The 2011 National Nutrition Survey (NNS) in Pakistan showed that Sindh province continues to have
some of the worst undernutrition rates in South Asia. For determinants of acute and chronic malnutrition to
be better understood, Action Against Hunger (ACF) conducted a Nutrition Causal Analysis (NCA) in two
districts of Sindh province, where persistently critical prevalences of wasting were recorded, for example,
Dadu district with GAM and SAM rates at 19.5 per cent and 5.3 per cent respectively (October 2011). ACF
findings confirmed that Infant and Young Child Feeding (IYCF) practices do not receive the attention required
to prevent the irreversible damages caused by undernutrition when occurring during the critical 1,000 days
window. The study also showed a high occurrence of illnesses related to poor access to water and sanitation
infrastructures, as well as a high level of poverty paired with the lack of alternative income sources.