Vol. 11 No. 8 (2025): August
Open Access
Peer Reviewed

The Long-Term Impact of Childhood Stunting on Cognitive Development and Educational Outcomes

Authors

Aceng Ali Awaludin , Annisa Nurrachmawati , Arifah Devi Fitriani , Casia Reski

DOI:

10.29303/jppipa.v11i8.12198

Published:

2025-08-25

Downloads

Abstract

This study aims to analyze the long-term impact of stunting in childhood on cognitive development and educational attainment through a meta-analysis approach. Stunting, which is indicated by stunted linear growth due to chronic malnutrition, has long been associated with various negative consequences on health and social aspects. By systematically examining the results of quantitative studies from various countries and socio-economic contexts, this study identified a consistent pattern of association between stunting in early life and decline in cognitive function and academic achievement in adolescence and adulthood. Data were obtained from 25 studies that met the inclusion criteria published in the 2015 to 2024 range, and were analyzed using fixed-effect and randomized effects models with the help of the JASP application. The results of the meta-analysis showed that children who experienced stunting had an effect on cognitive and education with a pooled effect size value (Hedges' g = 1.10 t= 9.103; p < 0.001) with a high effect size category. These findings confirm that stunting not only has an impact on short-term physical conditions, but also has significant consequences for human resource development in the long term. Therefore, comprehensive nutrition and education interventions in early life are essential to break the chain of loss due to stunting.

Keywords:

Child nutrition Cognitive development Educational attainment Meta-analysis Stunting

References

Ajayi, O. R., Matthews, G. B., Taylor, M., Kvalsvig, J. D., Davidson, L., Kauchali, S., & Mellins, C. (2017). Structural Equation Modeling of the Effects of Family, Preschool, and Stunting on the Cognitive Development of School Children. Frontiers in Nutrition, 4(May), 1–12. https://doi.org/10.3389/fnut.2017.00017

Alam, M. A., Richard, S. A., Fahim, S. M., Mahfuz, M., Nahar, B., Das, S., Shrestha, B., Koshy, B., Mduma, E., Seidman, J. C., Murray-Kolb, L. E., Caulfield, L. E., Lima, A. A. M., Bessong, P., & Ahmed, T. (2020). Erratum: Impact of Early-Onset Persistent Stunting on Cognitive Development at 5 Years of Age: Results from a Multi-Country Cohort Study. PLoS ONE, 15(2), 1–16. https://doi.org/10.1371/journal.pone.0229663

Amusa, L. B., Bengesai, A. V., & Khan, H. T. A. (2022). Childhood Stunting and Subsequent Educational Outcomes: A Marginal Structural Model Analysis from a South African Longitudinal Study. Public Health Nutrition, 25(11), 3016–3024. https://doi.org/10.1017/S1368980022001823

Asnur, L., Jalinus, N., Faridah, A., Apra, T., Ambiyar, R. D., & Utami, F. (2024). Video-Blogs (Vlogs)-Based Project: A Meta Analysis. Int. J. Adv. Sci. Eng. Inf. Technol., 14(5), 1553–1557. https://doi.org/10.18517/ijaseit.14.5.16804

Astuti, S. J. W., Dwiningwarni, S. S., & Atmojo, S. (2025). Modeling Environmental Interactions and Collaborative Interventions for Childhood Stunting: A Case from Indonesia. Dialogues in Health, 6(September 2024), 100206. https://doi.org/10.1016/j.dialog.2025.100206

Balza, L. H., Cuartas, J., Gomez-Parra, N., & Serebrisky, T. (2025). Infrastructure Services and Early Childhood Development in Latin America and the Caribbean: Water, Sanitation, and Garbage Collection. World Development, 185(October 2024), 106817. https://doi.org/10.1016/j.worlddev.2024.106817

Barham, T., Díaz-Botía, O. M., Macours, K., Maluccio, J. A., & Rueda, J. V. (2025). Second Generation Effects of an Experimental Conditional Cash Transfer Program on Early Childhood Human Capital in Nicaragua. Economics and Human Biology, 57(December 2023), 101483. https://doi.org/10.1016/j.ehb.2025.101483

Borenstein, M., Hedges, L., & Rothstein, H. (2007). Introduction to Meta-Analysis. Retrieved from www.Meta-Analysis.com

Cohen, J. (1988). Statistical Power Analysis for the Behavioral Sciences (2nd ed.). Hillsdale, NJ: Lawrence Erlbaum Associates, Publishers.

Dessie, G., Li, J., Nghiem, S., & Doan, T. (2025). Child Stunting, Thinness, and Their Academic Performance in Ethiopia: A Longitudinal Study. Social Science and Medicine, 373(March), 118050. https://doi.org/10.1016/j.socscimed.2025.118050

Dewey, K. G., & Begum, K. (2011). Long-Term Consequences of Stunting in Early Life. Maternal and Child Nutrition, 7(SUPPL. 3), 5–18. https://doi.org/10.1111/j.1740-8709.2011.00349.x

Duc, L. (2009). The Effect of Early Age Stunting on Cognitive Achievement Among Children in Vietnam (Publisher's Version). Young Lives.

Ekholuenetale, M., Barrow, A., Ekholuenetale, C. E., & Tudeme, G. (2020). Impact of Stunting on Early Childhood Cognitive Development in Benin: Evidence from Demographic and Health Survey. Egyptian Pediatric Association Gazette, 68(1). https://doi.org/10.1186/s43054-020-00043-x

Elfira, I., & Santosa, T. A. (2023). Literature Study: Utilization of the PjBL Model in Science Education to Improve Creativity and Critical Thinking Skills. Jurnal Penelitian Pendidikan IPA, 9(1), 133–143. https://doi.org/10.29303/jppipa.v9i1.2555

Gabain, I. L., Ramsteijn, A. S., & Webster, J. P. (2023). Parasites and Childhood Stunting – A Mechanistic Interplay with Nutrition, Anaemia, Gut Health, Microbiota, and Epigenetics. Trends in Parasitology, 39(3), 167–180. https://doi.org/10.1016/j.pt.2022.12.004

Gelli, A., Margolies, A., Santacroce, M., Roschnik, N., Twalibu, A., Katundu, M., Moestue, H., Alderman, H., & Ruel, M. (2018). Using a Community-Based Early Childhood Development Center as a Platform to Promote Production and Consumption Diversity Increases Children’s Dietary Intake and Reduces Stunting in Malawi: A Cluster-Randomized Trial. Journal of Nutrition, 148(10), 1587–1597. https://doi.org/10.1093/jn/nxy148

Grantham-McGregor, S., Cheung, Y. B., Cueto, S., Glewwe, P., Richter, L., & Strupp, B. (2007). Developmental Potential in the First 5 Years for Children in Developing Countries. The Lancet Journal, 369(9555), 60-70. Retrieved from https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(07)60032-4/fulltext

Handryastuti, S., Pusponegoro, H. D., Nurdadi, S., Chandra, A., Pramita, F. A., Soebadi, A., Widjaja, I. R., & Rafli, A. (2022). Comparison of Cognitive Function in Children with Stunting and Children with Undernutrition with Normal Stature. Journal of Nutrition and Metabolism, 2022. https://doi.org/10.1155/2022/9775727

Haywood, X., & Pienaar, A. E. (2021). Long-Term Influences of Stunting, Being Underweight, and Thinness on the Academic Performance of Primary School Girls: The NW-CHILD Study. International Journal of Environmental Research and Public Health, 18(17). https://doi.org/10.3390/ijerph18178973

Hukom, J. (2023). Integration of Blended Learning and Project-Based Learning (BPjBL) on Achievement of Students’ Learning Goals: A Meta-Analysis Study. Pegem Journal of Education and Instruction, 13(4), 274–281. https://doi.org/10.47750/pegegog.13.04.32

Ichsan, I., Suharyat, Y., Santosa, T. A., & Satria, E. (2023). Effectiveness of STEM-Based Learning in Teaching 21st Century Skills in Generation Z Student in Science Learning: A Meta-Analysis. Jurnal Penelitian Pendidikan IPA, 9(1), 150–166. https://doi.org/10.29303/jppipa.v9i1.2517

Koshy, B., Srinivasan, M., Gopalakrishnan, S., Mohan, V. R., Scharf, R., Murray-Kolb, L., John, S., Beulah, R., Muliyil, J., & Kang, G. (2022). Are Early Childhood Stunting and Catch-Up Growth Associated with School Age Cognition? -Evidence from an Indian Birth Cohort. PLoS ONE, 17(3), 1–14. https://doi.org/10.1371/journal.pone.0264010

Martorell, R., Horta, B. L., Adair, L. S., Stein, A. D., Richter, L., Fall, C. H., Bhargava, S. K., Biswas, S. K., Perez, L., Barros, F. C., Victora, C. G., & Consortium on Health Orientated Research in Transitional Societies Group (2010). Weight Gain in the First Two Years of Life is an Important Predictor of Schooling Outcomes in Pooled Analyses from Five Birth Cohorts from Low- and Middle-Income Countries. The Journal of Nutrition, 140(2), 348–354. https://doi.org/10.3945/jn.109.112300

McGovern, M. E., Krishna, A., Aguayo, V. M., & Subramanian, S. V. (2017). A Review of the Evidence Linking Child Stunting to Economic Outcomes. International Journal of Epidemiology, 46(4), 1171–1191. https://doi.org/10.1093/ije/dyx017

Moelyo, A. G., Pulungan, A. B., Sitaresmi, M. N., & Julia, M. (2025). The Effect of Early Childhood Stature on Later Cognitive Functions in Indonesian Adolescents: Comparation Using The National Growth Reference and the WHO Growth Standard. BMC Pediatrics, 25(1). https://doi.org/10.1186/s12887-025-05829-9

Nahar, B., Hossain, M., Mahfuz, M., Islam, M. M., Hossain, M. I., Murray-Kolb, L. E., Seidman, J. C., & Ahmed, T. (2020). Early Childhood Development and Stunting: Findings from the MAL-ED Birth Cohort Study in Bangladesh. Maternal and Child Nutrition, 16(1). https://doi.org/10.1111/mcn.12864

Nurtamam, M. E., Santosa, T. A., Ilwandri, I., Aprilisia, S., Rahman, A., & Suharyat, Y. (2023). Meta-Analysis: The Effectiveness of IoT-Based Flipped Learning to Improve Students’ Problem Solving Abilities. EDUMASPUL, 7(1), 2023–1492. http://dx.doi.org/10.33487/edumaspul.v7i1.6195

Osei, R. D., & Lambon-Quayefio, M. P. (2022). Effects of Long-Term Malnutrition on Education Outcomes in Ghana: Evidence from a Panel Study. European Journal of Development Research, 34(1). https://doi.org/10.1057/s41287-020-00350-4

Perignon, M., Fiorentino, M., Kuong, K., Burja, K., Parker, M., Sisokhom, S., Chamnan, C., Berger, J., & Wieringa, F. T. (2014). Stunting, Poor Iron Status and Parasite Infection Are Significant Risk Factors for Lower Cognitive Performance in Cambodian School-Aged Children. PLoS ONE, 9(11). https://doi.org/10.1371/journal.pone.0112605

Prado, E. L., Larson, L. M., Cox, K., Bettencourt, K., Kubes, J. N., & Shankar, A. H. (2019). Do Effects of Early Life Interventions on Linear Growth Correspond to Effects on Neurobehavioural Development? A Systematic Review and Meta-Analysis. The Lancet Global Health, 7(10), E1398-E1413. Retrieved from https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(19)30361-4/fulltext

Pravana, N. K., Piryani, S., Chaurasiya, S. P., Kawan, R., Thapa, R. K., & Shrestha, S. (2017). Determinants of Severe Acute Malnutrition Among Children under 5 Years of Age in Nepal: A Community-Based Case-Control Study. BMJ Open, 7(8), e017084. https://doi.org/10.1136/bmjopen-2017-017084

Rahman, A. A., Santosa, T. A., Nurtamam, M. E., Widoyo, H., & Rahman, A. (2023). Meta-Analysis: The Effect of Ethnoscience-Based Project Based Learning Model on Students’ Critical Thinking Skills. Jurnal Penelitian Pendidikan IPA, 9(9), 611–620. https://doi.org/10.29303/jppipa.v9i9.4871

Robinson, J. A., & Dinh, P. T. T. (2023). High Doses of a National Preschool Program Are Associated with the Long-Term Mitigation of Adverse Outcomes in Cognitive Development and Life Satisfaction Among Children Who Experience Early Stunting: A Multi-Site Longitudinal Study in Vietnam. Frontiers in Public Health, 11(December), 1–18. https://doi.org/10.3389/fpubh.2023.1087349

Santosa, T. A., Angreni, S., Sari, R. T., Festiyed, F., Yerimadesi, Y., Ahda, Y., Alberida, H., & Arsih, F. (2024). Effectiveness of Higher Order Thinking Skills-Based Test Instruments in Science Learning in Indonesia: A Meta-analysis. Jurnal Penelitian Pendidikan IPA, 10(5), 242–249. https://doi.org/10.29303/jppipa.v10i5.6654

Setianingsih, S., Permatasari, D., Sawitri, E., & Ratnadilah, D. (2020). Impact of Stunting on Development of Children Aged 12–60 Months. https://doi.org/10.2991/ahsr.k.200723.047

Sideropoulos, V., Draper, A., Munoz-Chereau, B., Ang, L., & Dockrell, J. E. (2024). Childhood Stunting and Cognitive Development: A Meta-Analysis. Retrieved from https://osf.io/7t9sr/download

Soliman, A., Sanctis, V. D., Alaaraj, N., Ahmed, S., Alyafei, F., Hamed, N., & Soliman, N. (2021). Early and Long-Term Consequences of Nutritional Stunting: From Childhood to Adulthood. Acta Biomedica, 92(1), 1–12. https://doi.org/10.23750/abm.v92i1.11346

Stein, A. D., Adair, L. S., Donati, G., Wray, C., Richter, L. M., Norris, S. A., Stein, A., Martorell, R., Ramirez-Zea, M., Menezes, A. M. B., Murray, J., Victora, C., Lee, N., Bas, I., Kowalski, A., DiGirolamo, A., Scerif, G., Mpondo, F., Belleza, D., … Wehrmeister, F. C. (2023). Early-Life Stature, Preschool Cognitive Development, Schooling Attainment, and Cognitive Functioning in Adulthood: A Prospective Study in Four Birth Cohorts. The Lancet Global Health, 11(1), e95–e104. https://doi.org/10.1016/S2214-109X(22)00448-X

Sudfeld, C. R., McCoy, D. C., Danaei, G., Fink, G., Ezzati, M., Andrews, K. G., & Fawzi, W. W. (2015). Linear Growth and Child Development in Low- and Middle-Income Countries: A Meta-Analysis. Pediatrics, 135(5), e1266–e1275. https://doi.org/10.1542/peds.2014-3111

Suryawan, A., Jalaludin, M. Y., Poh, B. K., Sanusi, R., Tan, V. M. H., Geurts, J. M., & Muhardi, L. (2022). Malnutrition in Early Life and Its Neurodevelopmental and Cognitive Consequences: A Scoping Review. Nutrition Research Reviews, 35(1), 136–149. https://doi.org/10.1017/S0954422421000159

Suyatmo, S., Yustitia, V., Santosa, T. A., Fajriana, F., & Oktiawati, U. Y. (2023). Effectiveness of the Inquiry Based Learning Model Based on Mobile Learning on Students’ Creative Thinking Skills: A Meta-Analysis. Jurnal Penelitian Pendidikan IPA, 9(9), 712–720. https://doi.org/10.29303/jppipa.v9i9.5184

Swandana, H., Tindangen, M., & Herliani, H. (2023). High School Students’ Perceptions About Implementation of the Merdeka Curriculum in Biology Lessons in Samarinda. Jurnal Penelitian Pendidikan IPA, 9(10), 8235–8244. https://doi.org/10.29303/jppipa.v9i10.4585

Tamur, M., Juandi, D., & Kusumah, Y. S. (2020). The Effectiveness of the Application of Mathematical Software in Indonesia; A Meta-Analysis Study. International Journal of Instruction, 13(4), 867–884. https://doi.org/10.29333/iji.2020.13453a

Walker, S. P., Chang, S. M., Wright, A., Osmond, C., & Grantham-McGregor, S. M. (2015). Early Childhood Stunting Is Associated with Lower Developmental Levels in the Subsequent Generation of Children. Journal of Nutrition, 145(4), 823–828. https://doi.org/10.3945/jn.114.200261

Winiasri, L., Santosa, T. A., Yohandri, Y., Razak, A., Festiyed, F., & Zulyusri, Z. (2023). Ethno-Biology Learning Model Based on Design Thinking to Improve Students’ Critical Thinking Skills. Jurnal Penelitian Pendidikan IPA, 9(9), 7767–7774. https://doi.org/10.29303/jppipa.v9i9.4213

Woldehanna, T., Behrman, J. R., & Araya, M. W. (2017). The Effect of Early Childhood Stunting on Children’s Cognitive Achievements: Evidence from Young Lives Ethiopia. Ethiopian Journal of Health Development, 31(2), 75–84. Retrieved from https://pubmed.ncbi.nlm.nih.gov/29249889/

Yan, C., Zhao, S., Cui, J., Shangguan, S., Wang, Z., & Tang, K. (2025). Co-Occurrence and Associated Factors of Developmental Delay, Functional Disability, and Undernutrition in Early Childhood: Evidence from 15 Population-Based Surveys in Sub-Saharan African Countries. EClinicalMedicine, 85, 103305. https://doi.org/10.1016/j.eclinm.2025.103305

Zulyusri, Z., Santosa, T. A., Festiyed, F., Yerimadesi, Y., Yohandri, Y., Razak, A., & Sofianora, A. (2023). Effectiveness of STEM Learning Based on Design Thinking in Improving Critical Thinking Skills in Science Learning: A Meta-Analysis. Jurnal Penelitian Pendidikan IPA, 9(6), 112–119. https://doi.org/10.29303/jppipa.v9i6.3709

Author Biographies

Aceng Ali Awaludin, STIKes Karsa Husada Garut

Author Origin : Indonesia

Annisa Nurrachmawati, Universitas Mulawarman

Author Origin : Indonesia

Arifah Devi Fitriani, Institut Kesehatan Helvetia

Author Origin : Indonesia

Casia Reski, Universitas Andalas

Author Origin : Indonesia

Downloads

Download data is not yet available.

How to Cite

Awaludin, A. A., Nurrachmawati, A., Fitriani, A. D., & Casia Reski. (2025). The Long-Term Impact of Childhood Stunting on Cognitive Development and Educational Outcomes. Jurnal Penelitian Pendidikan IPA, 11(8), 70–77. https://doi.org/10.29303/jppipa.v11i8.12198