ArticleNutrients2019
Drivers of Under-Five Stunting Trend in 14 Low- and Middle-Income Countries since the Turn of the Millennium: A Multilevel Pooled Analysis of 50 Demographic and Health Surveys.
Article in Nutrients, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 3 of them syntheses that pooled it.
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Who cites it
19 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Evaluating the current methodological practices and issues in existing literature in pooling complex surveys: a systematic review.BMC medical research methodology · 2024Pooled it
- Interventions on Food Security and Water Uses for Improving Nutritional Status of Pregnant Women and Children Younger Than Five Years in Low-Middle Income Countries: A Systematic Review.International journal of environmental research and public health · 2021Pooled it
- Ending malnutrition in all its forms requires scaling up proven nutrition interventions and much more: a 129-country analysis.BMC medicine · 2020Pooled it
- Altitude of area of residence as a risk factor for stunting in children aged 0-60 months: A systematic review and meta-analysis.Dialogues in health · 2026Review
- A novel average treatment effect estimation approach for integrated incomplete datasets, with application in childhood anemia.BMC medical research methodology · 2026Article
- Factors associated with childhood chronic malnutrition during the first 12 months of life in children from a peruvian cohort.Revista peruana de medicina experimental y salud publica · 2025Article
- Sociocultural environmental factors and childhood stunting: qualitative studies - a protocol for the Shared Values theme of the UKRI GCRF Action Against Stunting Hub.BMJ paediatrics open · 2024Article
- Concurrence of anemia and stunting and associated factors among children aged 6 to 59 months in Peru.PLOS global public health · 2024Article
- Local contextual factors of child stunting found via shared values of stakeholder groups: an exploratory case study in Kaffrine, Senegal.Public health nutrition · 2023Article
- Growth Anthropometrics as a Metric of Malnutrition Disparities Among Young Children Affected by HIV who are Orphaned Maternally, Paternally, or Totally in Western Kenya: A Retrospective Chart Review.Global pediatric health · 2023Article
- Understanding drivers of stunting reduction in Nigeria from 2003 to 2018: a regression analysis.Food security · 2022Article
- Households' Food Insecurity and Their Association With Dietary Intakes, Nutrition-Related Knowledge, Attitudes and Practices Among Under-five Children in Gaza Strip, Palestine.Frontiers in public health · 2022Article
- Consumption of animal source food and associated factors among pregnant women in eastern Ethiopia: A community-based study.PloS one · 2022Article
- Elucidating the sustained decline in under-three child linear growth faltering in Nepal, 1996-2016.Maternal & child nutrition · 2022Article
- Factors Associated with Stunted Growth in Children Under Five Years in Antananarivo, Madagascar and Bangui, Central African Republic.Maternal and child health journal · 2021Article
- Maternal factors associated with moderate and severe stunting in Ethiopian children: analysis of some environmental factors based on 2016 demographic health survey.Nutrition journal · 2021Article
- Determinants and constraints to household-level animal source food consumption in rural communities of Ethiopia.Journal of nutritional science · 2021Article
- Triple trouble: Understanding the burden of child undernutrition, micronutrient deficiencies, and overweight in East Asia and the Pacific.Maternal & child nutrition · 2020Article
- Productive simplification in the use of anthropometric nutritional status.European journal of clinical nutrition · 2020Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
backgroundUnderstanding the drivers contributing to the decreasing trend in stunting is paramount to meeting the World Health Assembly's global target of 40% stunting reduction by 2025.
methodsWe pooled data from 50 Demographic and Health Surveys since 2000 in 14 countries to examine the relationships between the stunting trend and potential factors at distal, intermediate, and proximal levels. A multilevel pooled trend analysis was used to estimate the association between the change in potential drivers at a country level and stunting probability for an individual child while adjusting for time trends and child-level covariates. A four-level mixed-effects linear probability regression model was fitted, accounting for the clustering of data by sampling clusters, survey-rounds, and countries.
resultsStunting followed a decreasing trend in all countries at an average annual rate of 1.04 percentage points. Among the distal factors assessed, a decrease in the Gini coefficient, an improvement in women's decision-making, and an increase in urbanization were significantly associated with a lower probability of stunting within a country. Improvements in households' access to improved sanitation facilities and drinking water sources, and children's access to basic vaccinations were the important intermediate service-related drivers, whereas improvements in early initiation of breastfeeding and a decrease in the prevalence of low birthweight were the important proximal drivers.
conclusionsThe results reinforce the need for a combination of nutrition-sensitive and -specific interventions to tackle the problem of stunting. The identified drivers help to guide global efforts to further accelerate stunting reduction and monitor progress against chronic childhood undernutrition.
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