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In this paper, I examine the relationship between three distinct attitudes of mothers (pro-boy, egalitarian, and pro-girl) and stunting among boys and girls of age 0–14 years in India using the Indian Human Development Survey (IHDS) 2004–2005. Probit model estimates suggest that mothers' pro-girl attitudes are associated with less likelihood of observing stunting among girls and boys. Additional analysis by wealth categories shows that stunting among girls reduces when they have mothers with pro-girl attitudes and live in wealthy households. Robustness tests conducted with "severely stunted" as the dependent variable confirm the findings. [ABSTRACT FROM AUTHOR]

Background: This study examines how significant is the changes in child stunting in Sub-Saharan African countries (SSA). Then, it investigates factors that contributed to the reduction in child stunting in those countries. For each country, we distinguish the contribution of compositional effects and structural effect. Methods: This paper uses data from Demographic and Health Surveys of 12 sub-Saharan African countries conducted between 2000 and 2020. The z-test to compare two independent proportions was used to assess changes in child stunting and explanatory variables over the period. Recentred influence function (RIF) decomposition method was used to decompose changes in stunting over the year in each country, and to determine the contribution of each variable to the changes. Results: The prevalence of child stunting declines significantly in 11 countries over the year. The decline varies from 6.8% in Cameroun to 19% in Mali. The average year of education of the child's mother and father, and the proportion of households with access to an improved drinking water source have contributed to the reduction in child stunting. This result was found in all the countries. Improvements in living standards, child vaccination, antenatal care attendance, delivery to health care centres, maternal education, improved drinking water sources, and improved sanitation make the largest contribution to the composition component, hence reducing child stunting. Conclusions: This study sheds light on what has contributed to the achieved improvement in child nutritional status and suggests how to possibly accelerate the reduction in undernutrition in countries that lag. [ABSTRACT FROM AUTHOR]

The acceleration of stunting reduction in Indonesia is one of the priority agendas in the health sector, its implementation being through various regional and tiered approaches. This paper aims to manage management using an integrated system framework approach at the regional level and to support the acceleration of stunting reduction nationally. It takes a quantitative description approach that uses secondary data sourced from the Directorate General of Regional Development, Ministry of Home Affairs, the Republic of Indonesia in 2019–2021. The locus of papers is in five provinces, North Kalimantan, South Kalimantan, Central Kalimantan, West Kalimantan, and East Kalimantan, Indonesia. The data collection and processing consisted of twenty stunting convergence coverage referring to regulations in Indonesia. The analysis used is an integrated framework based on five dimensions. Management based on an integrated framework in a regional-based system for stunting convergence can be a solution to accelerating stunting reduction. This paper provides an option to accelerate the handling of stunting through the Integration of Service Governance-Based Systems in Districts/Cities, considering the achievements in the last three years that have not been maximally carried out in every district/city in five provinces in Kalimantan, Indonesia. This study explains that the local government needs to socialize and disseminate the commitment to stunting reduction results to reaffirm commitment and encourage all parties to actively contribute to integrated stunting reduction efforts. This paper has limitations in the implementation of dimensions that can develop in a context that is correlated with several perspectives, such as regional planning, budgetary capacity, and regional capacity. [ABSTRACT FROM AUTHOR]

• The paper analyzes long-term impacts of electoral violence on health and education. • Areas exposed to violence in Kenya suffer inflation and fall in annual consumption. • Children and adolescents exposed to violence have stunted height as adults. • The sons of those exposed to violence during growing age also have stunted growth. • No long-term impact on education is found as violence peaks during school holidays. This paper examines whether prenatal, childhood, and teenage exposure to electoral violence has any long-term effects on height and human capital in Kenya. First, using the difference-in-difference estimator, we show that areas impacted by electoral violence see increases in local food prices and a decrease in annual nightlight, suggesting important local consumption shocks. We then identify people exposed to such violence using a nationally representative survey and take advantage of the temporal and spatial variation of electoral violence in Kenya between 1992 and 2013. Using coarsened exact matching, we find that exposure to electoral violence between prenatal and the age of sixteen reduces adult height. Previous research has demonstrated that protracted, large-scale armed conflicts can cause significant nutritional shocks and pass down stunting effects to descendants. In line with these studies, we find that the low-scale but recurrent electoral violence in Kenya has impacted the height-for-age of children whose parents were exposed to such violence while they were growing up. Only boys exhibit this intergenerational effect, possibly due to their increased susceptibility to malnutrition and stunting in Sub-Saharan Africa. The fact that most electoral violence in Kenya occurs over the school holidays may help explain why, in contrast to previous studies on large-scale conflicts, childhood exposure to electoral violence has no lasting impact on educational attainment. [ABSTRACT FROM AUTHOR]

Children are the most vulnerable victims of undernutrition. Undernutrition increases a child's risk of contracting common infections and also increases the frequency and severity of these illnesses in undernourished children. It is responsible for over half of all fatalities in children under the age of five. Inspite of being one of the fastest growing economies of the world, India ranks only 107th among 121 countries in terms of the global hunger index, 2022. This paper aims at estimating the relative position of various Indian states in terms of child malnutrition. For this purpose, a composite index for malnutrition was worked out for all the states on the basis of state-wise prevalence of stunting, wasting, anemia and low birth weight among children under five. The states were then ranked on the basis of malnutrition index and then classified as those having low, medium or high malnutrition. Maharashtra, Jharkhand, Bihar and Gujarat have high incidence of child malnutrition. The northeastern states of Manipur, Mizoram, Sikkim and Arunachal Pradesh and the southern state of Kerala are the best performing states. [ABSTRACT FROM AUTHOR]

This paper interrogates the discourses of stunting in Indonesia and its links to early childhood education. Here, stunting is analysed via Foucault's work, with data stemming from a long‐term ethnography study and analysis of relevant policy documents in Indonesia. We argue the discourses of stunting have been regulating children, teachers and parents by acting as a form of biopower of governing rationalities. Focusing merely on the individual and nutrition aspects, the discourses overlook larger societal problems. In such a space, the children, teachers and parents become a site of the state's surveillance and are produced as docile bodies. [ABSTRACT FROM AUTHOR]

Introduction: Childhood undernutrition has been investigated extensively in previous literature but gender inequality detailing the burden of undernutrition has not been adequately addressed in scientific papers, especially in Ethiopia, where undernutrition is known to be a public health problem of high significance, necessitating increased efforts to address it and reduce this inequality. This study was carried out to: (1) explore gender differences in the prevalence of stunting, wasting, and underweight, and (2) compare the factors associated with childhood undernutrition between boys and girls in Ethiopia. Methods: The study used a dataset of more than 33,564 children aged under 5 years (boys: 17,078 and girls: 16,486) who were included in the nationally representative Ethiopia Demographic and Health Survey (EDHS) from 2000 to 2016. The outcome variables were anthropometric indices: stunting (height-for-age < -2 standard deviations), wasting (weight-for-height < -2 standard deviations), and underweight (weight-for-age < -2 standard deviations). Gender-specific multilevel analyses were used to examine and compare the factors associated with child undernutrition. Results: The overall prevalence of stunting (49.1% for boys vs 45.3% for girls, p < 0.001), wasting (11.9% for boys vs 9.9% for girls, p < 0.001), and underweight (33.1% for boys vs 29.8% for girls, p < 0.001) higher among boys compared to girls. Boys significantly had higher odds of stunting (aOR: 1.31, 95%CI: 1.21–1.42), wasting (aOR: 1.35, 1.23–1.48), and underweight (aOR: 1.38, 95%CI: 1.26–1.50) than girls. The common factors associated with childhood undernutrition for male and female children were the child's age, perceived size of the child at birth, breastfeeding status, maternal stature, maternal education, toilet facility, wealth index, and place of residence. Boys who were perceived by their mothers to be average sized at birth and were born to uneducated mothers had a higher likelihood of experiencing wasting, in contrast to girls. Among boys, birth order (firstborn), household size (1–4), and place of residence (urban) were associated with lower odds of being underweight. Boys living in cities had lower odds of being stunted. While girls born to mothers with no education and worked in agriculture were at a higher odd of being stunted. Conclusion: Our study revealed that boys were more likely to be malnourished than girls, regardless of their age category, and there were variations in the factors determining undernutrition among boys and girls. The differences in the burden of undernutrition were significant and alarming, positioning Ethiopia to be questioned whether it will meet the set Sustainable Development Goals (SDGs), including SDG 2 of zero hunger by 2030. These findings call for more effort to address malnutrition as a significant public health issue in Ethiopia, and to urgently recognise the need for enhanced interventions that address the gender gap in childhood undernutrition. [ABSTRACT FROM AUTHOR]

Background: Stunting is one of the undernutrition outcomes commonly reported in LMICs. It results from chronic or recurrent undernutrition and is associated with social determinants. Indonesia has promoted various programs to reduce and prevent stunting. The programs tend to not be gender-responsive with no existence of gender analysis on the programs. Purpose: To analyze the intersectionality of gender with other social determinants of stunting, transforming into any stunting program barriers within the health system. Methods: This narrative review was conducted using original research articles on the Scopus database. Two independent reviewers performed review selection and characterization. We grouped the identified gender intersectionality and constraints imposed on stunting programs based on three-levels of health systems. Results: There were 19 papers included in this literature review. Two main messages were identified. First, gender has a different impact on any health program. It interacted with other social determinants in shaping the risk of being stunted. Second, the gender intersectionality will be different for each level of health system. Conclusion: Gender intersects with different social determinants in each level of the health system. The impact of gender intersectionality with other stunting determinant stunting is identified. Hence, stunting is not gender neutral. [ABSTRACT FROM AUTHOR]

This paper studies the effects of minimum wages in Indonesia around the time of birth on child height-for-age Z scores (HAZ) up to five years of age. Using variations in annual fluctuations in real minimum wages in different Indonesian provinces, it finds that children exposed to increases in minimum wages in their birth years have higher HAZ in the first five years of their lives. The estimated impacts are based on difference-in-differences models with biological-mother fixed effects and year-of-birth fixed effects and are robust to inclusion of multiple time-varying factors. The impacts are prominent particularly among male children. [ABSTRACT FROM AUTHOR]

Perinatal (antenatal and postpartum) depression is increasingly becoming a global public health problem. Studies have shown that the presence of depression during the perinatal period impact on a mother's ability to adequately provide nutritional care for herself and her infants and young children. This may thus negatively influence the nutritional status of these vulnerable children resulting in poor growth, such as stunting which is currently a public health problem in low- and middle-income countries (LMICs). The aim of this systematic review and meta-analysis was to determine the association between maternal postpartum depression and child growth in LMICs. Electronic databases were systematically reviewed by screening abstracts, titles, full text and additional data sources of eligible papers. Articles were eligible for inclusion if based on children aged 0 to 59 months, if reporting maternal postpartum depression as an exposure, if based on observational studies evaluating the relation between maternal postpartum depression and child growth, if reporting at least one physical growth indicator such as stunting as an outcome, and if published after 2000. Article selection was based on the PRISMA guidelines for reporting systematic reviews. Twelve articles were included in the quantitative synthesis (12 for stunting, 8 for underweight and 2 for wasting). Maternal postpartum depression was observed to be associated with an increased risk of child stunting (1.87 (95% CI: 1.52, 2.30; I2 = 41.6%, p = 0.064)) and underweight (1.81 (95% Cl: 1.25, 2.62; I2 = 70.7%, p = 0.001)). These results were confirmed after influence analyses, with publication bias being negligible. Conclusion: Maternal depression is a risk factor for poor child growth in LMICs. This study contributes to the knowledge on this topic and calls on policymakers to improve on its understanding, screening and treatment to alleviate the potential negative impact on child growth. What is Known: • Maternal postpartum depression is currently a public health relevance in low- and middle-income countries (LMICs). • Maternal postpartum depression is a risk factor for poor nutritional status in children from LMICs. What is New: • Maternal postpartum depression is associated with an 80 to 90% increased risk of childhood stunting and underweight in LMICs. • The association between risk of childhood stunting and underweight with maternal postpartum depression is slightly influenced by geographical area, rural or urban location, by factors such as study design, study quality and sample size. [ABSTRACT FROM AUTHOR]

Young children in the East Asia and the Pacific region1 are failing to thrive, in large numbers, as indicated by stagnation in the decline of stunting, wasting, and micronutrient deficiencies and the fastest growing rates of overweight in the world. Eliminating the triple burden of malnutrition is essential to ensure that, as a matter of right, all children reach their full physical growth and development potential and actively contribute to equitable prosperity and the sustainable development of their communities and nations. Ending all forms of malnutrition will only be achieved through the implementation of effective policies and programmes soundly based on an understanding of the leading contextual drivers of child malnutrition. To address the lack of data on these drivers in the region, the UNICEF regional office for East Asia and the Pacific commissioned a series of papers in 2017–2019 to fill gaps in the current body of evidence on the triple burden of maternal and child malnutrition. This series includes analyses of the determinants of child malnutrition including maternal nutrition status, dietary quality of children, inequity, and poverty. Additionally, policy and programmatic actions associated with improved coverage and quality of nutrition interventions are reviewed. This overview paper summarizes the findings of these analyses and presents recommendations for the direction of future advocacy, policy, and programmatic actions to address the triple burden of malnutrition in East Asia and the Pacific. [ABSTRACT FROM AUTHOR]

Aim: Health and nutrition in early childhood are essential for survival, growth and adult life outcomes. As such, a number of global and national interventions have been pursued to improve early childhood health and nutrition. However, child malnutrition is pervasive and endemic across the sub Saharan Africa. This paper therefore assesses the nature and trends of socioeconomic inequalities in child stunting. The paper proceeds to decompose the causes of such socioeconomic-related inequalities over the period covered. Subjects and methods: We used data from Demographic and Health Surveys (DHSs) for ten sub-Saharan African countries conducted between 2000 and 2016. The study employs an extension to the concentration index for binary health outcomes to measure socioeconomic inequalities in stunting and decompose the causes of inequalities in stunting using a generalized decomposition technique based on recentered influence function regressions. Results: The results show substantial pro-rich inequalities in child stunting across sub-Saharan Africa. The incidence of stunting are concentrated among children living in households with low socioeconomic status. In spite of persistent declines in the prevalence of stunting among children under 5 years across the study countries since 2000, trends in socioeconomic inequalities in stunting are mixed. We find significant contributions of child, maternal, and household characteristics to inequalities in child stunting. Conclusion: The results suggest that there is the need to design and target nutrition-based interventions at children in low socioeconomic households. In addition, promoting female education and improving access to health and nutrition information will be key to improving child nutrition across the region. [ABSTRACT FROM AUTHOR]

Globally, only 52% of children aged 6-23 months meet the minimum meal frequency and a mere 29% meet the minimum dietary diversity, with large disparities across and within regions. With most of the stunting occurring during the first thousand days-from conception to age 2 years-improving complementary feeding in children 6-23 months old is an urgent priority. With this evidence in mind, UNICEF collaborated with the governments of India and Maharashtra to convene a global meeting in Mumbai, India, under the theme: First Foods: A Global Meeting to Accelerate Progress on Complementary Feeding in Young Children (November 17-18, 2015). The global meeting provided a platform that aimed to (a) synthesize the biological and implementation science on complementary feeding; (b) review the practice and experience in improving access to nutritious complementary foods and good complementary feeding practices; and (c) consolidate a strong evidence base that can inform the development of strategies and approaches to improve complementary feeding that are fit to context. This overview paper summarizes the rationale on why improving complementary foods and feeding for infants and young children matters and what it takes to improve them. It builds on the papers presented at the First Foods Global Meeting and those commissioned as a follow on to it. [ABSTRACT FROM AUTHOR]

South Asia has made significant progress in reducing child undernutrition. The prevalence of stunting declined by one third between 2000 and 2019; as a result, in 2019, there were 34 million fewer stunted children than in 2000, indicating that progress for child nutrition is possible and is happening at scale. However, no country in South Asia is on track for all nutrition targets of Sustainable Development Goal 2, and the region has the highest prevalence of stunting (33.2%) and wasting (14.8%) in the world. Nepal, the best performing country in the region, narrowly missed the Millennium Development Goal (MDG) target to half the prevalence of child underweight between 1990 and 2015 and achieved the fastest recorded reduction in stunting prevalence in the world between 2001 and 2011. In 2019, UNICEF Nepal completed a series of papers to examine Nepal's progress on maternal and child nutrition during the MDG era. The series explores the trends, distribution and disparities in stunting, micronutrient deficiencies and feeding practices in children under 5 years and anaemia in adolescents and women. Besides, it reviews national micronutrient programmes (vitamin A supplementation, iron and folic acid supplementation and universal salt iodization) and Nepal's first Multi‐Sector Nutrition Plan, to illuminate the success factors and enduring challenges in the policy and programme landscape for nutrition. This overview paper summarizes the evidence from these analyses and examines the implications for the direction of future advocacy, policy and programme actions to improve maternal and child nutrition in Nepal and other similar contexts. [ABSTRACT FROM AUTHOR]

Introduction: The first "1000 days" is a critical period of opportunity for interventions to prevent stunting and other health problems. This paper describes a study protocol of a mobile phone-based nutrition education (MiNd) intervention on maternal, infant and young child nutrition. Methods: This is a six-months quasi-experimental intervention consisting of three phases; (i) Phase 1 - development of MiNd intervention modules, (ii) Phase 2 - evaluation of the effectiveness of MiNd intervention, and (iii) Phase 3 - a qualitative study exploring perceptions and experiences of the intervention. Discussion: Assessment of anthropometry, dietary intake, food security, mental health, knowledge, attitude, and practice (KAP) of food intake during pregnancy and breastfeeding will be evaluated during pre and post intervention. This is the first comprehensive mobile phone-based nutrition intervention study on pregnancy, lactation, and infant growth in Malaysia. The findings will be useful in modulating health intervention programme to prevent stunting and other health issues nationwide. [ABSTRACT FROM AUTHOR]

Vietnam has successfully reduced population stunting, but ethnic minority groups are being systematically left behind, limiting progress on national reductions. This mixed methods study aims to understand how policy drivers of stunting reduction differ between ethnic majority and minority communities. We used decomposition analysis to explain key determinants of stunting change between 2000 and 2010; and framework analysis to qualitatively assess changes in policy, actors and narratives that have underpinned these over decades. Our analysis shows that stunting reductions are associated with increased household wealth (accounting for 61% of change), improved access to specific health services (16%), and changes in level of maternal education (12%). Despite multiple actors involved in change and a large set of policies designed to address inequities, many among Vietnam's defined ethnic minority groups are not finding themselves able to effectively engage with central government plans for their communities, and central policies often do not consider their preferences or limitations. This in turn impacts the nutrition of minority groups through the determinants above. Vietnam has achieved the easier portion of stunting reduction through national economic growth and sustained commitment to socially-oriented policy. In order to tackle the remaining pockets of high malnutrition, more attention, thought and funding will need to focus on marginalised ethnic minority communities. The current national development discourse aims to incorporate minorities into mainstream majority systems. This paper argues that policy should rather take into account their particular needs and preferences to address and overcome the identified determinants of malnutrition. [ABSTRACT FROM AUTHOR]

Objective: This paper attempts to investigate the determinants of child malnutrition in Bangladesh by using a data set obtained from Urban Health Survey (UHS) 2013. Study design and method: The UHS 2013 followed a stratified three-stage sampling procedure. Information on maternal and child characteristics was collected from the last child born preceding three years of survey. Robust quantile regression (QR) models have been used to find out potential factors responsible for child malnutrition of urban areas of Bangladesh using standardized stunting score as dependent variable. Results: Place of residence (Domain), mother's age at birth of index child, gender of the child, wealth index, education of mother, working status of mother, access to media, antenatal care, and place of delivery were found to have significant association with the malnutrition of children of urban areas of Bangladesh. Conclusion: Some recommendations have been suggested to improve the nutrition status of children of urban areas of Bangladesh. [ABSTRACT FROM AUTHOR]

Child malnutrition is an enormous public health problem in low‐ and middle‐income countries (LMICs). In this paper, we study the relationship between non‐maternal adult female household members (AFHMs) and under‐5 child nutritional outcomes using nationally representative Ethiopian Demographic and Health Survey data, 2016. Because most of the primary inputs that go into the production of child health are intensive in maternal time, having additional AFHMs may ease the time constraints of the child's mother. We use anthropometric measures such as height‐for‐age z‐scores (HAZ) and weight‐for‐age z‐scores (WAZ) to measure stunting and underweight, respectively, as objective indicators of child nutritional status. Among our sampled households, we find that 40% of the children are stunted, 18% severely stunted, 27% underweight and 8% severely underweight. Furthermore, about 20% of the sampled children live with at least one extra non‐maternal AFHM. The multivariate regression results suggest that an additional AFHM is associated with significantly higher HAZ and WAZ scores and less likelihood of severe stunting compared with children living with fewer AFHMs. Finally, the paper discusses the potential pathways through which non‐maternal AFHMs can influence child nutritional status. [ABSTRACT FROM AUTHOR]

Background: Undernutrition among children is a primary concern in sub-Saharan African countries such as Ethiopia. The objective of this paper is to measure the magnitude of undernutrition and associated factors among children under 2 years of age in the Jimma Zone of Southwest Ethiopia. Methods: A community-based cross-sectional study with stratified multistage sampling was conducted. Data were collected using a semi-structured questionnaire and anthropometric measurements. Bivariate and multivariable logistic regression models were fitted using SPSS 20.0 for Windows. Adjusted odds ratios (AOR) with 95% confidence intervals (CI) were used to measure the strength of the association between dependent and associated variables at a p value <0.05. Results: Among the study participants, 142 (25.4%) were stunted, 73 (13.1%) were underweight, and 54 (9.7%) were wasted. Older child age [AOR = 1.1, 95% CI (1.1, 1.2)], male sex [AOR = 2.601, 95% CI (1.681, 4.025)], and residing in an urban area [AOR = 0.526, 95% CI (0.323, 0.857)] were significantly associated with stunting. Independent predictors of wasting were younger child age [AOR = 0.894, 95% CI (0.833, 0.96)], living in a lowland area [AOR = 3.3, 95% CI (1.4, 8.1)], and living a in poor household [AOR = 6.2, 95% CI (2.2, 17.7)]. Underweight was significantly associated with male sex [AOR = 2.09, 95% CI (1.179, 3.703)], delayed initiation of breastfeeding [AOR = 2.1, 95% CI (1.0, 4.2)], and living in a poor household [AOR = 2.2, 95% CI (1.0, 4.6)]. Conclusions: Child malnutrition was found to be a moderate public health problem in the study area. Urban dwellers had higher levels of undernutrition than rural dwellers. Children living in lowlands had higher undernutrition than those living in highland areas. [ABSTRACT FROM AUTHOR]

This paper examines the effect of terrain ruggedness on child stunting in Burundi, Cameroon, Ethiopia and Nigeria. Using a cross‐section analysis with data from the Demographic and Health Surveys (DHS) and a measure that captures variation in the terrains of the countries, we find that the more difficult it is to traverse the terrain in Burundi, Cameroon and Nigeria, the higher the likelihood of child stunting. However, this association is not consistent for Ethiopia until we account for the Oromia region, which has the capital city Addis Ababa. These results remain robust with the inclusion of socio‐economic factors related to child health (e.g. maternal health, maternal education and household income), demographic factors (e.g. gender of child), other geographical factors (e.g. rainfall patterns and malaria prevalence) and survey and region effects. The results suggest that there are complementary factors to geography that may contribute to poor child health outcomes, such as the quality of infrastructure and the ability to access healthcare services. Given that child health is a key development outcome, understanding such spatial variations associated with child health inequalities can assist in designing effective intervention programmes and allocating resources where they are most needed. [ABSTRACT FROM AUTHOR]

The latest available data indicate that 38% of South Asia's children aged 0–59 months are stunted. Such high prevalence combined with the region's large child population explain why South Asia bears about 40% of the global burden of stunting. Recent analyses indicate that the poor diets of children in the first years of life, the poor nutrition of women before and during pregnancy and the prevailing poor sanitation practices in households and communities are important drivers of stunting, most likely because of underlying conditions of women's status, food insecurity, poverty, and social inequalities. With this evidence in mind, UNICEF Regional Office for South Asia convened the Regional Conference: Stop Stunting: Improving Child Feeding, Women's Nutrition, and Household Sanitation in South Asia (New Delhi, November 10–12, 2014). The Conference provided a knowledge ‐ for ‐ action platform with three objectives: (1) share state ‐ of ‐ the ‐ art research findings on the causes of child stunting and its consequences for child growth and development and the sustainable growth and development of nations; (2) discuss better practices and the cost and benefits of scaling up programmes to improve child feeding, women's nutrition, and household sanitation in South Asia; and (3) identify implications for sectoral and cross ‐ sectoral policy, programme, advocacy and research to accelerate progress in reducing child stunting in South Asia. This overview paper summarizes the rationale for the focus on improving child feeding, women's nutrition, and household sanitation as priority areas for investment to prevent child stunting in South Asia. It builds on the invited papers presented at or developed as a follow on to the Stop Stunting Conference. [ABSTRACT FROM AUTHOR]

Globally, an estimated 15 million children are born prematurely each year, resulting in a high burden of under-five mortality and neurodevelopmental disability. Kangaroo Mother Care (KMC) is a key intervention to support the development of preterm infants. However, evidence on the impact of KMC in routine care settings remains limited. This paper examines the associations between maternal KMC efforts and child development among preterm infants using data from a prospective cohort study conducted in São Paulo, Brazil. Study outcomes were height-for-age z-scores (HAZ) and cognitive development at age 3 years. Practicing KMC was positively associated with HAZ (+0.91 SD, 95% CI [0.126, 1.695]), and cognition (+0.37 SD, [0.034, 0.806]) of preterm children. The results suggest that KMC can improve children's cognitive and physical development. New programmes to increase KMC uptake in the setting studied may be beneficial for both mothers and their preterm children. [ABSTRACT FROM AUTHOR]

Background: At present, South Asian Association for Regional Coorporation (SAARC) countries have tremendous pressure on child stunting along with the impact it is making on economic growth. World Health Organization (WHO), United Nations International Children's Emergency Fund (UNICEF), and The World Bank (WB) have emphasized for this region to reduce stunting by 40%. The objective of this paper is to analyze the impact of stunting on economic outcomes in SAARC countries so that to scale up policies and programs aiming to reduce child stunting. Methods: The systematic review has assessed five international databases; PubMed, JSTOR, Cochrane Library, Web of Science, and CINAHL Plus for published, unpublished, and ongoing research till the year 2020. Grey literature is searched using Google Scholar and Google search engines. The systematic review registration number in PROSPERO is CRD42021230279. Results: Thirty-three (33) studies matched the criteria. Most quantitative studies link stunting with economic repercussions. Three investigations found no or a weak link between the two. Nutritional intervention synthesis predicts a 12 percent return, a 5:1-6:1 benefit-cost ratio, and a 14mm height gain. A 1 cm increase in height increases pays by 4% for men and 6% for women. Stunting caused a 5%-7% income penalty and lower lifetime pay. Studies show that a 10% increase in agricultural growth reduces stunting by 9.6%, while a 10% increase in non-agricultural growth reduces stunting by 8.4%. Conclusion: To reduce stunting prevalence, policies should be scaled up, as well as targeted and structural interventions are needed. [ABSTRACT FROM AUTHOR]

In this paper, we explore the use of covariate balancing propensity scores (CBPS) in estimating the impact of the South African child support grant (CSG) on the height-for-age score of benefiting children. CBPS is a different approach to estimating propensity score, under CBPS the scores are estimated such that the estimation incorporates covariate balancing condition. This approach is therefore relatively robust to misspecification of the propensity score model which makes it ideal for this case study. We show that utilising the CBPS leads to treatment effect estimate that is larger and more precisely estimated than estimates that have been reported in the literature because the method exploits the dual function of propensity score. The effect of CSG under CBPS is as large as 44% of standard deviation on average. This implies that the effect of the grant cannot be regarded as small as previously reported in the literature. [ABSTRACT FROM AUTHOR]

This paper explores the association between changes in mother's relative educational status and changes in early childhood nutrition focusing on the case of Malawi and the sizable improvements in early childhood height-for-age z scores (HAZ) that occurred between 2000 and 2015. Using Demographic Health Survey data, the paper shows that there were changes in the composition of mothers with higher relative educational status in the population, and also changes in returns to mother's higher relative educational status between 2000 and 2015. A Blinder–Oaxaca decomposition suggests that improved returns to mother's higher relative educational status were associated with playing an important role in improvements in early childhood HAZ between 2000 and 2015, although compositional changes in mothers with higher relative education appear to be less important. Supplementary descriptive analyses suggest these results might have to do with changes in selection into non-hypergamous unions over time. [ABSTRACT FROM AUTHOR]

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Owing to suboptimum feeding practices, Filipino infants are vulnerable to undernutrition during the first two years of life. This present paper aimed to determine the complementary feeding practices of young children 6–23 mo old, and to assess the micronutrient status of children – with particular reference to hemoglobin (Hb), ferritin, zinc, and their determinants. The present paper was part of the randomized community trial (RCT) on micronutrient powder (MNP) supplementation involving four randomly selected barangays in Calauan, Laguna, Philippines, and covering a total of 126 children 6–23 mo old. Baseline and endline assessments were done to determine Hb, ferritin, retinol, zinc, and C-reactive protein (CRP) levels. Child’s breastfeeding and complementary feeding practices, weight, length, and dietary intakes were collected monthly for six months. Stepwise linear regression was performed to determine the biological and environmental factors associated with micronutrient status of the study children. The 24-hour dietary assessment showed that children consumed mainly thin porridge or lugaw – boiled rice mixed with broth of boiled fish, meat, or vegetables – and biscuits/bread as complementary foods. The majority of children had inadequate intake of energy, protein, and key micronutrients based on a single day food recall at endline assessment. Carbohydrates from complementary food remained the major energy contributor among children 6–11 mo (68.0%) and 12–23 mo old (66.9%). The prevalence of stunting, underweight, and wasting was 10.4%, 13.6%, and 8.0%, respectively. The mean Hb was 11.2 g/dL, of which 35.7% of infants were anemic (Hb<11.0 g/dL). The mean serum ferritin used to indicate storage iron was 23.8 ug/L, of which 27.8% of infants had low iron storage. Hb, ferritin, and zinc concentrations at endline consistently related to the corresponding outcome variables of Hb, ferritin, and zinc at endline, respectively. Adequacy of energy, vitamin A, and iron intake was positively associated with Hb at endline period. Other nutrition factors played a role in the level of Hb, including continued breastfeeding beyond one year and episode of diarrhea. Ferritin level at endline was associated with vitamin C adequacy, breastfeeding practices, child’s length, marker of infection (CRP), and occupation of household head in the expected directions. Stunting was strongly associated with zinc concentration at endline. There is an urgent need to improve the complementary food in terms of energy, protein, and micronutrient adequacy of complementary foods of children in the studied communities through increasing density and bioavailability of macro- and micronutrients. [ABSTRACT FROM AUTHOR]

Development of any nation hinges on its human capital. Human capital formation starts from early stages of childhood. Early childhood nutrition is one of the determinants of improved health and development. The purpose of this paper is to investigate the role of nutrition in impacting cognitive development, education attainment and skill development, which are the determinants of human capital. This is an attempt to analyse the intrinsic relationship between stunting and its intergenerational impact on human capital. Systemic review of literature method was put to use, to analyse the interactions between stunting and human capital. The search criteria limited the period to 30 years (1986-2017) and relevant to childhood nutrition. The search was drawn from PubMed, Web of Science and relevant independent surveys, journals and reports of repute. The study reveals that the human capital formation starts from the early stages of childhood and healthy childhood holds positive relationship to formation of human capital in the long run. Healthy childhood is largely attributed to improved nutrition which has an impact on underweight, wasting and stunting. While improvement in underweight and wasting can be achieved in short run, stunting is intergenerational and needs more long-term investments. Both nutrition specific as well as nutrition sensitive interventions play a critical role in development of robust human capital that leads to improved employability and enhanced earnings for an individual in the future. However, to have an impact on stunting, it calls for a shift in focus by augmenting investments towards nutrition sensitive domain as well, along with its present focus in nutrition specific domain. We use the evidences from South Asian and Sub Saharan countries, to make a case for India where 38 percent of children are stunted and where WASH, agriculture and women empowerment programmes do not focus on nutrition nor measure nutritional outcomes. [ABSTRACT FROM AUTHOR]

Copyright of World Food Policy is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

It is now clear that anthropogenic climate change is having a negative impact on human health. In this paper, we provide the first comprehensive assessment of the impact of climatic stressors on child health in Burkina Faso. We undertake a rigorous empirical analysis of the impact of climate and weather shocks on mortality, stunting (height‐for‐age Z‐score) and wasting (weight‐for‐age Z‐score), using Demographic and Health Surveys, combined with high‐resolution meteorological data, controlling for household and individual covariates. We find robust evidence that both lifetime and short‐term exposure to high temperatures and droughts have a negative impact on child health, as do increased temperature anomalies during crop seasons, suggesting a link between climate and health through domestic food production. Income and household wealth, access to electricity, sanitation and a health facility for childbirth negate some adverse impacts of climate change. Combining our econometric estimates with updated CMIP6 scenarios, we compute policy‐relevant projections of future child health. Our results show that future warming is projected to significantly increase child mortality, and share of underweight and stunted children, in all but the Paris Agreement scenario. Given the links between health, a key element of human capital, and economic growth, our findings and projections provide yet more evidence of the importance of a rapid reduction in global emissions combined with adaptation funding, if lower‐income countries are to achieve poverty reduction and increasing prosperity. [ABSTRACT FROM AUTHOR]

Background: Despite considerable public health efforts over the past 20 years, childhood stunting (physical and/or cognitive) levels globally remain unacceptably high—at 22% amongst children under 5 years old in 2020. The aetiology of stunting is complex and still largely unknown. Helminths can cause significant mortality and morbidity and have often been cited as major causative agents for stunting, although their actual role in childhood stunting remains unclear. Our aim was to systematically review the current evidence to help support or refute the hypothesis that helminths cause physical stunting in children. Methods: Inclusion criteria were as follows: infected with (and/or exposed to) helminths (soil-transmitted helminths, schistosomes or food-borne trematodes), children, pregnant or breastfeeding women as study participants (children included infants 0–1 year old, preschool-age children 1–5 years and school-age children > 5 years old), anthelmintic treatment intervention, stunting-related variables reported (e.g. height, height-for-age z-score, birth weight), helminth infection reported in relation to stunting, any geographic location, any date, peer-reviewed literature only. Exclusion criteria were: non-primary research, study protocols, studies with no new data, non-English language papers and animal (non-human) helminth studies. Seven databases were searched on 28 May 2021. Risk of bias was assessed for included studies and GRADE was used for studies included in RCT subgroup meta-analyses (in preschool-age children and pregnant women). This systematic review was registered with PROSPERO (CRD42021256201). Results: Eighty studies were included in the analyses. No significant overall evidence was found in support of the hypothesis that helminths cause physical stunting in children, although there was some association with wasting. Conclusions: Whilst analyses of the available literature to date failed to support a direct association between helminth infection and childhood stunting, there was significant heterogeneity between studies, and many had follow-up periods which may have been too short to detect impacts on growth. Most apparent was a lack of available data from key demographic groups wherein one may predict the greatest association of helminth infection with stunting—notably that of infants, preschool-age children, and pregnant or nursing women. Thus this review highlights the urgent need for further targeted empirical research amongst these potentially most vulnerable demographic groups. [ABSTRACT FROM AUTHOR]

Stunting (low height for age) is a crucial indicator for measuring child well-being and economic and social development of a country. Despite a decrease in overall children's stunting in the last decades, there are still significant geographic disparities between urban and rural areas in Colombia. This paper aims to identify the role of the main determinants of children's stunting in explaining the urban-rural stunting gap. We use data from the 2015 National Nutritional Situation Survey (the most recent available dataset) and the Yun's statistical decomposition technique. We find that the urban-rural gap in child stunting is 7.2 percentage points. Three determinants: household wealth, maternal education, and health services utilization, explain most of the gap (92%). Each determinant explains 54%, 26%, and 12% of the characteristics effect, respectively. Public health policies aiming to reduce the gap must seek improvements in access to institutional delivery and education services for mothers in rural areas in the short term. In the long term, increasing economic wealth in rural areas is essential. [ABSTRACT FROM AUTHOR]

Background: Undernutrition is the main cause of morbidity and mortality of children aged under five and it is an important indicator of countries' economic and health status. Limited attention is given to research papers conducted in Ethiopia that identified and estimates the determinants of under-five anthropometric indicators by considering their association and clustering effect. Therefore, this study aimed to identify and estimate the effects of important determinants of anthropometric indicators by taking into account their association and cluster effects. Methods: In this study, a cross-sectional study design was implemented based on the data obtained from the 2019 Ethiopia Mini Demographic and Health Survey (EMDHS) consists a total of 5027 under-five children. A multilevel multivariate logistic regression model was employed to estimate the effect of the determinants given their association of anthropometric indicators and clustering effect. Results: Among 5027 children considered in the study 36.0, 23.3, and 9.1% of them were stunted, underweight, and wasted, respectively. Whereas the total number of undernourished (stunting, underweight and/or wasting) children was 42.9%. More than half of the children (51.2%) were males and 77.0% lived in rural area. The estimated odds of children from households with secondary and above education levels being stunted was 0.496 (OR = 0.496) times the estimated odds of children from households with no education. Whereas children from the richest households were less likely to be stunted as compared to children from the poorest households (OR = 0.485). The estimated odds of children from urban areas being underweight and wasting were lower by 24.9 and 33.7% of estimated odds of children from rural areas respectively. Conclusion: The prevalence of anthropometric indicators of stunting, underweight, and wasting in Ethiopia was increased. The children underweight has significant dependency with both stunting and wasting. The sex of the child, wealth index, and education level of a household are the common important determinants of stunting, underweight and wasting. The undernourished status of children was more alike within the region and differences between regions. [ABSTRACT FROM AUTHOR]

Malnutrition, a word which seems to shake our roots and disturb our future. Today the underdeveloped and many developing countries are battling this threat in many ways. The reason behind malnutrition is the determinants which make it prevail in our neighborhood and our country on the whole. Malnutrition possess a very serious threat to the future of our country especially the children between (1 - 3) years of age. This paper attempts to identify the existing prevalence of malnutrition in Uttarakhand, to explore the predisposing factors contributing to it in under five children and compare the prevalence with the selected neighboring states. An in - depth survey of all the related literatures and published articles in the selected area was made. It has been reported in recent times about the hike in India's hunger problems and the number of reported cases of stunting and wasting has also rocketed though underweight has slightly reduced. The only way to curb malnutrition is by; breaking the shackles of the determinants, thorough regular surveys and screenings, improved and adequate health care services, reaching out to the needy and spreading awareness among the masses. [ABSTRACT FROM AUTHOR]

Childhood stunting is a serious public health concern in Bangladesh. Earlier research used conventional statistical methods to identify the risk factors of stunting, and very little is known about the applications and usefulness of machine learning (ML) methods that can identify the risk factors of various health conditions based on complex data. This research evaluates the performance of ML methods in predicting stunting among under-5 aged children using 2014 Bangladesh Demographic and Health Survey data. Besides, this paper identifies variables which are important to predict stunting in Bangladesh. Among the selected ML methods, gradient boosting provides the smallest misclassification error in predicting stunting, followed by random forests, support vector machines, classification tree and logistic regression with forward-stepwise selection. The top 10 important variables (in order of importance) that better predict childhood stunting in Bangladesh are child age, wealth index, maternal education, preceding birth interval, paternal education, division, household size, maternal age at first birth, maternal nutritional status, and parental age. Our study shows that ML can support the building of prediction models and emphasizes on the demographic, socioeconomic, nutritional and environmental factors to understand stunting in Bangladesh. [ABSTRACT FROM AUTHOR]

This paper looks at how changing cereal prices affect child undernutrition in Ethiopia. It derives height for age (stunting) and weight for height (wasting) as indicators of child undernutrition from the two most recent years of the Living Standards Measurement Survey and utilises market prices for key cereals, teff, wheat, and maize in enumeration areas across all regions of the country. Using a panel data fixed effects model, the analysis finds that, contrary to previous studies, rising cereal prices are positively associated with improved child stunting rates for children between ages 6 months and 5 years. There is no evidence to suggest that cereal prices have a significantly greater impact on height for age for children that come from households who are net sellers of these crops. Cereal prices do not appear to be associated with wasting, which is a short-term negative health outcome. [ABSTRACT FROM AUTHOR]

The level and relationship of child health, wealth, and basic amenities are changing fast in India. How strong are the relationships of state wealth, i.e., state GDP and basic household amenities like sanitation facilities with child health? Using recently published NFHS -2015 -16 at a macro level, the paper compares the change of stunting, underweight and under-five mortality over ten years (NFHS 2005-06 to 2015-16) and explores how far child health indices are associated with state GDP. Though wealth and child health are positively associated in India, the strength of the relationship is declining over time, indicating that wealth per se may not guarantee the betterment of child health. Undertaking a case study with 510 children in a low-income community of Mumbai, we further establish that the availability of basic facilities and recent infections play a stronger role in determining child nutrition status when household wealth is controlled. Higher-income (OR-0.405), more years of schooling (0.503), less crowding in a household (OR-1.564), covered drainage system (OR-0.653), the non-occurrence of Gastro intestine (OR-1.782), and infectious disease (OR-2.275) are significantly associated with better child nutrition status. Sincere attention to policy on improving basic facilities and living environment to address child health issues has become mandatory. National Health Mission (NHM) or health programs like Swachh Bharat Abhiyan are good initiatives to focus on improving basic facilities and living environment to address child health issues. [ABSTRACT FROM AUTHOR]

Public health issues should be a focal concern for public leaders. A critical moment for articulating intended policies is during elections. At this time, candidates present significant ideas and proposals derived from the evaluation and reflection on the previous administration’s governance. This approach ensures that the proposed programmes are grounded in evidence. In 2024, Indonesia conducted general elections, amid significant public health challenges such as the persistently high prevalence of stunting and poor maternal and child health outcomes. The Prabowo-Gibran, who then won the election, focused their campaign on providing free food and milk. This campaign appears to be unsupported by a comprehensive improvement plan, leading to the impression that public health issues are merely used to enhance electoral appeal. [ABSTRACT FROM AUTHOR]

Introduction: Malnutrition is a leading cause of childhood mortality and morbidity. It is a silent emergency which results from combination of factors and conditions. Growing children are most vulnerable to its consequences. Aim: To determine the prevalence of malnutrition among preschool children in Karnataka. Materials and Methods: A systematic review and meta-analysis was done to find out the pooled estimation of prevalence of malnutrition. An extensive literature search of International and National electronic databases were carried out. The criteria used for the search were limited to descriptive studies, crosssectional studies, and epidemiological studies in English language. Out of 2183 studies, 28 papers were assessed for methodological quality and finally 24 papers were included in the review based on the inclusion and exclusion criteria. These studies were then subjected to quality of assessment using the STROBE guidelines. Results: Out of 24 articles, 19 articles were graded prevalence of malnutrition as per New WHO 2006 child growth standards and five studies were graded malnutrition as per IAP classification. The pooled prevalence of malnutrition as per IAP classification was 41% with 95% CI (0.23-0.59). The pooled prevalence of underweight as per WHO child growth standard was 44% with 95% CI (0.38-0.49), stunting 35% with 95% CI (0.31-0.40), and wasting 28% with 95% CI (0.17-0.38). Conclusion: The findings of this review indicate that malnutrition is still an important problem in children. There is a need for finding the risk factors for malnutrition and a consistent effort from departments and parents concerned to improve the nutritional status further to reduce morbidity among children. [ABSTRACT FROM AUTHOR]