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Stunting

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Building on prior frameworks [27, 28], Figure 3 shows known determinants of child stunting organized along a simplified pathway. Being born small, unimproved sanitation, and diarrhea are important risk factors for stunting globally and particularly in South Asia [29]. Low maternal height and household wealth are also important predictors in South Asia [30]. The relationships between stunting and its determinants as well as their relative importance can vary substantially by context, even within a single country, as illustrated previously in India [27]. Within-country diversity in the drivers of stunting has also been documented in Vietnam [28]. Effective action to accelerate progress to address stunting may require interventions tailored to address these determinants, the composition of which may vary by geography or other factors. Path analyses of linear growth faltering using longitudinal data can also help identify where and how to intervene across the range of basic to immediate causes of stunting [31]. While data may be limiting in some contexts, in others, existing data have not been used to its full potential to document and understand the many determinants of child malnutrition and their variability by geographic or other factors like those from India and Vietnam. Longitudinal datasets are particularly powerful for understanding determinants but are rare and usually do not have sufficient geographically representation to explore variability within countries.

Global Landscape of Nutrition Challenges in Infants and Children

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