2nd Edition of Public Health World Conference (PHWC) 2026

Abstract

Background Child growth failure (CGF), expressed as stunting, wasting, and underweight in children under five years, is associated with negative health consequences.

Methods Data on disease attributable to CGF were downloaded from the Global Burden of Disease Study (GBD) 2021. We used estimated annual percentage change (EAPC) to quantify the temporal trends of CGF-related mortality and disability-adjusted life-years (DALYs) and explore their relationship with Socio-demographic Index (SDI, a composite indicator of societal development status) across 204 countries and territories from 1990 to 2021.

Results In 2021, CGF risks were responsible for nearly eight hundred thousand (95% UI, 4 to 11) deaths and over 70 million (36 to 99) DALYs among children under five globally. CGF accounted for significant proportions of the burden among children under five, with underweight being the leading risk factor. Between 1990 and 2021, deaths and DALYs attributable to CGF decreased by 78%, with the greatest reductions observed in high-middle SDI regions. East Asia showed the sharpest decline, especially China. However, the burden remained highest in low-SDI regions, particularly in Western Sub-Saharan Africa. Despite significant progress, CGF remains a major contributor to global disease burden among children under five. Among the five CGF-related diseases, lower respiratory infections and diarrheal diseases were the leading causes, accounting for 72% of CGF-related mortality and DALYs. Boys in most regions bore a higher burden than girls.

Conclusions CGF is an economic, behavioral, and cultural problem. The study highlighted the need for targeted interventions in low-SDI and special cultural regions. Future policies should prioritize water, sanitation, and hygiene (WASH) and malaria control in low-SDI regions, strengthen gender-responsive nutrition and breastfeeding interventions globally, and enhance resource allocation through comprehensive growth monitoring.