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


The Millennium Challenge Corporation (MCC) awarded URC the five-year (2018-2023), Reduce Impaired Child Growth & Development/Stunting for Timor-Leste Compact Development Project. Activities will support MCC’s development of a compact to reduce stunting among children in Timor-Leste, which has one of the highest stunting rates in the world. URC is working with MCC to identify the main drivers of the high prevalence of stunting in children 0-59 months of age through the collection of data and information on the prevalence and consequences of stunting in Timor- Leste. 

This project expands URC’s presence in the region and furthers work done in nutrition, WASH, and digital health technologies. URC is joined by WaterAid, an international organization increasing access to clean water and hygiene, and HIAM Health, a local community-based NGO with a unique, integrated approach to tackling malnutrition.


The Challenge

Stunting is largely an irreversible outcome of prolonged inadequate nutrition leading to insufficient weight gain and development during the first 1000 days from conception to age two. 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. Childhood stunting is the best-established indicator of child well-being and development as well as an indicator of social inequality. In communities where ‘being short’ is seen as normal, and linear growth is not routinely measured, stunting is largely 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 – four out of ten of whom (20 percent) are categorized as “severely stunted.” Maternal underweight and short stature are high in the country. Over one-quarter (27%) of women of reproductive age 15-49 years are underweight, and 10% are of short stature. The linear growth of infants and young children is affected by their nutrition in the “first 1,000 days of life” from pregnancy to the first two years of life, making pregnant women and children 0-23 months the primary focus of programs to reduce stunting.



  • Assess the drivers and root causes of impaired child growth and development or stunting children
  • Review, assess and provide feedback on the government's proposed compact design documents to provide evidence-based solutions and interventions to be successfully implemented
  • Identify and collect, as needed, data to inform possible interventions or project design studies to be carried by the government
  • Support MCC with the implementation of the compact by the government



The team interviewed key stakeholders about the problem of stunting (and its drivers obtained during field visits) and by discussions about the immediate and underlying drivers of stunting. The team concluded that reducing stunting could be achieved through a combination of behavior change on hygiene and child feeding practices, products and their delivery to facilitate infrastructure upkeep and support nutritional instruction, and infrastructure investments.

Through data collection, interviews with stakeholders, and interviews with local partners, major nutrition problems were identified as:

  • Malnutrition with mothers and/or children being underweight or children not gaining enough weight
  • Poverty
  • Illnesses/infections
  • Lack of access to clean water




Children in Baucau, Timor-Leste. © Arturo Sanabria, Courtesy of Photoshare
Children in Baucau, Timor-Leste. © Arturo Sanabria, Courtesy of Photoshare
2018 to 2023
Millennium Challenge Corporation (MCC)
HIAM Health
Regions/ Countries