Dismantling silos: what we have learnt about the relationship between child wasting and stunting, and the implications for connected policy, research and programmes

Abstract

Since 2014, the Wasting and Stunting Technical Interest Group and others have amassed a body of evidence on the relationship between child wasting and stunting. The resulting research papers and reports have enhanced our understanding of undernutrition, particularly how children become wasted and/or stunted and how they experience these conditions and their consequences. Evidence highlights the common determinants and interconnected physiological processes leading to a child becoming wasted and/or stunted and we have built a greater understanding of how wasting treatment, or its lack, impacts children's linear growth. We also know more about the mortality-risk consequences for a child being concurrently wasted and stunted, how commonly this occurs, which children are particularly at risk and how to best identify and potentially support them. Based on this evidence, some shifts to policy and programme approaches, and to how research is conducted, are indicated in order to more effectively address both forms of undernutrition. These include conducting common contextual causal analysis, developing common prevention strategies that target overlapping drivers including in utero, considering wasting as part of the pathway to stunting, and vice versa when designing prevention strategies and including children at greatest mortality risk owing to multiple deficits in treatment targeting. This article is part of the theme issue 'Biological, biomedical and environmental drivers of stunting'.