Stunting remains a significant public health challenge in Africa, with far-reaching implications for child health, development, and future prospects
Source Image: Getty
Stunting[1], a pervasive issue in Africa, underscores the complex interplay of factors shaping child health and well-being across the continent. In Africa, stunting rates are often high, affecting millions of children. In 2022, worldwide, approximately 148.1 million children under five were stunted, representing over one in five children globally. In Africa, the prevalence of stunting in this age group stands at 30 percent, significantly surpassing the global rate of 22.3 percent. Northern Africa and Southern Africa align closely with the global average, but the rates are notably higher in other sub-regions. Central Africa faces the highest burden, with nearly 37.4 percent.
Northern Africa and Southern Africa align closely with the global average, but the rates are notably higher in other sub-regions.
Across Africa, stunting rates vary widely by region and country (fig 1). According to data from the World Health Organization (WHO), the prevalence of stunting in children under five years old in Africa ranges from less than 10 percent in some countries to over 40 percent in others. In 2022, 10 countries had a high prevalence of stunting, exceeding 35 percent, while six countries, including Algeria, Cabo Verde, Mauritius, Sao Tome and Principe, Seychelles, and Tunisia, had rates below 10 percent. Over the period from 2000 to 2022, most countries made significant progress in reducing stunting. However, Eritrea and Libya experienced a worsening situation, with over half of children under five being stunted in 2022. These regional disparities are influenced by factors such as socioeconomic status, access to healthcare and education, food security, and environmental conditions.
Figure 1: Stunting Prevalence in Africa Region
Source: Africa - Regional Overview of Food Security and Nutrition 2023
The COVID-19 pandemic has had significant implications for stunting trends in Africa. Disruptions to healthcare services, economic shocks, food supply chain disruptions, and school closures have increased vulnerability to malnutrition and stunting, particularly among already marginalised populations. Urbanisation and rapid changes in dietary patterns are influencing stunting trends in Africa. As more people move to urban areas, there is a shift towards diets that are high in processed foods, sugar, and fats but low in essential nutrients, contributing to both undernutrition and overnutrition-related issues like stunting and obesity.
The prevalence of stunting in Africa and its sub-regions has been on a gradual decline since 2000. Nevertheless, the decrease in stunting rates has not been uniform across all sub-regions, as Central Africa, Northern Africa, and Southern Africa have seen a deceleration in the pace of progress in recent years. On the other hand, Eastern Africa achieved the most significant reduction, with a decrease of 18.1 percentage points compared to other sub-regions. Nevertheless, both the continent and its sub-regions are falling short of meeting the 2030 global nutrition target as well as Sustainable Development Goal target 2.2 for reducing stunting among children under five years of age.
Disruptions to healthcare services, economic shocks, food supply chain disruptions, and school closures have increased vulnerability to malnutrition and stunting, particularly among already marginalised populations.
Stunting has far-reaching consequences that extend beyond physical stature to impact cognitive development, educational attainment, and overall well-being. It increases susceptibility to infections, chronic diseases, and impaired immune function, leading to higher morbidity and mortality rates among affected children. Individuals who experience stunting in childhood are at a disadvantage in terms of productivity, earning potential, and socio-economic status in adulthood, perpetuating cycles of poverty and inequality. Stunting can have inter-generational effects, as malnourished mothers are more likely to give birth to underweight infants who are at higher risk of stunting, continuing the cycle of malnutrition and poor health outcomes.
Addressing stunting requires a multi-dimensional approach that integrates nutrition, healthcare, sanitation, education, and socio-economic development. Enacting and enforcing policies that prioritize nutrition, healthcare, sanitation, and education, as well as fostering multisectoral collaboration and partnerships, are critical for creating an enabling environment to combat stunting effectively.
Several initiatives and programmes are underway across Africa to address stunting, including national nutrition plans, community health interventions, and partnerships between governments, non-governmental organizations (NGOs), and international agencies. The African Union's Agenda 2063, is a strategic framework for the socio-economic transformation of Africa, which includes goals related to nutrition, food security, and health. Many African countries are part of the SUN Movement, which aims to improve nutrition through multi-sectoral approaches, including health, agriculture, education, and social protection. Several African countries have developed national policies specifically focused on food security and nutrition, outlining strategies to improve access to nutritious food and address malnutrition. Also, community-based nutrition programmes focus on improving nutrition at the grassroots level, often involving community health workers and volunteers. Several African countries have school feeding programmes aimed at improving children's nutrition and educational outcomes by providing nutritious meals at schools. Governments are increasingly adopting agriculture policies that promote the production and consumption of diverse and nutritious foods, addressing issues such as food availability, affordability, and access. The focus is on long-term sustainability and resilience-building; climate-smart agriculture, social protection programmes, education systems, and community empowerment initiatives that address the underlying determinants of stunting and promote holistic development. However, challenges persist, including limited funding, infrastructure constraints, political instability, and the impacts of climate change, which can exacerbate food insecurity and malnutrition.
Several African countries have developed national policies specifically focused on food security and nutrition, outlining strategies to improve access to nutritious food and address malnutrition.
Stunting remains a significant public health challenge in Africa, with far-reaching implications for child health, development, and future prospects. Addressing this complex issue requires sustained commitment, a collaboration involving governments, non-governmental organisations, healthcare professionals, educators, and communities, and investment in holistic approaches that prioritise nutrition, healthcare, sanitation, education, and poverty alleviation.
Shoba Suri is a Fellow at the Observer Research Foundation
[1] refers to impaired growth and development that occurs in children due to chronic malnutrition, inadequate healthcare, and poor sanitation
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Dr. Shoba Suri is a Senior Fellow with ORFs Health Initiative. Shoba is a nutritionist with experience in community and clinical research. She has worked on nutrition, ...
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