More than 20 years after independence, Timor Leste’s child-malnutrition rates remain stubbornly high, with nearly half of children suffering from stunting and only one child in eight receiving a balanced diet.

How can this be in a country like Timor Leste, where nearly anything grows? You’d think it would only afflict countries blighted by drought or conflict.

This is not just a problem right now but threatens this country’s future. Children who miss out on good nutrition in the first years of life are likely to be weaker, more prone to sickness and have intellectual impairments that will affect the rest of their lives. This is not just a personal tragedy for each child but also affects the nation as a whole through its flow-on impacts on education and even the economy.

Teams of international and domestic researchers have spent years investigating the causes of Timor Leste’s ongoing high rates of child malnutrition and have confirmed there is no single factor responsible for it. The problem’s complex and multi-faceted nature is reflected in its intractability, with the rate of childhood stunting having decreased by only a few percentage points since 2013.

The World Bank identified malnutrition – and particularly maternal and child undernutrition – as the single greatest contributor to premature death and disability in the country, presenting an “unparalleled development challenge”.

The causes are often straightforward, such as a paucity of nutritious food and a lack of clean water. But it also includes cultural factors, such as childcare and feeding practices, and economic factors, with household poverty leading to inadequate diets.

The solutions are similarly complex but the first action identified by the World Bank report is one HIAM Health knows all too well: community empowerment.