mother’s education, mother’s mental health, sanitation, handwashing, drinking water) and the names or types of programs that could influence child nutrition status (for example, social assistance, nutrition counseling, cash transfers, Lady Health Workers, the Benazir Income Support Program), combined with the location terms.

We supplemented this search with a general Google search, a professional search of major bibliographic databases performed by the World Bank library research service, and by inquiring with staff in World Bank departments that cover relevant topics (for example, health and nutrition; agriculture; and water, sanitation, and hygiene [WASH]). Importantly, the inquiries netted us unpublished provincial nutrition status notes for Pakistan. These notes empirically examine the determinants of stunting status in each of the provinces, which other studies we found do not.

We screened each study based on whether it directly discusses child undernutrition, or a potentially relevant determinant of child undernutrition. We do not screen out empirical studies based on rigor. Instead, we discuss the data and empirical approach used by each study before summarizing its findings, especially when the authors interpret the findings to be causal, such as for studies that examine the effects of interventions. We synthesize the findings from around 30 studies that directly examine child undernutrition in Pakistan, and discuss around 60 studies that only examine potentially relevant determinants of child undernutrition, including the enabling environment for nutrition policy and action, in the country.<sup>8</sup> We also present published statistics on the levels of child undernutrition and potential determinants of child undernutrition from large-scale household sample surveys for Pakistan. Most of the nutrition statistics that we report are from the 2012–13 DHS and the 2011 NNS, which are national surveys representative at the province level, and the 2014 Multiple Indicator Cluster Surveys (MICS) for Punjab and Sindh, which are provincial surveys representative at the district level.<sup>9</sup> Unless otherwise noted, we report moderate-to-severe rates for stunting, underweight, and wasting status, based on the 2006 World Health Organization (WHO) growth standards (WHO 2006a). A child is considered to be moderately-to-severely stunted if his or her height–for–age z score (HAZ) is two standard deviations below the international reference population median. A child is considered to be severely stunted if his or her HAZ is three standard deviations below the international reference population median. Moderate-to-severe and severe wasting, and moderateto-severe and severe underweight status, are defined analogously, based respectively on weight– for–height z scores (WHZ) and weight–for–age z scores (WAZ). Unless otherwise noted, the reported rates are for children 0 to 59 months of age.

> 8 The four unpublished provincial nutrition status notes are counted as one study that directly discusses child undernutrition. Studies that examine maternal undernutrition and child micronutrient deficiencies but not child stunting, wasting, or underweight status are counted in the second set.

> 9 2011 NNS: GOP 2013. 2012–13 DHS: National Institute of Population Studies [Pakistan] and ICF International 2013. 2014 Sindh MICS: Sindh Bureau of Statistics and UNICEF 2015. 2014 Punjab MICS: Bureau of Statistics Punjab, Planning and Development Department, Government of the Punjab and UNICEF Punjab 2016.

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