Unpredicted Growth from Ages 1 to 5 and 5 to 8 Years in Ethiopia, India, Peru and Vietnam: Key Distal Household and Community Factors

Abstract

Recent research has demonstrated some growth recovery among children stunted at infancy. Less is known about key ages for such growth recovery, and what factors underlie this growth. This study characterized growth from ages 1 to 5 and 5 to 8 years by focusing on growth that was not predicted by initial height‐for‐age z‐score (HAZ), and identified household and community factors associated with these changes using longitudinal data on 7,266 children in the Young Lives (YL) study in Ethiopia, India, Peru and Vietnam. HAZ at age 1 year did not predict 40–70% of variation in HAZ at age 5 years, and HAZ at age 5 years did not predict 26–46% of variation in HAZ at age 8 years. Multiple regression analysis suggested that these unpredicted changes in HAZ were significantly associated with household consumption, maternal height, hospital presence, and, in some cases, caregivers’ schooling, and fathers’ schooling. There was heterogeneity by urban/rural residence and to a limited extent by gender. These results underline the importance of a child's starting point in infancy in determining his or her growth and point to distal household and community factors that may determine growth recovery and growth failure.Support: Bill & Melinda Gates Foundation, NICHD, DFID and the Netherlands Ministry of Foreign Affairs