The problem of stunting – poor growth and development - which affects almost half of infants in Papua New Guinea, and the efforts of Burnet Institute researchers to discover how and why it’s happening, is the subject of an insightful two-part investigation newly published in Cosmos Magazine.
Written by Cosmos editor-at-large Dr Elizabeth Finkel, ‘The quest to find what’s happening to Papua New Guinea’s Children’ examines stunting from a wide range of key perspectives, and Burnet Institute’s flagship research program – Healthy Mothers, Healthy Babies – that has been put in place to address it.
Dr Finkel’s work acknowledges the dedication of field workers on the ground, the scientists for whom the puzzle of stunting is ‘harder than rocket science’, the administrators who understand the importance of collaboration, and the hopes of mothers and children in affected communities for fulfilling, healthy lives.
No one seems to believe that an intensive feeding program – a rollout of enriched protein biscuits, as I suggest – is the answer, Dr Finkel writes.
(Chris) Morgan points out that past interventions of this type have delivered little benefit. (Brendan) Crabb is dubious that nutrition, as far as calorie intake, is the major problem here. Measurements of mid-upper arm circumference show that most women are receiving sufficient food, though that still leaves open the possibility that micronutrients are missing, says (James) Beeson.
Surprisingly, all believe that the medical causes of stunting are poorly understood. Beeson points me to a recent paper that identified 18 risk factors in 137 developing countries.
The top five are: foetal growth restriction, unimproved sanitation, child nutrition, infections and indoor pollution resulting from the use of low-quality cooking fuels such as firewood or crop residue.
But the paper acknowledges that the relative impact of such factors differs from country to country. “It is also the interaction between factors, for instance, between food and infection, that is likely to be crucial, but is not well studied,” says Morgan.
Image: Dr Michelle Scoullar (left) and Dr Elizabeth Finkel meet a family in a village near Kokopo, East New Britain.
The second part of Finkel’s investigation examines the definition of stunting and the uneven advances being achieved globally by nations and administrations searching for answers.
Stunting as a marker of population health and development still throws up conundrums, Dr Finkel observes.
For instance, one place you would expect stunting rates to be low is Kerala, one of the most developed states of India with 92 percent female literacy and rates of infant mortality on par with that of the US. Yet the rate of childhood stunting is 19 percent, similar to that of Senegal, a West African nation with 47 percent female literacy and over four times the infant and maternal mortality rate.
As a recent online Indian article noted, “surely an impossibility”.
Elizabeth Finkel’s investigation is a provocative, informative and stimulating insight into an issue that is a major focus of Burnet’s research and central to the Institute’s mission to achieve better health for vulnerable communities.
To read the full articles: