placestats

Child stunting vs. Skilled birth attendance

Holds up after adjusting for income

Across 150 countries, Child stunting and Skilled birth attendance rise and fall together at r = -0.74 (on a scale from −1 to +1, where 0 means no link). Comparing only countries with similar income (GDP per person) shrinks it to -0.48 (q = 0.0051, allowing for the many pairs tested). Much of the first figure is that both measures rise with national income, but a moderate negative link remains.

Comparing countries across the middle half of child stunting, 5.9% to 24.2% of children under 5, skilled birth attendance is worse by 17.8% of births at the top of that range than the bottom. Comparing only countries with similar national income, the gap is 13% of births.

Link before adjusting (r)-0.745p = 8.6e-28 · 150 countries
After adjusting for national income-0.479p = 6.2e-10 · likely range [-0.59, -0.35]
p, allowing for regions9.6e-5standard error 0.052 · 7 regions
Check for luck (q)0.005across 12,497 pairs

How to read these.r runs from −1 (one goes up as the other goes down) to +1 (they rise together), and 0 means no link. Adjusting for national income means comparing countries with the same GDP per person, so differences in wealth can’t explain the link. Income is used in percentage terms, since an extra $1,000 means more to a poor country than to a rich one. p is how likely a link this strong would be if there were really none. Below 0.05 means it is unlikely to be chance. Very small values are written in short form: 1.1e-32 means a decimal point followed by 31 zeros and then 11, so very close to zero. The likely range is where the true figure probably lies, and a range that crosses zero means the link could easily be chance. Countries in the same region tend to resemble each other, so the third figure allows for that, which gives a fairer p. The standard error is the typical size of the error in r. Finally, testing this many pairs means some will look strong by luck alone. A q below 0.05 means this link is unlikely to be one of those.

Child stunting · % of children under 5link with income -0.80 · proxy
Skilled birth attendance · % of birthslink with income +0.69 · high

Both of these rise and fall closely with national income, so a strong link between them before adjusting was close to certain. Read the adjusted figure, not the first one.

“Link with income” is how closely each measure tracks GDP per person across countries, from −1 to +1.

Every country as a dot

Child stunting · % of children under 5 →Skilled birth attendance · % of births →1%55.3%31.9%100%Afghanistan: 42% of children under 5, 61.8% of birthsAngola: 47.7% of children under 5, 49.6% of birthsAlbania: 7.4% of children under 5, 99.8% of birthsArgentina: 10.7% of children under 5, 98.8% of birthsArmenia: 6.2% of children under 5, 99.8% of birthsAustralia: 3.1% of children under 5, 96% of birthsAzerbaijan: 6.8% of children under 5, 99.9% of birthsBurundi: 55.3% of children under 5, 76.5% of birthsBenin: 33.2% of children under 5, 78.1% of birthsBurkina Faso: 19.5% of children under 5, 79.8% of birthsBangladesh: 25.1% of children under 5, 59% of birthsBulgaria: 5.5% of children under 5, 94.5% of birthsBahrain: 4.6% of children under 5, 99.6% of birthsBosnia and Herzegovina: 7.9% of children under 5, 99.9% of birthsBelarus: 1.1% of children under 5, 99.9% of birthsBelize: 11.7% of children under 5, 94.6% of birthsBolivia: 10.7% of children under 5, 81.1% of birthsBrazil: 8.9% of children under 5, 98.4% of birthsBarbados: 5.8% of children under 5, 98.4% of birthsBrunei Darussalam: 9.9% of children under 5, 99.6% of birthsBhutan: 17.9% of children under 5, 98.9% of birthsBotswana: 21% of children under 5, 99.8% of birthsCentral African Republic: 38.9% of children under 5, 40.3% of birthsChile: 1.7% of children under 5, 99.8% of birthsChina: 4.5% of children under 5, 99.9% of birthsCote d'Ivoire: 20.3% of children under 5, 84% of birthsCameroon: 27.2% of children under 5, 69% of birthsCongo, Dem. Rep.: 44.1% of children under 5, 85.2% of birthsCongo, Rep.: 16.3% of children under 5, 91.2% of birthsColombia: 11.6% of children under 5, 98.8% of birthsComoros: 17.4% of children under 5, 82.2% of birthsCabo Verde: 5.3% of children under 5, 97.3% of birthsCosta Rica: 10.6% of children under 5, 99% of birthsCzechia: 2.4% of children under 5, 99.8% of birthsGermany: 2.2% of children under 5, 96.2% of birthsDjibouti: 20.9% of children under 5, 87.4% of birthsDominican Republic: 5.6% of children under 5, 99.2% of birthsAlgeria: 8.9% of children under 5, 98.8% of birthsEcuador: 17.7% of children under 5, 99.4% of birthsEgypt, Arab Rep.: 12.9% of children under 5, 97.1% of birthsEstonia: 1.3% of children under 5, 99.6% of birthsEthiopia: 35.5% of children under 5, 49.8% of birthsFinland: 1.7% of children under 5, 99.5% of birthsFiji: 7.2% of children under 5, 99.8% of birthsGabon: 13.7% of children under 5, 89.3% of birthsGeorgia: 4.7% of children under 5, 99.8% of birthsGhana: 15.6% of children under 5, 78.9% of birthsGuinea: 26.6% of children under 5, 55.3% of birthsGambia, The: 14% of children under 5, 83.8% of birthsGuinea-Bissau: 28.3% of children under 5, 53.8% of birthsEquatorial Guinea: 17.1% of children under 5, 68.3% of birthsGreece: 2% of children under 5, 99.9% of birthsGuatemala: 44.6% of children under 5, 69.6% of birthsGuyana: 7.1% of children under 5, 97.6% of birthsHonduras: 17.9% of children under 5, 94.1% of birthsHaiti: 21.6% of children under 5, 41.6% of birthsIndonesia: 22.6% of children under 5, 94.7% of birthsIndia: 32.9% of children under 5, 89.4% of birthsIreland: 2.2% of children under 5, 99.7% of birthsIran, Islamic Rep.: 4.8% of children under 5, 99% of birthsIraq: 9.4% of children under 5, 95.6% of birthsJamaica: 6.9% of children under 5, 99.7% of birthsJordan: 7.7% of children under 5, 99.7% of birthsJapan: 5.2% of children under 5, 99.8% of birthsKazakhstan: 4.4% of children under 5, 99.9% of birthsKenya: 17.9% of children under 5, 70.2% of birthsKyrgyz Republic: 11% of children under 5, 100% of birthsCambodia: 22% of children under 5, 98.7% of birthsKiribati: 14.7% of children under 5, 91.9% of birthsKorea, Rep.: 1.8% of children under 5, 100% of birthsKuwait: 4.5% of children under 5, 99.9% of birthsLao PDR: 29.9% of children under 5, 64.4% of birthsLiberia: 26.9% of children under 5, 84.4% of birthsLibya: 9.2% of children under 5, 99.9% of birthsSt. Lucia: 2.8% of children under 5, 100% of birthsSri Lanka: 10.1% of children under 5, 99.5% of birthsLesotho: 35% of children under 5, 86.6% of birthsLithuania: 1.6% of children under 5, 100% of birthsLatvia: 1.7% of children under 5, 99.9% of birthsMorocco: 13.7% of children under 5, 86.6% of birthsMoldova: 4.2% of children under 5, 99.6% of birthsMadagascar: 38.4% of children under 5, 45.8% of birthsMaldives: 14.2% of children under 5, 99.5% of birthsMexico: 13.1% of children under 5, 96.6% of birthsMarshall Islands: 30% of children under 5, 92.4% of birthsNorth Macedonia: 3.8% of children under 5, 100% of birthsMali: 23.2% of children under 5, 67.3% of birthsMalta: 3.5% of children under 5, 99.8% of birthsMyanmar: 24.5% of children under 5, 60.2% of birthsMontenegro: 8% of children under 5, 98.8% of birthsMongolia: 7.1% of children under 5, 99.3% of birthsMozambique: 37% of children under 5, 73% of birthsMauritania: 21.5% of children under 5, 70.4% of birthsMauritius: 7.8% of children under 5, 99.7% of birthsMalawi: 33.2% of children under 5, 96.4% of birthsMalaysia: 24.3% of children under 5, 99.6% of birthsNamibia: 16.4% of children under 5, 88.2% of birthsNiger: 48.3% of children under 5, 43.7% of birthsNigeria: 33.8% of children under 5, 50.7% of birthsNepal: 26% of children under 5, 77.2% of birthsOman: 12.9% of children under 5, 99.9% of birthsPakistan: 33.6% of children under 5, 68% of birthsPanama: 14% of children under 5, 95% of birthsPeru: 10.6% of children under 5, 94.9% of birthsPhilippines: 27.7% of children under 5, 84.4% of birthsPapua New Guinea: 47.6% of children under 5, 56.4% of birthsPoland: 1% of children under 5, 99.6% of birthsPortugal: 3.2% of children under 5, 98.6% of birthsParaguay: 3.2% of children under 5, 92.2% of birthsWest Bank and Gaza: 8% of children under 5, 99.7% of birthsQatar: 5.4% of children under 5, 100% of birthsRomania: 7% of children under 5, 93% of birthsRwanda: 29.8% of children under 5, 94.2% of birthsSaudi Arabia: 11.1% of children under 5, 94.8% of birthsSudan: 35.4% of children under 5, 77.7% of birthsSenegal: 17.2% of children under 5, 74.5% of birthsSingapore: 2.8% of children under 5, 99.6% of birthsSolomon Islands: 29.8% of children under 5, 86.2% of birthsSierra Leone: 25.2% of children under 5, 86.9% of birthsEl Salvador: 9.4% of children under 5, 99.9% of birthsSomalia, Fed. Rep.: 23.9% of children under 5, 31.9% of birthsSerbia: 4.6% of children under 5, 99.9% of birthsSao Tome and Principe: 10% of children under 5, 96.8% of birthsSuriname: 8% of children under 5, 98.4% of birthsEswatini: 18.9% of children under 5, 88.3% of birthsSeychelles: 6.2% of children under 5, 99.5% of birthsTurks and Caicos Islands: 3.2% of children under 5, 100% of birthsChad: 31.5% of children under 5, 47.2% of birthsTogo: 23% of children under 5, 69.4% of birthsThailand: 12.3% of children under 5, 99.1% of birthsTajikistan: 13.1% of children under 5, 94.8% of birthsTurkmenistan: 6.5% of children under 5, 100% of birthsTimor-Leste: 45.4% of children under 5, 56.7% of birthsTonga: 1.6% of children under 5, 98.3% of birthsTrinidad and Tobago: 7.8% of children under 5, 100% of birthsTunisia: 8.9% of children under 5, 99.5% of birthsTurkiye: 5.5% of children under 5, 97% of birthsTuvalu: 5.3% of children under 5, 99.5% of birthsTanzania: 29.9% of children under 5, 63.5% of birthsUganda: 23.5% of children under 5, 74.2% of birthsUkraine: 11.7% of children under 5, 99.9% of birthsUruguay: 6.5% of children under 5, 100% of birthsUnited States: 4.2% of children under 5, 99.1% of birthsUzbekistan: 6.7% of children under 5, 99% of birthsViet Nam: 19.2% of children under 5, 96.1% of birthsVanuatu: 31% of children under 5, 89.4% of birthsSamoa: 8.4% of children under 5, 88.9% of birthsSouth Africa: 24.4% of children under 5, 96.7% of birthsZambia: 32.3% of children under 5, 80.4% of birthsZimbabwe: 23.7% of children under 5, 86% of birthsAGOBDIBLRCAFCODHTILTUMWINERPOLSOMTCD

best-fit line line after adjusting

Four ways to measure the link

MethodrpCountries
Standard (Pearson), not adjusted-0.7458.6e-28150
By rank (Spearman), not adjusted-0.7877.9e-33150
Standard (Pearson), adjusted for national income-0.4796.2e-10150
By rank (Spearman), adjusted for national income-0.4863.4e-10150

The rank version uses only each country’s place in line, from lowest to highest, so a few extreme countries count for less. The adjusted and unadjusted versions use the same 150 countries: those that report both measures and GDP per person. So the gap between them comes from the adjustment, not from a change in which countries are counted. Drop in the size of r after adjusting: +0.265 (a minus sign means it grew).

How solid is it?

Leaving out one country at a time, r ranges from -0.524 (without SOM) to -0.440 (without AGO). The bar above shows that range on a scale from −1 to +1, with the solid line at the full result. The single country that moves r most: SOM (-0.045).

Within each region

Countries are not separate, unrelated cases, and neighbors share a lot. A link that holds inside each region is far more believable than one that shows up only when comparing regions.

nr
East Asia & Pacific25-0.67
Europe & Central Asia29-0.39
Latin America & Caribbean25-0.48
Middle East, North Africa, Afghanistan & Pakistan18-0.94
Sub-Saharan Africa46-0.31

By income third

If the link shows up only in the richest third of countries, it is a feature of rich countries, not a general pattern.

nr
Poorest third50-0.31
Middle third50-0.68
Richest third50-0.22

By largest religious group

Countries grouped by a label they share, such as main religion, rather than by a number. Groups of fewer than twelve countries are not shown. These groups differ in income, region and history all at once. So a gap between them is a place to start asking questions, not an answer.

nr
Christians84-0.49
Muslims46-0.63

By last european coloniser

Countries grouped by a label they share, such as main religion, rather than by a number. Groups of fewer than twelve countries are not shown. These groups differ in income, region and history all at once. So a gap between them is a place to start asking questions, not an answer.

nr
France23-0.47
Never a European colony21-0.84
Spain18-0.58
United Kingdom51-0.42

Without outliers (countries far outside the middle half of countries on either measure, by more than one and a half times the width of that middle half): r = -0.466 after dropping 14 countries.

Two series, one country

Both measures over the years for one country you pick. The two charts are stacked so they share only the years along the bottom.

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Over time, within countries

Everything above compares countries with each other at one moment. This section compares each country only with itself over 23years. So a link here can’t come from anything about a country that stays the same, such as its history, geography, institutions or culture.

The link shows up within countries over time (r = -0.541) but mostly disappears in year-to-year changes (r = -0.089). That points to slow trends particular to each country, not the two measures moving together from year to year.

Across countries (adjusted)-0.479for comparison
Within countries-0.673each country vs itself
…and vs the same year elsewhere-0.541q = 0.000 · 132 countries
Year-on-year changes-0.089q = 0.077
Read with care.
  • Almost all of this indicator's variation is between countries, not within them, so the within-country estimate rests on a small part of the data.
  • The association is much weaker in year-on-year changes than in levels, which points to shared country-specific trends.

1,709 country-years (one country in one year), 132 countries, 2000–2022, about 13 years each on average. Share of the variation that happens within countries over time: 7% for Child stunting, 13% for Skilled birth attendance. The margins of error allow for each country appearing many times, and for each year’s value being close to the year before.

Year-to-year changes are a cautious test, not a final answer. Looking only at changes from one year to the next removes each country’s own trends. But it also makes measurement mistakes louder, which pulls the results toward zero. A near-zero result here is weak evidence of no link, not proof.

With one measure years behind the other

0.60−0.6-100+10years Skilled birth attendance trails Child stunting →lag -10: r = -0.395 (n = 1,791)lag -9: r = -0.437 (n = 1,822)lag -8: r = -0.481 (n = 1,870)lag -7: r = -0.517 (n = 1,897)lag -6: r = -0.517 (n = 1,939)lag -5: r = -0.526 (n = 1,972)lag -4: r = -0.540 (n = 1,958)lag -3: r = -0.541 (n = 1,932)lag -2: r = -0.549 (n = 1,852)lag -1: r = -0.542 (n = 1,785)lag +0: r = -0.541 (n = 1,709)lag +1: r = -0.519 (n = 1,558)lag +2: r = -0.502 (n = 1,480)lag +3: r = -0.497 (n = 1,403)lag +4: r = -0.475 (n = 1,309)lag +5: r = -0.445 (n = 1,208)lag +6: r = -0.439 (n = 1,104)lag +7: r = -0.355 (n = 998)lag +8: r = -0.347 (n = 913)lag +9: r = -0.333 (n = 804)lag +10: r = -0.342 (n = 728)

Same year (lag 0): -0.541. A peak away from zero does not show which comes first. These series change slowly — this year’s value is close to last year’s. That makes the curve smooth and nearly symmetric, whatever produced the data. Even a sharp peak at one lag (a gap of some years) would not prove that one measure changes the other.

The data


% of children under 5
% of births		Years
Burundi BDI55.3%76.5%2024, 2021
Niger NER48.3%43.7%2024, 2021
Angola AGO47.7%49.6%2024, 2016
Papua New Guinea PNG47.6%56.4%2024, 2018
Timor-Leste TLS45.4%56.7%2024, 2016
Guatemala GTM44.6%69.6%2024, 2017
Congo, Dem. Rep. COD44.1%85.2%2024, 2018
Afghanistan AFG42%61.8%2024, 2020
Central African Republic CAF38.9%40.3%2024, 2019
Madagascar MDG38.4%45.8%2024, 2021
Mozambique MOZ37%73%2024, 2015
Ethiopia ETH35.5%49.8%2024, 2019
Sudan SDN35.4%77.7%2024, 2014
Lesotho LSO35%86.6%2024, 2018
Nigeria NGA33.8%50.7%2024, 2022

World Bank, World Development Indicators
World Bank, World Development Indicators

Sources

Child stunting

Prevalence of stunting, height for age, modelled estimate (% of children under 5)

UNICEF, WHO and World Bank Joint Child Malnutrition Estimates · CC BY 4.0 · updated quarterly

An estimate from a statistical model. The agencies fit a model to household surveys and predict every country and year. So this is smoother than the surveys behind it, and it has values for years nobody measured. The survey-only series never reaches sixty countries in any year.

Skilled birth attendance

Births attended by skilled health staff (% of total)

UNICEF and WHO · CC BY 4.0 · updated quarterly

Based on surveys, so a country reports it every few years rather than yearly.

How this was computed

Data used: most recent value in 2010-2025; values come from 2011–2024. To adjust for income, each measure is first predicted from GDP per person (in percentage terms, on a log scale) with a straight-line fit. Only what is left over is then compared. This is called a partial correlation. The line is drawn the standard way (ordinary least squares), which picks the line that comes closest to all the countries at once. The error margins allow for countries in the same region resembling each other, using 7 World Bank regions. The q-value corrects for testing all 12,497 pairs at once, using the Benjamini–Hochberg method. Underlying data last updated DYB 2024. How the country data works · explore Child stunting and Skilled birth attendance

This page shows that two measures go together. It does not show that Child stunting changes Skilled birth attendance, or the reverse. These figures also describe countries, not individual people. See the ecological fallacy.

More links with Child stunting or Skilled birth attendance