We thank the readers for their letter to the editor in response to our study. We agree with their observations, as we concluded in the paper, that the critical nature of child undernutrition remains a significant public health challenge, especially in the context of poor household environmental conditions, such as homes constructed with unimproved materials, exposure to household air pollution and lack of proper handwashing facilities^{(Reference Khan, Billah and Fatima1)}.

Malnutrition accounts for 45 % of deaths among children under five globally, not only increasing mortality risks but also leading to irreversible cognitive impairment, diminished educational outcomes and reduced economic productivity⁽²⁾. While there has been progress in reducing stunting since 2000, the current trajectory is insufficient to meet the 2030 global targets⁽³⁾. Wasting continues at unacceptably high levels, and the rising prevalence of childhood overweight signals an urgent need for policy shifts to reverse this trend⁽³⁾. However, while the letter rightly emphasizes the importance of monitoring undernutrition, we believe that achieving the goal requires more than just surveillance. Effective policy action must extend beyond monitoring and involve comprehensive, multisectoral interventions that integrate nutrition, health, WASH (water, sanitation and hygiene) and social protection measures. Such integrative approaches are essential for addressing the root causes of undernutrition and breaking the intergenerational cycle of poverty and ill health.

While the regional relevance of undernutrition is well recognized, strategies must be tailored to country-specific contexts. Lessons from Bangladesh’s nutrition-sensitive initiatives, such as community-based programs aimed at improving dietary diversity and sanitation, could provide valuable insights for similar South Asian contexts. However, successful implementation demands strong commitment, cross-sectoral collaboration and sustained investment. The broader relevance of this issue to other low- and middle-income countries, including neighbouring India, Pakistan and Myanmar, further underscores the need for cross-border collaboration in research and policy. Strengthening regional partnerships to share evidence-based interventions could accelerate progress in addressing undernutrition on a larger scale, particularly in a region with one of the highest prevalences of child malnutrition⁽³⁾.