Factors Associated with Stunting Prevalence in Indonesia: A Multilevel Analysis of Island Disparities

• Anna Vipta Resti Mauludyani ^[1] ; Mewa Ariani ^[2] ; Sri Hastuti Suhartini ^[2] ; Rindang Ekawati ^[2] ; Mugia Bayu Rahardja ^[2] ; Herlina Tarigan ^[2] ; Anggit Gantica ^[3] ; Ahmad yafiq ^[1]
  1. [1] University of Indonesia

     University of Indonesia

     Indonesia

     
  2. [2] National Research and Innovation Agency
  3. [3] National Food Agency

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• Localización: Nutrición clínica y dietética hospitalaria, ISSN 0211-6057, Vol. 45, Nº. 3, 2025, págs. 278-285
• Idioma: inglés
• DOI: 10.12873/453mauludyani
• Enlaces
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• Resumen

  • Introduction: Stunting among children under the age offive is a major public health challenge in Indonesia. Severalfactors have been identified as influencing stunting; however,Indonesia has several islands with unique characteristics thatmay impact them.

    Objectives: This study aims to investigate factors associ-ated with district-level stunting prevalence while accountingfor island-level variation.

    Methods: This study utilised data mainly from the 2020Food Security and Vulnerability Atlas (FSVA) of the IndonesianMinistry of Agriculture. The FSVA collected 2019 indicatorsand was published in 2020. The independent variables areclassified into two levels: the district level (514 districts) andthe island level (eight major islands). The analysis was doneusing multilevel linear regression.

    Results: Most districts (473 out of 514) have a high orvery high prevalence of stunting. The results showed thatpoverty, households with food expenditures greater than65%, households without water, and women’s education wereall positively associated with stunting at the district level, buthealth personnel coverage was negatively associated. At theisland level, Gross Regional Domestic Products (GRDP) werefound to be negatively linked with stunting Conclusion: Poverty and lack of basic infrastructure con-tinue to be major contributors to stunting. Given Indonesia’sbreadth and number of islands, stunting-reduction initiativesare customised to regional challenges, with a focus on regionswhere stunting is more prevalent.

• Referencias bibliográficas
  • 1. Huicho L, Huayanay-Espinoza CA, Herrera-Perez E, Segura ER,Niño de Guzman J, Rivera-Ch M, et al. Factors behind the successstory of under-five...
  • 2. UNICEF, WHO, World Bank. Level and trends in child malnutri-tion [Internet]. 2021 [cited 2023 Apr 11]. Available from:https://www.who.int/publications/i/item/97892400252573. . 3....
  • 4. Budge S, Parker AH, Hutchings PT, Garbutt C. Environmental en-teric dysfunction and child stunting. Nutr Rev [Internet]. 2019Apr 1;77(4):240–53....
  • 5. WHO. Childhood stunting: Context, causes and consequences[Internet]. 2016 [cited 2023 Apr 11]. 1–4 p. Available from:https://www.who.int/publications/m/item/childhood-stunting-context-causes-and-consequences-framework6....
  • 6. Beal T, Tumilowicz A, Sutrisna A, Izwardy D, Neufeld LM. A reviewof child stunting determinants in Indonesia. Matern Child Nutr[Internet]....
  • 7. Yaya S, Uthman OA, Kunnuji M, Navaneetham K, Akinyemi JO,Kananura RM, et al. Does economic growth reduce childhoodstunting? A multicountry...
  • 8. Mulyaningsih T, Mohanty I, Widyaningsih V, Gebremedhin TA,Miranti R, Wiyono VH. Beyond personal factors: Multilevel deter-minants of childhood...
  • 9. Wicaksono F, Harsanti T. Determinants of stunted children inIndonesia: A Multilevel Analysis at the individual, household, andcommunity...
  • 10. Titaley CR, Ariawan I, Hapsari D, Muasyaroh A, Dibley MJ.Determinants of the stunting of children under two years old inIndonesia:...
  • 12. Hox J, Moerbeek M, van de Schoot R. Multilevel analysis:Techniques and applications [Internet]. Vol. 2, Multilevel Analysis:Techniques...
  • 13. de Onis M, Borghi E, Arimond M, Webb P, Croft T, Saha K, et al.Prevalence thresholds for wasting, overweight and stunting inchildren under...
  • 16. Huicho L, Vidal-Cárdenas E, Akseer N, Brar S, Conway K, IslamM, et al. Drivers of stunting reduction in Peru: a country casestudy. Am...
  • 17. Woldeamanuel BT, Tesfaye TT. Risk factors associated with under-five stunting, wasting, and underweight based on EthiopianDemographic...
  • 18. Mauludyani AVR, Suryana EA, Ariani M. Factors associated withundernutrition and improvement in Indonesia. IOP Conf Ser Earth284Nutr Clín...
  • 19. Li H, Yuan S, Fang H, Huang G, Huang Q, Wang H, et al.Prevalence and associated factors for stunting, underweight andwasting...
  • Siswati T, Waris L, Paramashanti BA, Kusnanto H, Susilo J. Grossdomestic product and geographic area as social determinants ofchild stunting...
  • Mary S. How much does economic growth contribute to childstunting reductions? Economies [Internet]. 2018 Oct 9;6(4):55.Available from: http://www.mdpi.com/2227-7099/6/4/5522....
  • Smith LC, Haddad L. Reducing child undernutrition: Past driversand priorities for the Post-MDG Era. World Dev [Internet]. 2015Apr 1;68(1):180–204....
  • Yunitasari E, Lee BO, Krisnana I, Lugina R, Solikhah FK, AdityaRS. Determining the factors that influence stunting during pan-demic in rural...
  • Haq W, Abbas F. A multilevel analysis of factors associated withstunting in children less than 2 years using Multiple IndicatorCluster Survey...
  • Mangundap SA, Amyadin A, Tampake R, Umar N, Iwan I. Healthcadre education on providing stunting risk family assistance to-ward children. Open...
  • Shahid M, Ameer W, Malik NI, Alam MB, Ahmed F, Qureshi MG, etal. Distance to healthcare facility and lady health workers’ visitsreduce malnutrition...
  • Fajrianti D, Yunitasari E, Pradanie R. The correlation between per-sonal reference: Health workers and health facilities with parent-ing in...
  • Laksono AD, Sukoco NEW, Rachmawati T, Wulandari RD. Factorsrelated to stunting incidence in toddlers with working mothers inIndonesia. Int...
  • Mauludyani AVR, Khomsan A, Riyadi H, Nurhidayati VA, FatchiyaA. Determinants of children’s nutritional status in rural and urbanareas of West...
  • N Bitew FH, Sparks CS, Nyarko SH, Apgar L. Spatiotemporal varia-tions and determinants of under-five stunting in Ethiopia. FoodNutr Bull [Internet]....