Public Health Nutrition

Monitoring and Surveillance

Prevalence and trends of stunting among pre-school children, 1990–2020

Mercedes de Onisa1 c1, Monika Blössnera1 and Elaine Borghia1

a1 Growth Assessment and Surveillance Unit, Department of Nutrition for Health and Development, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland


Objective To quantify the prevalence and trends of stunting among children using the WHO growth standards.

Design Five hundred and seventy-six nationally representative surveys, including anthropometric data, were analysed. Stunting was defined as the proportion of children below −2sd from the WHO length- or height-for-age standards median. Linear mixed-effects modelling was used to estimate rates and numbers of affected children from 1990 to 2010, and projections to 2020.

Setting One hundred and forty-eight developed and developing countries.

Subjects Boys and girls from birth to 60 months.

Results In 2010, it is estimated that 171 million children (167 million in developing countries) were stunted. Globally, childhood stunting decreased from 39·7 (95 % CI 38·1, 41·4) % in 1990 to 26·7 (95 % CI 24·8, 28·7) % in 2010. This trend is expected to reach 21·8 (95 % CI 19·8, 23·8) %, or 142 million, in 2020. While in Africa stunting has stagnated since 1990 at about 40 % and little improvement is anticipated, Asia showed a dramatic decrease from 49 % in 1990 to 28 % in 2010, nearly halving the number of stunted children from 190 million to 100 million. It is anticipated that this trend will continue and that in 2020 Asia and Africa will have similar numbers of stunted children (68 million and 64 million, respectively). Rates are much lower (14 % or 7 million in 2010) in Latin America.

Conclusions Despite an overall decrease in developing countries, stunting remains a major public health problem in many of them. The data summarize progress achieved in the last two decades and help identify regions needing effective interventions.

(Received December 02 2010)

(Accepted April 28 2011)

(Online publication July 14 2011)


c1 Corresponding author: Email