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Nature. 2018 Feb 28;555(7694):41-47. doi: 10.1038/nature25760.

Mapping child growth failure in Africa between 2000 and 2015.

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Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington 98121, USA.
Department of Infectious Disease Epidemiology, Imperial College London, London SW7 2AZ, UK.
Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford OX3 7FZ, UK.
Commonwealth Scientific and Industrial Research Organisation, St Lucia, Queensland 4067, Australia.
Bill & Melinda Gates Foundation, Seattle, Washington 98109, USA.
Kenya Medical Research Institute-Wellcome Trust Collaborative Programme, Nairobi, Kenya.
Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford OX3 7FZ, USA.
Department of Anesthesiology and Pain Medicine, Seattle Children's Hospital, Seattle, Washington 98105, USA.


Insufficient growth during childhood is associated with poor health outcomes and an increased risk of death. Between 2000 and 2015, nearly all African countries demonstrated improvements for children under 5 years old for stunting, wasting, and underweight, the core components of child growth failure. Here we show that striking subnational heterogeneity in levels and trends of child growth remains. If current rates of progress are sustained, many areas of Africa will meet the World Health Organization Global Targets 2025 to improve maternal, infant and young child nutrition, but high levels of growth failure will persist across the Sahel. At these rates, much, if not all of the continent will fail to meet the Sustainable Development Goal target-to end malnutrition by 2030. Geospatial estimates of child growth failure provide a baseline for measuring progress as well as a precision public health platform to target interventions to those populations with the greatest need, in order to reduce health disparities and accelerate progress.

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