tests, the World Bank provincial nutrition status notes do not find an association in any of the provinces between stunting status and young birth age for mothers (that is, at least one pregnancy at 18 years of age or younger).

Fazal et al. (2013) find that certain types of nutrition knowledge matter: they find that mother’s knowledge about the importance of colostrum is negatively associated with wasting status. However, the authors do not find the same association for knowledge about the ideal duration of breastfeeding, about signs of child undernutrition, or about prevention of diarrhea.

Di Cesare et al. (2015) find that mother’s height and BMI are positively associated with HAZ, WAZ, and WHZ. The provincial nutrition status notes find that mother’s height is negatively associated with stunting status in Balochistan, Punjab, and Sindh based on multivariate tests; the notes do not find an association in KPK based on a bivariate test. The notes also find that mother’s BMI status (underweight, normal, overweight) is associated with stunting status in Punjab based on a multivariate test, but do not find an association in the other provinces based on either bivariate or multivariate tests. Fikree, Rahbar, and Berendes (2000) generally do not find mother’s low weight status to be associated with stunting or wasting status.

Rahman et al. (2004a) find that poor mental health status for the mother is positively associated with underweight status. Similarly, Rahman et al. (2004b) find that for a sample of tracked mothers and children, poor mental health status measured at pregnancy is positively associated with stunting and underweight status at six and 12 months of age.

Fikree, Rahbar, and Berendes (2000) generally do not find mother’s employment status to be associated with stunting or wasting status. Rahman et al. (2004b) do not find that mother’s financial decisionmaking authority is associated with underweight or stunting status.

_Household-level factors_ : Studies tend to find that household economic status—typically measured by income, consumption expenditure, or asset-based wealth—is positively associated with nutrition status.<sup>41</sup> Panel C in Figure 5, which plots child undernutrition rates by household wealth quintiles based on 2012–13 DHS statistics, shows the bivariate relationship. The stunting rate is 62% in the poorest wealth quintile, falling to 23% in the richest wealth quintile. As an exception, Arif et al. (2014) examine the effect of household consumption spending in 2001 on nutrition status in 2010 for a panel of rural households, instrumenting for consumption spending in 2001 using land and livestock ownership, household size, and household head’s employment status in the same year. Using this measure, the study does not find that consumption spending is associated with HAZ, WHZ, or WAZ.

In terms of WASH indicators measured at the household level, Mahmood (2001) and Ibrahim (1999) find, on the positive side, that a flush toilet at home is associated with better child nutrition status. Fazal et al. (2013) find that access to sufficient water, measured by the collection of more than 20 liters of water per day, is associated with lower wasting status. Fikree, Rahbar, and Berendes (2000) find that access to piped water is negatively associated with stunting status, but do not find an association with wasting status. In contrast, other studies do not find that nutrition

> 41 See World Bank provincial nutrition status notes; Headey, Hoddinott, and Park 2016; Di Cesare et al. 2015; Haddad et al. 2003; Mahmood 2001; Hazarika 2000; Ibrahim 1999.

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