Stunting in children: why nutrition matters most

Stunting remains one of Uganda’s most pressing child health challenges, affecting millions of children and shaping their future development, learning and productivity. At the heart of the solution is the first 1,000 days of life, a critical window from conception to a child’s second birthday where proper nutrition can change the course of a life.

In this episode, we explore how feeding practices, maternal health, and early childhood care influence stunting and overall development. We are joined by Dr Sabrina Kitaka, Pediatrician at Mulago National Referral Hospital; Esther Nalugga, Clinical Nutritionist; Laura Ahumuza, Senior Nutritionist at the Ministry of Health; and Yves Willemot, Chief Communication Officer at UNICEF Uganda, as we unpack what it takes to give every child a healthy start in life.

Through a month-long campaign from April to May, 2026, New Vision in partnership with UNICEF and the Ministry of Health spotlight the challenges and solutions shaping children’s diets and their chances of a healthy start.

Transcript

SPEAKER_03 0:04

Hello and welcome to the new vision daily podcast around Uganda. I'm Razia Uthman. Today we bring you a special feature on understanding stunting in children and why the first a thousand days of a child's life are critical to their future health, growth, and development. Across Uganda, malnutrition continues to affect thousands of children, with experts warning that poor nutrition in early childhood can have lifelong consequences on learning, immunity, and productivity. But health professionals say many of these challenges can be prevented through better feeding practices, awareness, and stronger community support. In this special report narrated by Marjorie Namogeny, we hear from Dr. Sabrina Chitaka, a pediatrician at Mulago National Referral Hospital, Esther Naluga, a clinical nutritionist, Laura Ahumuza, a senior nutritionist at the Ministry of Health, and Eve Wilmore, the Chief Communication Officer at UNICEF Uganda. The feature is part of a month-long campaign by the new vision in partnership with UNICEF and the Ministry of Health, highlighting the causes of malnutrition, the dangers of stunting, and the solutions needed to give Uganda's children a healthier start in life. Here is Majorin Namogeni with a report.

SPEAKER_01 1:47

When we look at children playing, we see joy, energy, and life, but sometimes they are hidden in plain sight as signs that something is not right. A child who looks smaller than others of the same age. A lovely leader girl who is not growing the way they do. These are not deleted differences in size or personality. They could be warning signs or require signals from the body that something is amazing. Malnutrition doesn't always look the same. Sometimes it shows up suddenly. Other times it develops slowly over months or even years. And not as serious as the forms are wasting and stunting. Westing happens when a child becomes a dozen for their height. It is often the result of a sudden shortage of food or illness that weakens the body. In a short time, a child can lose weight rapidly, their body using up its reserves just to survive.

SPEAKER_02 2:43

There's undernutrition. We know that chronic malnutrition results in stunting. You're shorter than you expected height for age, right? And that means you've been chronically not eating well. So stunting is um weight for height, height for age, which is less than three standard deviations. And it's a marker of extreme starvation. Like you've not been able to attain your maximum height for your age. Simply saying.

SPEAKER_04 3:58

And stunting is a form of malnutrition, but it's a form of long-term malnutrition. Children just don't get stunted. If a child has a dad that is deficient in protein, because remember I said protein is the growth food. If the body is deficient in protein for a long period of time, the body is going to prioritize looking after itself now to height. And so you have a child who looks okay, but they are stunted because for a long period of time there was a deficiency of mainly protein. So the body prioritized staying alive and okay to growing tall. And so that's why we have children who are stunted. And sadly, when you have a child who is stunted, because these things follow through, that child sometimes gives birth to a stunted child, and it just becomes a lineage of people who are stunted, and then we say it is genes. But no, no, no, no, not at all, not at all. And still, in most cases, you can't see that from home. It still has some someone has to go and do the measurements of the height and the weight, and then you read on the Z scores or the BMI for edge scores, and then we can let you know. But in most cases, it starts with being underweight. Again, you're underweight because you are taking in little for what your body really requires.

SPEAKER_05 5:20

So those body measurements uh uh are used, we combine them to come up with what we call indices. So we by looking at your height, for example, if you're an adult, by looking at your height and weight, we work out a BMI body mass index, and then we can know your nutrition status. We rank it whether you're okay, normal, overweight, obese. Yeah, it's so it's the same for children, but we will not talk about BMI in children, but we use what we call Z scores. So these are like standards, WHO, World Health Unity of Standards. But the basics is that we will need to take your measurements, the weight, the height, and then we use that to determine your nutrition status. So that's how we are able to know that this child is standard, this one is normal, this one is overweight, this one is obese based on the measurements.

SPEAKER_02 6:21

Please, parents out there, do not just look at the immunization card and think that it's only for immunization. It's also, it contains a lot of information for your child, um, the growth monitoring or growth faltering for that matter. And if you see that your child is on a straight line, it means they are not growing. If they are growing in a good curve along the growth chart, it means they are growing normally. But if there's a dip in their growth, that means they are losing weight. And if that faltering of weight is very fast, that means there's something wrong. And losing weight rapidly means either that this child has a chronic illness or is not feeding well, or we need to investigate, or perhaps the food you're giving is not of good value.

SPEAKER_05 7:13

And we do this through mass screening. So you go in a community if you have indications, indicate there are indicators that maybe somewhere in Kamwenge the situation is not good. So we'll go in that community, do mass screening, pick up the numbers, uh, and then we'll handle them based on the severity, like I said. So if they are not yet malnourished, we cancel, we educate and do that package. If they are malnourished, then we do nutrition support and counselling.

SPEAKER_01 7:48

When a child who is wasted may appear visibly thin, their ribs may show, they may feel weak, tired, or uninterested in play, stunting tells a different story. A stunted child may look sick, they may laugh, play, and may go to school like any other child. But inside, their growth has been limited. Stunting can affect how a child learns, how they concentrate, and even how they perform in school.

SPEAKER_02 8:11

As children are growing up, and I want to put this as an emphasis, that the more protein you're giving to them as they are growing before the age of three years, the first 1,000 days conversation, it's so relevant because if you don't feed your child properly as they are growing up, then you're going to affect their cognition, their ultimate brain function. So children need a lot of protein. They need eggs, they need milk, they need the meat, the beans, the, you know, and then the carbohydrate diet, which we have a lot, from potion to maize flour to wheat flour to matoke to cassava, it's a lot, right? However, as we feed our children, we must balance. We must ensure that they are also getting in the zinc, the iron, the copper, the magnesium, the manganese, all those things are also vital to their growing up bodies.

SPEAKER_00 9:10

Well, uh dealing with having access to um uh nutritious food is for children is something that should be uh our priority uh throughout the country, throughout Uganda. But obviously there are pockets where the situation uh with regard to malnutrition is more uh concerning than others, and we're speaking about the Karamoja uh subregion, we're speaking about uh uh the Torah subregion as as uh uh key areas as well as um the districts that are hosting refugees, where obviously the continuous uh attention for uh in uh ensuring access to uh proper nutrition is key. The government is pushing for agriculture.

SPEAKER_02 9:52

Like everybody is literally a farmer. And even at the back of people's yards, people are growing um things in in jericans, in sacks, in all that, and they are growing green leafy vegetables, they are growing potatoes in sacks. People are being encouraged to do home farming. But also in the market, there are things that come fresh from the farm. We are very fortunate as a country. Like I mentioned, we are a food basket. We have all the available foods that people would need. From ground nuts to beans to peas to meat to fish, to all those proteins are available to grasshoppers. People like stalk on grasshoppers and eat them. And that's healthy protein. But also for the carbohydrates, we have so much.

SPEAKER_01 10:44

And unlike wasting, the effects of stunting are often irreversible.

SPEAKER_04 10:49

And I also just want to say that stunting is not reversible. It is not reversible, you cannot reverse it. Once your child is stunted, you missed it.

SPEAKER_01 10:59

A child may eat, but not eat enough of the right foods. A child may fall sick often and lose nutritions faster than they gain them. A family may lack access to clean water or proper health care. All of these factors shape how a child grows. Unfortunately, the youngest children are the most vulnerable, especially those under five years of age, and most critically, those in the first 1,000 days of life. During this time, the body and the brain are developing rapidly, and without proper nutrition, the effects can last a lifetime.

SPEAKER_02 11:32

So good nutrition is when you are eating healthy, and if you're talking children, you're thinking, what's the best fast food that a child should eat? And that's breast milk. It contains everything that a child would need, including proteins, water, vitamins, essential uh immunoglobulins. So babies start with breast milk. And as babies grow, we would like to see that they get enough protein in there, they have enough carbohydrates to give them energy, but also to have the necessary micronutrients and essential electrolytes. So as children grow even bigger, it's important for them to have a balanced diet. And that's the good nutrition that we talk about. Organic food straight from the garden to the table, instead of having overprocessed food that would harm them in a way, and then having um multicolours of food on their plate, not the color of the plate, but the food on the plate. The orange and green, giving them the minerals and the vitamins, and then water, and then having a protein source, and then carbohydrates.

SPEAKER_01 12:46

Preventing wasting and stunting begins long before the signs appear. It starts with everyday choices, feeding children a variety of foods, breastfeeding in the early months of life, introducing nutritious meals at the right time. Westing and stunting may not always be obvious. They don't always come with loud warnings, but their impact is real and far-reaching. The earlier we can recognize the signs, the sooner we can act. Because every child desires more than just to grow older, but to grow strong, to learn fully and to reach their true potential.

SPEAKER_03 13:43

It is part of the Good Nutrition for All campaign by the New Vision in partnership with UNICEF and the Ministry of Health, highlighting the importance of early childhood nutrition and the fight against stunting in Uganda. You've been listening to the New Vision daily podcast around Uganda. I'm Razya Osman. Thank you for listening.