Water, sanitation, and hygiene vulnerability in child stunting in developing countries: a systematic review with meta-analysis

Child undernutrition in Brazil: the wound that never healed

OBJECTIVE

To describe the scenario of child undernutrition in Brazil and its determinants.

DATA SOURCE

Narrative review of the literature with inclusion of data from population surveys, surveillance and monitoring systems, and active search in favelas and underserved communities carried out by CREN.

DATA SYNTHESIS

Household surveys carried out from 1974 to 2019 indicate that undernutrition (<5 years) decreased until 2006. Underweight (W/A ≤-2 Z) and stunting (H/A ≤-2 Z) showed a decrease of 17% to 3% and 37% to 7%, respectively. After 2006, there was an increase in underweight of 53% and 76% for wasting (BMI/A ≤-2 Z), with the prevalence of stunting being stagnant at around 7%. Active search data in favelas and underserved communities show that the prevalence of stunting is 11% in those <5 years. In 2021, 30% of the population lived in poverty, 73% of which were black or brown. Stunting in black and brown children <5 years old is, respectively, 9% and 12% higher when compared to white children. Poverty decreased between 2012 and 2015 (27 to 25%), but increased again (2016=26% to 2021=30%), in parallel with food insecurity, which decreased between 2004 and 2013 (12% to 6%), but reached its worst level in the historical series (2022:15%).

CONCLUSION

Despite advances, Brazil's social protection system was not able to reduce inequalities and the reversal of the trend towards decreasing child undernutrition could be observed from 2006 onwards.

Less stunted? The impact of Chinese health aid on child nutrition

Despite the increasing recognition of China's role as a global health donor, particularly in Africa, few studies have explored its effectiveness. We geographically matched project-level aid data from AidData with household survey data from Demographic and Health Surveys across eight African countries to examine the effect of Chinese health aid on the nutritional status of children in recipient countries. In addition to adopting a spatiotemporal identification strategy, we also included mother fixed-effects to examine variations among siblings who were exposed to Chinese health aid projects at different times. The empirical results consistently indicated that children living adjacent to Chinese health aid projects had a better nutritional status. The treatment effect of Chinese health aid projects is heterogeneous across household characteristics, types, and sectors of aid projects. Finally, vaccination may serve as a mechanism linking Chinese health aid and child nutrition in the treatment areas of recipient countries.