Smallholder dairy farming, child dairy consumption and nutritional status in rural Pakistan

Child undernutrition is a critical public health challenge in Pakistan. Milk, a nutrient-dense food, can play an important role in reducing nutritional challenges. Some studies suggest that increasing dairy animal ownership could be a potential pathway to improve dairy consumption, and reduce child stunting, wasting and underweight. However, there is limited research into the association between family dairy animal ownership and child nutrition in Pakistan. This study utilised data from the Pakistan Demographic and Health Survey 2017–18 to investigate associations between dairy animal ownership, dairy food consumption and the nutritional status of children aged 6–23 months residing in rural areas of Punjab and Sindh provinces. Data from 655 households (including 708 children) were analysed using univariable and multivariable logistic regression as well as generalised linear mixed-effects regression. Results showed that region is significantly associated with child dairy consumption and nutritional status. Children from Sindh were less likely to consume dairy foods (OR 0.23; 95% CI 0.16–0.32) and were more likely to be stunted (OR 3.12; 95% Cl 1.79–5.49), wasted (OR 2.83; 95% Cl 1.26–6.57) or underweight (OR 4.37; 95% Cl 2.36–8.31). Moreover, parental education and household wealth index were strongly associated with child dairy consumption and nutritional status. Decisions regarding major household purchases, particularly who makes them, showed a significant association with child stunting, wasting and underweight. Interestingly, no association between dairy animal ownership, child dairy consumption, and nutritional status were identified. Despite households owning dairy animals, 33% of children in Punjab and 60% of children in Sindh did not consume milk. This study emphasises that the relationships between dairy animal ownership, dairy consumption, and child nutritional status are not straightforward. They are shaped by a complex interplay of multiple socio-economic factors unique to each province. Dairy animal ownership alone does not seem to improve child nutritional status in smallholder dairy farming households in Pakistan. Improving parental education, household wealth status and women’s empowerment, however, could lead to better child nutrition. Further research is needed to enhace understanding of household milk utilisation practices and decision-making processes in order to develop more effective strategies for overcoming child undernutrition.