Childhood stunting – a condition where children fail to grow properly for their age – remains a serious health concern in Tanzania, affecting their growth, development, and long-term well-being. Despite ongoing efforts to improve child nutrition, stunting rates continue to be high with recent findings suggesting that while feeding practices play a crucial role, they alone do not fully address the underlying causes, which are complex and multifaceted.

The study, conducted by Ifakara Health Institute and published in the Bulletin of the National Research Centre, underlines the need to address the complex factors that hinder optimal feeding practices to effectively reduce childhood stunting. The research investigates the relationship between feeding practices, stunting, and barriers affecting children aged 6–23 months.

Key findings on stunting risk
The study analyzed data from 1,806 children aged 6–23 months, gathered through the Next Generation Nutrition Program conducted in Tanzania from 2015 to 2019 in five regions of Tanzania mainland, namely Simiyu, Ruvuma, Tabora, Lindi and Coast region. 

Results revealed that 28.8% of children in this age group were stunted, with the majority (65%) being over one year old. Low dietary diversity was widespread, with 88.3% of stunted children and 86.3% of non-stunted children consuming fewer than five food groups. 

Additionally, adherence to WHO-recommended feeding practices – such as early breastfeeding initiation time of stopping breastfeeding, and minimum dietary diversification – were not significantly associated with child stunting. These findings highlight that while feeding practices are essential, they are not sufficient on their own to prevent stunting and that broader factors play must be considered.

Barriers to proper feeding practices
The study identified several barriers hindering proper feeding practices. Despite widespread awareness of breastfeeding’s importance, many mothers reported a lack of knowledge of feeding practices, health challenges, economic hardships, and cultural issues as significant obstacles. Additionally, seasonal variations affected food access, complicating access to nutritious foods, and making consistent dietary diversity challenging for many families.

Addressing these barriers, the scientists called for “a holistic approach to nutrition intervention services.” They emphasized that this approach would “involve educating mothers on nutrition and health, empowering them to make informed choices for better feeding practices, and implementing an economic empowerment and gender-transformative approach to reduce women’s workloads.”

Additional influences on stunting
Beyond feeding practices, the study found that other maternal and child factors strongly influenced stunting outcomes. For example, a mother’s age and height (particularly heights above 150 cm) were linked to a lower risk of stunting in children. Child-specific factors such as sex, age, and birth weight, along with maternal marital status and place of delivery, also played roles in stunting risk. These findings underscore the need for broader interventions to stunting prevention, beyond just feeding practices.

Recommendations for long-term outcomes
While improving feeding practices is essential, the study emphasizes the importance of addressing broader influences to reduce stunting effectively. 

The study’s authors recommend a multi-layered approach that includes educational programs to dispel harmful cultural beliefs, economic support for low-income families, enabling better access to nutritious food options, and health services tailored to meet the diverse needs of families.

The scientists concluded, “The prevalence of stunting is a pressing issue both in Tanzania and worldwide. To address this issue, it is crucial to emphasize the importance of following the breastfeeding recommendations for various reasons, including optimizing child nutrition and development, enhancing immunity against diseases, fostering mother–child bonding and promoting long-term health outcomes.”

Ifakara scientists lead the study
This study was led by Faith Mandara, a research scientist at Ifakara Health Institute with affiliation to the Nelson Mandela African Institute of Science and Technology (NM-AIST). Additional contributors include Charles Festo, Samwel Lwambura, Jackline Mrema, Farida Katunzi and Ester Elisaria also from Ifakara and Erick Killel from Tanzania Food and Nutrition Center.

Read the publication here.