Stunting trajectories from post-infancy to adolescence in Ethiopia, India, Peru, and Vietnam

Jewel Gausman1, Rockli Kim2, S V Subramanian3

  • 1Women and Health Initiative, Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.

Insights

Many children experience stunting, with some recovering while others develop it later in childhood. Interventions should support healthy growth throughout childhood, not just the first 1,000 days.

Area of Science:

  • Childhood Growth and Development
  • Nutritional Epidemiology
  • Public Health Interventions

Background:

  • Most interventions target the first 1,000 days to prevent stunting.
  • A broader perspective on childhood growth trajectories is needed.
  • Understanding stunting dynamics beyond infancy is crucial.

Purpose of the Study:

  • To assess the prevalence of persistent stunting, recovery, and new stunting cases from birth to adolescence.
  • To analyze childhood growth patterns beyond the critical first 1,000 days.
  • To inform comprehensive child growth intervention strategies.

Main Methods:

  • Longitudinal study of 7,128 children across Ethiopia, India, Peru, and Vietnam.
  • Data collected across five survey waves from ages 1 to 15 years.
  • Descriptive and graphical analyses of stunting trajectories.

Main Results:

  • On average, 29.6% were stunted by age 1, 12.9% by age 5.
  • Children stunted by age 1 had higher persistent stunting rates at age 15 (40.7%) compared to those stunted by age 5 (32.3%).
  • Significant proportions recovered but later faltered (33.7% and 31.1%), and new stunting emerged between ages 8-15 (13.1%).

Conclusions:

  • Childhood stunting is dynamic, with both onset and recovery occurring into adolescence.
  • Interventions focused solely on the first 1,000 days may be insufficient.
  • Long-term, holistic approaches are necessary to support healthy child growth.

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