Abstract Childhood stunting is defined by the World Health Organization (WHO) as a height-for-age z-score that is more than two standard deviations below the median of the WHO Child Growth Standards. As of 2025, an estimated 150.2 million children under 5 years of age worldwide are affected. The aetiology of childhood stunting is multifaceted, involving a complex network of interconnected factors. This collection advances understanding of the drivers underlying stunting and proposes actionable preventative strategies by bringing together research on its multifactorial nature. It integrates insights from molecular biology, clinical medicine, environmental health, food systems, nutritional epidemiology, microbiology and parasitology. The articles address three interlinked domains: biological and biomedical drivers, including parasite and pathogen infection, gut–diet–microbiome interactions and gut dysfunction; and environmental drivers such as food security, water, sanitation and hygiene. Together, they provide new evidence on how biological and biomedical processes interact with environmental exposures to influence child linear growth. The collection highlights emerging intervention targets and integrated approaches to reduce stunting, emphasizing multi-sectoral strategies that combine nutrition, food systems, healthcare and environmental interventions, including pathogen control. Overall, this work provides a foundation for future research and policy aimed at breaking the cycle of stunting and improving child health globally. This article is part of the theme issue ‘Biological, biomedical and environmental drivers of stunting’.
Webster et al. (2026) studied this question.