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child stunting

All hands on deck: Halting the vicious circle of stunting in Sub-Saharan Africa

Emmanuel Skoufias's picture
Betty teaches mothers with small children about nutrition, Uganda. Photo: © Stephan Gladieu / World Bank

In a large, complex, or urgent situation, the command goes out: “All hands on deck!”

Sub-Saharan Africa faces such a clarion call now. It is the only region in the world with a growing number of children under the age of five who have stunted growth, meaning they are too short for their age. Although the number of children affected by stunting globally has decreased drastically since 1990, Africa is the only region that has seen an increase in the number of children stunted despite a decrease in the prevalence of stunting.

Poor sanitation is stunting children in Pakistan

Ghazala Mansuri's picture
A nutrition assistant measures 1 year old Gullalay’s mid-upper arm circumference (MUAC) at UNICEF supported nutrition center in Civil Dispensary Kaskoruna, Mardan District, Khyber-Pakhtunkhwa province, Pakistan.
With a stunting rate of 38 percent, Pakistan is still among the group of countries with the highest rates of stunting globally and the pace of decline remains slow and uneven. In Sindh, for example, things have worsened over time, with one in two children now stunted. Credit: UNICEF


More than one in every three children born in Pakistan today is stunted.

Child stunting, measured as low height for age, is associated with numerous health, cognition and productivity risks with potential intergenerational impacts.

With a stunting rate of 38 percent (Demographic & Health Survey 2018), Pakistan is still among the group of countries with the highest rates of stunting globally and the pace of decline remains slow and uneven.

In Sindh, for example, things have worsened over time, with one in two children now stunted!

The policy response to this enormous health crisis has been almost entirely centered on interventions at the household level—reducing open defecation (OD), improving household behaviors like child feeding and care practices and food intake.  

A recent World Bank report, which I co-authored, suggests that a major shift is this policy focus is required for significant progress on child stunting.

The report begins by showing that over the past 15 years Pakistan has made enormous progress in reducing extreme poverty, with the poverty rate falling from 64 percent to just under 25 percent in 2016.

This has improved dietary diversity, even among the poorest, and increased household investment in a range of assets, including toilets within the home.

This has, in turn, led to a major drop in OD, from 29 percent to just 13 percent. Curative care has also expanded, with the mainstreaming of basic health units and the lady health worker program.
 

Reaching for the SDGs: the untapped potential of Tanzania’s water supply, sanitation and hygiene (WASH) sector

George Joseph's picture


When it comes to economic success, Tanzania offers a model for the rest of Sub-Saharan Africa. Growth has averaged 6.5 percent per year over the past decade, and between 2007 and 2012 nearly a third of the poorest 40% of the population rose out of poverty. However, the progress towards improving water and sanitation access for all has not kept a similar pace.
 
A new report by the World Bank, ‘Reaching For The SDGs’ was launched by the Honorable Eng. Isack Kamwelwe, Minister of Water and Irrigation on March 20 in Dar es Salaam. In her welcome address, Ms. Bella Bird, Country Director for Tanzania, Malawi, and Burundi said, “adequate WASH is a crucial component of basic human necessities that allow a person to thrive in life”.  The report shows how water and sanitation services need to advance substantially in order to achieve much needed improvements in health and wellbeing that will help the country fulfill its true potential.  Progress in this area still has a long way to go.  

For Central Asia, investing in children’s health is the best investment for the future

Lilia Burunciuc's picture


Millions of children around the world are prevented from reaching their full developmental potential because of poor environment and nutrition. In the more extreme cases, these children face stunting — a condition that arises when children grow much less than is expected for their age.

In 2016, an estimated 155 million kids – about one quarter of all young children worldwide – were affected by stunting. Sadly, undernutrition claims about 3 million young lives every year – representing almost half of all deaths of children under the age of five.

Young children who lack access to pre-primary education also lack access to essential services that support a healthy childhood. Kids who are poorly nourished, who are stunted, and who do not receive adequate stimulation before their fifth birthday are likely to learn less at school and earn less as adults. They are also less ready to compete as adults in an increasingly digital economy.

In Central Asia, I am glad to say that we are starting to see progress on the path toward eliminating childhood stunting. In every country in the region, the share of children who are stunted is on the decrease. This is a remarkable achievement, due in large part to the commitment of governments and communities to address malnutrition. We must remain determined to ensure this progress continues.

Campaign Art: Why it’s imperative to scale-up maternal and child nutrition

Darejani Markozashvili's picture
People, Spaces, Deliberation bloggers present exceptional campaign art from all over the world. These examples are meant to inspire.

Maternal and child nutrition is a key driver for sustainable development, yet about 155 million children worldwide are still stunted (children below average height for their age). According to the 2008 Lancet Maternal and Child Undernutrition Series “more than a third of child deaths and 11% of the total diseases burden worldwide are due to maternal and child undernutrition.”

More recent estimates released in May 2017 by UNICEF, WHO, and World Bank suggest that number of children under 5 stunted has decreased from 254.2 million in 1990 to 154.8 million in 2016. While this a great progress in the last 26 years, 154.8 million stunted children is still a staggering number.
 

Source: WHO, UNICEF, World Bank
 

All hands on deck: new evidence on the need for a multi-sectoral approach to reducing childhood stunting

Emmanuel Skoufias's picture



In Indonesia, chronic malnutrition is widespread with more than one-third of young children being stunted. Despite the reduction of the poverty rate from 16.6% to 11.4% from 2007 to 2013, the rate of stunting amongst children under the age of five has remained alarmingly high, exceeding 37% in 2013, although that figure has declined in the last two years. Stunting has important lifelong consequences for health, as well as for cognitive development, education, human capital accumulation, and ultimately for economic productivity.

However, to reduce stunting it’s not only important to focus on the health sector. It also requires improvements in other sectors such as agriculture, education, social protection, and water, sanitation, and hygiene (WASH). As originally emphasized by the UNICEF conceptual framework, to ensure that a child receives adequate nutrition depends on four critical factors: care, health, environment, and food security, areas that straddle multiple sectors.

A Basic Need to Help Children

Alassane Sow's picture

Alassane Sow, World Bank Country Manager for Cambodia, and Rana Flowers, UNICEF Representative to Cambodia, wrote an op-ed for The Phnom Penh Post. Read the op-ed below, courtesy of The Phnom Penh Post.

Did you know that in communities where a high proportion of people defecate outdoors, children are on average shorter than children living in communities where most people use toilets?

From the Annals of Puzzles: Why Indian Children Are More Stunted than African Children

Berk Ozler's picture
I recently finished teaching smart and hard working honours students. In Growth and Development, we covered equity and talked about inequalities of opportunity (and outcomes) across countries, across regions within countries, between different ethnic groups, genders, etc. In Population and Labour Economics, we covered intra-household bargaining models and how spending on children may vary depending on the relative bargaining power of the parents.

Stunting: The Face of Poverty

Sri Mulyani Indrawati's picture
Globally, 165 million children under age 5 suffer from chronic malnutrition – also known as stunting, or low height for age. Much of this damage happens in pregnancy and the first two years of a child’s life. It means a child has failed to develop in full and it is essentially irreversible – which means that the child will have little hope of ever achieving her full potential. 
 
The evidence tells us that malnutrition costs lives, perpetuates poverty, and slows economic growth. We now know that nearly half of all child deaths globally are attributed to malnutrition. I have seen in my own country, Indonesia, how stunting caused by malnutrition has diminished too many children’s futures before they even begin. Malnourished children are more likely to perform poorly in school and drop out earlier than their better-nourished peers, limiting their future earnings. Data from Guatemala show that boys who had good nutrition before age 3 are earning nearly 50% more as adults, and girls had a greater likelihood of having an independent source of income and were less likely to live in poor households.
 
Malnutrition diminishes not only the futures of individuals, but also of nations. Recent estimates suggest that as much as 11% of gross national product in Africa and Asia is lost annually to the impact of malnutrition. To end extreme poverty and promote shared prosperity, the world must commit to end child stunting due to malnutrition. I will be joining leaders from around the world in London this week to focus on this critical challenge.