“The reason I am pushing so hard on stunting is because we have spent a lot of time looking at possible paths of economic development in developing countries. It is my suggestion to the government of India to work with us on stunting. This is the bottom line: if you walk into the future economy with 40% of your workforce having been stunted as children, you are simply not going to be able to compete.”

— Jim Yong Kim, president of World Bank, on his visit to New Delhi in June

Kim’s warning was timely: India will indeed find it difficult to compete with other countries in the future if it cannot help its current generation of children grow as they should and develop into productive adults.

As many as 39% of Indian children aged five or younger are stunted – short for their age – higher than the global average of 24%, according to the Global Nutrition Report 2015. This poses a threat to millions from the next generation with lower literacy, diminished cognitive skills, health risks and a greater likelihood of being poor.

In South Asia, only Nepal (41%) and Pakistan (45%) have a larger proportion of stunted children than India.

Sri Lanka has the subcontinent’s lowest percentage of stunted children: 15%. Bangladesh and Bhutan have lower rates of stunting than India. In 1997, when 46% of India’s children were stunted, the corresponding rate in Bangladesh was significantly higher at 59.7%.

India also has the highest stunting rate among BRICS (Brazil, Russia, India, China and South Africa) nations, followed by South Africa with 24%.

Cause of concern

Stunting has long-term effects on individuals and societies, including diminished cognitive and physical development, reduced productive capacity and poor health and an increased risk of degenerative diseases like diabetes, according to the World Health Organisation.

As many as 61.8 million Indian children aged five or less are stunted, according to the Rapid Survey on Children 2013. That is about 39% of all children in that age group.

This is an improvement from the 48% rate according to the National Family Health Survey 2005-06. The number of children aged five or less was 158.8 million in 2011, down by 3.1% from 163.8 million in 2001.

If current global trends persist, 127 million children under five will be stunted in 2025. This is higher than the target of 100 million fixed under the Sustainable Development Goals, according to this WHO estimate. The main reason the target may not be met is the lack of funding, globally and locally.

Recent longitudinal studies (where the progress of children is tracked over many years) of children from Brazil, Guatemala, India, the Philippines and South Africa associate stunting with a reduction in years at school.

Adults who were stunted at age two completed nearly one year less school than non-stunted individuals, according to this study conducted by University of Atlanta in 2010.

Similarly, a study of Guatemalan adults found that those stunted as children had less schooling, lower test performances, lower household per-capita expenditure and a greater likelihood of being poor. For women, stunting in early life was associated with a lower age at first birth and more pregnancies and children, according to this 2008 World Bank study.

A 1% loss in adult height due to childhood stunting is associated with a 1.4% loss in economic productivity, according to World Bank estimates. Stunted children earn 20% less as adults compared to non-stunted individuals.

This article first appeared on IndiaSpend, a data-driven and public-interest journalism non-profit.