Abstract
Stunting in children less than five years of age is widespread in Sub-Saharan Africa. We aimed to: (i) evaluate how the prevalence of stunting has changed by socio-economic status and rural/urban residence, and (ii) assess inequalities in children’s diet quality and access to maternal and child health care. We used data from nationally representative demographic and health- and multiple indicator cluster-surveys (DHS and MICS) to disaggregate the stunting prevalence by wealth quintile and rural/urban residence. The composite coverage index (CCI) reflecting weighed coverage of eight preventive and curative Reproductive, Maternal, Neonatal, and Child Health (RMNCH) interventions was used as a proxy for access to health care, and Minimum Dietary Diversity Score (MDDS) was used as a proxy for child diet quality. Stunting significantly decreased over the past decade, and reductions were faster for the most disadvantaged groups (rural and poorest wealth quintile), but in only 50% of the countries studied. Progress in reducing stunting has not been accompanied by improved equity as inequalities in MDDS (p < 0.01) and CCI (p < 0.001) persist by wealth quintile and rural-urban residence. Aligning food- and health-systems’ interventions is needed to accelerate stunting reduction more equitably.
Highlights
Stunting in children less than five years of age is widespread in low and middle income countries (LMIC), with significant proportions of stunted children found in South East Asia and Sub-Saharan
Stunting prevalence was significantly reduced in most regions of the world, where the highest burden of stunting is reported (Figure 1)
Africa has witnessed an average of 18-percentage point reduction in stunting, since 2000
Summary
Stunting in children less than five years of age is widespread in low and middle income countries (LMIC), with significant proportions of stunted children found in South East Asia and Sub-SaharanAfrica [1]. Stunting in children less than five years of age is widespread in low and middle income countries (LMIC), with significant proportions of stunted children found in South East Asia and Sub-Saharan. This is significantly higher than in WHO regions like Latin America and the Caribbean (9%) [2]. The causes of stunting can be complex and includes poor maternal health and nutrition, suboptimal infant and young child feeding practices, as well as diseases (e.g., infections); addressing these causes has been given a priority [3]. Stunting has been associated with the compromised growth and development of several organs, including the brain; is linked to poor cognitive and physical performance, which in turn undermines the education, productivity, and future earnings of those affected [4,5,6]. The economic cost of stunting has been estimated to be as high as
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