Stunting in childhood: an overview of global burden, trends, determinants, and drivers of decline
| Autor: | Nadia Akseer, Selai Akseer, Zulfiqar A Bhutta, Tyler Vaivada, Marianne Stefopulos, Ahalya Somaskandan |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Male
Sanitation Adolescent Psychological intervention Medicine (miscellaneous) Nutritional Status length AcademicSubjects/MED00160 AcademicSubjects/MED00060 Child Development Health facility Environmental health Medicine Humans Open defecation Improved sanitation Socioeconomic status Growth Disorders linear growth child Nutrition and Dietetics Supplements and Symposia business.industry Child Health stunting infant nutrition Family planning Child Preschool Birth attendant Female business height |
| Zdroj: | The American Journal of Clinical Nutrition |
| ISSN: | 1938-3207 0002-9165 |
| Popis: | Background Progress has been made worldwide in reducing chronic undernutrition and rates of linear growth stunting in children under 5 y of age, although rates still remain high in many regions. Policies, programs, and interventions supporting maternal and child health and nutrition have the potential to improve child growth and development. Objective This article synthesizes the available global evidence on the drivers of national declines in stunting prevalence and compares the relative effect of major drivers of stunting decline between countries. Methods We conducted a systematic review of published peer-reviewed and gray literature analyzing the relation between changes in key determinants of child linear growth and contemporaneous changes in linear growth outcomes over time. Results Among the basic determinants of stunting assessed within regression-decomposition analyses, improvement in asset index score was a consistent and strong driver of improved linear growth outcomes. Increased parental education was also a strong predictor of improved child growth. Of the underlying determinants of stunting, reduced rates of open defecation, improved sanitation infrastructure, and improved access to key maternal health services, including optimal antenatal care and delivery in a health facility or with a skilled birth attendant, all accounted for substantially improved child growth, although the magnitude of variation explained by each differed substantially between countries. At the immediate level, changes in several maternal characteristics predicted modest stunting reductions, including parity, interpregnancy interval, and maternal height. Conclusions Unique sets of stunting determinants predicted stunting reduction within countries that have reduced stunting. Several common drivers emerge at the basic, underlying, and immediate levels, including improvements in maternal and paternal education, household socioeconomic status, sanitation conditions, maternal health services access, and family planning. Further data collection and in-depth mixed-methods research are required to strengthen recommendations for those countries where the stunting burden remains unacceptably high. |
| Databáze: | OpenAIRE |
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