In today’s post, I wanted to revisit stunting. Over and over again, stunting emerges as one of the most critical hurdles to achieving full economic and social development in a global context. The condition affects over 162 million children under the age of 5 (Stunting Policy Brief, WHO and 1,000 Days). There is a significant amount of research into the causes and effects of this state of malnutrition, and a growing body of evidence-based interventions to combat it. So what is stunting?
Technically, the condition of stunting is defined as “a height that is more than two standard deviations below the World Health Organization (WHO) child growth standards median.” (Stunting Policy Brief, WHO and 1,000 Days) As any statistician might tell you, that’s quite extreme. It is important to recognize that so many hundreds of millions of children persist in this condition despite the extremity of its definition. However, the real tragedy of stunting is the irreversible long-term damage it inflicts including “diminished cognitive and physical development, reduced productive capacity and poor health, and an increased risk of degenerative diseases such as diabetes.” (Stunting Policy Brief, WHO and 1,000 Days)
Research has demonstrated the correlation between stunting before the age of 2 with diminished cognitive and educational ability later in life. Stunting is associated with fewer years of school completed, and significantly lower academic performances compared to non-stunted peers. In addition, stunting in women is associated with lower age at first childbirth and a higher number of total pregnancies. Stunting has been estimated by economists to reduce a country’s GDP by up to 3%. Furthermore it is associated with lower household income and a greater chance of living in poverty. One of the most shocking data points I came across is that stunted children earn an “estimated 20% less as adults compared to non-stunted individuals”. (Investing in Nutrition, World Bank)
Think about that for a minute – in India, the average GDP per capita in 2015 was roughly USD 1,581 (World Bank). If you were unfortunate enough to be stunted as a child, something that you had no control over, you can expect to earn on average USD 316 less every year, a truly significant amount of money at the margins. If you take into consideration the mean individual income of only the bottom 50% of income earners, you can imagine how disenfranchising that 20% diminishment in income really is.
One of the most important developments in the fight against malnutrition, including stunting, occurred in 2012 when the 194 member states of the World Health Assembly (WHA) endorsed six global targets to improve nutrition by 2025. (Interestingly enough, the world is currently not on track to meet even a single one of these targets…more on that later). The nutrition target for stunting is a 40% reduction in the number of children under 5 who are stunted. This translates roughly to at least 65 million fewer children who are stunted in 2025 and an estimated 2.8 million child lives saved. (Investing in Nutrition, World Bank)
As part of the effort to successfully reach the target goal for stunting, the WHO recommends the following actions to drive progress:
- Improve the identification, measurement and understanding of stunting and scale up coverage of stunting-prevention activities.
- Enact policies and/or strengthen interventions to improve maternal nutrition and health, beginning with adolescent girls.
- Implement interventions for improved exclusive breastfeeding and complementary feeding practices.
- Strengthen community-based interventions including improved water, sanitation and hygiene (WASH), to protect children from diarrheal diseases and malaria, intestinal worms and environmental causes of subclinical infection.
To learn more about stunting, please visit and donate generously to 1,000 Days.