Peer-reviewed article
Association between stunting and early childhood development among children aged 36–59 months in South Asia
Yunhee Kang, Víctor M. Aguayo, Rebecca K. Campbell, Keith P. West ·
Summary
Written by AI, not yet AICS's view · claude-sonnet-5-5This study used household survey data (Multiple Indicator Cluster Surveys) from Bangladesh, Bhutan, Nepal and Pakistan (Punjab and Sindh) to look at children aged 36–59 months. It examined whether being short for age (stunted), underweight or wasted was linked to being developmentally on track in learning/cognition and in social–emotional skills. Stunted and underweight children were less likely to be on track for learning/cognition. No link was found between any nutrition measure and social–emotional development. The authors suggest that preventing stunting may also benefit child development.
Key points
- Data came from Bangladesh (n = 8,659), Bhutan (n = 2,038), Nepal (n = 2,253) and Pakistan (Punjab n = 11,369, Sindh n = 6,718).
- On-track learning/cognition was positively associated with height-for-age (OR = 1.17, 95% CI 1.07–1.27) and weight-for-age (OR = 1.18, 95% CI 1.07–1.31).
- Stunting (OR = 0.72, 95% CI 0.60–0.86) and underweight (OR = 0.75, 95% CI 0.66–0.86) were associated with lower odds of being on track for learning/cognition.
- Weight-for-height and wasting were not associated with learning/cognition.
- On-track social–emotional development was not associated with any z score or undernutrition indicator.
Limitations
The abstract describes an observational association study using survey data, so it cannot show that stunting causes poorer development. It also does not report details on how well the development measures capture children's skills or on differences between individual countries.
Abstract
Abstract Stunting (length‐for‐age z score < −2) before 2 years of age has shown associations with poor child developmental indicators, but information at the population level is scarce in South Asia, the region with the highest burden of stunting. We examined associations between z scores (i.e., height for age [HAZ], weight for age [WAZ], and weight for height [WHZ]) and undernutrition (i.e., stunting [HAZ < −2], wasting [WHZ < −2], and underweight [WAZ < −2]) with learning/cognition and social–emotional development among children 36–59 months of age. Data from Multiple Indicator Cluster Surveys in Bangladesh ( n = 8,659), Bhutan ( n = 2,038), Nepal ( n = 2,253), and Pakistan (Punjab n = 11,369 and Sindh n = 6,718) were used. Children were considered developmentally “on‐track” in learning/cognition or social–emotional domains if they met specific early child development criteria. Meta‐analysis was conducted to examine regional associations, adjusting for socio‐economic status, early childhood education, and quality of care. In a pooled sample, on‐track learning/cognition development was positively associated with HAZ ( OR = 1.17, 95% CI [1.07, 1.27]) and WAZ ( OR = 1.18, 95% CI [1.07, 1.31]) and negatively associated with stunting ( OR = 0.72, 95% CI [0.60, 0.86]) and underweight ( OR = 0.75, 95% CI [0.66, 0.86]) but not associated with WHZ or wasting. On‐track development of social–emotional domain was not associated with any z scores or undernutrition indicators. Across several countries of South Asia, stunted children were less likely to be developmentally “on track” for learning/cognition. It is likely that interventions that prevent stunting may benefit child development, leading to significant individual and societal gains given the large burden of child stunting in regions like South Asia.