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NEW DELHI – A sobering new study published in The Lancet Child & Adolescent Health reveals that nearly one million children under the age of five died globally in 2023 due to complications stemming from Child Growth Failure (CGF). Most significantly, the research finds that two nations—India and Nigeria—shoulder approximately one-third of this global burden, highlighting a persistent public health crisis despite decades of economic and medical advancements.
Drawing from the comprehensive Global Burden of Disease (GBD) Study 2023, researchers found that while global child mortality has plummeted since 1990, the pace of progress is slowing. In 2023 alone, CGF—a cluster of conditions including stunting, wasting, and being underweight—was linked to 880,000 deaths and nearly 80 million years of healthy life lost due to disability.
The Triple Threat: Stunting, Wasting, and Underweight
Child Growth Failure is not a single disease, but a manifestation of chronic and acute malnutrition that leaves the youngest populations defenseless against common, treatable illnesses.
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Stunting: Chronic undernutrition resulting in low height-for-age.
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Wasting: Acute malnutrition causing dangerously low weight-for-height.
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Underweight: A combined measure of both chronic and acute growth deficits.
According to the study, being underweight contributed to 12% of all under-five deaths globally, while wasting accounted for 9% and stunting for 8%. These conditions act as “risk multipliers.” A child suffering from growth failure is significantly more likely to die from common infections like pneumonia, diarrhea, malaria, and measles because their immune system lacks the nutritional reserves to fight back.
In South Asia, the study noted a staggering correlation: 79% of diarrheal deaths and 53% of respiratory infection deaths among children under five were tied directly to CGF. In sub-Saharan Africa, those figures were 77% and 65%, respectively.
A Tale of Two Regions: India and Nigeria
The geographical concentration of these deaths is one of the study’s most urgent findings. Nigeria recorded the highest toll with 188,000 deaths, followed by India with over 100,000, and the Democratic Republic of Congo with more than 50,000.
“The drivers behind child growth failure are complex and cumulative,” says Bobby Reiner, a professor at the Institute for Health Metrics and Evaluation (IHME) and a co-author of the study. “They range from immediate feeding issues and food insecurity to broader systemic challenges like climate change, lack of sanitation, or the displacement caused by war.”
For India, the numbers present a paradox. The country has achieved a remarkable 78% reduction in its under-five mortality rate since 1990—falling from 127 deaths per 1,000 live births to 27 in 2024. This actually outpaces the global average reduction of 61%. However, because of India’s massive birth volume, the absolute number of children lost remains among the highest in the world.
Expert Perspectives: Beyond the Statistics
Medical experts emphasize that CGF is now the third leading contributor to under-five mortality and morbidity worldwide.
“We are seeing a shift where it isn’t just about the absence of food, but the absence of quality care and environment,” says Dr. Robert Black, a pediatric epidemiologist who has provided independent analysis on GBD data. He argues that the world needs “integrated nutrition and health programs” rather than isolated interventions.
In India, health professionals point to a “last mile” problem. Dr. Vineeta Bal, an immunologist, notes that while national averages look promising, they mask deep-seated inequities. “Regional disparities persist, with rural and marginalized communities hit hardest,” she warns. While India has successfully reduced its “zero-dose” children (those who have received no vaccinations) to just 0.06% in 2024, those remaining children are often the ones most at risk for growth failure.
Public Health Implications: What Can Be Done?
The findings serve as a roadmap for policymakers and a call to action for families. Nearly half of all under-five deaths (approximately 2.3 million globally) occur during the neonatal period—the first 28 days of life.
For parents and caregivers, the practical implications are clear and evidence-based:
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Exclusive Breastfeeding: Providing only breast milk for the first six months of life offers critical antibodies and nutrition.
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Timely Vaccinations: Protecting children from measles and pneumonia prevents the infections that lead to rapid wasting.
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Hygiene and Sanitation: Handwashing and clean water are essential to prevent the diarrheal diseases that strip nutrients from a child’s body.
On a systemic level, programs like India’s POSHAN Abhiyaan (Prime Minister’s Overarching Scheme for Holistic Nutrition) and Mission Indradhanush (an immunization surge) have shown that government-led interventions can move the needle. However, UNICEF warns that without a surge in global funding, preventable child deaths could rise by 30 million by 2030.
Limitations of the Research
While The Lancet study provides the most robust estimates available, researchers acknowledge certain limitations. The GBD modeling relies on statistical extrapolations in regions where data may be sparse or delayed.
Furthermore, some critics argue that focusing on absolute death counts can be misleading. While India has 100,000 CGF-linked deaths, its mortality rate is now below the global average. Additionally, the study finds it difficult to perfectly isolate CGF from other overlapping risks like extreme poverty or lack of maternal education, which often occur simultaneously.
Looking Ahead
The message from the global health community is one of “cautious urgency.” The world has proven it can reduce child mortality, but the concentration of deaths in India and Nigeria suggests that the current “one-size-fits-all” approach may be reaching its limit.
As climate change and conflict threaten food security in sub-Saharan Africa and parts of Asia, the battle against child growth failure will require more than just calories; it will require a global commitment to the fundamental right of every child to grow to their full potential.
Medical Disclaimer: This article is for informational purposes only and should not be considered medical advice. Always consult with qualified healthcare professionals before making any health-related decisions or changes to your treatment plan. The information presented here is based on current research and expert opinions, which may evolve as new evidence emerges.
References
- https://telanganatoday.com/india-nigeria-account-for-one-third-of-global-under-five-deaths-in-2023
