WHO/NMH/NHD/17.7

STUNTED GROWTH AND DEVELOPMENT

Context, Causes and Consequences

Stunted Growth and Development: Context, Causes and Consequences

Community/Nation

Society & Education Culture Household

Inadequate Inadequate Breastfeeding Care Child Inadequate Complementary The Mother Feeding Health & Stunted Growth Political Healthcare & Development Economy The Home

Infection Poor Quality Foods Food & Water Safety Water, Sanitation & Agriculture & Environment Food Systems Child

Consequences

Concurrent problems and Long-term consequences short-term consequences • Health: ↓ Adult stature, ↑ Obesity and associated • Health: ↑ Mortality, ↑ Morbidities co-morbidities, ↓ Reproductive health • Developmental : ↓ Cognitive, motor, • Developmental : ↓ School performance, and language development ↓ Learning capacity, Unachieved potential • Economic : ↑ Health expenditures, ↑ Opportunity • Economic: ↓ Work capacity, ↓ Work productivity costs for care of sick child Household

Causes

The home The mother • Inadequate sanitation and water supply • Poor nutrition during pre-conception, • Low wealth and socioeconomic status pregnancy and lactation • Food insecurity • Short maternal stature • Low status of women • Infection • Low caregiver education • Adolescent pregnancy • Inappropriate intra-household food allocation • Short birth spacing • IUGR and preterm birth Poor quality foods • Poor mental health • Poor micronutrient quality • Hypertension • Low dietary diversity and intake of animal-source foods • Anti-nutrient content Inadequate care • Low energy content of complementary foods • Poor care practices • Inadequate child stimulation and activity Food and water safety • Non-responsive feeding • Contaminated food and water • Poor hygiene practices Inadequate breastfeeding • Unsafe storage and preparation of foods • Delayed initiation • Non-exclusive breastfeeding Infection • Early cessation of breastfeeding • Enteric infection: Diarrhoeal disease, environmental enteropathy, helminths Inadequate complementary feeding • Respiratory infections • Infrequent feeding • Malaria • Inadequate feeding during and after illness • Reduced appetite due to infection • Thin food consistency • Inflammation • Feeding insufficient quantities Community/ Nation

Context

Political economy Health and healthcare • Food prices and trade policy • Access to healthcare • Marketing regulations • Qualified healthcare providers • Political stability • Availability of supplies • Poverty, income and wealth • Infrastructure • Financial services • Health care systems and policies • Employment and livelihoods Society and culture Agriculture and food systems • Beliefs and norms • Food production and processing • Social support networks • Availability of micronutrient-rich foods • Child caregivers (parental and non-parental) • Food safety and quality • Women’s status Water, sanitation and environment Education • Water and sanitation infrastructure and services • Access to quality education • Population density • Qualified teachers • Climate change • Qualified health educators • Urbanization • Infrastructure (schools and training institutions) • Natural and manmade disasters

An interactive version of the conceptual framework in a ZIP file click here CC BY-NC-SA 3.0 IGO licence . This work is available under the CC BY-NC-SA © WHO 2017. Some rights reserved.