compared to recent corresponding rates for other South Asian countries. Pakistan ranks at the poorperforming end of the regional distribution for stunting rates, in the middle with respect to underweight rates, and at the better-performing end with respect to wasting rates.

- B. _Differences in child undernutrition rates between rural and urban areas_

Based on the 1998 national population census, which is the latest census available for the country, 33% of Pakistan’s population reside in urban areas. The 2012–13 DHS finds that the stunting rate is 48% in rural areas, compared to 37% in urban areas, while the underweight rate is 33% in rural areas and 24% in urban areas. The survey also finds that the wasting rate is similar for rural areas (11%) and urban areas (10%). Panel B in Figure 1 shows the rural-urban difference in child undernutrition rates in Pakistan compared to other South Asian countries. Measured in percentage point terms, Pakistan’s rural-urban difference with respect to the stunting rate is on the higher end of the distribution for South Asia, and in the middle with respect to wasting and underweight rates.

Mahmood (2001), Hazarika (2000), and Ibrahim (1999) find that the national urban-rural difference in nutrition status becomes insignificant after controlling for other factors. Likewise, the World Bank provincial nutrition status notes do not find that the urban-rural difference in stunting status is significant in any of the provinces, based on either a bivariate or a multivariate test depending on the province. As an exception, Ibrahim (1999) finds that the regression-based national urban-rural difference in WAZ is significant.

- C. _Differences in child undernutrition rates among provinces_

Based on the 1998 census, 56% of the country’s population resided in Punjab, 23% in Sindh, 13% in KPK, and 5% in Balochistan.<sup>21</sup> Figure 2 shows child undernutrition rates across Pakistan’s provinces, based on the 2011 NNS. We use this survey because the 2012–13 DHS does not report statistics for Balochistan. Undernutrition rates differ greatly across provinces. For example, the stunting rate varies from 39% in Punjab to 52% in Balochistan. Province differences in stunting and underweight status remain significant even after controlling for other factors (for example, see Mahmood 2001, and Ibrahim 1999).

Sizeable discrepancies exist at times between the 2011 NNS and the 2012–13 DHS statistics. The 2011 NNS and 2012–13 DHS find that the stunting rate in Sindh is 50% and 57%, respectively, and that the stunting rate in KPK is 48% and 42%, respectively. Across the provinces, wasting rates are lower by 4–5 percentage points in the 2012–13 DHS than in the 2011 NNS, which is a large difference given that wasting rates range from 10% to 20%. Data issues may be behind these discrepancies, as discussed in Box 1.

# D. _Differences in child undernutrition rates among districts in Punjab and Sindh_

> 21 The socioeconomic context of the four provinces differs substantially, as reflected by the levels of food production and security, income poverty, access to safe drinking water, improved sanitation, preventive and promotive health services, social exclusion, violence and conflict, and natural disaster risk. Balochistan tends to have the poorest levels, followed by KPK and Sindh as a pair, and then Punjab (see Zaidi et al. 2013a for details on the differences among the four provinces).

10