Multisectoral approach to nutrition in Pakistan

The under-five stunting rate in Pakistan is one of the highest in the world despite rapid decline in poverty and open defecation over the years. To identify the determinants of childhood stunting in Pakistan, this study used a parsimonious regression model to quantitatively apply the UNICEF multisectoral nutrition framework to Pakistan using Demographic and Health Survey 2012–13 data. The econometric analysis shows that simultaneous improvements in determinants of nutrition are more likely to reduce malnutrition in Pakistan compared to improvements in individual components. Adequacies in ‘food only’ and ‘health only’ are the strongest determinants of height-for-age while adequacy in Water, Sanitation and Hygiene (Environment) alone does not have a robust relationship with height-for-age. Food has a much stronger and more robust correlation with height-for-age when it is combined with Environment. Under Adequacy Definition 1, children with access to all four dimensions are significantly taller than others. The results show that multisectoral interventions are more likely to be successful in reducing malnutrition as compared to isolated interventions targeting one of the determinants of malnutrition; this is especially true for interventions in Water, Sanitation and Hygiene.