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Understanding the association between stunting and child development in low- and middle-income countries: Next steps for research and intervention

Listed author(s):
  • Jessica M. Perkins
  • Rockli Kim
  • Aditi Krishna
  • Mark McGovern
  • Victor M. Aguayo
  • S.V. Subramanian

Stunting, caused by experiences of chronic nutritional deprivation, affects approximately 25% of children under age five globally (i.e., 156 million children). In this review, evidence of a relationship between stunting and child development in low- and middle-income countries is summarized, and issues for further research are discussed. We focus on studies that measured low height-for-age among children less than 5 years old as the exposure and gross/fine motor skills, psychosocial competencies, cognitive abilities, or schooling and learning milestones as the outcomes. This review highlights three key findings. First, the variability in child development tools and metrics used among studies and the differences in the timing and frequency of the assessments complicate comparisons across study findings. Second, considerable evidence from across many countries supports an association between stunting and poor child development despite methodological differences and heterogeneity in the magnitude of associations. Further, effect sizes differ by developmental domain with greater associations shown for cognitive/ schooling outcomes. How stunting influences child development, which domains of child development are more affected, and how the various domains of child development influence one another require further experimental research to test causal pathways. Finally, there is mixed evidence of the additive effect of nutrition and stimulation interventions on child development. However, understanding best methods for improving child developmental outcomes - either through nutrition programs or through integrated nutrition and psychosocial stimulation programs (or nutrition and other program interventions) - is a key area of further inquiry. Given that nearly 40% of children under age five suffer from loss of developmental potential - for which stunting is likely one of the key risk factors - reductions in stunting could have tremendous implications for child development and human capital formation, particularly in low- and middle-income countries.

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File URL: ftp://ftp.qub.ac.uk/pub/users/repec/qub/charms/MS_WPS_CHARMS_17_05.pdf
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Paper provided by Centre for HeAlth Research at the Management School (CHaRMS) in its series CHaRMS Working Papers with number 17-05.

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Length: 44 pages
Date of creation: Oct 2017
Handle: RePEc:qub:charms:1705
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  1. Stefan Dercon & Catherine Porter, 2014. "Live Aid Revisited: Long-Term Impacts Of The 1984 Ethiopian Famine On Children," Journal of the European Economic Association, European Economic Association, vol. 12(4), pages 927-948, August.
  2. Karen Macours & Norbert Schady & Renos Vakis, 2012. "Cash Transfers, Behavioral Changes, and Cognitive Development in Early Childhood: Evidence from a Randomized Experiment," American Economic Journal: Applied Economics, American Economic Association, vol. 4(2), pages 247-273, April.
  3. Georgiadis, Andreas & Benny, Liza & Duc, Le Thuc & Galab, Sheikh & Reddy, Prudhvikar & Woldehanna, Tassew, 2017. "Growth recovery and faltering through early adolescence in low- and middle-income countries: Determinants and implications for cognitive development," Social Science & Medicine, Elsevier, vol. 179(C), pages 81-90.
  4. Christina Paxson & Norbert Schady, 2010. "Does Money Matter? The Effects of Cash Transfers on Child Development in Rural Ecuador," Economic Development and Cultural Change, University of Chicago Press, vol. 59(1), pages 187-229, October.
  5. Lia C. H. Fernald & Patricia Kariger & Patrice Engle & Abbie Raikes, 2009. "Examining Early Child Development in Low-Income Countries," World Bank Other Operational Studies 28107, The World Bank.
  6. repec:idb:brikps:publication-detail,7101.html?id=32886 is not listed on IDEAS
  7. Outes, Ingo & Porter, Catherine & Sanchez, Alan & Escobal, Javier, 2011. "Early Nutrition and Cognition in Peru: A Within-Sibling Investigation," Working Papers 2011-017, Banco Central de Reserva del Perú.
  8. Janet Currie & Tom Vogl, 2013. "Early-Life Health and Adult Circumstance in Developing Countries," Annual Review of Economics, Annual Reviews, vol. 5(1), pages 1-36, May.
  9. Karen Macours & Norbert Schady & Renos Vakis, 2012. "Cash Transfers, Behavioral Changes, and Cognitive Development in Early Childhood: Evidence from a Randomized Experiment," American Economic Journal: Applied Economics, American Economic Association, vol. 4(2), pages 247-273, April.
  10. Glewwe, Paul & Jacoby, Hanan G. & King, Elizabeth M., 2001. "Early childhood nutrition and academic achievement: a longitudinal analysis," Journal of Public Economics, Elsevier, vol. 81(3), pages 345-368, September.
  11. Fernald, Lia C.H. & Hidrobo, Melissa, 2011. "Effect of Ecuador's cash transfer program (Bono de Desarrollo Humano) on child development in infants and toddlers: A randomized effectiveness trial," Social Science & Medicine, Elsevier, vol. 72(9), pages 1437-1446, May.
  12. Outes, Ingo & Porter, Catherine & Sanchez, Alan & Escobal, Javier, 2011. "Early Nutrition and Cognition in Peru: A Within-Sibling Investigation," Working Papers 2011-017, Banco Central de Reserva del Perú.
  13. Ingo Outes-Leon & Catherine Porter & Alan Sanchez, 2011. "Early Nutrition and Cognition in Peru," Research Department Publications 4743, Inter-American Development Bank, Research Department.
  14. Behrman, Jere R & Birdsall, Nancy, 1983. "The Quality of Schooling: Quantity Alone is Misleading," American Economic Review, American Economic Association, vol. 73(5), pages 928-946, December.
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