Drivers of stunting reduction in Senegal: A country case study

Samanpreet Brar, Nadia Akseer, Mohamadou Sall, Kaitlin Conway, Ibrahima Diouf, Karl Everett, Muhammad Islam, Papa Ibrahima Sylmang Sène, Hana Tasic, Jannah Wigle, Zulfiqar Bhutta

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Senegal has been an exemplar country in the West African region, reducing child stunting prevalence by 17.9% from 1992 to 2017. Objectives: In this study, we aimed to conduct a systematic in-depth assessment of factors at the national, community, household, and individual levels to determine the key enablers of Senegal’s success in reducing stunting in children <5 y old between 1992/93 and 2017. Methods: A mixed methods approach was implemented, comprising quantitative data analysis, a systematic literature review, creation of a timeline of nutrition-related programs, and qualitative interviews with national and regional stakeholders and mothers in communities. Demographic and Health Surveys and Multiple Indicator Cluster Surveys were used to explore stunting inequalities and factors related to the change in height-for-age z-score (HAZ) using difference-indifference linear regression and the Oaxaca-Blinder decomposition method. Results: Population-wide gains in average child HAZ and stunting prevalence have occurred from 1992/93 to 2017. Stunting prevalence reduction varied by geographical region and prevalence gaps were reduced slightly between wealth quintiles, maternal education groups, and urban compared with rural residence. Statistical determinants of change included improvements in maternal and newborn health (27.8%), economic improvement (19.5%), increases in parental education (14.9%), and better piped water access (8.1%). Key effective nutrition programs used a community-based approach, including the Community Nutrition Program and the Nutrition Enhancement Program. Stakeholders felt sustained political will and multisectoral collaboration along with improvements in poverty, women’s education, hygiene practices, and accessibility to health services at the community level reduced the burden of stunting. Conclusions: Senegal’s success in the stunting decline is largely attributed to the country’s political stability, the government’s prioritization of nutrition and execution of nutrition efforts using a multisectoral approach, improvements in the availability of health services and maternal education, access to piped water and sanitation facilities, and poverty reduction. Further efforts in the health, water and sanitation, and agriculture sectors will support continued success. Am J Clin Nutr 2020;112(Suppl):860S–874S.

Original languageEnglish (US)
Pages (from-to)860S-874S
JournalAmerican Journal of Clinical Nutrition
Volume112
DOIs
StatePublished - Jul 21 2020
Externally publishedYes

Keywords

  • Children
  • Exemplar
  • Linear growth
  • Mixed methods
  • Nutrition
  • Senegal
  • Stunting
  • West africa

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics

Fingerprint Dive into the research topics of 'Drivers of stunting reduction in Senegal: A country case study'. Together they form a unique fingerprint.

Cite this