29 S Shikarpur 30 1 S Nawabshah 68 13 P Lahore 106 30 N Chitral 31 3 P Bahawalnagar 69 10 P Mandi Bahaud Din 107 31 B Sibi 32 22 P D.G Khan 70 11 P Sialkot 108 32 S Khairpur 33 2 P Pakpattan 71 12 B Ziarat 109 25 N Upper Dir 34 4 P Okara 72 13 P Gujranwala 110 33 N Swat 35 5 A Sudhnoti 73 4 P Rawalpindi 111 34 A Kotli 36 1 P Jhang 74 14 S Karachi 112 17 N D.I.Khan 37 6 P Vehari 75 15 S Larkana 38 3 S Sanghar 76 14 P: Punjab, S: Sindh, N:NWFP, C: Capital, B: Balochistan, NA: Northern Area, A:Azad Jammu & Kashmir, F: Federally Administered Areas National Rankings are from 1 to 112,1 being the worst and 112 the best. Provincial Rankings depend on the number of districts per province.

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Annexure-23 Adult Literate (Total) in Urban Pakistan 2004-05 Provincial Provincial Provincial Provincial Provincial Provincial National National National District District District Rank Rank Rank Rank Rank Rank Rank Code Code Code Code

B Musa Khel 1 1 B Pashin 39 19 P D.G.khan 77 16 B Dera Bugti 2 2 P Bhakhar 40 2 B Sibbi 78 24 B Qilla Abdullah 3 3 P Khushab 41 3 P Rahim Yar Khan 79 17 F Kurram 4 1 S Tharparkar 42 6 P Sargodha 80 18 B Khuzdar 5 4 P Bahawalpur 43 4 S Nowshero Feroze 81 15 N Charsada 6 1 S Khairpur 44 7 P Faisalabad 82 19 F Khyber 7 2 P Okara 45 5 P Pakpatten 83 20 B Kohlu 8 5 S Nawabshah 46 8 N D.I.Khan 84 18 B Nasirabad 9 6 S Dadu 47 9 NA Ghanche 85 4 B Barkhan 10 7 B Loralai 48 20 P Layyah 86 21 S Thatta 11 1 B Qilla Saifullah 49 21 A Bhimber 87 2 B Kalat 12 8 P Muzaffar Garh 50 6 A Muzaffarabad 88 3 B Jhal Magsi 13 9 P Rajanpur 51 7 P Narowal 89 22 B Gwadar 14 10 P Vehari 52 8 P Sheikhupura 90 23 B Panjgur 15 11 P Mianwali 53 9 S Sukkur 91 16 B Jafarabad 16 12 N Swat 54 11 B Quetta 92 25 P Lodhran 17 1 N Mansehra 55 12 A Mirpur 93 4 S Larkana 18 2 P Hafizabad 56 10 P T.T.Singh 94 24 B Ziarat 19 13 N Karak 57 13 A Kotli 95 5 B Lasbilla 20 14 S Sanghar 58 10 A Bagh 96 6 B Bolan 21 15 S Badin 59 11 P Gujranwala 97 25 N Tank 22 2 P Kasur 60 11 P Gujrat 98 26 N Nowshera 23 3 P Multan 61 12 A Rawalakot 99 7 N Swabi 24 4 N Peshawar 62 14 P Sahiwal 100 27 N Malakand 25 5 S Shikarpur 63 12 P Jehlum 101 28 S Jaccobabad 26 3 B Zhob 64 22 P Mandi Bahuddin 102 29 S Umer kot 27 4 N Bannu 65 15 P Attock 103 30 B Kharan 28 16 N Kohat 66 16 N Haripur 104 19 NA Diamer 29 1 S Hyderabad 67 13 P Sialkot 105 31 N Upper Dir 30 6 NA Gilgit 68 2 P Lahore 106 32 B Chaghi 31 17 P Jhang 69 13 N Abbottabad 107 20 B Ketch 32 18 P Khanewal 70 14 P Chakwal 108 33 N Lakki Marwat 33 7 S Mir Pur Khas 71 14 P Rawalpindi 109 34 N Hangu 34 8 NA Skardu 72 3 S Karachi 110 17 N Mardan 35 9 A Sudhnoti 73 1 NA Ghizer 111 5 F N.Waziristan 36 3 N Chitral 74 17 C Islamabad 112 1 N Lower Dir 37 10 B Mastung 75 23 S Ghotki 38 5 P Bahawalnager 76 15 P: Punjab, S: Sindh, N:NWFP, C: Capital, B: Balochistan, NA: Northern Area, A:Azad Jammu & Kashmir, F: Federally Administered Areas National Rankings are from 1 to 112,1 being the worst and 112 the best. Provincial Rankings depend on the number of districts per province.

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Annexure-24 Adult Literate (Male) in Urban Pakistan 2004-05 Provincial Provincial Provincial Provincial Provincial Provincial National National National District District District Rank Rank Rank Rank Rank Rank Rank Code Code Code

B Musa Khel 1 1 B Kharan 39 16 N Kohat 77 14 NA Diamer 2 1 B Panjgur 40 17 P Narowal 78 24 NA Ghanche 3 2 N Upper Dir 41 7 P Sahiwal 79 25 B Dera Bugti 4 2 B Ketch 42 18 S Khairpur 80 14 B Qilla Abdullah 5 3 B Jafarabad 43 19 NA Gilgit 81 4 S Thatta 6 1 N Hangu 44 8 N Swat 82 15 NA Ghizer 7 3 P Jhang 45 9 P T.T.Singh 83 26 N Charsada 8 1 P Vehari 46 10 P Sialkot 84 27 B Kohlu 9 4 S Tharparkar 47 5 A Sudhnoti 85 1 B Khuzdar 10 5 S Badin 48 6 B Mastung 86 22 F Kurram 11 1 B Loralai 49 20 N Chitral 87 16 B Ziarat 12 6 N Swabi 50 9 P Layyah 88 28 B Gwadar 13 7 P Muzaffar Garh 51 11 P Lahore 89 29 B Kalat 14 8 P Faisalabad 52 12 P Jehlum 90 30 P Lodhran 15 1 S Hyderabad 53 7 B Quetta 91 23 B Lasbilla 16 9 B Qilla Saifullah 54 21 N D.I.Khan 92 17 B Jhal Magsi 17 10 N Peshawar 55 10 S Sukkur 93 15 B Barkhan 18 11 P D.G.khan 56 13 NA Skardu 94 5 S Umer kot 19 2 P Khushab 57 14 B Sibbi 95 24 P Bahawalpur 20 2 S Ghotki 58 8 N Haripur 96 18 N Malakand 21 2 S Nawabshah 59 9 P Mandi Bahuddin 97 31 B Pashin 22 12 P Rahim Yar Khan 60 15 S Karachi 98 16 B Nasirabad 23 13 P Sheikhupura 61 16 A Mirpur 99 2 B Bolan 24 14 P Khanewal 62 17 A Bhimber 100 3 N Tank 25 3 S Mir Pur Khas 63 10 A Muzaffarabad 101 4 P Bhakhar 26 3 F N.Waziristan 64 3 B Zhob 102 25 S Larkana 27 3 N Lakki Marwat 65 11 P Attock 103 32 F Khyber 28 2 N Lower Dir 66 12 S Nowshero Feroze 104 17 N Nowshera 29 4 P Bahawalnager 67 18 P Rawalpindi 105 33 P Okara 30 4 P Gujrat 68 19 A Rawalakot 106 5 P Hafizabad 31 5 P Pakpatten 69 20 A Bagh 107 6 P Kasur 32 6 P Mianwali 70 21 A Kotli 108 7 P Multan 33 7 P Sargodha 71 22 N Karak 109 19 S Jaccobabad 34 4 S Shikarpur 72 11 N Abbottabad 110 20 N Mardan 35 5 S Sanghar 73 12 P Chakwal 111 34 N Mansehra 36 6 N Bannu 74 13 C Islamabad 112 1 P Rajanpur 37 8 P Gujranwala 75 23 B Chaghi 38 15 S Dadu 76 13 P: Punjab, S: Sindh, N:NWFP, C: Capital, B: Balochistan, NA: Northern Area, A:Azad Jammu & Kashmir, F: Federally Administered Areas National Rankings are from 1 to 112,1 being the worst and 112 the best. Provincial Rankings depend on the number of districts per province.

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Annexure-25 Adult Literate (Female) in Urban Pakistan 2004-05 Provincial Provincial Provincial Provincial Provincial Provincial National National National District District District District Rank Rank Rank Rank Rank Rank Rank Code Code Code

B Musa Khel 1 1 S Khairpur 39 6 P Bahawalnager 77 12 F Khyber 2 1 P Lodhran 40 1 P Layyah 78 13 B Barkhan 3 2 N Mardan 41 10 P Kasur 79 14 B Nasirabad 4 3 NA Ghizer 42 3 P Multan 80 15 B Dera Bugti 5 4 N Karak 43 11 P Jhang 81 16 B Panjgur 6 5 P Khushab 44 2 S Sukkur 82 16 F Kurram 7 2 N Swat 45 12 NA Gilgit 83 5 B Qilla Abdullah 8 6 B Pashin 46 20 P Rahim Yar Khan 84 17 NA Diamer 9 1 S Tharparkar 47 7 P D.G.khan 85 18 B Kohlu 10 7 S Dadu 48 8 P Sargodha 86 19 B Jafarabad 11 8 B Loralai 49 21 P T.T.Singh 87 20 B Khuzdar 12 9 B Qilla Saifullah 50 22 P Pakpatten 88 21 B Kalat 13 10 P Mianwali 51 3 A Sudhnoti 89 1 B Kharan 14 11 P Bhakhar 52 4 P Faisalabad 90 22 N Charsada 15 1 S Nawabshah 53 9 P Narowal 91 23 B Jhal Magsi 16 12 N Chitral 54 13 P Sheikhupura 92 24 F N.Waziristan 17 3 S Sanghar 55 10 A Muzaffarabad 93 2 NA Ghanche 18 2 B Sibbi 56 23 P Mandi Bahuddin 94 25 S Jaccobabad 19 1 N Bannu 57 14 P Attock 95 26 N Lower Dir 20 2 S Nowshero Feroze 58 11 A Kotli 96 3 B Zhob 21 13 P Muzaffar Garh 59 5 A Bhimber 97 4 B Ketch 22 14 P Rajanpur 60 6 P Gujranwala 98 27 B Gwadar 23 15 S Shikarpur 61 12 P Jehlum 99 28 B Bolan 24 16 S Badin 62 13 N Abbottabad 100 19 N Lakki Marwat 25 3 B Mastung 63 24 P Sahiwal 101 29 B Chaghi 26 17 P Vehari 64 7 A Mirpur 102 5 N Tank 27 4 N Kohat 65 15 P Gujrat 103 30 N Nowshera 28 5 N Peshawar 66 16 N Haripur 104 20 S Larkana 29 2 N Mansehra 67 17 A Bagh 105 6 N Swabi 30 6 P Bahawalpur 68 8 P Chakwal 106 31 N Upper Dir 31 7 P Okara 69 9 P Rawalpindi 107 32 B Lasbilla 32 18 P Hafizabad 70 10 A Rawalakot 108 7 N Malakand 33 8 S Hyderabad 71 14 P Lahore 109 33 S Ghotki 34 3 NA Skardu 72 4 S Karachi 110 17 S Umer kot 35 4 N D.I.Khan 73 18 P Sialkot 111 34 N Hangu 36 9 S Mir Pur Khas 74 15 C Islamabad 112 1 S Thatta 37 5 P Khanewal 75 11 B Ziarat 38 19 B Quetta 76 25 P: Punjab, S: Sindh, N:NWFP, C: Capital, B: Balochistan, NA: Northern Area, A:Azad Jammu & Kashmir, F: Federally Administered Areas National Rankings are from 1 to 112,1 being the worst and 112 the best. Provincial Rankings depend on the number of districts per province.

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Annexure-26 Gender Gap in Literacy Rate in Urban Pakistan 2004-05 Provincial Provincial Provincial Provincial Provincial Provincial National National National District District District Rank Rank Code Code Code Code Code Pank Pank Pank

F Khyber 1 1 S Umer kot 39 6 P Okara 77 11 B Barkhan 2 1 P Khushab 40 1 NA Gilgit 78 5 B Nasirabad 3 2 S Nowshero Feroze 41 7 P Hafizabad 79 12 B Panjgur 4 3 B Sibbi 42 19 A Kotli 80 1 B Jafarabad 5 4 NA Diamer 43 1 P Sargodha 81 13 B Musa Khel 6 5 N Chitral 44 13 P Bahawalpur 82 14 F Kurram 7 2 B Loralai 45 20 N Abbottabad 83 19 B Zhob 8 6 P Mianwali 46 2 A Muzaffarabad 84 2 B Qilla Abdullah 9 7 B Qilla Saifullah 47 21 P Attock 85 15 B Dera Bugti 10 8 S Tharparkar 48 8 P Rahim Yar Khan 86 16 B Kharan 11 9 B Ziarat 49 22 P Jhang 87 17 F N.Waziristan 12 3 P Lodhran 50 3 P D.G.khan 88 18 B Kohlu 13 10 B Pashin 51 23 A Sudhnoti 89 3 B Khuzdar 14 11 S Nawabshah 52 9 P T.T.Singh 90 19 B Kalat 15 12 B Mastung 53 24 P Mandi Bahuddin 91 20 N Lower Dir 16 1 S Sanghar 54 10 P Kasur 92 21 N Lakki Marwat 17 2 N Bannu 55 14 P Multan 93 22 B Ketch 18 13 NA Ghanche 56 2 A Bhimber 94 4 S Jaccobabad 19 1 N Kohat 57 15 A Bagh 95 5 B Jhal Magsi 20 14 S Shikarpur 58 11 P Narowal 96 23 B Chaghi 21 15 NA Skardu 59 3 P Chakwal 97 24 B Bolan 22 16 S Thatta 60 12 P Pakpatten 98 25 N Karak 23 3 P Bhakhar 61 4 P Rawalpindi 99 26 N Swabi 24 4 N D.I.Khan 62 16 A Rawalakot 100 6 N Nowshera 25 5 P Muzaffar Garh 63 5 A Mirpur 101 7 N Tank 26 6 S Badin 64 13 N Haripur 102 20 S Larkana 27 2 P Vehari 65 6 P Jehlum 103 27 N Charsada 28 7 B Quetta 66 25 P Faisalabad 104 28 S Ghotki 29 3 N Peshawar 67 17 P Sheikhupura 105 29 N Upper Dir 30 8 P Rajanpur 68 7 P Gujranwala 106 30 S Khairpur 31 4 NA Ghizer 69 4 P Sahiwal 107 31 B Gwadar 32 17 P Layyah 70 8 S Karachi 108 17 N Hangu 33 9 S Sukkur 71 14 P Lahore 109 32 N Swat 34 10 N Mansehra 72 18 P Gujrat 110 33 N Malakand 35 11 S Mir Pur Khas 73 15 P Sialkot 111 34 B Lasbilla 36 18 P Khanewal 74 9 C Islamabad 112 1 N Mardan 37 12 S Hyderabad 75 16 S Dadu 38 5 P Bahawalnager 76 10 P: Punjab, S: Sindh, N:NWFP, C: Capital, B: Balochistan, NA: Northern Area, A:Azad Jammu & Kashmir, F: Federally Administered Areas National Rankings are from 1 to 112,1 being the worst and 112 the best. Provincial Rankings depend on the number of districts per province.

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Annexure-27 Unemployment Ratio in Urban Pakistan Provincial Provincial Provincial Provincial Provincial Provincial National National National District District District Rank Rank Rank Rank Rank Rank Code Code Code Code

S Tharparkar 1 1 B Jafarabad 39 16 P Multan 77 22 B Musa Khel 2 1 B Lasbela 40 17 S Shikarpur 78 9 B Killa Abdullah 3 2 N Lakki 41 8 P Jhang 79 23 F N.Waziristan 4 1 S Larkana 42 6 S Thatta 80 10 F Kurram 5 2 NA Ghanche 43 2 P Pakpattan 81 24 F Khyber 6 3 B Dera Bugti 44 18 A Bhimber 82 6 S Sukkar 7 2 P Sheikhupura 45 4 P T.T.Singh 83 25 B Kharan 8 3 P Hafizabad 46 5 NA Ghizer 84 4 NA Diamer 9 1 P Layyah 47 6 NA Gilgit 85 5 B Panjgur 10 4 A Kotli 48 5 N Kohat 86 12 B Pishin 11 5 P Bhakkar 49 7 S Mirpurkhas 87 11 N Malakand 12 1 B Sibi 50 19 S Badin 88 12 B Khuzdar 13 6 B Turbat 51 20 S Khairpur 89 13 A Bagh 14 1 P Khushab 52 8 S Sanghar 90 14 B Ziarat 15 7 P D.G Khan 53 9 P Okara 91 26 P Lodhran 16 1 S Jacobabad 54 7 N Mansehra 92 13 N Karak 17 2 P Rahim Yar Khan 55 10 N Bannu 93 14 B Bolan 18 8 P Muzaffargarh 56 11 A Mirpur 94 7 B Mastung 19 9 B Kohlu 57 21 P Gujrat 95 27 B Chagai 20 10 P Chakwal 58 12 S Nawabshah 96 15 B Jhal Magsi 21 11 P Vehari 59 13 N Mardan 97 15 N Tank 22 3 P Bahawalpur 60 14 N Charsadda 98 16 B Gawader 23 12 P Bahawalnagar 61 15 P Attock 99 28 A Rawalakot 24 2 B Loralai 62 22 N Abbottabad 100 17 P Mianwali 25 2 B Zhob 63 23 N Peshawar 101 18 N Upper Dir 26 4 B Nasirabad 64 24 N D.I.Khan 102 19 A Sudhnoti 27 3 P Khanewal 65 16 P Jhelum 103 29 B Quetta 28 13 N Chitral 66 9 N Nowshera 104 20 N Hangu 29 5 P Mandi Bahaud Din 67 17 S Hyderabad 105 16 B Barkhan 30 14 N Haripur 68 10 P Gujranwala 106 30 B Kalat 31 15 P Sargoda 69 18 P Faisalabad 107 31 S Noushero Feroze 32 3 N Swat 70 11 S Karachi 108 17 N Lower Dir 33 6 S Ghotki 71 8 P Lahore 109 32 P Rajanpur 34 3 P Sahiwal 72 19 P Sialkot 110 33 S Dadu 35 4 P Kasur 73 20 P Rawalpindi 111 34 A Muzaffarabad 36 4 NA Skardu 74 3 C Islamabad 112 1 N Swabi 37 7 P Narowal 75 21 S Umerkot 38 5 B Killa Saifullah 76 25 P: Punjab, S: Sindh, N:NWFP, C: Capital, B: Balochistan, NA: Northern Area, A:Azad Jammu & Kashmir, F: Federally Administered Areas National Rankings are from 1 to 112,1 being the worst and 112 the best. Provincial Rankings depend on the number of districts per province.

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Annexure-28 Food Insecurity in Urban Pakistan 2006 Provincial Provincial Provincial Provincial Provincial Provincial National National National District District District District Rank Rank Rank Rank Rank Rank Rank Code Code Code Code

B Musa Khel 1 1 N Lakki 5 39 P Bahawalnagar 15 77 F Kurram 1 2 P Layyah 3 40 P Mandi Bahaud Din 16 78 NA Diamer 1 3 N Charsadda 6 41 P Chakwal 17 79 NA Ghizer 2 4 B Pishin 21 42 N Mardan 14 80 B Panjgur 2 5 N Chitral 7 43 N Mansehra 15 81 NA Ghanche 3 6 B Sibi 22 44 P Mianwali 18 82 S Tharparkar 1 7 P Bhakkar 4 45 N Bannu 16 83 B Jhal Magsi 3 8 S Badin 7 46 S Mirpurkhas 15 84 B Khuzdar 4 9 S Ghotki 8 47 P Rahim Yar Khan 19 85 B Kohlu 5 10 B Zhob 23 48 A Bhimber 5 86 F Khyber 2 11 NA Skardu 4 49 P Narowal 20 87 B Killa Saifullah 6 12 N Lower Dir 8 50 P Sargoda 21 88 B Nasirabad 7 13 S Thatta 9 51 A Muzaffarabad 6 89 B Kharan 8 14 S Larkana 10 52 N Nowshera 17 90 B Mastung 9 15 P Muzaffargarh 5 53 P Attock 22 91 N Karak 1 16 P Khanewal 6 54 NA Gilgit 5 92 S Umerkot 2 17 S Dadu 11 55 P Multan 23 93 B Dera Bugti 10 18 N D.I.Khan 9 56 P Gujrat 24 94 B Barkhan 11 19 P Okara 7 57 P D.G Khan 25 95 B Bolan 12 20 A Sudhnoti 1 58 P Gujranwala 26 96 B Turbat 13 21 A Rawalakot 2 59 P Sahiwal 27 97 B Killa Abdullah 14 22 P Bahawalpur 8 60 N Abbottabad 18 98 B Lasbela 15 23 P Jhang 9 61 N Peshawar 19 99 S Jacobabad 3 24 S Sanghar 12 62 B Quetta 25 100 B Loralai 16 25 P Khushab 10 63 N Haripur 20 101 N Upper Dir 2 26 N Swabi 10 64 S Hyderabad 16 102 B Kalat 17 27 P T.T.Singh 11 65 P Kasur 28 103 B Jafarabad 18 28 N Swat 11 66 P Sheikhupura 29 104 S Shikarpur 4 29 A Kotli 3 67 P Faisalabad 30 105 N Hangu 3 30 B Ziarat 24 68 A Mirpur 7 106 F N.Waziristan 3 31 N Tank 12 69 P Rawalpindi 31 107 B Chagai 19 32 P Hafizabad 12 70 P Jhelum 32 108 P Rajanpur 1 33 P Vehari 13 71 P Lahore 33 109 S Khairpur 5 34 N Kohat 13 72 P Sialkot 34 110 P Lodhran 2 35 P Pakpattan 14 73 S Karachi 17 111 B Gawader 20 36 S Nawabshah 13 74 C Islamabad 1 112 N Malakand 4 37 A Bagh 4 75 S Noushero Feroze 6 38 S Sukkar 14 76 P: Punjab, S: Sindh, N:NWFP, C: Capital, B: Balochistan, NA: Northern Area, A:Azad Jammu & Kashmir, F: Federally Administered Areas National Rankings are from 1 to 112,1 being the worst and 112 the best. Provincial Rankings depend on the number of districts per province.

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Annexure - 29 Food Consumption Index in Kcal per cu in Urban Pakistan Provincial Provincial Provincial Provincial Provincial Provincial National National National District District District Rank Rank Rank Rank Code Code Code rank rank rank

C Islamabad 1 1 S Badin 39 8 P Vehari 77 31 S Karachi 2 1 P Chakwal 40 20 S Nawabshah 78 12 P Jhelum 3 1 P Jhang 41 21 P Lodhran 79 32 P Sialkot 4 2 A Bagh 42 4 S Noushero Feroze 80 13 P Kasur 5 3 A Kotli 43 5 NA Diamer 81 4 P Faisalabad 6 4 B Killa Saifullah 44 2 NA Ghanche 82 5 P Sheikhupura 7 5 P Khanewal 45 22 P Narowal 83 33 A Mirpur 8 1 P Okara 46 23 F Khyber 84 2 P Lahore 9 6 P T.T.Singh 47 24 P Rajanpur 85 34 P Rawalpindi 10 7 NA Gilgit 48 1 S Mirpurkhas 86 14 S Hyderabad 11 2 B Kharan 49 3 B Gawader 87 4 N Peshawar 12 1 S Dadu 50 9 B Lasbela 88 5 N Nowshera 13 2 A Bhimber 51 6 B Turbat 89 6 N Haripur 14 3 F Kurram 52 1 S Shikarpur 90 15 B Quetta 15 1 P Mandi Bahaud Din 53 25 B Kohlu 91 7 P Mianwali 16 8 N Bannu 54 8 B Panjgur 92 8 N Mardan 17 4 P Bahawalpur 55 26 B Ziarat 93 9 P Multan 18 9 N Charsadda 56 9 B Barkhan 94 10 N Swabi 19 5 P Pakpattan 57 27 F N.Waziristan 95 3 P Rahim Yar Khan 20 10 S Sanghar 58 10 B Chagai 96 11 N Swat 21 6 S Jacobabad 59 11 B Nasirabad 97 12 P D.G Khan 22 11 A Sudhnoti 60 7 B Jhal Magsi 98 13 P Sahiwal 23 12 NA Skardu 61 2 B Loralai 99 14 A Muzaffarabad 24 2 N D.I.Khan 62 10 B Mastung 100 15 P Sargoda 25 13 P Bhakkar 63 28 B Jafarabad 101 16 P Khushab 26 14 N Tank 64 11 B Zhob 102 17 P Gujranwala 27 15 N Kohat 65 12 B Bolan 103 18 P Muzaffargarh 28 16 P Bahawalnagar 66 29 B Kalat 104 19 S Sukkar 29 3 P Layyah 67 30 B Killa Abdullah 105 20 N Abbottabad 30 7 NA Ghizer 68 3 B Pishin 106 21 P Hafizabad 31 17 N Malakand 69 13 B Sibi 107 22 S Ghotki 32 4 N Mansehra 70 14 B Khuzdar 108 23 P Gujrat 33 18 N Lakki 71 15 B Musa Khel 109 24 S Larkana 34 5 N Hangu 72 16 B Dera Bugti 110 25 S Khairpur 35 6 N Chitral 73 17 S Umerkot 111 16 A Rawalakot 36 3 N Lower Dir 74 18 S Tharparkar 112 17 P Attock 37 19 N Karak 75 19 S Thatta 38 7 N Upper Dir 76 20 P: Punjab, S: Sindh, N:NWFP, C: Capital, B: Balochistan, NA: Northern Area, A:Azad Jammu & Kashmir, F: Federally Administered Areas National Rankings are from 1 to 112,1 being the worst and 112 the best. Provincial Rankings depend on the number of districts per province.

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Annexure - 30 Housing Structure and Facilities Index in Urban Pakistan Provincial Provincial Provincial Provincial Provincial Provincial National National National District District District Rank Rank Rank Rank Rank Rank Code Code Code Code

B Musa Khel 1 1 N Upper Dir 39 4 P Multan 77 18 F Kurram 2 1 P Rajanpur 40 1 N Bannu 78 12 NA Ghanche 3 1 N Swat 41 5 N Mardan 79 13 NA Diamer 4 2 S Jacobabad 42 7 N Swabi 80 14 B Panjgur 5 2 S Larkana 43 8 A Sudhnoti 81 4 NA Ghizer 6 3 P Lodhran 44 2 N Kohat 82 15 B Jhal Magsi 7 3 N D.I.Khan 45 6 S Mirpurkhas 83 15 B Killa Saifullah 8 4 A Kotli 46 1 N Mansehra 84 16 B Khuzdar 9 5 P Layyah 47 3 A Muzaffarabad 85 5 B Gawader 10 6 P Muzaffargarh 48 4 P Sahiwal 86 19 B Kharan 11 7 N Charsadda 49 7 N Peshawar 87 17 B Chagai 12 8 S Noushero Feroze 50 9 P Chakwal 88 20 B Barkhan 13 9 P Bahawalpur 51 5 N Nowshera 89 18 B Kohlu 14 10 P Khanewal 52 6 P Hafizabad 90 21 N Karak 15 1 S Ghotki 53 10 P Faisalabad 91 22 B Kalat 16 11 S Dadu 54 11 S Hyderabad 92 16 B Dera Bugti 17 12 N Malakand 55 8 NA Gilgit 93 5 B Killa Abdullah 18 13 P Rahim Yar Khan 56 7 C Islamabad 94 1 B Mastung 19 14 P Bhakkar 57 8 P Kasur 95 23 B Bolan 20 15 P Bahawalnagar 58 9 P Sargoda 96 24 B Nasirabad 21 16 F N.Waziristan 59 3 N Abbottabad 97 19 B Loralai 22 17 S Sukkar 60 12 P Attock 98 25 B Turbat 23 18 B Quetta 61 24 P Jhelum 99 26 S Tharparkar 24 1 P Jhang 62 10 P Sheikhupura 100 27 S Khairpur 25 2 A Rawalakot 63 2 N Haripur 101 20 B Lasbela 26 19 P Pakpattan 64 11 P Narowal 102 28 S Thatta 27 3 P Okara 65 12 A Bhimber 103 6 B Pishin 28 20 N Hangu 66 9 P Mandi Bahaud Din 104 29 F Khyber 29 2 P T.T.Singh 67 13 A Mirpur 105 7 B Jafarabad 30 21 N Lower Dir 68 10 P Gujrat 106 30 S Shikarpur 31 4 N Tank 69 11 P Lahore 107 31 S Umerkot 32 5 S Sanghar 70 13 P Gujranwala 108 32 B Sibi 33 22 P Khushab 71 14 P Sialkot 109 33 N Lakki 34 2 S Nawabshah 72 14 S Karachi 110 17 B Zhob 35 23 P Vehari 73 15 B Ziarat 111 25 N Chitral 36 3 P D.G Khan 74 16 P Rawalpindi 112 34 NA Skardu 37 4 P Mianwali 75 17 S Badin 38 6 A Bagh 76 3 P: Punjab, S: Sindh, N:NWFP, C: Capital, B: Balochistan, NA: Northern Area, A:Azad Jammu & Kashmir, F: Federally Administered Areas National Rankings are from 1 to 112,1 being the worst and 112 the best. Provincial Rankings depend on the number of districts per province.

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