Mapping child malnutrition

Insufficient growth during childhood is associated with poor health outcomes. Undernourished children are more likely to experience cognitive, physical, and metabolic developmental impairments that can lead to later cardiovascular disease, reduced intellectual ability and school attainment, and reduced economic productivity in adulthood.

We contribute to the Local Burden of Disease Child Growth Failure Collaborators, who map high-spatial-resolution estimates of child growth failure indicators, which include under-5 stunting, wasting, and underweight and publish their work in high impact journals such as Nature. We contribute key data maps of agricultural production and nutrient diversity that together with other data, are used to explain child growth failure. The addition of our data helps to achieve a more complete and robust analysis.

Kinyoki et al. (2020) mapped child growth failure from  2000 to 2017 across 105 low- and middle-income countries, where 99% of affected children live. The study found that despite remarkable declines over the study period, many low- and middle-income countries remain far from the ambitious World Health Organization Global Nutrition Targets to reduce stunting by 40% and wasting to less than 5% by 2025. The study found large disparities in prevalence and progress exist across and within countries and also identify high-prevalence areas even within nations otherwise succeeding in reducing overall child growth failure prevalence.

Previous work by Osgood-Zimmerman et al. (2018) found that between 2000 and 2015, nearly all African countries demonstrated improvements in under-5 stunting, wasting, and underweight, the core components of child growth failure (see below figure).

This work identified that there are striking subnational heterogeneity in levels and trends of child growth. If current rates of progress are sustained, many areas of Africa will meet the World Health Organisation Global Targets 2025 to improve maternal, infant and young child nutrition, but high levels of growth failure will persist across the Sahel region. At these rates, much, if not all of the continent will fail to meet the Sustainable Development Goal target—to end malnutrition by 2030.

This work offers highly relevant subnational information on key nutrition indicators for policymakers and health practitioners at all administrative subdivisions. This facilitates targeted interventions to those populations with the greatest need, in order to reduce health disparities and accelerate progress.

 

ac, Prevalence of moderate and severe stunting (MSS) at the 5 × 5-km resolution in 2000 (a), 2010 (b) and 2015 (c). d, Prevalence of stunting at the first administrative subdivision in 2015. e, Overlapping population-weighted lowest and highest 10% of pixels and AROC in stunting from 2000 to 2015 across the continent. f, Overlapping population-weighted quartiles of stunting and relative 95% uncertainty in 2015. g, Annualized decrease (AD) in stunting prevalence from 2000 to 2015 relative to rates needed during 2015–2025 to meet the WHO GNT. 100% indicates the annualized decrease from 2000 to 2015 equivalent to the pace of progress required during 2015–2025 to meet the WHO GNT by 2025 (40% decrease in stunting, relative to 2010). Blue pixels exceeded this pace; green to yellow pixels proceeded at a slower rate than required; orange pixels were non-decreasing; and purple pixels were estimated to have met the target by 2015 (‘Met GNT’). h, Pixel-level prevalence of stunting was predicted for 2025 on the basis of the annualized decrease achieved from 2000 to 2015 and projected from 2015. i, Acceleration in the annualized decrease in stunting required to meet the WHO GNT by 2025. Purple pixels were either non-decreasing or must accelerate their rate of decline by more than 400% over 2000–2015 rates during 2015–2025 to achieve the target; white pixels require no increase. Maps reflect administrative boundaries, land cover, lakes and population; pixels with fewer than ten people per 1 × 1 km and classified as ‘barren or sparsely vegetated’ are coloured in grey. Figure from Osgood-Zimmerman et al. (2018).

Explore the prevalence of stunting, wasting and underweight in children from Africa using the app below.

 

Watch a short clip about the Local Burden of Disease in Africa.