Stunting in childhood: an overview of global burden, trends, determinants, and drivers of decline

Tyler Vaivada, Nadia Akseer, Selai Akseer, Ahalya Somaskandan, Marianne Stefopulos, Zulfiqar A Bhutta, Tyler Vaivada, Nadia Akseer, Selai Akseer, Ahalya Somaskandan, Marianne Stefopulos, Zulfiqar A Bhutta

Abstract

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.

Keywords: child; height; infant; length; linear growth; nutrition; stunting.

Copyright © The Author(s) on behalf of the American Society for Nutrition 2020.

Figures

FIGURE 1
FIGURE 1
Global and regional comparison of the total number of children aged 0–59 mo experiencing linear growth stunting in 1990 and 2019. Source of data: UNICEF, World Bank Group joint malnutrition estimates, 2020 edition (6). Data not available for Europe and Central Asia.
FIGURE 2
FIGURE 2
Stunting prevalence for children under 5 y based on the most recently available country-level estimates. Map based on longitude (generated) and latitude (generated). Color shows sum of stunting prevalence. Details are shown for country. Source of data: UNICEF, WHO, World Bank Group joint malnutrition estimates, 2020 edition (6). Data not available for Europe and Central Asia.
FIGURE 3
FIGURE 3
Global and regional trends in stunting prevalence, 1990–2019. Source of data: UNICEF, WHO, World Bank Group joint malnutrition estimates, 2020 edition (6). Data not available for Europe and Central Asia.
FIGURE 4
FIGURE 4
Stunting prevalence, top-performing countries. Source of data: UNICEF, WHO, World Bank Group joint malnutrition estimates, 2020 edition (6).
FIGURE 5
FIGURE 5
Conceptual framework of child stunting determinants. Determinants include those identified during the review process, and are based on those originally described in the UNICEF Undernutrition Conceptual Framework (8) and 2013 Lancet Maternal and Child Nutrition Series framework (1).

References

    1. Black RE, Victora CG, Walker SP, Bhutta ZA, Christian P, De Onis M, Ezzati M, Grantham-McGregor S, Katz J, Martorell R. Maternal and child undernutrition and overweight in low-income and middle-income countries. Lancet North Am Ed. 2013;382(9890):427–51.
    1. Sudfeld CR, Charles McCoy D, Danaei G, Fink G, Ezzati M, Andrews KG, Fawzi WW. Linear growth and child development in low- and middle-income countries: a meta-analysis. Pediatrics. 2015;135(5):e1266–e75.
    1. Perumal N, Bassani DG, Roth DE. Use and misuse of stunting as a measure of child health. J Nutr. 2018;148(3):311–15.
    1. Leroy JL, Frongillo EA. Perspective: what does stunting really mean? A critical review of the evidence. Adv Nutr. 2019;10(2):196–204.
    1. Hoddinott J, Alderman H, Behrman JR, Haddad L, Horton S. The economic rationale for investing in stunting reduction. Matern Child Nutr. 2013;9:69–82.
    1. UNICEF/WHO/World Bank.. Joint child malnutrition estimates, March 2020 edition. 2020; [cited 2020 May 05]. Available from: .
    1. Olofin I, McDonald CM, Ezzati M, Flaxman S, Black RE, Fawzi WW, Caulfield LE, Danaei G, for the Nutrition Impact Model Study (anthropometry cohort pooling) . Associations of suboptimal growth with all-cause and cause-specific mortality in children under five years: a pooled analysis of ten prospective studies. PLoS One. 2013;8(5):e64636.
    1. UNICEF.. Strategy for improved nutrition of children and women in developing countries. New York: United Nations Children's Fund; 1990.
    1. Stewart CP, Iannotti L, Dewey KG, Michaelsen KF, Onyango AW. Contextualising complementary feeding in a broader framework for stunting prevention. Matern Child Nutr. 2013;9:27–45.
    1. Black RE, Allen LH, Bhutta ZA, Caulfield LE, De Onis M, Ezzati M, Mathers C, Rivera J. Maternal and child undernutrition: global and regional exposures and health consequences. Lancet North Am Ed. 2008;371(9608):243–60.
    1. Danaei G, Andrews KG, Sudfeld CR, Fink G, McCoy DC, Peet E, Sania A, Fawzi MCS, Ezzati M, Fawzi WW. Risk factors for childhood stunting in 137 developing countries: a comparative risk assessment analysis at global, regional, and country levels. PLoS Med. 2016;13(11):e1002164.
    1. Smith LC, Haddad L. Reducing child undernutrition: past drivers and priorities for the post-MDG era. World Dev. 2015;68:180–204.
    1. Headey DD. Developmental drivers of nutritional change: a cross-country analysis. World Dev. 2013;42:76–88.
    1. Adesugba M, Edeh H, Mavrotas G. Child nutritional status, welfare and health in Nigerian households. IFPRI—Discussion Papers; 2018 (1776) Washington, DC: International Food Policy Research Institute; 2018.
    1. Adhikari RP, Shrestha ML, Acharya A, Upadhaya N. Determinants of stunting among children aged 0–59 months in Nepal: findings from Nepal Demographic and Health Survey, 2006, 2011, and 2016. BMC Nutr. 2019;5(1):37.
    1. Adjaye-Gbewonyo K, Vollmer S, Avendano M, Harttgen K. Agricultural trade policies and child nutrition in low- and middle-income countries: a cross-national analysis. Global Health. 2019;15(1):21.
    1. Akombi BJ, Agho KE, Renzaho AM, Hall JJ, Merom DR. Trends in socioeconomic inequalities in child undernutrition: evidence from Nigeria Demographic and Health Survey (2003–2013). PLoS One. 2019;14(2):e0211883.
    1. Alfani F, Dabalen A, Fisker P, Molini V. Vulnerability to Malnutrition in the West African Sahel. Washington, DC: World Bank Group; 2015. Contract No.: 7171.
    1. Almasi A, Saeidi S, Zangeneh A, Ziapour A, Choobtashani M, Saeidi F, Salahshoor MR, Azar FEF. Investigation of some factors affecting stunting and wasting among the under-five children in eastern Mediterranean region. Int J Pediatr Mashhad. 2019;7(7):9759–72.
    1. Amaral MM, Herrin WE, Gulere GB. Using the Uganda National Panel Survey to analyze the effect of staple food consumption on undernourishment in Ugandan children. BMC Public Health. 2018;18(1):32.
    1. Amarante V, Figueroa N, Ullman H. Inequalities in the reduction of child stunting over time in Latin America: evidence from the DHS 2000–2010. Oxford Development Studies. 2018;46(4):519–35.
    1. Ambel AA, Andrews C, Bakilana AM, Foster EM, Khan Q, Wang H. Examining changes in maternal and child health inequalities in Ethiopia. Int J Equity Health. 2017;16(1):152.
    1. Angdembe MR, Dulal BP, Bhattarai K, Karn S. Trends and predictors of inequality in childhood stunting in Nepal from 1996 to 2016. Int J Equity Health. 2019;18(1):42.
    1. Bagmar SH, Khudri M. Tracking changes and identifying determinants of child malnutrition status over the past decade in Bangladesh. Pakistan J Nutr. 2015;14(12):964–71.
    1. Ballew C, Khan LK, Kaufmann R, Mokdad A, Miller DT, Gunter EW. Blood lead concentration and children's anthropometric dimensions in the Third National Health and Nutrition Examination Survey (NHANES III), 1988–1994. J Pediatr. 1999;134(5):623–30.
    1. Barankanira E, Molinari N, Msellati P, Laurent C, Bork KA. Stunting among children under 3 years of age in Cote d'Ivoire: spatial and temporal variations between 1994 and 2011. Public Health Nutr. 2017;20(9):1627–39.
    1. Biadgilign S, Ayenew HY, Shumetie A, Chitekwe S, Tolla A, Haile D, Gebreyesus SH, Deribew A, Gebre B. Good governance, public health expenditures, urbanization and child undernutrition nexus in Ethiopia: an ecological analysis. BMC Health Serv Res. 2019;19(1):40.
    1. Biadgilign S, Shumetie A, Yesigat H. Does economic growth reduce childhood undernutrition in Ethiopia?. PLoS One. 2016;11(8):e0160050.
    1. Boccanfuso D, Bruce O. A new avenue for understanding the nutritional status of children in Guinea. Eur J Dev Res. 2013;25(5):714–36.
    1. Buisman LR, Van de Poel E, O'Donnell O, van Doorslaer EKA. What explains the fall in child stunting in sub-Saharan Africa?. SSM Popul Health. 2019;8:100384.
    1. Christiaensen L, Alderman H. Child malnutrition in Ethiopia: can maternal knowledge augment the role of income?. Econ Dev Cultural Change. 2004;52(2):287–312.
    1. Corsi DJ, Gaffey MF, Bassani DG, Subramanian SV. No female disadvantage in anthropometric status among children in India: analysis of the 1992–1993 and 2005–2006 Indian National Family Health Surveys. J South Asian Dev. 2015;10(2):119–47.
    1. Cunningham K, Headey D, Singh A, Karmacharya C, Rana PP. Maternal and child nutrition in Nepal: examining drivers of progress from the mid-1990s to 2010s. Global Food Security. 2017;13:30–7.
    1. da Silva ICM, Franca GV, Barros AJD, Amouzou A, Krasevec J, Victora CG. Socioeconomic inequalities persist despite declining stunting prevalence in low- and middle-income countries. J Nutr. 2018;148(2):254–8.
    1. Darrouzet-Nardi AF. Nonviolent civil insecurity is negatively associated with subsequent height-for-age in children aged <5 y born between 1998 and 2014 in rural areas of Africa. Am J Clin Nutr. 2017;105(2):485–93.
    1. Das Gupta M, Gragnolati M, Ivaschenko O, Lokshin M. Improving child nutrition outcomes in india: can the integrated child development services program be more effective?. Washington, DC: World Bank Group; 2005. Contract No.: No. 3647.
    1. Doctor HV, Nkhana-Salimu S. Trends and determinants of child growth indicators in malawi and implications for the Sustainable Development Goals. AIMS Public Health. 2017;4(6):590–614.
    1. Efevbera Y, Bhabha J, Farmer PE, Fink G. Girl child marriage as a risk factor for early childhood development and stunting. Soc Sci Med. 2017;185:91–101.
    1. World Bank.. Stunting reduction in Sub-Saharan Africa. Washington, DC: World Bank Group; 2017.
    1. Ervin PA, Bubak V. Closing the rural-urban gap in child malnutrition: evidence from Paraguay, 1997–2012. Econ Hum Biol. 2019;32:1–10.
    1. Goyal N, Canning D. Exposure to ambient fine particulate air pollution in utero as a risk factor for child stunting in Bangladesh. Int J Environ Res Public Health. 2017;15(1):23.
    1. Greffeuille V, Sophonneary P, Laillou A, Gauthier L, Hong R, Hong R, Poirot E, Dijkhuizen M, Wieringa F, Berger J. Persistent inequalities in child undernutrition in Cambodia from 2000 until today. Nutrients. 2016;8(5):16.
    1. Hangoma P, Aakvik A, Robberstad B. Explaining changes in child health inequality in the run up to the 2015 Millennium Development Goals (MDGs): the case of Zambia. PLoS One. 2017;12(2):e0170995.
    1. Harttgen K, Klasen S, Vollmer S. Economic growth and child undernutrition in sub-Saharan Africa. Popul Dev Rev. 2013;39(3):397–412.
    1. Hasan MT, Soares Magalhaes RJ, Williams GM, Mamun AA. The role of maternal education in the 15-year trajectory of malnutrition in children under 5 years of age in Bangladesh. Matern Child Nutr. 2016;12(4):929–39.
    1. Headey D. An analysis of trends and determinants of child undernutrition in Ethiopia, 2000‐2011. Washington, DC: International Food Policy Research Institute; 2014. Contract No.: 70.
    1. Headey D, Hirvonen K, Hoddinott J. Animal sourced foods and child stunting. Am J Agric Econ. 2018;100(5):1302–19.
    1. Headey D, Hoddinott J, Ali D, Tesfaye R, Dereje M. The other Asian enigma: explaining the rapid reduction of undernutrition in Bangladesh. World Dev. 2015;66:749–61.
    1. Headey D, Hoddinott J, Park S. Drivers of nutritional change in four South Asian countries: a dynamic observational analysis. Matern Child Nutr. 2016;12(Suppl 1):210–18.
    1. Headey D, Hoddinott J, Park S. Accounting for nutritional changes in six success stories: a regression-decomposition approach. Glob Food Secur-AgricPolicy. 2017;13:12–20.
    1. Headey DD, Hoddinott J. Understanding the rapid reduction of undernutrition in Nepal, 2001–2011. PLoS One. 2015;10(12):e0145738.
    1. Hoffman D, Cacciola T, Barrios P, Simon J. Temporal changes and determinants of childhood nutritional status in Kenya and Zambia. J Health Popul Nutr. 2017;36(1):27.
    1. Huda TM, Hayes A, El Arifeen S, Dibley MJ. Social determinants of inequalities in child undernutrition in Bangladesh: a decomposition analysis. Matern Child Nutr. 2018;14(1):e12440.
    1. Huicho L, Huayanay-Espinoza CA, Herrera-Perez E, Segura ER, Nino de Guzman J, Rivera-Ch M, Barros AJ. Factors behind the success story of under-five stunting in Peru: a district ecological multilevel analysis. BMC Pediatr. 2017;17(1):29.
    1. Ikeda N, Irie Y, Shibuya K. Determinants of reduced child stunting in Cambodia: analysis of pooled data from three demographic and health surveys. Bull World Health Organ. 2013;91(5):341–9.
    1. Jahagirdar D, Harper S, Heymann J, Swaminathan H, Mukherji A, Nandi A. The effect of paid maternity leave on early childhood growth in low-income and middle-income countries. BMJ Glob Health. 2017;2(3):e000294.
    1. Joe W, Rajaram R, Subramanian SV. Understanding the null-to-small association between increased macroeconomic growth and reducing child undernutrition in India: role of development expenditures and poverty alleviation. Matern Child Nutr. 2016;12(Suppl 1):196–209.
    1. Joshi N, Bolorhon B, Narula I, Zhu S, Manaseki-Holland S. Social and environmental determinants of child health in Mongolia across years of rapid economic growth: 2000–2010. Int J Equity Health. 2017;16(1):189.
    1. Kabubo-Mariara J, Ndenge GK, Mwabu DK. Determinants of children's nutritional status in Kenya: evidence from Demographic and Health Surveys. J African Econ. 2009;18(3):363–87.
    1. Khatun W, Rasheed S, Alam A, Huda TM, Dibley MJ. Assessing the intergenerational linkage between short maternal stature and under-five stunting and wasting in Bangladesh. Nutrients. 2019;11(8):07.
    1. Kien VD, Lee HY, Nam YS, Oh J, Giang KB, Van Minh H. Trends in socioeconomic inequalities in child malnutrition in Vietnam: findings from the Multiple Indicator Cluster Surveys, 2000–2011. Glob Health Action. 2016;9:29263.
    1. Kinyoki DK, Berkley JA, Moloney GM, Kandala NB, Noor AM. Predictors of the risk of malnutrition among children under the age of 5 years in Somalia. Public Health Nutr. 2015;18(17):3125–33.
    1. Kov P, Smets S, Spears D, Vyas S. Growing taller among toilets: evidence from changes in sanitation and child height in Cambodia, 2005–2010. Amston, CT: Research Institute for Compassionate Economics Working Paper; 2013.
    1. Krishna A, Mejia-Guevara I, McGovern M, Aguayo VM, Subramanian SV. Trends in inequalities in child stunting in South Asia. Matern Child Nutr. 2018;14(Suppl 4):e12517.
    1. Lovo S, Veronesi M. Crop diversification and child health: empirical evidence from Tanzania. Ecol Econ. 2019;158:168–79.
    1. Masibo PK, Makoka D. Trends and determinants of undernutrition among young Kenyan children: Kenya Demographic and Health Survey; 1993, 1998, 2003 and 2008–2009. Public Health Nutr. 2012;15(9):1715–27.
    1. Matanda DJ, Mittelmark MB, Kigaru DM. Child undernutrition in Kenya: trend analyses from 1993 to 2008–09. BMC Pediatr. 2014;14:5.
    1. Milman A, Frongillo EA, de Onis M, Hwang JY. Differential improvement among countries in child stunting is associated with long-term development and specific interventions. J Nutr. 2005;135(6):1415–22.
    1. Mohsena M, Goto R, Mascie-Taylor CG. Socioeconomic and demographic variation in nutritional status of under-five Bangladeshi children and trend over the twelve-year period 1996–2007. J Biosoc Sci. 2017;49(2):222–38.
    1. Monteiro CA, Benicio MH, Conde WL, Konno S, Lovadino AL, Barros AJ, Victora CG. Narrowing socioeconomic inequality in child stunting: the Brazilian experience, 1974–2007. Bull World Health Organ. 2010;88(4):305–11.
    1. Monteiro CA, Benicio MH, Konno SC, Silva AC, Lima AL, Conde WL. Causes for the decline in child under-nutrition in Brazil, 1996–2007. Rev Saude Publica. 2009;43(1):35–43.
    1. Nepali S, Simkhada P, Davies I. Trends and inequalities in stunting in Nepal: a secondary data analysis of four Nepal demographic health surveys from 2001 to 2016. BMC Nutrition. 2019;5(1):19.
    1. Nie P, Rammohan A, Gwozdz W, Sousa-Poza A. Changes in child nutrition in India: a decomposition approach. Int J Environ Res Public Health. 2019;16(10):22.
    1. Nisar YB, Dibley MJ, Aguayo VM. Iron-folic acid supplementation during pregnancy reduces the risk of stunting in children less than 2 years of age: a retrospective cohort study from Nepal. Nutrients. 2016;8(2):67.
    1. Ntenda PAM, Chuang YC. Analysis of individual-level and community-level effects on childhood undernutrition in Malawi. Pediatr Neonatol. 2018;59(4):380–9.
    1. O'Donnell O, Nicolas AL, Van Doorslaer E. Growing richer and taller: explaining change in the distribution of child nutritional status during Vietnam's economic boom. J Dev Econ. 2009;88(1):45–58.
    1. Otterbach S, Rogan M. Exploring spatial differences in the risk of child stunting: evidence from a South African national panel survey. J Rural Stud. 2019;65:65–78.
    1. Pierce H. Increasing health facility deliveries in Cambodia and its influence on child health. Int J Equity Health. 2019;18(1):67.
    1. Ponce N, Shimkhada R, Raub A, Daoud A, Nandi A, Richter L, Heymann J. The association of minimum wage change on child nutritional status in LMICs: a quasi-experimental multi-country study. Glob Public Health. 2018;13(9):1307–21.
    1. Rabassa M, Skoufias E, Jacoby H. Weather and child health in rural Nigeria. Washington, DC: World Bank; 2012. Report No.: 1813–9450; Contract No.: 6214.
    1. Rabbani A, Khan A, Yusuf S, Adams A. Trends and determinants of inequities in childhood stunting in Bangladesh from 1996/7 to 2014. Int J Equity Health. 2016;15(1):186.
    1. Rannan-Eliya RP, Hossain SM, Anuranga C, Wickramasinghe R, Jayatissa R, Abeykoon AT. Trends and determinants of childhood stunting and underweight in Sri Lanka. Ceylon Med J. 2013;58(1):10–18.
    1. Rashad A, Sharaf M. Does economic growth reduce child malnutrition in Egypt?. New evidence from National Demographic and Health Survey. Working Papers—Department of Economics, University of Alberta; 2015. Alberta, Canada: University of Alberta; 2015.
    1. Restrepo-Mendez MC, Barros AJ, Black RE, Victora CG. Time trends in socio-economic inequalities in stunting prevalence: analyses of repeated national surveys. Public Health Nutr. 2015;18(12):2097–104.
    1. Rieger M, Trommlerova SK, Ban R, Jeffers K, Hutmacher M. Temporal stability of child growth associations in Demographic and Health Surveys in 25 countries. SSM Popul Health. 2019;7:100352.
    1. Saha UR, Chattapadhayay A, Richardus JH. Trends, prevalence and determinants of childhood chronic undernutrition in regional divisions of Bangladesh: evidence from demographic health surveys, 2011 and 2014. PLoS One. 2019;14(8):e0220062.
    1. Smith T, Shively G. Multilevel analysis of individual, household, and community factors influencing child growth in Nepal. BMC Pediatr. 2019;19(1):91.
    1. Sobrino M, Gutierrez C, Alarcon J, Davila M, Cunha AJ. Birth interval and stunting in children under five years of age in Peru (1996–2014). Child Care Health Dev. 2017;43(1):97–103.
    1. Spears D. How much international variation in child height can sanitation explain?. Washington, DC: World Bank Group; 2013. Contract No.: WPS 6351.
    1. Stifel D, Alderman H. The “Glass of Milk” subsidy program and malnutrition in Peru. World Bank Econ Rev. 2006;20(3):421–48.
    1. Subramanyam MA, Kawachi I, Berkman LF, Subramanian SV. Socioeconomic inequalities in childhood undernutrition in India: analyzing trends between 1992 and 2005. PLoS One. 2010;5(6):e11392.
    1. Subramanyam MA, Kawachi I, Berkman LF, Subramanian SV. Is economic growth associated with reduction in child undernutrition in India?. PLoS Med. 2011;8(3):e1000424.
    1. Sunil TS, Sagna M. Decomposition of childhood malnutrition in Cambodia. Matern Child Nutr. 2015;11(4):973–86.
    1. Surkan PJ, Ettinger AK, Ahmed S, Minkovitz CS, Strobino D. Impact of maternal depressive symptoms on growth of preschool- and school-aged children. Pediatrics. 2012;130(4):e847–55.
    1. Urke HB, Mittelmark MB, Valdivia M. Trends in stunting and overweight in Peruvian pre-schoolers from 1991 to 2011: findings from the Demographic and Health Surveys. Public Health Nutr. 2014;17(11):2407–18.
    1. Wagstaff A, van Doorslaer E, Watanabe N. On decomposing the causes of health sector inequalities with an application to malnutrition inequalities in Vietnam. J Econometrics. 2003;112(1):207–23.
    1. Woodruff BA, Wirth JP, Bailes A, Matji J, Timmer A, Rohner F. Determinants of stunting reduction in Ethiopia 2000-2011. Matern Child Nutr. 2017;13(2):e12307.
    1. Woodruff BA, Wirth JP, Ngnie-Teta I, Beauliere JM, Mamady D, Ayoya MA, Rohner F. Determinants of stunting, wasting, and anemia in Guinean preschool-age children: an analysis of DHS data from 1999, 2005, and 2012. Food Nutr Bull. 2018;39(1):39–53.
    1. World Bank. Maintaining momentum to 2015: an impact evaluation of interventions to improve maternal and child health and nutrition in Bangladesh. Washington, DC: World Bank, Operations Evaluation Department; 2005.
    1. Wu L, Yang Z, Yin SA, Zhu M, Gao H. The relationship between socioeconomic development and malnutrition in children younger than 5 years in China during the period 1990 to 2010. Asia Pac J Clin Nutr. 2015;24(4):665–73.
    1. Yang YY, Kaddu G, Ngendahimana D, Barkoukis H, Freedman D, Lubaale YA, Mupere E, Bakaki PM. Trends and determinants of stunting among under-5s: evidence from the 1995, 2001, 2006 and 2011 Uganda Demographic and Health Surveys. Public Health Nutr. 2018;21(16):2915–28.
    1. Zanello G, Srinivasan CS, Shankar B. What explains Cambodia's success in reducing child stunting—2000-2014?. PLoS One. 2016;11(9):e0162668.
    1. Fortin NM. The gender wage gap among young adults in the United States: the importance of money versus people. J Hum Resour. 2008;43(4):884–918.
    1. Yun MS. A simple solution to the identification problem in detailed wage decompositions. Econ Inq. 2005;43(4):766–72.
    1. Fairlie RW. An extension of the Blinder-Oaxaca decomposition technique to logit and probit models. JEM. 2005;30(4):305–16.
    1. Vollmer S, Bommer C, Krishna A, Harttgen K, Subramanian S. The association of parental education with childhood undernutrition in low-and middle-income countries: comparing the role of paternal and maternal education. Int J Epidemiol. 2016;46(1):312–23.
    1. Checkley W, Buckley G, Gilman R, Assis A, Guerrant R, Morris S, Molbak K, Valentiner-Branth P, Lanata C, Black R. Multi-country analysis of the effects of diarrhoea on childhood stunting. Int J Epidemiol. 2008;37(4):816–30.
    1. Humphrey JH. Child undernutrition, tropical enteropathy, toilets, and handwashing. Lancet North Am Ed. 2009;374(9694):1032–5.
    1. Budge S, Parker AH, Hutchings PT, Garbutt C. Environmental enteric dysfunction and child stunting. Nutr Rev. 2019;77(4):240–53.
    1. Tickell KD, Atlas HE, Walson JL. Environmental enteric dysfunction: a review of potential mechanisms, consequences and management strategies. BMC Med. 2019;17(1):181.
    1. Curtis V, Kanki B, Mertens T, Traore E, Diallo I, Tall F, Cousens S. Potties, pits and pipes: explaining hygiene behaviour in Burkina Faso. Soc Sci Med. 1995;41(3):383–93.
    1. Cairncross S, Valdmanis V. Water supply, sanitation and hygiene promotion (chapter 41). In: Jamison D, Breman J, Measham A, Alleyne G, Claeson M, Evans DB, Jha P, Mills A, Musgrove P et al.editors. Disease control priorities in developing countries. Washington, DC: The World Bank; 2006. p. 771–92.
    1. Kuhnt J, Vollmer S. Antenatal care services and its implications for vital and health outcomes of children: evidence from 193 surveys in 69 low-income and middle-income countries. BMJ Open. 2017;7(11):e017122.
    1. Headey D, Hoddinott J, Park S. Accounting for nutritional changes in six success stories: a regression-decomposition approach. Global Food Security. 2017;13:12–20.
    1. Eisele TP, Larsen DA, Anglewicz PA, Keating J, Yukich J, Bennett A, Hutchinson P, Steketee RW. Malaria prevention in pregnancy, birthweight, and neonatal mortality: a meta-analysis of 32 national cross-sectional datasets in Africa. Lancet Infect Dis. 2012;12(12):942–9.
    1. Lamberti LM, Walker CLF, Noiman A, Victora C, Black RE. Breastfeeding and the risk for diarrhea morbidity and mortality. BMC Public Health. 2011;11(3):S15.
    1. Smith R, Ashford L, Gribble J, Clifton D. Family planning saves lives. Washington, DC: Population Reference Bureau; 2009.
    1. Gribble JN, Murray NJ, Menotti EP. Reconsidering childhood undernutrition: can birth spacing make a difference? An analysis of the 2002–2003 El Salvador National Family Health Survey. Matern Child Nutr. 2009;5(1):49–63.
    1. Rutstein SO. Further evidence of the effects of preceding birth intervals on neonatal infant and under-five-years mortality and nutritional status in developing countries: evidence from the Demographic and Health Surveys 2008. DHS Working Paper 41.Calverton, MD: DHS; 2008.
    1. Huicho L, Huayanay-Espinoza CA, Herrera-Perez E, Segura ER, de Guzman JN, Rivera-Ch M, Barros AJ. Factors behind the success story of under-five stunting in Peru: a district ecological multilevel analysis. BMC Pediatr. 2017;17(1):29.
    1. Ponce N, Shimkhada R, Raub A, Daoud A, Nandi A, Richter L, Heymann J. The association of minimum wage change on child nutritional status in LMICs: a quasi-experimental multi-country study. Global Public Health. 2018;13(9):1307–21.
    1. Özaltin E, Hill K, Subramanian S. Association of maternal stature with offspring mortality, underweight, and stunting in low-to middle-income countries. JAMA. 2010;303(15):1507–16.
    1. Arimond M, Ruel MT. Dietary diversity is associated with child nutritional status: evidence from 11 demographic and health surveys. J Nutr. 2004;134(10):2579–85.
    1. Briend A. Is diarrhoea a major cause of malnutrition among the under-fives in developing countries? A review of available evidence. Eur J Clin Nutr. 1990;44(9):611–28.
    1. Kosek MN, Ahmed T, Bhutta Z, Caulfield L, Guerrant R, Houpt E, Kang G, Kosek M, Lee G, Lima A. Causal pathways from enteropathogens to environmental enteropathy: findings from the MAL-ED birth cohort study. EBioMedicine. 2017;18:109–17.
    1. Schnee AE, Haque R, Taniuchi M, Uddin MJ, Alam MM, Liu J, Rogawski ET, Kirkpatrick B, Houpt ER, Petri WA Jr. Identification of etiology-specific diarrhea associated with linear growth faltering in Bangladeshi infants. Am J Epidemiol. 2018;187(10):2210–18.

Source: PubMed

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