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Related Experiment Video

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Determining Soil-transmitted Helminth Infection Status and Physical Fitness of School-aged Children
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Risk Factors for Childhood Stunting in 137 Developing Countries: A Comparative Risk Assessment Analysis at Global,

Goodarz Danaei1,2, Kathryn G Andrews1, Christopher R Sudfeld1

  • 1Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America.

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Summary

Fetal growth restriction (FGR) and poor sanitation cause millions of childhood stunting cases globally. Addressing stunting requires a broader approach, focusing on maternal health and living environments, not just children.

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Area of Science:

  • Global Health
  • Pediatrics
  • Epidemiology

Background:

  • Stunting affects one-third of children under five in developing nations, contributing to 14% of childhood deaths.
  • Numerous risk factors for stunting have been identified, but their comparative impact across countries remains unclear.

Purpose of the Study:

  • To estimate the number of stunting cases attributable to 18 risk factors in 137 developing countries.
  • To analyze the relative contribution of various risk factors to childhood stunting.

Main Methods:

  • Risk factors were categorized into five clusters: maternal factors, teenage motherhood/birth intervals, fetal growth restriction (FGR)/preterm birth, child factors, and environmental factors.
  • Data from published estimates and population-based surveys were combined to determine risk factor prevalence and effect sizes in 137 countries for 2010.
  • Stunting prevalence and attributable cases were estimated by country and region.

Main Results:

  • Fetal growth restriction (FGR) was the leading risk factor, contributing to 10.8 million stunting cases. Unimproved sanitation and diarrhea followed, accounting for 7.2 and 5.8 million cases, respectively.
  • FGR and preterm birth emerged as the leading risk factor cluster across all regions.
  • Environmental factors and child nutrition/infection represented the second most significant clusters of risk factors globally and regionally.

Conclusions:

  • Fetal growth restriction (FGR) and unimproved sanitation are identified as the primary drivers of stunting in developing countries.
  • Reducing stunting necessitates a shift towards interventions encompassing maternal health, family well-being, and environmental improvements, beyond child-focused approaches.