Breaking the vicious cycle of stunting in children under 5 in developing countries of South Asia by overcoming barriers and recommending interventions : a systematic review

Date of Award


Document Type


Degree Name

Master of Science in Health Policy & Management (MSc Health Policy & Mgmt)


Community Health Sciences


Maternal malnutrition contributes 20% of childhood stunting globally. Stunting prevalence in children under 5 years has declined globally in last few decades, but is no progress has been made still higher in developing countries of Asia and sub-Saharan Africa. It has effected more than 165 million children worldwide in 2011. Poor health and nutrition related indicators across south Asia; claimed to be a significant cause of increased malnutrition rate specifically stunting in children under 5 years of age. Maternal nutrition has a vital role in improving better health and birth outcomes. Methods: Systematic search for published literature using search term "barriers", "stunting", "children under 5", "developing countries" and "South Asia". Data bases like Pub-Med, Science direct and Google Scholars were used to search the studies; using search strategy "Reducing OR overcoming AND barriers AND stunting OR Chronic malnutrition AND under 5 children AND developing countries AND South Asia OR South East Asia OR South West Asia. Criteria were set to select the article for review eligibility. Filters for article type, free full text, years of publication and human species were applied to limit the search for more focused review Results: Systematic review finding revealed that general lack of awareness, poor infant and IYCF practices, lack of safe and acceptable form of sanitation, low literacy rate of women, limited financial resources (assets, credits and income), lack of leadership capacity/Knowledge on roles of strategic significance, narrow focus on nutrition and lack of integrated efforts were identified as the potential barriers in stunting prevention. Conclusion: Study findings indicate that stunting or undernutrition is multifactorial and multi sectoral issue. Basic level causes are the major contributor as a barrier in stunting reduction. For malnutrition intervention; using standalone nutrition specific approach wasn't helpful. Nutrition sensitive modalities (WASH, Social protection schemes) and secondary education of women need to be taken into consideration.

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