Missing Dimensions in Addressing Child Malnutrition in Pakistan: Lessons from the Tawana Experience

This article uses the Tawana Pakistan Project (TPP) as a case study of how to promote self-sustaining improvements in nutrition status. The programme used a participatory approach to mobilisation around malnutrition, had a transparent information system for monitoring resources, and brought a focus on deeper structural issues to the analysis of malnutrition. We argue that Tawana was cancelled because it did not provide sufficient opportunities for leakage and diversion. This amply illustrates the political nature of nutrition. Yet efforts to reduce malnutrition continue to focus primarily on technical fixes. For long-term change researchers and programme implementers will need to understand the political space they operate within. Tawana was not perfect but it offered a glimpse of a different way forward, one that struck a balance between inclusiveness and action; transparency and accountability; and health and social science perspectives. It affected politics and was undone by them. It is not too late to include these concepts and approaches in future nutrition policies and interventions.