Background: Infant and child nutrition in Zambia remains a pressing public health problem. The Zambia Demographic and Health Survey (ZDHS) indicates that 35% of children under-five and 36 % among those aged 6-23 months are stunted. This study set out to assess the influence of Infant and Child Feeding (IYCF) practices on child stunting (6-23 months) in Zambia. Methods: The 2008 ZDHS children’s data were analysed to measure stunting among infants aged 6-23 months. We fitted a bivariate logistic regression to measure association between feeding practices and stunting in children. Pearson’s Chisquare test of proportions and adjusted odd ratios (AOR) with confidence intervals at 95% are reported. Results: Findings indicate that 36% of children 6-23 months old were stunted. IYCF practices indicators remain relatively poor in Zambia with only 13% of children age 6-23 months having received minimum acceptable diet, 23% received minimum dietary diversity and 42% received minimum meal frequency. Breastfeeding and receipt of a minimum dietary diversity reduced the odds of stunting among children age 6-23 months by 38% and 33% respectively. A child’s perceived low birth size, being male, maternal anaemia status and mother’s use of the internet were significant predictors of stunting. Conclusion: The study shows that IYCF practices have an influence on stunting in Zambia and that socio-economic and demographic factors are likewise associated with stunting although the main determinants are amendable to intervention. Promoting the recommended WHO IYCF practices; breastfeeding, minimum meal frequency, receiving foods with diverse dietary content and accelerated investment in nutrition programs is recommended.
Background: Child nutrition and growth are often framed as the responsibility of mothers. Global programs on infant and young child feeding (IYCF) emphasize maternal education, breastfeeding practices, and household food preparation. However, recent evidence suggests that fathers play a significant but under-recognized role in shaping dietary practices, health-seeking behaviors, and growth outcomes. Fathers influence family income allocation, food purchasing decisions, and the overall household environment. Their attitudes toward nutrition and health services can affect maternal practices and children’s access to adequate diets. In many low- and middle-income countries (LMICs), including Indonesia, cultural norms may limit paternal involvement in caregiving, leaving gaps in nutrition promotion and child health. As stunting continues to affect one in five Indonesian children under five (SSGI 2024), exploring fathers’ role in child nutrition may offer new insights for public health interventions. Objective: To review recent literature (2015–2024) on the role of fathers in child nutrition and growth, with a focus on implications for stunting prevention strategies in LMICs. Method: A narrative mini-review was conducted using PubMed, Google Scholar, and UNICEF/WHO reports. Keywords included father involvement, child nutrition, infant and young child feeding, growth, stunting. Inclusion criteria: studies published between 2015 and 2024 that assessed paternal knowledge, attitudes, or practices related to child feeding and growth outcomes. Results: Father involvement in IYCF: Studies from South Asia and Africa show that paternal support improves breastfeeding initiation and reduces early introduction of formula or complementary foods. Dietary diversity: Children with fathers engaged in meal planning or food purchasing were more likely to receive diverse diets. Knowledge gaps: Surveys reveal that fathers generally have lower awareness of nutrition guidelines compared to mothers, particularly regarding sugar-sweetened beverages, portion sizes, and micronutrient supplementation. Impact on growth outcomes: Limited but growing evidence links paternal involvement with reduced risk of stunting and underweight, suggesting indirect pathways through maternal support and household food security. Cultural barriers: In many LMICs, caregiving is socially framed as a maternal duty, leading fathers to underestimate their role in nutrition. Discussion: The literature indicates that fathers’ engagement is a missing link in stunting prevention efforts. While mothers remain primary caregivers, fathers strongly shape the food environment and resource allocation. Addressing paternal knowledge gaps and cultural barriers could enhance the effectiveness of child nutrition programs. Community-based interventions that include fathers have shown promising results in improving IYCF practices. Conclusion: Fathers play a crucial yet under-recognized role in child nutrition and growth. Integrating paternal involvement into public health strategies may improve dietary practices, support maternal caregiving, and reduce stunting risk. More research is needed in Indonesia and other LMICs to quantify this impact and design culturally appropriate interventions.
ABSTRACT Stunting, largely established during the first 1000 days of life, remains a major public health challenge in sub‐Saharan Africa, contributing to early‐life deficits and perpetuating intergenerational disadvantage. Children born to stunted mothers are at increased risk of experiencing stunting themselves, reflecting the persistence of nutritional vulnerability across generations. This study examines the association between maternal and child stunting across 19 sub‐Saharan African countries using recent Demographic and Health Survey (DHS) data. A cross‐sectional analysis was conducted using pooled DHS data from 91,840 children aged 6–59 months and their mothers, collected between 2013 and 2024. Child stunting was defined as a height‐for‐age Z‐score (HAZ) below −2 standard deviations. Multivariable logistic regression models were used to assess the association between maternal and child stunting, adjusting for key sociodemographic and household characteristics. The overall prevalence of child stunting was 31.5%. Stunting prevalence was substantially higher among children of stunted mothers (66.6%) compared to those of non‐stunted mothers (32.3%). Maternal stunting was associated with significantly increased odds of child stunting (adjusted odds ratio [AOR]: 3.79; 95% CI: 3.25–4.43). Additional determinants included maternal education, household wealth, and place of residence. Marked regional disparities were observed, with the highest prevalence in Central Africa (37.8%) and the lowest in Western Africa (26.6%). Maternal stunting emerges as a strong and independent predictor of child stunting, underscoring the importance of life‐course approaches to nutrition. Interventions targeting maternal nutrition, female education, and structural socioeconomic inequalities are essential to disrupt the intergenerational transmission of stunting in sub‐Saharan Africa.
AbstractMany interventions focus on preventing stunting in the first 1,000 days of life. We take a broader perspective on childhood growth to assess the proportions of children who suffer persistent stunting, recover, and falter and become newly stunted between birth and adolescence. We use longitudinal data collected on 7,128 children in Ethiopia, India, Peru, and Vietnam. Data were collected in five survey waves between the ages of 1 to 15 years. We use descriptive and graphical approaches to compare the trajectories of children first stunted by age 1, first stunted by age 5, and those remained not stunted until age 5. On average, 29.6% of children were first stunted by age 1, 12.9% of children were first stunted by the age 5, and 68.7% of children were not stunted at either age 1 or age 5. A larger percentage of children stunted by age 1 remained stunted at age 15 (40.7%) compared with those who were first stunted by age 5 (32.3%); 33.7% of children first stunted by age 1 and 31.1% of children first stunted by age 5 go on to recover, but then falter during later childhood. 13.1% of children who were not stunted at age 1 or age 5 become newly stunted between the ages of 8 and 15. Our results show that children both become stunted and recover from stunting into adolescence. More attention should be paid to interventions to support healthy growth throughout childhood.
Abstract Child stunting reduction is the first of 6 goals in the Global Nutrition Targets for 2025 and a key indicator in the second Sustainable Development Goal of Zero Hunger. The prevalence of child stunting in Indonesia has remained high over the past decade, and at the national level is approximately 37%. It is unclear whether current approaches to reduce child stunting align with the scientific evidence in Indonesia. We use the World Health Organization conceptual framework on child stunting to review the available literature and identify what has been studied and can be concluded about the determinants of child stunting in Indonesia and where data gaps remain. Consistent evidence suggests nonexclusive breastfeeding for the first 6 months, low household socio‐economic status, premature birth, short birth length, and low maternal height and education are particularly important child stunting determinants in Indonesia. Children from households with both unimproved latrines and untreated drinking water are also at increased risk. Community and societal factors—particularly, poor access to health care and living in rural areas—have been repeatedly associated with child stunting. Published studies are lacking on how education; society and culture; agriculture and food systems; and water, sanitation, and the environment contribute to child stunting. This comprehensive synthesis of the available evidence on child stunting determinants in Indonesia outlines who are the most vulnerable to stunting, which interventions have been most successful, and what new research is needed to fill knowledge gaps.
Background: This study investigates whether the observed negative relationship between national income and child stunting prevalence reflects short-term causal effects or long-term structural differences between countries. Methods: A balanced panel of 104 countries from 2000 to 2020 was analyzed using pooled ordinary least squares and two-way fixed effects estimators. Robustness checks included lagged specifications, Hausman tests, and dynamic panel System Generalized Method of Moments models with clustered standard errors. Results: Approximately 95% to 96% of the observed income–stunting association was attributable to cross-sectional differences rather than short-run within-country dynamics. While pooled ordinary least squares suggested that a 1% increase in gross domestic product per capita was associated with a 0.84 percentage-point reduction in stunting prevalence, the within-country effect declined to 0.03 percentage points after controlling for country and year effects. No statistically robust short-run within-country association was detected between aggregate consumer price index inflation and stunting prevalence. Conclusions: The findings suggest that child stunting is shaped more by long-term structural determinants than by short-run macroeconomic fluctuations. Policies should prioritize sustained investments in institutional quality, health systems, sanitation, maternal education, human capital, and social protection.
In this study we surveyed families’ experiences with parental depression, stress, relationship conflict, and child behavioral issues during six months of the COVID-19 pandemic through the COVID-19: Global Social Trust and Mental Health Study. The current analyses used data collected from online surveys completed by adults in 66 countries from 17 April 2020–13 July 2020 (Wave I), followed by surveys six months later at Wave II (17 October 2020–31 January 2021). Analyses were limited to 175 adult parents who reported living with at least one child under 18 years old at Wave I. Parents reported on children’s level of externalizing and internalizing behavior at Wave I. At Wave II, parents completed self-reported measures of stress, depression, and inter-partner conflict. Child externalizing behavior at Wave I significantly predicted higher levels of parental stress at Wave II, controlling for covariates. Child internalizing behavior at Wave I did not predict parental stress or depression, controlling for covariates. Neither child externalizing nor internalizing behavior predicted parental relationship conflict. The overall findings demonstrate that child behavior likely influenced parental stress during the COVID-19 pandemic. Findings suggest that mental health interventions for children and parents may improve the family system during times of disaster.
Jill Portnoy, AnaCristina Bedoya, Keri Ka-Yee Wong
Canada has welcomed over 100,000 Syrian refugees since 2015, many of whom have faced displacement-related challenges that shape their socio-emotional well-being. Refugee children, in particular, are at heightened risk for socio-emotional difficulties due to their developmental sensitivity to adversity, exposure to traumatic events, and resettlement stressors. Assessing children’s socio-emotional well-being often relies on both parent-reports and child self-reports; however, discrepancies between these reports commonly occur, and the factors influencing such discrepancies are not well understood, particularly in displaced populations. The present study examined predictors of parent-child discrepancies in reports of socio-emotional well-being and explored whether such discrepancies were associated with children’s learning outcomes. Participants were Syrian refugee children (N = 55, Mage = 14.42) who were resettled in Canada for an average of six years. Results revealed that children consistently self-reported more socio-emotional problems than their parents reported. Moreover, longer time resettled in Canada predicted greater parent-child discrepancies, suggesting that resettlement-related factors and acculturation influence parent-child discrepancies. However, child self-reports, but not parent-reports, showed limited external validity; while parent-child communication barriers may contribute to discrepancies, differences in how socio-emotional constructs are understood and reported by parents and children are important to consider. These findings underscore the importance of including multiple informants in socio-emotional well-being assessments and carefully considering cultural and contextual factors when designing assessments, specifically given the complex dynamics in displaced families. Future research is important to advance the literature to determine whether assessments of socio-emotional well-being should be adapted for specific populations, as suggested by the present findings.
Andrea De Bartolo, Yuying Huang, Hamza Qayumi et al.
We offer a child-centric framework for reparations with considerations for policy and implications for child descendants of enslaved African Americans. We apply economic theory of human capital integrated with the theories of bioecological developmental systems to illustrate the multilayered aspects of harm from the legacy of slavery and racism. Our curation of estimates shows that relative to white peers, black children bear more than double the risk in outcomes unfavorable to educational and economic prosperity from birth through young adulthood. We also find that enduring racial wealth differences are larger among households with children than without children, with the child household racial wealth gap in 2019 remaining comparable to that seen 60 years ago. Simulations suggest that a government wealth transfer of approximately $120,000 per black child during early childhood reduces the black-white gap in high school graduation by 13 percentage points and increases college attendance by 26 percentage points. A review of existing U.S. reparations initiatives shows that few include direct financial transfers or other forms of investments specifically for black families or children. Based on a contemporary survey, we find that black parents with young children express support for reparations in the form of direct cash payments as well as other forms of financial assistance.
Lisa A. Gennetian, Christina Gibson-Davis, William Darity
How do parents contend with threats to the health and survival of their children? Can the social safety net mitigate negative economic effects through transfers to affected families? We study these questions by combining the universe of cancer diagnoses among Danish children with register data for affected and matched unaffected families. Parental income declines substantially for 3-4 years following a child’s cancer diagnosis. Fathers’ incomes recover fully, but mothers’ incomes remain 3% lower 12 years after diagnosis. Using a policy reform that introduced variation in the generosity of targeted safety net transfers to affected families, we show that such transfers play a crucial role in smoothing income for these households and, importantly, do not generate work disincentive effects. The pattern of results is most consistent with the idea that parents’ preferences to personally provide care for their children during the critical years following a severe health shock drive changes in labor supply and income. Mental health and fertility effects are also observed but are likely not mediators for impacts on economic outcomes.
Achyuta Adhvaryu, N. Meltem Daysal, Snaebjorn Gunnsteinsson et al.
