MOTHERS’ EMPOWERMENT, UNCONDITIONAL CASH TRANSFERS AND CHILD UNDERNUTRITION: EVIDENCE FROM MULTAN DIVISION, PAKISTAN

Abstract

Many young children in Pakistan are undernourished. More than a third of children under five are stunted, and the problem is worst in poorer areas such as southern Punjab. This study asks whether children are better nourished when their mothers receive the Benazir Income Support Programme (BISP) cash transfer and when their mothers have more say in the household. We interviewed mothers in 768 households in Multan Division. Half received BISP and half were neighbours of similar income who did not. We measured the height and weight of their 1,179 children under five. We measured mothers’ empowerment with economic, social, familial, political and overall scores built by principal component analysis. Because empowerment may depend on other household factors, we used the mother’s ownership of a house and of land as instruments and estimated control-function probit models for the whole division and for each district. Children of BISP mothers were 5.0 percentage points less likely to be stunted, 4.4 points less likely to be wasted and 4.7 points less likely to be underweight. The mother’s control over money was the type of empowerment most closely linked to better nutrition. BISP helped more when mothers had more economic and social empowerment, while the familial and political interactions were mostly not significant. Recent diarrhoea was the biggest risk factor, and being large at birth and being breastfed lowered the risk. The protective links were weakest in Lodhran, the poorest district. The main policy lessons are to add nutrition supplements and counselling to BISP, to support mothers’ earnings, and to invest in clean water and sanitation in Lodhran and Vehari.