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Review of the links between wasting and stunting

Donor: OFDA and Irish Aid 

Collaborators: Technical Interest Group

ENN project lead: Carmel Dolan

Timeframe: 2014 - ongoing

Background

While wasting and stunting share some of the same causal pathways, there has been limited evidence to describe the relationship and associations between them, and whether one precedes, or predisposes, the other. Additionally, almost nothing has been written on the biochemical and physiological processes through which the relationship between stunting and wasting might be both mediated and magnified.

 

Growth monitoring

More evidence is required in order to better understand the complex relationships and associations between these two forms of undernutrition. Deeper understanding of changes in weight and length will mean that resources can be better targeted to combat undernutrition and reduce child mortality and eventually, pave the way for more connected programming for stunting and wasting.

Project summary

The Wasting-Stunting (WaSt) Project is guided by a Technical Interest Group (TIG) made up of 30 experts in child growth and nutrition. In Phase 1 (2014/15) the ENN undertook a narrative review of the relationship between wasting and stunting to further the understanding of the biological links between the two conditions. The review concluded on the policy and programmatic implications for all actors concerned with addressing undernutrition. 

A research prioritisation exercise was conducted and a draft for peer review publication was prepared and subsequently publishedwas prepared and subsequently published. In addition, the ENN carried out an analysis of five high burden country datasets to estimate the burden of concurrent wasting and stunting for the 2015 Global Nutrition Report.

UNICEF growth monitoring programme

In WaSt Phase 2 (2016-2017), a re-analysis of DHS and MICS datasets from 83 countries was carried out to generate a pooled prevalence estimate of the burden of concurrent of wasting and stunting. These findings were published in October 2017 with open access in Maternal and Child Nutrition in a paper entitled 'Children concurrently wasted and stunted: A meta-analysis of prevalence data of children 6–59 months from 84 countries’.

Phase two also involved a second face to face meeting of the WaSt TIG members in London in January 2016. The meeting involved a series of fascinating technical presentations from a number of renowned child growth and nutrition experts, followed by Q&A sessions and discussions about potential research priorities. Considerable attention was given to how best to use existing cross sectional and cohort data to answer key questions about both forms of infant and child undernutrition. The meeting agenda and participant list is available here

Based on this meeting, two working groups were established; the ‘SMART Data Analysis Group’, which is looking at the utility of cross sectional datasets to understand wasting and stunting, and the ‘MRC Gambia Working Group’ which employed the services of a post-doctoral analyst based at the MRC to answer some of the outstanding WaSt research questions amenable to longitudinal data. Both groups will be reporting on the findings by mid-2017.

In late 2017 a third WaSt TIG face to face meeting will be held. Date and venue to be determined.

For more information please contact Carmel@ennonline.net or Tanya@ennonline.net

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Publications

 

Technical Briefing Paper: The relationship between wasting and stunting: policy, programming and research implications (2014)

wasting2Research priorities on the relationship between wasting and stunting (2016)

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Reference this page

Chloe Angood (2014). Review of the links between wasting and stunting. www.ennonline.net/ourwork/reviews/wastingstunting