Abstract
Background: Child growth stunting, defined as a height-for-age z-score (HAZ) below −2 SD based on World Health Organization standards, remains a major global public health challenge, affecting approximately 149 million children under five worldwide. Progress has stalled well short of the World Health Assembly target of a 40% reduction by 2030.
Objective: This literature review synthesizes current evidence on the epidemiology, determinants, biological mechanisms, consequences, and interventions related to child stunting.
Methods: A structured search of Scopus, PubMed, and Google Scholar covering 2010 to 2026 retrieved 3,412 records, of which 265 peer-reviewed studies and agency reports met the eligibility criteria and were thematically synthesized.
Results: Global stunting prevalence declined from 33% in 2000 to 22% in 2020, although substantial disparities persist, particularly in South Asia and sub-Saharan Africa. Stunting is driven by multifactorial determinants, including inadequate dietary intake, recurrent infections, food insecurity, poor water, sanitation, and hygiene (WASH), inadequate childcare practices, poverty, and limited education. Environmental enteric dysfunction (EED) has emerged as an important mechanism linking poor sanitation to impaired growth.
Conclusion: Evidence suggests that integrated multisectoral interventions combining nutrition-specific and nutrition-sensitive approaches are more effective than single-sector strategies. This review contributes an integrated synthesis linking cellular-level mechanisms to multisectoral policy design, explaining why single-sector programs may reach a ceiling. Acceleration requires sustained political commitment, adequate financing, and context-specific delivery.