1 Introduction
The deadly interplay of child malnutrition, infections, and preventable deaths threatens the lives of millions of children across the globe. Despite modest progress over the past two decades, the fragile gains have been uneven, and the pace of change has stagnated, veering dangerously off track from the global goal of halving stunting by 2030. As per the latest estimates (UNICEF/World Bank/WHO Joint Malnutrtition Estimates (JME), 2023), 148 million children—more than one in five under the age of five—suffer from stunting, a condition where chronic undernutrition leaves them too short for their age. Furthermore, 45 million children (7% of under-fives) are wasting, perilously thin for their height, while another 37 million (6%) are overweight, marking a troubling rise in dual forms of malnutrition at opposite ends of the spectrum.1
Progress on wasting has flat-lined, even as the prevalence of childhood overweight continues to climb. The latest estimates (JME, op. cit) report that only 1 in 3 countries are on track to halve stunting by 2030 and half that number, 1 in 6 countries is on track to reduce overweight prevalence. Beneath this grim reality lies a web of entrenched socio-economic inequalities: poverty, systemic discrimination, and insufficient investment in fundamental services like health, education, and nutrition. These challenges are compounded by escalating conflicts, the relentless march of climate change, and the degradation of our environment.
Together, these forces spell not only a tragic loss of human potential and economic capital but also a grave violation of children’s rights. As the world grapples with children’s exposure to geopolitical turbulence, economic instability and conflict, and a rapidly warming planet, this growing crisis demands urgent and unified global action to safeguard the future of millions of children—and the societies they will one day shape.
This document visualizes the twelve most affected countries for each of the following indicators using the April 2024 release of the JME malnutrition data2: Stunting prevalence, Wasting prevalence, Overweight prevalence and the numbers affected for each of these indicators. It presents a static overview in the sense that the latest data (since 2000) are analyzed. A forthcoming paper will analyze the dynamics of progress and interaction with child mortality across the world using JME modeled estimates that provide a continuous time-series of data across many years.
Tip
The figures are all interactive and created in Python using Plotly. Hover over the bars for further details on year of estimate and data source. Use the Region menu to isolate regions - double click to select, single click to remove. Isolate any region of the graphs by highlighting with finger or mouse.
2 Stunting prevalence and numbers affected
Stunting is a critical indicator of chronic malnutrition, reflecting long-term deficiencies in essential nutrients that inhibit a child’s growth and development. It occurs when a child’s height-for-age is more than two standard deviations below the median of the World Health Organization (WHO) Child Growth Standards. In other words, the child is too short for their age. This condition not only signals inadequate nutrition but also highlights a range of deprivations, including poor maternal health, recurrent infections, insufficient breastfeeding, and limited access to clean water and sanitation. Stunted children often face impaired cognitive development, reduced educational attainment, and lower economic productivity later in life, perpetuating cycles of poverty and inequality. Addressing stunting requires comprehensive interventions targeting food security, health care, education, and social protection services to break this vicious cycle and ensure children can reach their full potential.
In 20233, the global average for stunting prevalence was estimated at approximately 22%. However, many countries far exceed this average, with the burden of stunting disproportionately concentrated in a select few. Burundi holds the highest stunting rate globally, with 56% of children under five being too short for their age. Among the twelve most affected countries, seven are in Sub-Saharan Africa (Burundi, Niger, Madagascar, Mozambique, Malawi, Benin, and Rwanda), highlighting a regional crisis. Other severely affected nations include Yemen from the Middle East and North Africa, Timor-Leste from East Asia and the Pacific, Guatemala from Latin America and the Caribbean, and Afghanistan and India from South Asia. This distribution underscores the geographical disparities in stunting prevalence, reflecting broader socio-economic and health inequities.
As of 2023, global estimates indicate that 148 million children under five are stunted, a condition with profound implications for their health, cognitive development, and future productivity. Alarmingly, India alone accounts for 30% of these cases. Together with Nigeria, these two countries represent over one-third of the global burden of stunting among children under five. Consequently, global progress in reducing stunting hinges critically on the success of interventions in India and Nigeria. Among the twelve most affected countries, three are in South Asia (India, Bangladesh, and Afghanistan), six are in Sub-Saharan Africa (Nigeria, United Republic of Tanzania, Niger, Mozambique, and Madagascar), two are in East Asia and the Pacific (Philippines and Vietnam), and one in the Middle East and North Africa (Yemen). These twelve countries collectively bear more than half of the global burden of stunted children under five. The high prevalence of stunting in these countries signals a pressing need for multi-sectoral interventions that address the root causes of chronic malnutrition, including food insecurity, inadequate healthcare, poor sanitation, and insufficient maternal and child nutrition. Reducing stunting is not only a health and nutrition imperative but also a critical factor in fostering human capital and driving socio-economic development. Without decisive action, the long-term impacts on individual potential and national growth will be profound, underscoring the urgency of sustained global and national efforts to combat this silent crisis.
3 Wasting prevalence and numbers affected
Under five child wasting, technically defined as a weight-for-height measurement that is more than two standard deviations below the median of the World Health Organization (WHO) Child Growth Standards, signifies acute malnutrition. It reflects a significant weight loss or a failure to gain weight, often due to insufficient nutrient intake or the body’s inability to utilize nutrients effectively. This condition can arise from a sudden shock such as food scarcity, disease outbreaks, or socio-economic upheaval, leading to an imbalance between dietary intake and the body’s nutritional needs. Children suffering from wasting appear emaciated with a lack of muscle mass and fat, which are crucial for healthy growth and development. Their weakened physical state leads to compromised immune function, making them highly susceptible to infections such as pneumonia and diarrhea. Without timely intervention, the consequences of wasting are dire: it can lead to stunted growth, severe developmental delays, and increased risk of mortality. In fact, wasting is one of the leading contributors to under-five mortality, underscoring its critical impact on child survival rates.
The latest global estimates for wasting prevalence in 2023 stand at 6.8%, only a modest improvement from 8.7% in 2000. However, this global average conceals the stark disparities seen across different regions. In India, the wasting prevalence is alarmingly high at 19.2%, nearly three times the global average, underscoring a critical public health challenge. Yemen follows with a wasting prevalence of 16.8%, reflecting the severe impact of prolonged conflict and economic instability.
Among the twelve countries with the highest wasting rates, two are in South Asia (India and Bangladesh), four are in the East Asia and Pacific region (Malaysia, Lao People’s Democratic Republic, Cambodia, and Timor-Leste), one is in the Middle East and North Africa region (Yemen), and five are in Sub-Saharan Africa (Mauritania, Niger, Mali, Burkina Faso, and Senegal). These countries highlight a concerning concentration of acute malnutrition, necessitating urgent and targeted interventions.
Recent global estimates (2023) indicate that approximately 45 million children under the age of five are wasted, with India alone bearing a staggering share of this burden—over 22 million children, nearly half of the global total, are affected. The issue is not confined to South Asia, however. Among the twelve countries with the highest wasting prevalence, eight are in Sub-Saharan Africa (Nigeria, Niger, Mali, Burkina Faso, Côte d’Ivoire, United Republic of Tanzania, Kenya, and Madagascar), one in the Middle East and North Africa region (Yemen), and one in East Asia and the Pacific (Philippines).
The root causes of wasting are complex and intertwined, involving not only inadequate nutrition and healthcare but also exacerbating factors like ongoing conflict and climate change. In Yemen, for example, years of conflict have decimated healthcare infrastructure and worsened food insecurity, leaving millions of children vulnerable. Similarly, climate change-induced droughts and food shortages in Sub-Saharan Africa and East Asia and Pacific region have intensified the prevalence of wasting.
Wasting is not just a health crisis; it is a profound developmental challenge. Children suffering from wasting face heightened risks of disease, impaired cognitive and physical development, and, in severe cases, death. This acute malnutrition traps children in a vicious cycle of poor health and diminished potential, ultimately stunting economic growth and perpetuating poverty.
Addressing this crisis demands a multi-faceted approach. Emergency nutrition programs, such as therapeutic feeding, must be complemented by long-term strategies to improve food security, healthcare access, and maternal and child health practices. Socio-economic interventions are crucial to breaking the cycle of poverty that underpins malnutrition. Only through comprehensive and coordinated efforts can we hope to reduce wasting, save lives, and foster a generation of healthier, more resilient children.
4 Overweight prevalence and numbers affected
Overweight in children is defined by the World Health Organization (WHO) as having a weight-for-age greater than two standard deviations above the median of the WHO Child Growth Standards. This condition reflects an excess of body fat relative to age, and is typically associated with poor dietary habits, such as high intake of sugary, fatty foods, and insufficient physical activity. Overweight children are often exposed to factors such as sedentary lifestyles, urbanization, and easy access to unhealthy, calorie-dense foods, which lead to an imbalance between energy intake and expenditure. This condition stands at the opposite spectrum of wasting, where children are too thin for their height, as it indicates an overaccumulation of weight rather than insufficient growth of body weight. The consequences of childhood overweight are far-reaching. Overweight children face an increased risk of developing chronic non-communicable diseases (NCDs), such as type 2 diabetes, cardiovascular diseases, and hypertension, even in early childhood. In addition to physical health risks, overweight children often experience psychological impacts, including low self-esteem, anxiety, and social stigma, which can affect their emotional and social development. Long-term, overweight and obesity in childhood are strongly linked to the persistence of these conditions into adulthood, which can lead to a lifetime of health complications and elevated healthcare costs. Addressing childhood overweight requires a comprehensive approach, focusing on improving nutrition, increasing physical activity, and promoting awareness of the long-term consequences of unhealthy weight gain.
In 2023, the global prevalence of overweight among children under five was estimated at 5.6%, slightly higher than the 5% recorded in 1990. This underscores the alarming persistence of childhood overweight, with no significant improvement in recent decades. Achieving the global target of reducing overweight prevalence to 3% or below by 2030 will require concerted efforts to address this growing issue. Many countries exhibit a prevalence rate significantly higher than the global average, with the 12 countries with the highest overweight rates ranging from 7% (Kyrgyzstan and Mexico) to 18.2% (Turks and Caicos Islands).
Notably, this issue affects both wealthy and developing nations, highlighting the diverse drivers of childhood overweight and obesity. Of the twelve countries with the highest prevalence rates, four are from the Middle East (Saudi Arabia, Jordan, State of Palestine, and Kuwait), four from Latin America and the Caribbean (Turks and Caicos Islands, Peru, El Salvador, and Mexico), two from East Asia and the Pacific (Thailand and Fiji), and just one from Sub-Saharan Africa (Eswatini). Compared to the global challenges of stunting and wasting, South Asia is notably absent from this list, while the inclusion of affluent nations underscores the complex interplay of urbanization, changing diets, and sedentary lifestyles that contribute to rising childhood overweight rates.
Addressing overweight requires not only nutrition interventions but also broader public health strategies, including promoting healthy diets, physical activity, and awareness about the long-term consequences of childhood obesity, such as the increased risk of chronic diseases like diabetes, hypertension, and cardiovascular problems.
The global number of overweight children under five was estimated at 37 million in 2023, reflecting a serious public health issue with profound long-term consequences. While the prevalence rate offers insight into the extent of the problem within specific populations, the total number of affected children gives a clearer picture of the widespread nature of childhood overweight and obesity, as countries with larger populations may have higher absolute numbers despite having a lower prevalence.
India, once again, tops the list with an estimated 4.1 million overweight children, making it the only country to lead in the numbers for all three malnutrition indicators: stunting, wasting, and overweight. This indicates the country’s complex malnutrition burden, with high levels of both undernutrition and overnutrition in its population. Similarly, other countries in the South Asia region, such as Afghanistan and Bangladesh, are also facing high absolute numbers of overweight children, despite these countries having relatively lower prevalence rates compared to wealthier nations.
The list of the twelve most affected countries based on the total number of overweight children includes South Asia (India, Afghanistan, and Bangladesh), Latin America and the Caribbean (Mexico and Peru), East Asia and the Pacific (Philippines and Thailand), Sub-Saharan Africa (Nigeria, Kenya, and Uganda), and the Middle East and North Africa (Saudi Arabia). This diverse geographical spread points to the global nature of the overweight epidemic, which is not limited to high-income countries but is increasingly affecting low- and middle-income nations as well.
5 Summary of findings
Countries and regions with the highest vulnerability to malnutrition-related issues are predominantly found in Sub-Saharan Africa, South Asia, and parts of the Middle East, Latin America, and the Pacific. Sub-Saharan Africa is heavily affected by stunting and wasting, with countries like Burundi, Niger, Madagascar, Mozambique, and Malawi leading in stunting prevalence, while Mauritania, Niger, and Mali are severely impacted by wasting. In South Asia, India, Bangladesh, and Afghanistan exhibit high rates of both stunting and wasting, with India bearing the largest share of the global burden. In the Middle East, Yemen faces a high prevalence of both stunting and wasting due to ongoing conflict and instability. Conversely, overweight issues are more prevalent in Middle Eastern nations like Saudi Arabia and Jordan, as well as in Latin American countries like Mexico and Peru, and East Asian regions such as Thailand and Fiji. India stands out as a unique case, struggling with high levels of both undernutrition and overnutrition, which underscores the complex nature of its malnutrition burden.
| Indicators | World Bank Regions | |||||
|---|---|---|---|---|---|---|
| Sub-Saharan Africa |
East Asia & Pacific |
Europe & Central Asia |
Latin America & Caribbean |
Middle East & North Africa |
South Asia |
|
| Stunting Prevalence | Burundi, Niger, Madagascar, Mozambique, Malawi, Benin, Rwanda | Timor-Leste | Gautemala | Yemen | Afghanistan, India | |
| Stunting Numbers Affected | Nigeria, United Republic of Tanzania, Niger, Mozambique, Uganda, Madagascar | Philippines, Viet Nam | Yemen | India, Bangladesh, Afghanistan | ||
| Wasting Prevalence | Mauritania, Niger, Mali, Burkina Faso, Senegal | Malaysia, Lao People's Democratic Republic, Cambodia, Timor-Leste | Yemen | India, Bangladesh | ||
| Wasting Numbers Affected | Nigeria, Niger, Mali, Burkina Faso, Côte d'Ivoire , United Republic of Tanzania, Kenya, Madagascar | Philippines | Yeman | India, Bangladesh | ||
| Overweight Prevalence | Thailand, Fiji | Kyrgistan | Turks and Cacaos Islands, Peru, El Savador, Mexico | Saudi Arabia, Jordan, State of Palestine, Kuwait | ||
| Overweight Numbers Affected | Nigeria, United Republic of Tanzania, Kenya, Uganda | Philippines, Thailand | Saudi Arabia | Mexico, Peru | India, Afghanistan, Bangladesh | |
5.1 Common Challenges:
Nutritional Deficiencies and Imbalances: All three conditions—stunting, wasting, and overweight—stem from malnutrition, but they manifest differently. Stunting results from long-term deficiencies in essential nutrients, while wasting is linked to acute malnutrition from immediate nutrient imbalances, often triggered by crises. Overweight, on the other hand, results from excess calorie intake relative to expenditure.
Poverty and Inequality: In many regions, poverty exacerbates malnutrition, as households struggle to access sufficient nutritious food, clean water, sanitation, and adequate healthcare. The poorest children are often the most vulnerable to both undernutrition (stunting and wasting) and overnutrition (overweight).
Geographical Disparities: There are significant geographical disparities in the prevalence of these malnutrition forms. South Asia and Sub-Saharan Africa bear the largest burdens for stunting and wasting, while the Middle East, Latin America, and parts of East Asia are witnessing rising rates of overweight children.
Healthcare and Infrastructure Gaps: In regions affected by conflict (like Yemen) or underdeveloped healthcare systems (like parts of Sub-Saharan Africa), children are more likely to suffer from wasting due to inadequate access to nutrition and healthcare. Similarly, growing urbanization in many countries is associated with a rise in childhood overweight, reflecting changes in lifestyle and diet.
Impact of Climate Change: Droughts and food shortages exacerbated by climate change have increased the risk of wasting, particularly in Sub-Saharan Africa and parts of Asia.
5.2 Consequences:
Physical and Cognitive Development: Stunted and wasted children suffer from impaired growth and cognitive development. This leads to reduced educational attainment, which in turn limits future economic productivity, perpetuating cycles of poverty. Overweight children are at risk of developing chronic non-communicable diseases (NCDs) like diabetes, hypertension, and cardiovascular diseases, which can begin in early childhood and lead to long-term health complications.
Increased Mortality and Morbidity: Wasting, especially, is a major contributor to under-five mortality, as children with low weight-for-height are highly vulnerable to infections like pneumonia and diarrhea. Overweight children also face risks such as early onset of NCDs and psychological impacts, including low self-esteem and social stigma.
Economic Impact: Malnutrition reduces a child’s potential for economic productivity later in life. This affects national economies, as the long-term health consequences of stunting, wasting, and overweight contribute to increased healthcare costs, lost productivity, and social inequalities.
5.3 Policy Interventions:
Multi-Sectoral Approaches: Addressing stunting, wasting, and overweight requires a combination of food security, healthcare, education, and social protection policies. Interventions must focus on improving maternal and child nutrition, ensuring access to clean water and sanitation, and addressing poverty and inequality.
Emergency and Long-Term Nutrition Programs: In crisis-affected regions, emergency nutrition programs, such as therapeutic feeding for wasted children, are essential to save lives. At the same time, long-term strategies to improve food security and healthcare access must be implemented to reduce chronic malnutrition.
Public Health Strategies for Overweight: Reducing childhood overweight requires not only improving diet quality but also promoting physical activity. Governments must prioritize policies to reduce unhealthy food consumption, increase access to healthy foods, and create environments conducive to physical activity, particularly in urban areas.
Targeted Interventions in High-Burden Countries: Given that a disproportionate number of malnourished children live in countries like India, Nigeria, and Yemen, targeted interventions in these countries are critical. These should include strengthening healthcare systems, improving maternal health, and ensuring that children have access to adequate nutrition during the first 1,000 days of life.
Education and Awareness Campaigns: Raising awareness about the importance of good nutrition and physical activity at the community level can help prevent both undernutrition and overweight. Education programs should target caregivers, particularly in rural and disadvantaged urban areas, to encourage healthy feeding practices, early interventions, and lifestyle changes.
5.4 Conclusion:
Stunting, wasting, and overweight in children are interconnected malnutrition forms, each posing unique but overlapping challenges. They are deeply influenced by poverty, inadequate nutrition, poor healthcare, lack of access to sanitation and drinking water, and insufficient infrastructure, with devastating consequences for child health, cognitive development, and future productivity. Addressing these issues requires comprehensive, multi-sectoral strategies, with a particular focus on high-burden countries. By taking immediate action and implementing both emergency and long-term interventions, the global community can break the cycle of malnutrition and build a healthier, more resilient generation of children.
Footnotes
The 2023 Joint Child Malnutrition Estimates (JME) from UNICEF, the World Health Organization (WHO), and the World Bank↩︎
Available here for download: https://cdn.who.int/media/docs/default-source/child-growth/jme-by-country-april2024.xlsx%3Fsfvrsn%3D6ad632f4_3&ved=2ahUKEwiB8PHi9t2KAxXU4zgGHdDeOPAQFnoECBQQAQ&usg=AOvVaw3qVIcY273a9dWIU4Bsbtbh↩︎
Note that the estimates for 2023 refer to the latest available data in 2022.↩︎