Risk Factors for Stunting among Children Aged 24-59 Months: A Case-Control Study in Rural Stunting Hotspots, Yogyakarta, Indonesia
DOI:
https://doi.org/10.71164/socialmedicine.v19i1.2026.2019Keywords:
risk factors, stunting, breastfeeding, birth length, socioeconomicAbstract
Background. Stunting remains a major public health nutrition challenge in developing countries, including Indonesia, and is influenced by multiple factors at different levels. Aims. This study aimed to identify risk factors for stunting among children aged two to five years in Pleret and Pajangan Subdistricts, Bantul District, Yogyakarta, Indonesia. Methods. We conducted a case-control study between January and March 2019 with 98 children (49 cases and 49 controls) selected using multistage random sampling. Cases were defined as children with a height-for-age z-score (HAZ) < −2 SD, and controls as children with HAZ > +2 SD. Multiple logistic regression analysis was used to examine risk factors for stunting, adjusting for child, parental, and household characteristics. Results. Children who were breastfed for 12–23 months (AOR = 0.14; 95% CI: 0.02–0.82) or for more than 24 months (AOR = 0.21; 95% CI: 0.05–0.87) were less likely to be stunted. Short birth length increased the risk of stunting (AOR = 3.94; 95% CI: 1.40–11.1), while higher household economic status was protective (AOR = 0.17; 95% CI: 0.04–0.66). Conclusions. Breastfeeding duration, birth length, and household economic status are significantly associated with stunting. Strengthening breastfeeding promotion and implementing both specific and sensitive interventions may accelerate progress toward reducing stunting and improving child growth outcomes.
References
Victora CG, Christian P, Vidaletti LP, Gatica-Domínguez G, Menon P, Black RE. Revisiting maternal and child undernutrition in low-income and middle-income countries: variable progress towards an unfinished agenda. Lancet. 2021; 397:1388-99.
National Institute for Health Research and Development. Laporan nasional riskesdas 20182019 [cited 2019 Sep 17]: Available from: http://labdata.litbang.kemkes.go.id/images/download/laporan/RKD/2018/Laporan_Nasional_RKD2018_FINAL.pdf.
World Health Organization. WHO child growth standards: length/height-for-age, weight-for-age, weight-for-length, weight-for-height and body mass index-for-age: methods and development. Geneva: World Health Organization; 2006.
De Sanctis V, Soliman A, Alaaraj N, Ahmed S, Alyafei F, Hamed N. Early and Long-term Consequences of Nutritional Stunting: From Childhood to Adulthood: Early and Long-term Consequences of Nutritional Stunting. Acta Biomedica Atenei Parmensis. 2021; 92:11346.
World Health Organization, United Nations Children's Fund, World Bank. Levels and trends in child malnutrition: UNICEF / WHO / The World Bank Group joint child malnutrition estimates: key findings of the 2021 edition. Geneva: World Health Organization; 2021.
National Institute for Health Research and Development. Laporan nasional riskesdas 20132013: Available from: http://labdata.litbang.kemkes.go.id/images/download/laporan/RKD/2013/Laporan_riskesdas_2013_final.pdf.
de Onis M, Borghi E, Arimond M, Webb P, Croft T, Saha K, et al. Prevalence thresholds for wasting, overweight and stunting in children under 5 years. Public health nutrition. 2019; 22:175-9.
Chaparro C, Oot L, Sethuraman K. Overview of the nutrition situation in four countries in South and Central Asia2014: Available from: https://www.fantaproject.org/sites/default/files/download/South-and-Central-Asia-Nutrition-Overview-Mar2014.pdf.
Ministry of National Development Planning of Indonesia. Determination of districts/municipalities focus locations for accelerated stunting reduction in 20232022: Available from: https://jdih.bappenas.go.id/data/abstrak/2022kepmenppn101.pdf.
Stewart CP, Iannotti L, Dewey KG, Michaelsen KF, Onyango AW. Contextualising complementary feeding in a broader framework for stunting prevention. Maternal & Child Nutrition. 2013; 9:27-45.
Campos AP, Vilar-Compte M, Hawkins SS. Association Between Breastfeeding and Child Stunting in Mexico. Ann Glob Health. 2020; 86:145-.
Titaley CR, Ariawan I, Hapsari D, Muasyaroh A, Dibley MJ. Determinants of the Stunting of Children Under Two Years Old in Indonesia: A Multilevel Analysis of the 2013 Indonesia Basic Health Survey. Nutrients. 2019; 11:1106.
Mulyaningsih T, Mohanty I, Widyaningsih V, Gebremedhin TA, Miranti R, Wiyono VH. Beyond personal factors: Multilevel determinants of childhood stunting in Indonesia. PloS one. 2021; 16:e0260265-e.
Paramashanti B, Hadi H, Gunawan I. Pemberian ASI eksklusif tidak berhubungan dengan stunting pada anak usia 6–23 bulan di Indonesia. Jurnal Gizi dan Dietetik Indonesia (Indonesian Journal of Nutrition and Dietetics). 2016; 3:162.
Aryastami NK, Shankar A, Kusumawardani N, Besral B, Jahari AB, Achadi E. Low birth weight was the most dominant predictor associated with stunting among children aged 12–23 months in Indonesia. BMC Nutrition. 2017; 3:16.
Supriyanto Y, Paramashanti BA, Astiti D. Berat badan lahir rendah berhubungan dengan kejadian stunting pada anak usia 6-23 bulan. Jurnal Gizi dan Dietetik Indonesia (Indonesian Journal of Nutrition and Dietetics). 2018; 5:23-30.
Judiono J, Priawantiputri W, Indraswari N, Widawati M, Ipa M, Megawati G, et al. Determinant Factors of Short Birth Length Baby as a Risk Factor of Stunting in West Java: Faktor Determinan Panjang Badan Bayi Lahir Pendek sebagai Faktor Risiko Stunting di Jawa Barat. Amerta Nutrition. 2023; 7:240-7.
Mahmudiono T, Sri Sumarmi M, Rosenkranz R. Household dietary diversity and child stunting in East Java, Indonesia. Asia Pacific Journal of Clinical Nutrition. 2017; 26:317-25.
Paramashanti BA, Benita S. Early introduction of complementary food and childhood stunting were linked among children aged 6-23 months. 2020. 2020:8.
Prentice AM, Ward KA, Goldberg GR, Jarjou LM, Moore SE, Fulford AJ, Prentice A. Critical windows for nutritional interventions against stunting. The American Journal of Clinical Nutrition. 2013; 97:911-8.
BPS-Statistics of Bantul. Bantul in Figure 20192019: Available from: https://bappeda-lama.bantulkab.go.id/filestorage/dokumen/2019/10/Kabupaten%20Bantul%20Dalam%20Angka%202019.pdf.
BPS-Statistics of Bantul. Village Potential Statistics of Bantul2018: Available from: https://bantulkab.bps.go.id/publication/2019/01/08/d5219b57cf6d545e7cf3b911/statistik-potensi-desa-kabupaten-bantul-2018.html.
Ministry of Health of Indonesia. Ayo ke posyandu2012: Available from: https://promkes.kemkes.go.id/pub/files/files5270buku_saku_Posyandu.pdf.
ILO. Guidelines concerning a statistical definition of informal employment2003: Available from: https://www.ilo.org/global/statistics-and-databases/standards-and-guidelines/guidelines-adopted-by-international-conferences-of-labour-statisticians/WCMS_087622/lang--en/index.htm.
Utami N, Rachmalina R, Irawati A, Sari K, Rosha BC, Amaliah N, Besral B. Short birth length, low birth weight and maternal short stature are dominant risks of stunting among children aged 0-23 months: Evidence from Bogor longitudinal study on child growth and development, Indonesia. Malaysian Journal of Nutrition. 2018; 24:11-23.
Beal T, Tumilowicz A, Sutrisna A, Izwardy D, Neufeld LM. A review of child stunting determinants in Indonesia. Maternal & Child Nutrition. 2018; 14:e12617.
Krebs NF, Hambidge KM, Westcott JL, Garcés AL, Figueroa L, Tshefu AK, et al. Birth length is the strongest predictor of linear growth status and stunting in the first 2 years of life after a preconception maternal nutrition intervention: the children of the Women First trial. The American Journal of Clinical Nutrition. 2022; 116:86-96.
Danaei G, Andrews KG, Sudfeld CR, Fink G, McCoy DC, Peet E, et al. Risk Factors for Childhood Stunting in 137 Developing Countries: A Comparative Risk Assessment Analysis at Global, Regional, and Country Levels. PLOS Medicine. 2016; 13:e1002164.
Paramashanti BA, Dibley MJ, Huda TM, Prabandari YS, Alam NA. Factors influencing breastfeeding continuation and formula feeding beyond six months in rural and urban households in Indonesia: a qualitative investigation. International Breastfeeding Journal. 2023; 18:48.
Khan S, Zaheer S, Safdar NF. Determinants of stunting, underweight and wasting among children < 5 years of age: evidence from 2012-2013 Pakistan demographic and health survey. BMC public health. 2019; 19:358-.
Goudet SM, Bogin BA, Madise NJ, Griffiths PL. Nutritional interventions for preventing stunting in children (birth to 59 months) living in urban slums in low‐ and middle‐income countries (LMIC). Cochrane Database of Systematic Reviews. 2019.
Mekonnen TC, Tadesse SE, Dawed YA, Cherie N, Abebe H, Shumye G, et al. The role of nutrition-sensitive agriculture combined with behavioral interventions in childhood growth in Ethiopia: An adequacy evaluation study. Health Science Reports. 2022; 5:e524.
Downloads
Published
Issue
Section
License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.