Bangladesh has beaten child stunting — but one child in nine is still too thin for their height

Introduction

Bangladesh’s record on child nutrition is usually told as a success story, and much of it is. The share of children under five who are stunted, meaning too short for their age, fell from 51.1% in 2000 to 23.6% in 2022.¹ The share who are underweight fell from 42.4% to 21.7% over the same years.²

12.5% → 10.7%

Share of Bangladeshi children under 5 who are wasted (too thin for their height), 2000 and 2022. Stunting fell from 51.1% to 23.6% over the same period.

The third measure of child undernutrition has not followed. Wasting, a low weight for height that signals recent or acute undernutrition, was 12.5% in 2000 and 10.7% in 2022.³ The government’s own 2022 survey puts it at 11%, up from 8% in 2017–18.⁴ This article looks at what the three measures say, who is most affected, and what the evidence suggests for policy.

Two caveats apply throughout. All three indicators come from household surveys in which children are measured, and the World Bank series used here is the UNICEF–WHO–World Bank joint estimate, so a figure can differ by a few tenths of a point from the national survey report. Survey years are irregular, so single-year jumps should be read with caution.

Two kinds of undernutrition, two different stories

Stunting reflects chronic undernutrition over a child’s early life, and it has improved steadily. Wasting reflects a recent shortfall in food or an illness such as diarrhoea, and it can rise or fall quickly. In the joint estimates it fell by just 1.8 percentage points between 2000 and 2022, against 27.5 points for stunting.¹³

The 2022 Bangladesh Demographic and Health Survey (BDHS) confirms that the two have diverged recently. Between 2017–18 and 2022, stunting fell from 31% to 24%. Underweight was unchanged at 22%, and wasting rose from 8% to 11%.⁴ The 2011 survey had recorded wasting at 16%, so 2017–18 was the exception, not the trend.⁴

Still a “high” problem by international standards

WHO and UNICEF classify national prevalence into five bands. For wasting, 10% to under 15% is “high” and 15% or more is “very high”. For stunting, 20% to under 30% is “high” and 30% or more is “very high”.⁵ On those bands, Bangladesh in 2022 is “high” on both counts: its stunting rate was still “very high” (30.9%) in 2018 and has since entered the “high” band, but wasting has been in the “high” or “very high” band in most survey years since 1990.¹³⁵

The long series is noisy because surveys differ in timing and sampling. Even so, the picture is clear. In 1990 stunting was 63.4% and wasting 17.5%; by 2022 stunting was 23.6% and wasting 10.7%.¹³ Wasting has moved within a band of roughly 8% to 18% for most of that time, with one outlier of 20.7% in 1997. The 8.4% of 2018 is the lowest reading in the series.

Who is most affected

The BDHS 2022 shows that wasting is spread across the country, but not evenly.

• Mother’s education: 22.0% of children whose mothers have no schooling are wasted, against 9.7% for mothers who completed secondary school.⁴
• Household wealth: 13.1% in the poorest fifth of households, against 10.0% in the richest fifth.⁴
• Division: highest in Barishal (14.1%) and Mymensingh (12.8%), lowest in Dhaka (8.9%).⁴
• Age: 12.0% among children aged 24–59 months, compared with 9.5% for those under two.⁴
• Place and sex: almost no gap between urban (10.9%) and rural (11.0%) children, or between boys (10.6%) and girls (11.4%).⁴

Maternal education stands out. The gap between children of mothers with no schooling and those whose mothers completed secondary school is larger than the gap between the richest and poorest households. The survey cannot say why. Education coincides with differences in income, feeding practices and access to health services, and the table does not separate them. The number of children with unschooled mothers is also small, 255 in the sample, so the estimate carries a wide margin of error.⁴

A warning from infant feeding

One related indicator points the wrong way. The share of infants under six months who are exclusively breastfed fell from 65% in 2017–18 to 55% in 2022.⁴ The survey reports the fall but does not link it to wasting, and the evidence here does not show that it caused the rise in wasting. It is, however, one of the practices that nutrition programmes target, and it moved in the wrong direction at the same time.

What it will take

The sources cited here support the following priorities, though none of them estimates the effect of a specific policy on wasting in Bangladesh.

• Measure wasting as seriously as stunting. The government’s 4th Health, Population and Nutrition Sector Programme set a stunting target of 25% by 2023, which the 2022 survey shows was met.⁴ The same attention to a wasting target, reported alongside stunting, would make the lack of progress visible.
• Target the places and households with the highest rates. Barishal and Mymensingh divisions and households with unschooled mothers show the highest wasting in the survey, and are the clearest candidates for early detection and treatment of acute undernutrition.
• Reverse the fall in exclusive breastfeeding. Counselling at antenatal and postnatal contacts is the obvious channel, since the 2022 survey shows that only 55% of infants under six months are exclusively breastfed.⁴
• Keep more frequent data. Survey rounds in 2011, 2014, 2017–18 and 2022 are four to five years apart, a long gap for an indicator that can change within a season. Routine facility or community screening, if reported publicly, would show earlier whether wasting is rising.