BETTER, BUT NOT QUITE GOOD

BETTER, BUT NOT QUITE GOOD.

Key points

• Atifuddin Khan Published September 8, 2026 Updated September 8, 2026 12: 01pm.
• From 2011 to 2018, Khyber Pakhtunkhwa (KP) and parts of Punjab recorded significant improvements, with stunting falling from 43.0pc to 38.3pc in the areas studied.
• In 2020, the Benazir Nashonuma Programme (BNP) was introduced, combining conditional cash transfers with specialised nutritional backing for pregnant and lactating women and young children.
• THE year 2026 has not been a kind year for Pakistan.
• As per the World Health Organisation (WHO), stunting is the impaired expansion and development that children experience from poor nutrition, repeated infection and inadequate psychosocial stimulation.

For years, our nutritional challenges have silently been chipping away at the country's future.

THE year 2026 has not been a kind year for Pakistan. In terms of headlines, doomsday is right around the corner. Economic crises, energy crises, debt renegotiations, political uncertainty, inflation, floods, poverty and other problems that might turn a beautiful morning dark and murky have dominated the national conversation. Health problems in particular have residents running to check if they are taking the right and the right quantity of medicine. This is so since we have, generally speaking, not been kind to our own cause. Against this backdrop, there is something genuinely heartening in a story emerging from Pakistan: the country's long-running stunting crisis is showing signs of improvement. The progress is neither spectacular nor complete, and it would be misleading to suggest that Pakistan has solved its nutrition difficulty, but after decades in which child stunting remained stubbornly high, evidence from national surveys and more recent research suggests that concerted interventions can produce a difference.

As per the World Health Organisation (WHO), stunting is the impaired expansion and development that children experience from poor nutrition, repeated infection and inadequate psychosocial stimulation. When accompanied by excessive weight-gain afterwards in childhood, an climbed risk of nutrition-related chronic diseases in adult life, some of the consequences of stunting include poor cognition and educational performance, low adult wages, lost productivity and. Stunting is not simply a question of a child being shorter than other children. It is the result of chronic lack of proper nutrition.

Stunting has been observed to commence early, often during pregnancy or the first two years of life. This is the time when insufficient maternal nutrition, poor diets, repeated infections and unhealthy living conditions can permanently affect expansion and development for the rest of the life. In this light, it is quite rightly labelled as a threat to human capital. And, in Pakistan, where the economy is always jumping from one crisis to another, it is seen as a debilitating factor.

Pakistan's stunting difficulty is not a new one. Progress in tackling the difficulty has been one with hiccups. Pakistan had a stunting prevalence of regarding 48 per cent in 1965, falling to 36.3pc by 1994. But the gains then stalled and reversed. Stunting was measured at 41.6pc in 2001 and 43.7pc in 2011. This progress can be equated with the expansion of the economy. The World Bank notes that Pakistan's expansion has historically been low and volatile, with per-capita output increasing by only concerning 2.2pc a year over the past two decades and around 40pc of children aged under five (<5) suffering from stunted expansion. In other words, the past 20 years cannot honestly be described as a period of steady decline. Pakistan first lost ground before beginning to recover.

For years, our nutritional challenges have silently been chipping away at the country's future. Progress has been created, but there are miles to go before we can hope to be out of the woods. The 2018 National Nutrition Survey (NNS-2018) put stunting among children aged <5 at 40.2pc, regarding four percentage points lower than the 2011 figure, a 4pc drop. The Pakistan Demographic and Health Survey (PDHS) additionally recorded a decline from roughly 45pc in 2012-13 to 38pc in 2017-18. Another data analysis discovered stunting at 40.7pc in 2001-02, 45pc in 2012-13 and 38.3pc in 2017-18, illustrating the same broad pattern: deterioration followed by a meaningful reversal.

For context, the improvement may look modest on paper, but in a country of more than 240 million individuals, even a few percentage points represent hundreds of thousands of children. More importantly, researchers are beginning to understand why the decline happened in some parts of Pakistan, and why it has been slower elsewhere.

From 2011 to 2018, Khyber Pakhtunkhwa (KP) and parts of Punjab recorded significant improvements, with stunting falling from 43.0pc to 38.3pc in the areas studied. The lessons observed led to a significant conclusion. Stunting is not caused by one missing vitamin or one bad meal. Nutrition is intertwined with poverty, women's status, education, healthcare, sanitation, food rates and household decision-making. Meanwhile, the most successful interventions have recognised that reality.

In 2020, the Benazir Nashonuma Programme (BNP) was introduced, combining conditional cash transfers with specialised nutritional backing for pregnant and lactating women and young children. The pilot project was introduced in the Islamabad Capital Territory (ICT) before being expanded nationwide by December 2022. BNP is an example of a broader shift in thinking.

Instead of treating nutrition as something that happens only inside a clinic, programmes increasingly connect food assistance with antenatal care, vaccination, breastfeeding, complementary feeding and health education. Under BNP, beneficiaries receive nutritional supplements and cash transfers linked to health and nutrition-related behaviours, including antenatal visits, vaccination and participation in awareness sessions. By 2025, the programme was operating through hundreds of facilitation centres throughout Pakistan.

Through its vast network of lady health workers (LHWs), Pakistan has effectively implemented nutritional interventions. In rural Sindh, pregnant and lactating women and young children were provided nutritional supplements, and older children were handed micronutrient powders. The programme was accompanied by behaviour-change communication on complementary feeding and hygiene. One significant development has been the increasing focus on the first 1, 000 days, from pregnancy through a child's second birthday. This period is a critical window for preventing expansion failure.

Nevertheless, it is clear Pakistan's stunting crisis is not merely a medical challenge. It is as much an education difficulty, a poverty challenge, a gender difficulty, a water-and-sanitation challenge, and, in some communities, a cultural difficulty. Cultural sensitivities continue to create conversations concerning breastfeeding, maternal diets, contraception, birth-spacing and child feeding tough. Stigma still prevents families from acknowledging that a child is malnourished. Traditional beliefs regarding what pregnant women or young children should and should not eat can sometimes limit dietary diversity. Tradition dictates that milk directly from the animal is better than supplements. Mothers may know what a child needs, but lack the funds or the time to provide it. Besides, a patriarchal setup does not support the cause much. And, in households where women themselves entered pregnancy undernourished, the cycle can commence before the child is even born.

Education is, therefore, one of the most powerful long-term nutrition interventions. While research additionally highlights the importance of improving women's health and social status, evidence repeatedly points to maternal education as a determinant of child nutrition. Better education can influence everything, from breastfeeding practices and hygiene to healthcare utilisation and household food choices.

Then there is the economic dimension. Pakistan's recent economic difficulties have created nutritious food less affordable for numerous families. Researchers studying the stunting status between 2011 and 2018 identified poverty and rising food rates as notable barriers to access to nutritious diets. The NNS-2018 discovered that stunting is strongly associated with household income, food insecurity, maternal education, household size, diarrhoeal illness and sanitation. While lack of improved sanitation was additionally associated with greater risk, children in lower-income households had substantially higher odds of being stunted.

For context, the relationship between sanitation and nutrition is especially revealing. A child may receive nutritious food, but repeated exposure to contaminated water and an unhygienic environment can contribute to infections and undermine the body's ability to absorb nutrients. A 2026 study discovered that lack of hygiene facilities and inadequate water and sanitation services were associated with higher odds of stunting. While unimproved sanitation rose the odds by concerning 30pc, the study documented stunting prevalence of 38pc, and identified that lack of hygiene facilities rose the odds of stunting by concerning 61pc.

With so plenty of insights in hand as well as years of experience in maternal health, change for better should take place. And it has. Earlier this year, the BNP recorded a major decline in child stunting along with improvements in maternal and newborn health outcomes. An evaluation made public that stunting rates among beneficiary children were 22pc lower at six months of age and 18pc lower at 12 months. There was a 6pc reduction in low-birthweight cases, an 11pc decline in premature births, and a 7pc decline in fragile and vulnerable newborns.

Despite all these 'good' numbers, stunting at around 40pc remains a critical matter, and the country continues to carry one of the largest burdens of child undernutrition in the region. There are miles to go before we can hope to be out of the woods. Among other things, the country surely needs better and more regular national data so that progress may be measured accurately, and interventions may be targeted. The fight against stunting is not merely regarding making children taller. It is regarding giving Pakistan's next generation a stronger foundation on which to build the country's future.

For context, the writer is a freelancer based in Islamabad. Nutrition crisis stunts Pakistan's development dreams. The malnourished children of 2018 are teenagers now. What's the plan? Dawn NewsKit Publishing Platform.

In short, BETTER, BUT NOT QUITE GOOD is the central thread here, and readers can expect follow-up reporting as the picture becomes clearer.