Wasting and Stunting in Children Under Five in Afghanistan: A Needs and Assets Assessment Study

Background: Child malnutrition, particularly wasting and stunting, affects nearly half of Afghanistan’s children and poses serious health, social, and economic risks. Despite ongoing efforts, malnutrition rates remain high, which demonstrates the urgent need for systematic and evidence-based strategies. We conducted a qualitative needs and assets assessment in order to inform the development of behavior change interventions targeting the prevention of wasting and stunting in children under five in Afghanistan.Methods: Semi-structured online interviews (N = 10) were conducted with UNICEF program teams and implementing partners in Afghanistan to explore the problem of child wasting and stunting. The interviews focused on factors contributing to child wasting stunting at individual and environmental levels, their underlying causes, available resources to support intervention efforts, and potential barriers and facilitators to implementation. All interviews were transcribed verbatim and analyzed using thematic analysis.Results: Individual-level behaviors, such as maternal feeding practices, WASH (water, sanitation, and hygiene) behaviors, and access to healthcare, along with environmental factors like resource constraints in health facilities, limited access to sanitation and safe water, and high levels of food insecurity, contribute to child wasting and stunting in Afghanistan. Underlying causes include poverty, cultural beliefs and practices, education, knowledge, social norms, funding, and infrastructure. Community-based systems and local organizations were identified as assets for delivering interventions. However, barriers such as weak coordination, limited implementation capacity, and the fact that most projects are short-term hinder effective implementation and long-term sustainability.Discussion: The high rates of child malnutrition in Afghanistan, driven by both individual and environmental factors, demand urgent attention. This study provides a structured analysis of the problem and community assets. The findings inform the design and implementation of behavior change interventions aimed at reducing child malnutrition in Afghanistan.