Reduce Impaired Child Growth & Development – Stunting Program for Timor-Leste Compact Development

The Challenge

Adequate nutrition during pregnancy and the first two years of life is necessary for normal brain development, laying the foundation for future cognitive and social ability, school success, and productivity. Stunting is largely an irreversible outcome of prolonged inadequate nutrition leading to insufficient weight gain and development from conception to age two. In communities where being short is seen as normal, and linear growth is not routinely measured, stunting often is an invisible form of malnutrition.

Timor-Leste has one of the highest prevalence of child stunting in the world (IFPRI, 2016) with over 50% of Timorese children 0-59 months of age stunted in their growth. Of those children, four out of 10 are categorized as severely stunted.

Overview and Objectives

URC, working with the Millennium Challenge Corporation (MCC), is identifying the main drivers of the high prevalence of stunting in children 0-59 months of age through the collection of data on the prevalence and consequences of stunting in Timor-Leste. The project’s activities are supporting MCC to reduce stunting among children in Timor-Leste. The project also expands URC’s work in nutrition, water/sanitation/hygiene, and digital health technologies in the region.

Specific program objectives include:

• Assessing the drivers and root causes of impaired child growth and development or stunting children;
• Reviewing, assessing, and providing feedback on the government’s proposed compact design documents to provide evidence-based solutions and interventions to be successfully implemented;
• Identifying and collecting data to inform possible interventions or project design studies to be carried out by the government; and
• Supporting MCC with the implementation of the compact by the government.

Achievements

The team interviewed key stakeholders about stunting and discussed the immediate and underlying drivers of stunting in Timor-Leste. They concluded that reducing stunting could be achieved through a combination of behavior change on hygiene and child feeding practices. Additionally, the team committed to facilitating service delivery and infrastructure to support nutritional instruction and inspire investments.

Under the project’s first phase, URC created a comprehensive system for data management related to the first 1,000 days of a child’s life, called the Sentinel Site Monitoring Program, and implemented it in 100 sites in 11 provinces across the country, to enable program managers to monitor nutrition-related behaviors and delivery of related health services. URC has also designed water, sanitation, and drainage improvement activities to address drivers of child stunting.