and tertiary education given that the effects of mother’s education attainment on child nutrition status either materialize or are largest in size at those education levels. International evidence shows that mother’s education attainment and household economic status are complements in influencing child nutrition status. This suggests that initiatives that produce large gains in mother’s education attainment or household income may have amplified effects on child nutrition status (Alderman and Headey 2017). While mother’s education attainment can influence child nutrition status through different channels (Alderman and Headey 2017; Ruel et al. 2013), we hypothesize that delayed marriage and pregnancy is a key channel for Pakistan.

The international scientific community has largely reached a consensus on the technical solutions to child and maternal undernutrition. For example, Bhutta et al. (2013) review the existing evidence, mainly from efficacy trials, on a wide range of nutrition-specific interventions, and find that a number of the interventions are successful in reducing maternal and child undernutrition. These include micronutrient supplementation, breastfeeding, complementary feeding, and the management of SAM. The authors also predict that scaling up these interventions to near-universal coverage would produce large reductions in child mortality, stunting, and severe wasting; that certain packages of these interventions—specifically, management of SAM, and infant and young child feeding—would produce relatively large gains in child survival; and that the use of community-based systems to deliver some of these interventions would help in reaching and benefiting the poorest households. The study conducts these prediction exercises for countries that register the largest numbers of children with poor nutrition status, including Pakistan.

Notwithstanding, developing countries face a number of challenges that constrain sustained, effective public nutrition action. These factors include a lack of will and interest at the political and senior bureaucratic levels; weak government strategic and operational capacity (that is, the capacity to plan, design, implement, monitor, and evaluate); the prevailing view that the causes of undernutrition and solutions for fixing the problem lie in food, health, and income; the typically narrow, protracted, and fitful operationalization of nutrition initiatives under government health ministries/departments; weak incentives for coordinating initiatives or partnering among government ministries/departments, different tiers of government, and local government agencies; and a lack of robust, durable, and proactive coalitions of external stakeholders (NGOs, civil society organizations, research organizations, international and national technical and financial institutions, private sector entities) (Bryce et al. 2013; Gillespie et al. 2013; Heikens et al. 2008). These same challenges are considered to hamper Pakistan’s efforts (Das, Achakzai, and Bhutta 2016; Levinson 2013; Zaidi et al. 2013a; Zaidi et al. 2013b).

To generate greater will and interest among national governments to tackle undernutrition, Gillespie et al. (2013) call for rigorous research on the economic and long-term benefits of preventing undernutrition; initiatives to strengthen commitment to, and accountability for, public nutrition delivery; and initiatives aimed at creating an enabling environment for public and private nutrition actions. They also call for sustained, strong, and deliberate action focused on creating greater government will. To strengthen government accountability and capacity for public nutrition action, the same study calls for capacity development; citizen and private sector engagement; inclusion of nutrition goals in nutrition-sensitive interventions; nutrition surveillance systems; generation and public release of nutrition statistics on a regular basis; and rigorous process (or operational) and impact evaluations of interventions. These recommendations warrant 31