This is a draft presentation, for a general and student audience, aiming to be easy to read on mobile or laptop. Constructive feedback via Messenger / Google form is very welcome, and so are early volunteers (call me! Whatsapp +447765477305)
The problem:
Stunting-at-birth affects whole family well being; baby's brain, gut, immune system; adult IQ, adult earnings. It is preventable. The term "stunting" is actually from forestry (impaired growth of trees) but in human babies it's much more than just the visible impact on height/length: it's a whole syndrome of direct and epigenetic consequences, set in motion near the start of pregnancy.
One very useful focus is from Tufts/USAID's Dr Richard Webb on "group 1 stunting" because this is very serious, affects lifetime IQ, gut, nutrient absorption, and appears to be irreversible, so it must be prevented.
Triple win:
Many of the interventions which end group 1 stunting-at-birth also reduce prematurity and maternal mortality.
Why neglected?
The people who see stunting and its near term consequences are parents, nurses, midwives, paediatricians, UN agencies and later teachers, but research now shows that the people who can prevent it, alongside parents, are working in adolescent health, nutrition, agriculture, ventilation, women's empowerment, education, media. The research and impact studies connecting the two is only now coming through.
It seemed hard to solve. Until recent research by Webb and LHSTM, and some great work by NGOs listed below, it wasn't clear why anti-stunting interventions weren't working through age five: we now know that nutrition before conception is vital, and that aflatoxin and smoke play a role. So, suddenly, stunting-at-birth is solvable!
In the last 2 decades, stunting has been neglected relative to wasting, which is a more visible problem, popular with donors and paediatricians.
Most senior doctors alive today were taught in the 1970s-90s that the placenta ensures the foetus has all it needs, even if mother is malnourished, but research since then has overturned this ... so the worst case is that adolescent girls and women are being neglected, because some powerful doctors/funders haven't updated, and governments and large NGOs are fixated on infant feeding, PlumpyNuts, etc. There are exceptions, including Dr Andrew Prentice, a remarkable team at the World Bank, and many brilliant women's and community CSOs.
Solutions summary:
# Eliminate aflatoxins, smoke, anaemia before pregnancy
Aflatoxin can be done fast: the mould glows with a <$9 UV light
# Eradicate parasites before pregnancy
Cheap, relatively easy; very important for countries with malaria etc; ante-natal care and maternity also important, reduce maternal mortality.
# Empowerment including conditional cash transfers
Community interventions which reach mothers before conception are vital, and have other benefits - many studies prove this.
# Enable good NUTRITION BEFORE CONCEPTION
Varied diet is crucial, but it can take 6 months to get a healthy level of iron; in clinics or UNHCR camps, IV infusion is possible.
# Education/media work (integrated with the above)
In the "Solutions Gallery" below, I've included (on the left) real world studies showing routes to impact, and (on the right) ways to make this fundable.
For those who like a video intro, Dr Andrew Prentice below explains why programmes on ante-natal care, breastfeeding and infant feeding alone are important but not sufficient: