THE Sindh government’s agreement with the World Bank to combine health, nutrition, sanitation, social protection and agriculture programmes acknowledges that child stunting cannot be treated by the health department alone. The proposed secretariat, district committees and dashboard could replace scattered schemes with targets and accountability. But institutional architecture will mean little unless it reaches mothers and children consistently. More than 40pc of Pakistani children under five are stunted, while Unicef estimates that nearly 10m children are affected. This is not simply a shortage of food. Repeated infections, unsafe water, poor sanitation, maternal undernutrition, inadequate breastfeeding, low-quality diets, poverty and limited primary healthcare all impair growth during pregnancy and the first two years of life. The damage can reduce learning, health and earning capacity for decades.

Sindh’s model should therefore become part of a national, provincially implemented strategy centred on the first 1,000 days of life. Every pregnant woman should have access to antenatal care, micronutrient supplementation, nutrition counselling and income support; every child should be tracked for growth, vaccination and timely treatment through strengthened basic health units and Lady Health Workers. Governments must promote exclusive breastfeeding, improve complementary feeding after six months and expand fortification of staple foods. Cash transfers should be linked to health visits without penalising families unable to reach distant facilities. Safe drinking water, toilets, drainage and water-quality testing must be treated as nutrition spending, not separate municipal concerns. District plans should identify the highest-burden union councils, publish budgets and quarterly results, and trigger corrective action when targets are missed. Independent surveys must verify official dashboards. Longer-term progress also requires girls’ education, family planning, and affordable eggs, milk, pulses, fruit and vegetables. Pakistan has run nutrition projects for years; what it has lacked is sustained political ownership, reliable local delivery and consequences for failure. Sindh now has a framework. Its value will be measured not by meetings, but by children growing, learning and thriving.

Published in Dawn, August 7th, 2026