HEALTH

Stunting is an anthropometric indicator of chronic undernutrition identifying low height for age and capturing the cumulative effects of linear growth retardation. Stunting is responsible for 14.5% of deaths and 12.6% of the total disease burden among under-five children, most of which is concentrated in the low and middle-income countries in Africa and South-Central Asia. Through pathways such as reduced schooling ( 1.6 years on average), reduced height in adulthood ( 6 cm on average), and lower cognitive skills ( 0.6 standard deviations on a typical test), the impact of chronic nutritional deprivation during childhood on lifetime income can be very high. For South Asia and Africa, the income penalty of stunting has been estimated to be as large as 9-10% of GDP per capita. In Pakistan, 44% children under 5-years old are stunted, with marked socioeconomic inequality in its distribution.

We hypothesise that caregivers from disadvantaged communities in developing countries do not receive adequate, direct, and regular feedback on the growth-trajectory of children in their care. It also constrains them in developing a better understanding of the relationship between different childcare inputs – such as appropriate nutrition and safe drinking water – and healthy physical development. Consequently, despite having access to information on optimal parenting practices via traditional nutritional counseling, caregivers do not respond to signals on their child’s growth by adjusting their nutritional and child-care inputs, leading to stunting of their children.

As a prospective solution, we propose an easily implementable, flexible, and low-cost in-home growth monitoring tool called GroMoTo and intend to test its effectiveness with an open-label randomised controlled trial (RCT).
Findings
Findings revealed positive and significant improvement in children’s height-for-age z-score (HAZ) and reduction in severe stunting in treatment arms as compared to the matched control group one year after baseline.