28.4% in Southern Africa. North Africa is at 18%, and the Middle East at 16.2%. In Asia, the highest rate is observed in South Asia at 34.4%. South-East Asia is at 26.3%. Pacific Islands also display a high rate at 38.2%. Central and South America are respectively at 15.6 and 9.9%. South Asia, given its very high population at over 1 billion and high prevalence rate of stunting, is the region currently hosting the highest absolute number of children with stunting (60 million plus). Looking at absolute numbers of children under 5 affected by stunting, it is obvious why current efforts and reductions are insufficient. The absolute number of stunted children has increased in Africa from 50.4 to 58.5 million in the time 2000–2015. This is despite the reduction in percentage prevalence of stunting, and is due to the high rates of population growth. The data therefore indicate that the rate of reduction of stunting in Africa has not been able to counterbalance the increased number of growing children that fall into the trap of malnutrition, due to population growth in the region. This is also true in Oceania, unlike Asia and Latin America and the Caribbean where substantial absolute reductions in the number of stunted children have been observed (for example, Asia reduced its number of stunted children from 133 million to 88 million between 2000 and 2015). The reduction in stunting is closely linked to poverty reduction and the will and ability of governments to set up solid multisectoral approaches to reduce chronic malnutrition. Low income countries are the only group with more stunted children today than in the year 2000. Conversely, all other countries (high-income, upper-middle income, lower-middle income) have achieved reductions in the numbers of stunted children. This sadly perpetuates a vicious cycle of poverty and malnutrition, whereby malnourished children are not able to maximally contribute to economic development as adults, and poverty increases chances of malnutrition. Research The Water and Sanitation Program of the World Bank has investigated links between lack of sanitation and stunting in Vietnam and Lao PDR. An example is in Vietnam where the lack of sanitation in rural villages in mountainous regions of Vietnam led to five-year-old children being 3.7 cm shorter than healthy children living in villages with good access to sanitation. This difference in height is irreversible and matters a great deal for a child's cognitive development and future