Nearly one million children under the age of five die each year due to health problems linked to child growth failure, according to new findings from the Global Burden of Disease 2023 study published in The Lancet Child & Adolescent Health.
The report states that deaths associated with child growth failure (CGF) have decreased significantly over the past two decades, falling from 2.75 million in 2000 to 880,000 in 2023. Despite this progress, the burden remains high in certain regions. Sub-Saharan Africa recorded 618,000 deaths and South Asia reported 165,000 deaths related to CGF last year.
Researchers found that among indicators of CGF, being underweight accounted for the highest share of disease burden—12% of all deaths in children under five—followed by wasting at 9% and stunting at 8%. The study also revealed that more children are affected by stunting than previously estimated.
Child growth failure increases vulnerability to diseases such as lower respiratory infections, diarrheal diseases, malaria, and measles. Nearly 800,000 children under five died from these illnesses in connection with CGF. In sub-Saharan Africa, CGF was linked to 77% of diarrheal disease deaths and 65% of lower respiratory infection deaths among young children in 2023. South Asia saw similarly high proportions: an estimated 79% of diarrheal disease deaths and 53% of lower respiratory infection deaths were associated with CGF. High-income regions had much lower fractions—about one-third—for both causes.
"The drivers behind child growth failure are complex and cumulative due to feeding issues, food insecurity, climate change, lack of sanitation, or war," said Dr. Bobby Reiner, co-author and professor at the Institute for Health Metrics and Evaluation at the University of Washington School of Medicine. "Therefore, no single strategy will improve their health across all regions."
The research shows that most infants who experience stunting do so within their first three months. This highlights the need for interventions before conception and during pregnancy. Wasting and stunting often reinforce each other: stunted children are more likely to become wasted later on and vice versa—a cycle that worsens as they grow older. Growth failure early in life can signal premature birth or low birth weight; later failures may be tied to poor nutrition or repeated infections.
"Given the difficulty in reversing stunting, the latest estimates in this study should be used to identify high prevalence locations, as early detection and intervention are critical," said Dr. Reiner.
