The report first provides an overview of the extent, causes and consequences of undernutrition. The report considers data on anthropometric status of women and children, the extent of micronutrient deficiencies and indicators of nutrition behaviour in Pakistan. This is followed by an overview of guiding principles of the two DFID nutrition strategy papers (2010, 2011), and how the strategies can be implemented in Pakistan. The report considers how DFID Pakistan programmes could contribute directly and indirectly to improving the nutritional status of the population.

Conclusions include:

• Up to half the under-fives suffer from stunting, underweight or wasting
• Addressing undernutrition will require multisectoral approaches in addition to direct (health) interventions. Direct interventions have the potential to address one third of the problem.
• Health interventions focusing on pregnancy, newborn and the under-fives should be delivered through existing health service provision.
• Direct cash transfers to women presents an opportunity to improve food security in Pakistan, although review of the literature presents mixed results.
• Direct and indirect nutrition interventions could be incorporated in existing and future DFID programmes; impact measurement and demonstrating attribution will present a major challenge.
• DFID programmes supporting policy and governance could impact on the underlying causes of malnutrition if they influence economic opportunities and food production.