Objective: Stunting is a chronic condition reflecting poor nutrition and health. Our aim was to ascertain major predictors of stunting in children ,5 years old in Libya. (OR 5 0?53, 95 % CI 0?32, 0?90) and water storage (OR 5 0?70, 95 % CI 0?54, 0?90). These variables only explained 20 % of cases of stunting. Conclusion: Various multilevel actions are needed to improve nutritional status of under-fives in Libya. At risk-groups include those with young age (1-3 years), resident of Al-Akhdar region, boys, father's low educational level, poor psychosocial stimulation, poor housing environment, diarrhoea and low birth weight.

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In the last four decades, there has been a substantial horizontal expansion of health services in Libya. This resulted in improvement in morbidity and mortality, in particularly those related to infectious disease. However, measures such as the national performance gap indicator reveal an underperforming health system. In this article, we discuss aspects related to the Libyan health system and its current status including areas of weakness. Overcoming current failures and further improvement are unlikely to occur spontaneously without proper planning. Defining community health problems, identifying unmet needs, surveying resources to meet them, establishing SMART (specific, measurable, achievable, and realistic and time specific) objectives, and projecting administrative action to accomplish the proposed programs, are a must. The health system should rely on newer approaches such as management-by-objectives and risk-management rather than the prevailing crisis-management attitude.

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