Rates of acute malnutrition for vulnerable populations are concerning across 45 rural districts in Pakistan’s Balochistan, Khyber Pakhtunkhwa and Sindh provinces. The situation is driven primarily by seasonal diseases, inadequate feeding and caring practices, poor child dietary diversity, limited access to health services and recurrent natural shocks. 

Over 2.71 million cases of children aged 6-59 months are currently suffering from acute malnutrition—conditions expected to persist through September 2026. This includes around 706,000 will be cases of children suffering from severe acute malnutrition (SAM) at risk of death and around 2 million children suffering from moderate acute malnutrition (MAM). Around 232,000 cases of pregnant and breastfeeding women (PBW) suffering from acute malnutrition are expected during the same period. Sindh Province records the highest number of malnourished children with 1.18 million (44 percent of the total population), followed by Khyber Pakhtunkhwa with 1.11 million (41 percent) and Balochistan with 420,000 (15 percent). 

There are currently 28 districts (out of the 45 analysed) classified in IPC AMN Phase 4 (Critical). In these areas, acute malnutrition among children is characterised by widespread wasting, as well as death from preventable diseases. Urgent response actions are needed, including supplementary feeding in the most affected areas to protect children and PBW from acute malnutrition. The Sindh province presents the most critical situation with 11 out of 12 districts classified in Phase 4. In Khyber Pakhtunkhwa, 10 out of 14 districts are in Phase 4, while in Balochistan, 7 out of 19 districts are in Phase 4. 

During the projected period (April–September 2026), a slight improvement in the nutrition situation is expected, particularly in districts affected by harsh winters and limited access to health services in the current period. 

• Stabilise acute malnutrition levels through strengthened and scaled up Emergency Response Plan (ERP) and CMAM services through nutrition sector, including timely identification, referral, TSFP, and micronutrient supplementation. 
• Improve access to adequate and safe food for vulnerable households through emergency food and cash assistance.
• Reduce disease incidence by reinforcing primary health outreach, essential preventive services, and targeted vaccination campaigns (measles, polio, cholera, etc.), particularly in high risk and hard to reach areas.
• Enhance early detection of wasting through community-based screening, lady health workers (LHWs), family mid-upper arm circumference (MUAC), and improved surveillance for diarrhea, ARI, malaria, and other outbreaks. 
• Strengthen IYCF/MIYCAN practices through rapid, community-based counselling that supports breastfeeding, timely complementary feeding, and caregiver decision making. 
• Improve access to safe drinking water and basic sanitation through emergency WASH actions, including water treatment, hygiene kits, temporary sanitation, and contamination prevention in flood prone areas. 
• Ensure continuity of essential health and nutrition services during monsoon, harvesting, and seasonal stress periods through outreach teams, mobile services, and emergency response team deployment. 
• Strengthen community engagement via behavior change communication, support groups, and awareness on early care seeking, hygiene, and risk factors for acute malnutrition.