Wasting and Stunting-making progress on understanding the links

By Carmel Dolan on 24 February 2017

Some of you will know that ENN has been coordinating a project with the expert steer of around 30 child growth and nutrition specialists from academia, donor and operational agencies. Collectively, we are known as the Wasting-Stunting Technical Interest Group (WAST-TIG) and we have been interacting across various work streams for a few years thanks to generous funding from Irish Aid and USAID OFDA.  

ENN originally formed this group because we wanted to better understand whether there are physiological/biological links between the process of becoming wasted and stunted and particularly, if one increases the risk of the other. We also want to understand the possible mechanisms for this interaction.

As many of you reading this blog will know, the nutrition sector has tended to focus on wasting more in emergency situations and stunting, from more of a developmental perspective and this has tended to manifest itself in ‘siloed’ policies, plans, programmes and research (read more about that here). It’s good to know that this is changing thanks to initiatives like the SUN Movement, through donors challenging these assumptions and beginning to put in place more flexible funding facilities and the general focus in the sector to support governments to develop more holistic nutrition planning to address all forms of malnutrition where these exist.

The WAST TIG have been focussed on two main areas of work in 2016; re-analysis of data from the MRC Gambia and, cross sectional data from SMART surveys. Our process is to form small but dynamic working groups from the wider TIG, agree which research questions we can answer from our priorities (read more about research priorities here) and regularly interact with the data analysts to discuss emerging results and next steps. Many of the people in the TIG give their time and expertise freely and have greatly enriched and guided the process. It is a laudable model for getting research undertaken through such open collaboration and by analysing data which already exists.  

We are now at a point when important findings are emerging. So, as a flavour of what we will be sharing in 2017, here a few headlines;

1. A period of being wasted (even just once) is a risk factor for being stunted.
2. Being wasted and stunted at the same time (concurrently) conveys an elevated risk of mortality comparable with that associated with being severely wasted
3. Boys are more likely to be concurrently wasted and stunted than girls. It looks like this is also the case for wasting and stunting dealt with separately.
4. Younger children (<2yrs) are more likely to be concurrently wasted and stunted than older children.
5. The season a child is born in defines its experience of wasting and stunting throughout childhood.

Although some might say, ‘well, this isn’t new’, it would be right to ask questions about whether enough attention is being given to the heightened nutrition vulnerability amongst young males and the causes of this vulnerability? Why are we not intervening given the very high mortality risk associated with being concurrently wasted and stunted? Whether we are doing enough to prevent poor infant and child growth where seasonality places added risks and, whether we are getting better at tackling wasting and stunting in the same programmes? 

2017 will see the WAST TIG do further analysis, publications, a policy-practice brief and meet at various intervals in the year. We will keep our network informed of any updates but meanwhile, if you want to know more, feel free to contact carmel@ennonline.net and tanya@ennonline.net or read more about the ENN's WAST project here.

Read more about the ENN's work on the links between Wasting and Stunting:

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

Field Exchange 50: The relationship between wasting and stunting: policy, programming and research implications

Nutrition Exchange 4: Wasting & stunting technical interest group meeting: summary points