A Systematic Review of Maternal and Child Health Policies in Addressing Stunting: Trends and Challenges
Abstract
Introduction: Stunting, recognized as a prominent global health issue, particularly in low-income countries, arises from persistent undernutrition and frequent infections, adversely impacting children's physical development, cognitive abilities, and future economic productivity. Notwithstanding the implementation of various maternal and child health strategies designed to mitigate stunting, its incidence remains alarmingly high, exhibiting differential efficacy across diverse contexts due to obstacles in policy execution, accessibility issues, and socio-cultural influences.
Methods: This study utilized a research methodology that included a bibliometric analysis of publications retrieved from the Scopus Database relating to maternal and child health policies in reducing stunting prevalence using the keywords “maternal and child health policies” and “stunting”. The findings were directly related to the research topic, revealing a total of 154 articles published from 2004 to 2023. The criteria set emphasized articles written in English, with the data obtained exported in CSV format. VOS viewer version 1.6.17 was used for bibliometric analysis in this study.
Results: The results showed a significant increase in publications addressing the relationship between health policies and stunting prevalence. Academic discussions on policy and stunting have also increased, especially in the fields of medicine and nursing, which reveal the health impacts on stunted children. Data analysis from various studies emphasized the importance of evidence-based strategies that combine medical interventions with structural, social and economic transformation.
Conclusion: In conclusion, this review emphasizes the importance of collaboration between various sectors, including health, education, and agriculture, in addressing stunting. Policymakers should consider establishing dedicated funding streams through public-private partnerships to ensure the sustainability of stunting prevention programs. Implementing regulatory frameworks that mandate intersectoral collaboration between health, education, and agriculture sectors can enhance policy coherence and resource optimization. Furthermore, adopting performance-based incentives for local health agencies may encourage more effective policy implementation and service delivery.
References
Vaivada T, Akseer N, Akseer S, Somaskandan A, Stefopulos M, Bhutta ZA. Stunting in childhood: An overview of global burden, trends, determinants, and drivers of decline. Am J Clin Nutr. 2020;112:777S-791S.
Taib WRW, Ismail I. Evidence of stunting genes in Asian countries: A review. Meta Gene [Internet]. 2021;30(June):100970. Available from: https://doi.org/10.1016/j.mgene.2021.100970
Suarayasa K, Wandira BA. The Relationship Between Children ’ s Health Status and Stunting in Toddlers at Mamboro Health Center , Palu. 2024;2013(1):132–8.
Ssentongo P, Ssentongo AE, Ba DM, Ericson JE, Na M, Gao X, et al. Global, regional and national epidemiology and prevalence of child stunting, wasting and underweight in low- and middle-income countries, 2006-2018. Vol. 11, Scientific reports. 2021. p. 5204.
Malta DC, Romero-Sandoval N, Cardoso LSDM, Arcos P, Gualán M, Pescarini JM, et al. Sustainable Development Goals’ health-related indicators for Brazil and Ecuador: an analysis for the period of 1990–2019. Public Health [Internet]. 2024;231:88–98.
Huicho L, Huayanay-Espinoza CA, Herrera-Perez E, Segura ER, Niño de Guzman J, Rivera-Ch M, et al. Factors behind the success story of under-five stunting in Peru: A district ecological multilevel analysis. BMC Pediatr [Internet]. 2017;17(1).
Hume-Nixon M, Kuper H. The association between malnutrition and childhood disability in low- and middle- income countries: systematic review and meta-analysis of observational studies. Trop Med Int Heal [Internet]. 2018;23(11):1158–75.
Dong B, Zou Z, Song Y, Hu P, Luo D, Wen B, et al. Adolescent Health and Healthy China 2030: A Review. J Adolesc Heal [Internet]. 2020;67(5):S24–31.
Brown A, Trimble M, Sokal-Gutierrez K, Fernald L, Madsen K, Turton B. Sugar-Sweetened Beverages, Foods of Low Nutritional Value, and Child Undernutrition in Cambodia. Int J Environ Res Public Health [Internet]. 2024;21(2).
Chakraborty R, Armijos RX, Beidelman ET, Rosenberg M, Margaret Weigel M. Household food and water insecurity and its association with diarrhoea, respiratory illness, and stunting in Ecuadorian children under 5 years. Matern Child Nutr [Internet]. 2024;
Ali M, Amin MR, Jarl J, Chisholm N, Saha S. Maternal health status and household food security on determining childhood anemia in Bangladesh -a nationwide cross-sectional study. BMC Public Health [Internet]. 2021;21(1).
Santas G, Eryurt MA. Distribution of child health indicators according to internal migration and various social variables in Turkey. Rural Remote Health [Internet]. 2020;20(1):1–9.
Wandera M, Åstrøm AN, Okullo I, Tumwine JK. Determinants of periodontal health in pregnant women and association with infants’ anthropometric status: a prospective cohort study from Eastern Uganda. BMC Pregnancy Childbirth [Internet]. 2012;12.
Palupi RA, Sulistiadi W, Asyary A. Public Health Policy Practice for Early-Age Marriage in Gunung Kidul, Indonesia: An Evaluation of Regent Regulation Practice on Child Health. In: null H, B. W, E. M, editors. E3S Web of Conferences [Internet]. Department of Health Administration and Policy, Faculty of Public Health, University of Indonesia, Depok, Indonesia: EDP Sciences; 2019.
Grundy J, Annear P, Chomat AM, Ahmed S, Biggs B-A. Improving average health and persisting health inequities - Towards a justice and fairness platform for health policy making in Asia. Health Policy Plan [Internet]. 2014;29(7):873–82.
Misselhorn A, Hendriks SL. A systematic review of sub-national food insecurity research in South Africa: Missed opportunities for policy insights. PLoS One [Internet]. 2017;12(8).
Smith SL, Shiffman J, Kazembe A. Generating political priority for newborn survival in three low-income countries. Glob Public Health [Internet]. 2014;9(5):538–54.
Hong SA, Winichagoon P, Khang Y-H. Rural–urban differences in socioeconomic inequality trends for double burden of malnutrition in Thailand 2005–2016. Eur J Clin Nutr [Internet]. 2020;74(3):500–8.
Cardenas E, Osorio AM, Barandica OJ, Pico Fonseca SM. Mind the Gap! Socioeconomic Determinants of the Stunting Urban-Rural Gap for Children in Colombia. Child Indic Res [Internet]. 2022;15(2):415–32.
Karlsson O, De Neve J-W, Subramanian S V. Weakening association of parental education: Analysis of child health outcomes in 43 low- and middle-income countries. Int J Epidemiol [Internet]. 2019;48(1):83–97.
Herawati DMD, Sunjaya DK. Implementation Outcomes of National Convergence Action Policy to Accelerate Stunting Prevention and Reduction at the Local Level in Indonesia: A Qualitative Study. Int J Environ Res Public Health [Internet]. 2022;19(20).
Arokiasamy P, Pradhan J. Measuring wealth-based health inequality among Indian children: The importance of equity vs efficiency. Health Policy Plan [Internet]. 2011;26(5):429–40. 63494d60948b
Heidkamp RA, Piwoz E, Gillespie S, Keats EC, D’Alimonte MR, Menon P, et al. Mobilising evidence, data, and resources to achieve global maternal and child undernutrition targets and the Sustainable Development Goals: an agenda for action. Lancet [Internet]. 2021;397(10282):1400–18.
Mugomeri E. Identifying Imperatives for an Effective Nutrition Surveillance Policy Framework for Maternal and Child Health in Lesotho. Food Nutr Bull [Internet]. 2018;39(4):608–20.
Kim C, Mansoor GF, Paya PM, Ludin MH, Ahrar MJ, Mashal MO, et al. Multisector nutrition gains amidst evidence scarcity: scoping review of policies, data and interventions to reduce child stunting in Afghanistan. Vol. 18, Health research policy and systems. 2020. p. 65.
Yang B, Huang X, Liu Q, Tang S, Story M, Chen Y, et al. Child nutrition trends over the past two decades and challenges for achieving nutrition SDGs and national targets in China. Int J Environ Res Public Health [Internet]. 2020;17(4).
Yaya S, Uthman OA, Kunnuji M, Navaneetham K, ... Does economic growth reduce childhood stunting? A multicountry analysis of 89 demographic and health surveys in sub-Saharan Africa. BMJ Glob … [Internet]. 2020; Available from: https://gh.bmj.com/content/5/1/e002042.abstract
Kennedy E, Branca F, Webb P, Bhutta Z, Brown R. Setting the scene: An overview of issues related to policies and programs for moderate and severe acute malnutrition. Food Nutr Bull [Internet]. 2015;36:S9–14.
Muhamad Z, Nurdin SSI, Asnidar, Abbas MI, Katili DNO. Family Support for Short-Status Pregnant Women to Prevent Gestational Stunting: Phenomenological Studies. J Public Heal Pharm. 2024;4(2):182–8.
Banerjee S, Roy S, Pal M, Hossain MG, Bharati P. Nutritional and immunization status of under-five children of India and Bangladesh. BMC Nutr [Internet]. 2021;7(1).
Groce N, Challenger E, Berman-Bieler R, Farkas A, Yilmaz N, Schultink W, et al. Malnutrition and disability: Unexplored opportunities for collaboration. Paediatr Int Child Health [Internet]. 2014;34(4):308–14.
Dewey KG. Reducing child stunting: Moving forward on evaluating effectiveness of programs. J Nutr [Internet]. 2020;150(11):2843–5. Aa8c4b2b8
Ridlo IA. Frequency and specificity of health issues in local political campaigns. Int J Heal Gov [Internet]. 2023;28(4):368–82.
Narayan J, John D, Ramadas N. Malnutrition in India: status and government initiatives. J Public Health Policy [Internet]. 2019;40(1):126–41.
Assis AMO, Barreto ML, Santos NS, De Oliveira LPM, Dos Santos SMC, Pinheiro SMC. Inequality, poverty, and childhood health and nutritional conditions in Northeast Brazil. Cad Saude Publica [Internet]. 2007;23(10):2337–50.
Grajeda R, Hassell T, Ashby-Mitchell K, Uauy R, Nilson E. Regional Overview on the Double Burden of Malnutrition and Examples of Program and Policy Responses: Latin America and the Caribbean. Ann Nutr Metab [Internet]. 2019;75(2):139–43.
Kurata M, Takahashi K, Hibiki A. Gender differences in associations of household and ambient air pollution with child health: Evidence from household and satellite-based data in Bangladesh. World Dev [Internet]. 2020;128.
Copyright (c) 2025 Journal of Public Health and Pharmacy
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
Authors who publish with Journal of Public Health and Pharmacy retain the copyright of their work. The journal applies a Creative Commons Attribution-ShareAlike 4.0 International License (CC BY-SA 4.0), which grants the following rights:
-
Copyright Retention: Authors retain the copyright of their work, maintaining full control over their intellectual property without restrictions.
-
Right of First Publication: Authors grant the journal the right of first publication of their work. This ensures that the work is initially published and credited in Journal of Public Health and Pharmacy.
-
License to Share and Reuse: The work is licensed under CC BY-SA 4.0, allowing others to copy, distribute, remix, and build upon the work for any purpose, even commercially, as long as proper credit is given to the authors, and any new creations are licensed under the same terms.
