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Programming implications of stunting in protracted emergency contexts

The objectives of nutrition sensitive programming are most often framed in terms of reducing levels of stunting. Funded by Irish Aid, ENN recently undertook a scoping exercise to explore the implications of operating in situations of protracted crisis where wasting prevalence may not trigger emergency nutrition interventions but levels of stunting are high. The exercise involved document review and informal discussions with nutrition focal points in a number of agencies (donor, United Nations) and non-governmental organisations. The brief report summarises key quantitative data (see Box 1), the funding context, the extent of monitoring stunting levels in protracted crisis, what we are doing about stunting in programming terms, and what could or should we be doing about it (see Box 2).

Box 1: Figures on stunting in fragile and conflicted affected states (FCAS)*

  • 55% of the countries have Serious or Critical levels of stunting
  • Only 4 of the countries have Acceptable levels of stunting (and of these 2 are out of date)
  • Total stunted children in the world (WHO/UNICEF/WB 2015) = 23.8%, 158,600,000 children
  • Therefore an estimated 45% of the total stunted children in the world live in fragile and conflict affected states
  • The 2030 Global target is to reduce the number of stunted children in the world to 86 million
  • Severe stunting is over 15% in 26/54 – nearly half of the countries

* Note that FCAS are taken as a very rough proxy of countries experiencing protracted crises.


Box 2: Ten evidence based interventions for stunting reduction

  1. Salt iodisation
  2. Multiple micronutrient supplementation in pregnancy (includes iron-folate)
  3. Calcium supplementation in pregnancy
  4. Energy-protein supplementation in pregnancy
  5. Vitamin A supplementation in childhood
  6. Zinc supplementation in childhood
  7. Breastfeeding promotion
  8. Complementary feeding education
  9. Complementary food supplementation
  10. (Management of SAM – included in the Lancet 10 interventions for its impact on mortality)

The investigation raised more questions that can currently be answered; recommended next steps are to:

A print copy of the review is included with this edition of Field Exchange. It is also available online here.

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Reference this page

Editors (2016). Programming implications of stunting in protracted emergency contexts. Field Exchange 51, January 2016. p94.