One Million Under-Five Deaths Globally in 2023 Linked to Child Growth Failure; India Second Highest Contributor

A new study has revealed that approximately one million children worldwide died before their fifth birthday in 2023 due to factors related to ‘Child Growth Failure’ (CGF), such as being underweight, stunted, or wasted. The findings, published in The Lancet Child and Adolescent Health journal, highlight a concentrated health crisis in South Asia and sub-Saharan Africa.

India was identified as the second-highest contributor globally, reporting over 100,000 of these under-five deaths linked to CGF.

Global Impact and Key Contributors

The analysis, which used data from the Global Burden of Disease Study 2023, ranked the countries with the highest associated mortality:

• Nigeria: Highest number of CGF-linked under-five deaths at 188,000.
• India: Second highest with over 100,000 deaths.
• Democratic Republic of Congo (DRC): Ranked third with more than 50,000 deaths.

Globally, the total number of under-five deaths attributed to growth factors has significantly declined from $2.75$ million in 2000 to $0.8$ million in 2023. However, sub-Saharan Africa and South Asia still account for the majority of the burden, with over $600,000$ and $165,000$ deaths, respectively.

The Role of Growth Failure

Child Growth Failure significantly increases the risk of mortality and disability from common childhood illnesses, including:

• Lower respiratory infections
• Diarrhoeal diseases
• Malaria
• Measles

The study found that being underweight accounted for the largest share of these deaths at 12 per cent, followed by wasting at nine per cent and stunting at eight per cent.

In South Asia, a staggering 79 per cent of diarrhoeal disease deaths and 53 per cent of lower respiratory infection deaths among under-fives were linked to CGF.

Complex Drivers and Intervention Focus

Co-author Bobby Reiner from the University of Washington’s Institute for Health Metrics and Evaluation emphasized the complexity of the issue: “The drivers behind child growth failure are complex and cumulative due to feeding issues, food insecurity, climate change, lack of sanitation, or war.” He noted that no single strategy would suffice to improve health across all affected regions.

Researchers stress that most stunted infants show signs of growth failure within the first three months of life, underscoring the vital importance of interventions applied before and during pregnancy. The destructive cycle of stunting and wasting, which worsens as children age, must be addressed in early childhood.

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