Growth Faltering and Recovery in Children aged 1-8 Years in Four Low- and Middle-income Countries

Objective: We characterized post-infancy child growth patterns and determined the incidence of becoming stunted and of recovery from stunting.

Design: Data came from Young Lives, a longitudinal study of childhood poverty in four low- and middle-income countries.

Setting: We analysed length/height measurements for children at ages 1, 5 and 8 years.

Subjects: Children (n7171) in Ethiopia, India, Peru and Vietnam.

Results: Mean height-for-age Z-score (HAZ) at age 1 year ranged from -1.51 (Ethiopia) to -1.08 (Vietnam). From age 1 to 5 years, mean HAZ increased by 0.27 in Ethiopia (P<0.001) and decreased among the other cohorts (range: -0.19 (Peru) to -0.32 (India); all P<0.001). From 5 to 8 years, mean HAZ increased in all cohorts (range: 0.19 (India) to 0.38 (Peru); all P,0.001). Prevalence of stunting (HAZ,-2.0) at 1 year ranged from 21% (Vietnam) to 46% (Ethiopia). From age 1 to 5 years, stunting prevalence decreased by 15.1 percentage points in Ethiopia (P<0.001) and increased in the other cohorts (range: 3.0 percentage points (Vietnam) to 5.3 percentage points (India); all P?0.001). From 5 to 8 years, stunting prevalence decreased in all cohorts (range: 5.0 percentage points (Vietnam) to 12.7 percentage points (Peru); all P<0.001). The incidence of becoming stunted between ages 1 to 5 years ranged from 11% (Vietnam) to 22% (India); between ages 5 to 8 years, it ranged from 3% (Peru) to 6% (India and Ethiopia). The incidence of recovery from stunting between ages 1 and 5 years ranged from 27% (Vietnam) to 53% (Ethiopia); between ages 5 and 8 years, it ranged from 30% (India) to 47% (Ethiopia).
Conclusions: We found substantial recovery from early stunting among children in four low- and middle-income countries.

Keywords: Child growth, stunting, growth faltering, growth recovery, height-for-age-score

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Reference: 

Elizabeth A. Lundeen, et al (2014) Growth Faltering and Recovery in Children aged 1–8 years in Four Low- and Middle-income Countries: Young Lives, Public Health Nutrition 17 (9): 2131-2137. DOI: http://dx.doi.org/10.1017/S1368980013003017