Adequate nutrition during pregnancy and in the first two years of a child’s life has been shown to have a
substantial influence on long-term health, growth and brain development. In Pakistan, the prevalence of
stunting in children under five years has remained above global critical levels over the last two decades, with
the current stunting rate being 40.2% in 20181. Children living in rural areas and in the poorest households
suffer the most from stunting across the country – 43.2% in rural areas and 51.4% in the lowest wealth
quintile. As a continuing public health concern, it is essential that stunting prevention is a national priority in
order to ensure human capital development, especially among the poorest households.
The World Food Programme (WFP), in collaboration with the Benazir Income Support Programme (BISP)
and the Integrated Reproductive Maternal Newborn, Child Health & Nutrition Program (IRMNCH&NP)
commissioned a stunting prevention operational research study from April 2017 to November 2019 in district
Rahim Yar Khan, Punjab province, Pakistan. As a third party, Aga Khan University (AKU) conducted a fivearm
cluster randomized trial to examine the effectiveness and cost-effectiveness of specialized nutritious
foods (SNF), unconditional cash transfers delivered to the regular Benazir Income Support Programme
(BISP) beneficiaries and social and behavioural change communication (SBCC) to prevent stunting among
children 6-23 months. This study was funded by the Economic Cooperation and Development Section of
