A better start

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THE first 1,000 days of a child’s life often shape decades to come. In Pakistan, where chronic malnutrition has long harmed childhood development, an evaluation of the Benazir Nashonuma Programme shows that some children are finally getting a better start. The Aga Khan University study found a 22pc reduction in child stunting among beneficiary children at six months and an 18pc decline at one year. Equally encouraging were the reductions in low birth weight, premature births and vulnerable newborns. In a country long burdened by malnutrition and poor healthcare access, these are significant gains that could improve health, learning and productivity for years to come. That these gains were recorded across 157 districts makes them especially encouraging. More than 4.5m women and children have reportedly been reached through hundreds of facilitation and stabilisation centres. The BNP reflects a more thoughtful approach to poverty and nutrition: one that recognises that child stunting is linked not only to food insecurity, but also to maternal health, healthcare access and financial vulnerability. By combining social protection with nutrition support and maternal care, the programme appears to have improved outcomes during the earliest stages of life.

Yet Pakistan has much further to go; it ranks among the countries carrying the highest burdens of child stunting and maternal malnutrition. Millions of women continue to face pregnancies without adequate prenatal care, trained birth attendants or emergency obstetric services. In remote, impoverished areas, healthcare facilities are often understaffed, poorly equipped or too distant to reach in time. Too often, the quality of care a woman receives still depends on geography and income. A major reason is Pakistan’s chronically low investment in health. Public healthcare spending has hovered at around 1pc to 1.5pc of GDP for years which is among the lowest levels in the region. This is reflected in overcrowded hospitals, failing community health centres, medicine shortages, and limited prenatal and paediatric care. Programmes such as the BNP can ease immediate vulnerabilities, but they cannot substitute for a robust public healthcare system. Pakistan must commit to sustained investment in healthcare, nutrition and preventive services for its women and children. Ensuring that every mother and child has access to quality care is not charity, it is a measure of national development itself.

Published in Dawn, May 11th, 2026

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