About one million children under the age of five died worldwide in 2023 due to conditions linked to impaired growth — including being underweight, stunted or wasted — with India accounting for more than 100,000 of these deaths, a new study has found.
According to findings published in The Lancet Child and Adolescent Health, Nigeria registered the highest number of under-five deaths associated with 'child growth failure' at 188,000. India followed, while the Democratic Republic of Congo ranked third with over 50,000 such deaths.
Researchers noted that 'child growth failure' heightens the risk of death and disability from several illnesses such as lower respiratory infections, diarrhoeal diseases, malaria and measles. Their assessment draws on data from the Global Burden of Disease Study 2023, the latest comprehensive evaluation of health loss attributable to diseases, injuries and risk factors across 204 countries and territories.
The analysis shows a sharp reduction in global deaths linked to child growth issues — from 2.75 million in 2000 to 0.8 million in 2023. Despite the progress, sub-Saharan Africa and South Asia continue to experience severe impacts, with more than 600,000 and 165,000 under-five deaths respectively.
"The drivers behind child growth failure are complex and cumulative due to feeding issues, food insecurity, climate change, lack of sanitation, or war," said co-author Bobby Reiner, professor at the University of Washington's Institute for Health Metrics and Evaluation in the US, which leads the Global Burden of Disease study. "Therefore, no single strategy will improve their health across all regions," he added.
The authors reported that "in children younger than five years in 2023, CGF (child growth failure) was associated with 79.4 million DALYs lost (disability-adjusted life years lost) and 880,000 deaths." Being underweight contributed to 12 per cent of deaths in this age group — the highest share — followed by wasting at nine per cent and stunting at eight per cent.
In South Asia, 79 per cent of diarrhoeal disease deaths and 53 per cent of lower respiratory infection deaths among under-fives were tied to child growth failure. The region’s high-income subgroup, which recorded the fewest deaths from growth-related issues, also had the lowest proportions of deaths due to these causes at about 33 per cent and 35 per cent, respectively.
The researchers highlighted that most stunted infants exhibit signs of growth failure within their first three months, underscoring the critical need for interventions before and during pregnancy.
They warned that wasting and stunting can fuel a destructive cycle, as each condition increases the likelihood of the other, with the effects compounding as children grow older. Growth failure detected in the earliest months often reflects babies born too small or too early, while in later infancy and early childhood it may signal inadequate nutrition, recurrent infections or other underlying factors, the team said.