A new study reports that nearly one million children under the age of five died in 2023 due to factors linked to child growth failure, including being underweight, stunted or wasted. India accounted for over 100,000 of these deaths, while Nigeria recorded the highest number at 188,000. The Democratic Republic of Congo followed with more than 50,000 deaths. The findings, published in The Lancet Child and Adolescent Health, highlight the persistent global challenge of improving child nutrition and health.
Child Growth Failure Drives Major Childhood Diseases
Child growth failure (CGF) significantly increases the risk of death and disability from several childhood illnesses, including lower respiratory infections, diarrhoeal diseases, malaria and measles. According to the analysis, the Global Burden of Disease (GBD) Study 2023 data showed that CGF contributed to 880,000 deaths and 79.4 million disability-adjusted life years (DALYs) lost among children under five in 2023.
Being underweight accounted for 12% of all under-five deaths, the highest proportion, followed by wasting at 9% and stunting at 8%—all forms of malnutrition that severely weaken immunity and hinder development.
Deaths Decline Globally but Hotspots Persist
Globally, deaths related to child growth failure declined from 2.75 million in 2000 to 0.8 million in 2023. However, sub-Saharan Africa and South Asia continue to experience disproportionately high mortality. Sub-Saharan Africa recorded more than 600,000 deaths among children under five, while South Asia accounted for 165,000 deaths.
In South Asia, growth failure contributed to 79% of diarrhoeal disease deaths and 53% of lower respiratory infection deaths in young children. Interestingly, South Asia’s high-income subgroup, which reported the lowest number of CGF-related deaths, also showed the lowest mortality share from these infections—around 33% and 35%, respectively.
Complex and Overlapping Drivers of Growth Failure
As reported by NDTV, the study highlights that the factors behind child growth failure are deeply interconnected. Co-author Bobby Reiner from the University of Washington’s Institute for Health Metrics and Evaluation explains that feeding issues, food insecurity, climate change, poor sanitation and conflict all contribute to the crisis. Therefore, he stresses that no single intervention can address growth failure uniformly across all regions.
Early Life Vulnerabilities Demand Early Interventions
Most stunted infants begin to show signs of growth failure within the first three months of life. This finding underscores the need for interventions before and during pregnancy to support maternal health, nutrition and prenatal care.
Growth failure in the earliest months may reflect babies born too small or too early. As children grow older, inadequate nutrition, repeated infections and other environmental factors become the primary contributors. Moreover, wasting and stunting often reinforce each other, creating a harmful cycle of poor growth and increased vulnerability to illness.
The Road Ahead
The study indicates that preventing child growth failure requires a multi-layered strategy—one that strengthens food security, improves sanitation, reduces conflict-related disruptions and ensures maternal and neonatal care. Without targeted and sustained action, millions of children will continue to face preventable illness, disability and death.