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Aisha S. F., Jocelyn A. S., Alayya M. H.
Oct 17, 20205 min read

Crescere's Quick Guide to Stunting

WHAT IS STUNTING?

Stunting is happening all around the world, but the knowledge and awareness of it are still low. According to the World Health Organization (2015), stunting is the impaired growth and development that children experience from poor nutrition, repeated infection, and inadequate psychosocial stimulation. A child is classified as stunted if their height-for-age is more than two standard deviations below the WHO Child Growth Standards median. Most of the time, stunting is a form of chronic malnutrition. It can reduce a person’s productivity at a young age, in addition to increasing risks of developing non-communicable diseases when older.


WHO SUFFERS FROM STUNTING?

Stunting is the most common sign of malnutrition, especially for kids between the ages of 3 to 24 months. As a matter of fact, there are an estimated 144 million children below 5 who are stunted worldwide (WB, UNICEF & WHO, 2020). Although its proportions do not differ much between sexes, stunting is heavily influenced by economic conditions. In their 2013 research, Black et al. concluded that the stunting prevalence, in the majority of countries, amidst those under 5 years of age is “about 2.5 times higher in the lowest wealth quintile compared with the highest”. Gender-wise, they stated that the rate of stunting for boys is higher than for girls, with only a minor gap.


WHERE DOES STUNTING HAPPEN?

Another significant risk factor for stunting is place of residence. Based on the joint research between the World Bank, WHO, and UNICEF, 2 out of 5 stunted children in 2019 lived in Africa, while more than half of them lived in Asia. Figure 1 maps United Nations sub-regions according to their latest stunting prevalence estimates. Very high levels, with rates more than or equal to 30%, are shown by the Southern Asia, Middle Africa, as well as Eastern Africa sub-regions. Moreover, Branca and de Onis (2016) uttered that there are considerable inequalities among regions in various countries. Stunting rates are persistently higher in rural areas as opposed to urban areas. Since they are located further away from the city center, the equitable development of health facilities and distribution of trained medical personnel in rural lands are more difficult and time-consuming.

Figure 1

Percentage of stunted children under 5, by United Nations sub-region, 2019.



WHEN WILL WE ELIMINATE STUNTING CASES?

Unfortunately, the world’s cumulative stunting declination rate, as of 2019, is still too slow (WB, UNICEF & WHO, 2020). With regards to this matter, several institutions have made plans to reduce stunting figures globally. One of the deeply involved organizations is the World Health Assembly (WHA). WHA plans a 40% reduction in the number of children below the age of 5 who are stunted by 2025. Proceeding from current trends, the projected digit is 125 million kids, and that organization aims to decrease it to 100 million. WHA actions in reducing stunting rates include improving the identification and understanding of stunting, setting policies to improve nutrition and health, implementing interventions for improved exclusive breastfeeding, as well as strengthening community-based interventions.


WHY DOES STUNTING HAPPEN AND WHY IS IT A SERIOUS PROBLEM?

According to the WHO (2015), stunting is mainly still happening due to poor maternal nutrition and health, inadequate breastfeeding, and recurrent infections. During pregnancy, the embryo relies on the nutrients consumed by the mother for their growth. Even after babies are born, they continue to depend on their mothers to get food through breastfeeding. Therefore, maternal nourishment has a direct impact on the development of their child. Not only that, the likelihood of stunting is increased when the mother is infected with malaria, intestinal worms, or HIV/AIDS. Pregnancy in adolescence creates competition for nutrition between the baby and the still-growing mother, thus also increasing the risk of stunting. Many parents, primarily in developing countries, do not realize that their kid is suffering from stunting because of genetic or hereditary reasons. Stunted children who are born in families with heights lower than average are often considered normal. The lack of education concerning stunting is a major reason why its global rates are still high, too.

As explained above, stunting has both short term and long term impacts. It will affect a child’s health, productivity, and increase the risk of non-communicable diseases, such as cancer and diabetes, when they are older. A child who is stunted might still have problems with speaking and struggle to sit still at the age of 5, hindering them from getting the appropriate level of education they are supposed to. According to powerofnutrition.org (n.d.), all forms of malnutrition will cost the global economy about 500 dollars per individual or about 3.5 trillion dollars per year in total. Adults who are stunted also earn 22% less money as stated by concernusa.org (n.d.). Stunting will bring disadvantages for both the person and the economy of the country. Thus, the prevention of stunting is very important and needs to be done as soon as possible. Children who are currently already stunted must also receive nutritional restoration through properly-nourished diets and a balanced lifestyle to reduce the risks and side-effects of stunting.


HOW CAN WE IDENTIFY A STUNTED CHILD AND HOW CAN WE REDUCE STUNTING RATES?

Characteristics of kids who suffer from stunting vary and they are closely related to its effects. Several of them, as reported by the World Food Programme (2017), are impaired brain development, lower IQ, weakened immune system, in addition to a height-for-age which is more than two standard deviations below the WHO Child Growth Standards median. Poor cognition and educational performance are also typical features of stunting.


Nonetheless, there are still numerous things that can be done from early on to prevent stunting. Children should receive exclusive breastfeeding during the first 6 months after they are born. Ensuring the fulfillment of the nutrition of pregnant women is therefore crucial. To establish it on a massive scale, awareness regarding this issue must be improved. Another alternative is through social entrepreneurship. An example of that is the 'Du Anyam' social enterprise. Du Anyam offers a variety of wicker products made by Flores women. The profit gained from their sales will then be allocated to educate women about nutrition and to provide supplementary feeding for weavers and their children. Enterprises with similar programs can help reduce the number of stunting cases locally.



 

REFERENCES


Black, R. E., Victora, C. G., Walker, S. P., Bhutta, Z. A., Christian, P., Onis, M. D., Ezzati, M., Grantham-_______Mcgregor, S., Katz, J., Martorell, R., & Uauy, R. (2013). MATERNAL AND CHILD NUTRITION. _______Maternal and child undernutrition and overweight in low-income and middle-income countries, _______382(9890), 427-451. https://doi.org/10.1016/S0140-6736(13)60937-X


Bloem, M. (2013, September 26). Preventing Stunting: Why it Matters, What it Takes. The Road to Good _______Nutrition, 13-23. https://doi.org/10.1159/000355990


Borghi, E., Casanovas, E., Onyango, A. (2014). WHA Global Nutrition Targets 2025: Stunting Policy _______Brief. https://www.who.int/nutrition/topics/globaltargets_stunting_policybrief.pdf?ua=1


Branca, F., & de Onis, M. (2016, May). Childhood stunting: A global perspective. _______https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5084763/


Concern Worldwide US. (2019, July 21). STUNTING: WHAT IT IS AND WHAT IT MEANS. _______https://www.concernusa.org/story/what-is-stunting/


Nshimyiryo, A., Heth-Gauthier, B., Mutaganzwa, C., Kirk, C. M., Beck, K., Ndayisaba, A., El-Khatib, Z. _______(2019, February 11). Risk factors for stunting among children under five years: A cross-sectional _______population-based study in Rwanda using the 2015 Demographic and Health Survey. _______https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-019-6504-z


Indonesia Investments. (2015, April 24). Malnutrition in Indonesia: 8.4 Million Children Stunted!


Tanoto, B. (2020, July 22). Stunting prevention in Indonesia: Strategy, will and collective effort. _______https://www.thejakartapost.com/academia/2020/07/22/stunting-prevention-in-indonesia-_______strategy-will-and-collective-effort.html


The Power of Nutrition. (2020, February 19). The Impact of Stunting. _______https://www.powerofnutrition.org/the-impact-of-stunting/


The World Bank, UNICEF, WHO. (2020, March 31). LEVELS AND TRENDS IN CHILD MALNUTRITION: _______Key findings of the 2020 edition. https://www.who.int/publications/i/item/jme-2020-edition


Victoria, C., de Onis, M., Hallal, P., Blössner, M., & Shrimpton, R. (2010, February 15.). Worldwide _______timing of growth faltering: Revisiting implications for interventions. _______https://pubmed.ncbi.nlm.nih.gov/20156903/



WHO. (2015, November 19). Stunting in a nutshell. _______https://www.who.int/nutrition/healthygrowthproj_stunted_videos/en/


Wild, C. P., Miller, J. D., Groopman, J. D. (2015). CHAPTER 2. Child stunting in developing countries. _______MYCOTOXIN CONTROL IN LOW- AND MIDDLE-INCOME COUNTRIES. International Agency for _______Research on Cancer. https://www.ncbi.nlm.nih.gov/books/NBK350567/

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