Kuala Lumpur: With the prevalence of childhood stunting steadily rising over the last few years, it remains one of Malaysia's biggest hurdles to overcome.

Stunting refers to the inability for a child to reach the potential height for their age. One is considered stunted if their height is more than two standard deviations below the World Health Organisation’s (WHO) Child Growth Standards.

According to the 2019 National Health and Morbidity Survey, stunting among Malaysian children increased from 17% in 2015 to 21.8% in 2019. 

Dr See Kwee Ching, Head of Department of Paediatrics at Hospital Sg Buloh, explained that stunting involves a complex interaction of household, environmental, social, economic and cultural influences.

Some major underlying causes include post-pandemic food security – which affects the quality and quantity of food that a household consumes – and maternal anaemia.

“We have close to 25% of mothers of reproductive age who have anaemia. In terms of mothers who are pregnant with anaemia, it is close to about 37%.

“Almost one third of mothers have anaemia during pregnancy. This has a lot of influence on the foetus in the uterus,” he said, adding that this could lead to one developing hypertension, diabetes and cardiovascular diseases later on in life.

Other common factors were inadequate care and feeding practices, which See said were prevalent in society.

The ones most at risk of stunting, he said, are those from poorer households, minorities and marginalised communities, particularly refugees and the homeless.

However, stunting still cuts across ethnicities, occupations, income levels, education levels and states – making it a national issue.

Health Minister Khairy Jamaluddin previously said the country was facing a “double burden” of malnutrition among children under the age of five and increasing obesity rates among adults.

Kelantan, Putrajaya, Terengganu and Pahang have recorded the highest rates of stunted growth among children.

The government now aims to reduce the prevalence of stunting among children to 11% by 2025 and at least 8% by 2030.

In order to achieve this target, See said there needs to be a “holistic approach” when addressing the underlying causes of stunting, especially food security.

“The key principles regarding the management of stunting in the country is an ‘all-of-society, all-of-country’ approach. It should not fall just on the Ministry of Health or any other ministry.”

He added that there should be more focus on the critical 1,000-day period, which refers to a child’s life from the moment they are conceived until they have reached two years of age.

“It’s good to note that all children across the world would have the same growth trajectory in the first five years of life, whether you’re Malaysian, born in America, or born in Europe.

“It is only by the influences of nutrition, environment and healthcare facilities that these things are sometimes affected to a certain degree. So, modifying a lot of these along the way will help to prevent stunting in children.”

Following the impacts of the COVID-19 pandemic, See said it was worth amending Malaysia's target to 15% by 2025 and 10% by 2030.

“I think we are on good footing to tackle this at the moment, given that the government has taken note of the problem,” he said.

“Hopefully we can see some good outcomes as the years go, but it’s going to be challenging post-pandemic and with the rising inflation index in the country.”