This study presents an analysis of policies addressing child mortality in Pakistan focusing on problem structuring, using a comparison with Bangladesh. Pakistan's progress in addressing child mortality rate has been much slower than that of Bangladesh despite the fact that Pakistan has excelled in economic growth, and the two countries have comparable populations and share political history. This study analyzes and provides an explanation for differential outcomes in terms of problem structuring in the two countries. A comparative analysis of policy documents reviewed for the two countries illustrates the fact that Bangladesh, in formulating its child health policy, has emphasized the input factors such as nutrition and environmental aspects, besides health services. Pakistan, on the other hand, maintains a general problem formulation strategy focusing mainly on health service and ignoring the social, environmental, and other factors causing morbidity and mortality in children. Another comparison between policy formulation in each country and the extensive literature available on child mortality suggest that neither country pays as much attention to structural factors as the literature does. The analysis provides some insight into differentials in policy formulation associated with child mortality in the two countries, but more importantly, it provides an understanding of the underlying elements for inadequate policy outcomes in case of Pakistan.