Magnitude and Determinants of Stunting Among Children in Africa: A Systematic Review

Abstract

Globally it is estimated that 162 million under-five year old children are stunted. Africa is known with one of the highest prevalence of stunting in the world. Even though studies suggested various determinants for stunting in Africa; there is lack of agreement about the relative importance of factors affecting the nutritional status of children. We reviewed all literatures, including: observational studies, and prospective randomized controlled trials (RCTs) evaluating the prevalence and determinants of stunting in children under the age of five years in Africa to identify systematically, appraise and synthesize the best available evidence on the magnitude and epidemiological factors for stunting among children under the age of five years in Africa by conducting electronic search of Medline, Pub Med, Health Inter-network access to Research Initiative (HINARI), and Google Scholar databases. After exclusion of irrelevant ones, 21 out of 55 articles were considered for the final analysis. On the basis of this review, majority of the articles reported highest prevalence of stunting in Africa and its progress is found unsatisfactory. Inappropriate complementary feeding practice, maternal under nutrition, household food insecurity, economic growth and maternal education, are identified as the principal determinants of stunting. Some studies confer the determinants of stunting is multidimensional and intertwined. The remaining articles reviewed, noted the synergistic interaction between inadequate dietary intake and disease as the main determinant of stunting. The magnitude of stunting in Africa is found as one of the highest in the world and the trend shows stagnating rather than progress. It is confirmed that the determinants of stunting in the continent are varied and intertwined; showing variations from region to region. It is recommended that; African countries should give more emphasis to fight stunting; further research on target implementation sites is needed before creating health policies. They should also consider the cultural beliefs and socio cultural realities of their population. We therefore encourage policy makers to use facts from this review on creating policies to reverse the situation.