Analyzing Nutritional Factors that Affect Toddler’s Stunting in Malang Regency, Indonesia

I. Dewa Nyoman Supariasa; Ibnu Fajar; Khairuddin Khairuddin; Rany Adelina

doi:10.3889/oamjms.2023.10199

Authors

I. Dewa Nyoman Supariasa Undergraduate Program in Applied Nutrition and Dietetics, Department of Nutrition, Politeknik Kesehatan Kementerian Kesehatan, Malang, Indonesia; Center of Excellence for Local-based Material Science and Technology for Non-communicable Diseases, Politeknik Kesehatan Kementerian Kesehatan Malang, Ministry of Health, Malang, Indonesia
Ibnu Fajar Dietitian Professional Education Study Program, Department of Nutrition, Politeknik Kesehatan Kementerian Kesehatan, Malang, Indonesia
Khairuddin Khairuddin Undergraduate Program in Applied Nutrition and Dietetics, Department of Nutrition, Politeknik Kesehatan Kementerian Kesehatan, Malang, Indonesia https://orcid.org/0000-0003-4769-1999
Rany Adelina Undergraduate Program in Applied Nutrition and Dietetics, Department of Nutrition, Politeknik Kesehatan Kementerian Kesehatan, Malang, Indonesia https://orcid.org/0000-0002-6312-6634

DOI:

https://doi.org/10.3889/oamjms.2023.10199

Keywords:

stunting, household income, exclusive breastfeeding, household size, education, occupation

Abstract

BACKGROUND: The proportion of short and very short toddlers in Indonesia is 30.8%. East Java is among the 18 provinces with high prevalence (30%–<40%), having made Malang Regency included among the 100 regencies/cities prioritized for intervention.

AIM: This study aimed to analyze sociodemographic and nutritional factors affecting toddler’s stunting in Malang Regency, Indonesia.

DESIGN AND METHODS: A case–control analytic survey research with retrospective approach was used: An epidemiologic observation design to study the effect of exposures to diseases or other health problems occurrences. The investigation was conducted during July to August time period through observation, weight measurement and interview in order to collect the data about mother’s knowledge, childcare practices, household food security, healthcare services, access to clean water, economic and socio-cultural background, parenting practices, and causes of stunting. The data were processed using SPSS 16.0, bivariate analysis (Chi-square), and multivariate analysis using multiple logistic regression testing with odds ratio and confidence interval calculation.

RESULTS: Parenting practices of the toddlers were not ideal, with only 60% of mothers had good knowledge about stunting. About 76% of the stunted toddlers’ households had insecure food availability and security. Up to 98% of the mothers with stunted toddlers received blood-boosting tablets during pregnancy from health-care services; however, interview results disclosed that they were not consumed. As many as, 98% of the households got access to clean water from Malang Municipal Waterworks and 2% from closed well. A total of 96% of the households made income fewer than Malang Regency’s minimum wage. The stunted toddlers’ households who had eating restrictions during pregnancy and breastfeeding were 13%. Most stunted toddlers as many as 76% were taken care of by their biological mothers, while the remaining 24% by grandmothers or other relatives. Thus, the causes of stunting from the most to the least dominant were as follows: Household’s income, exclusive breastfeeding, household size, father’s education, mother’s nutritional knowledge, household’s food security, mother’s level of education, toddler’s energy intake, appropriate feedings of weaning food, toddler’s fat intake, toddler’s history of infectious diseases, sociocultural background, toddler’s protein intake, mother’s occupation, household’s nutritional awareness behavior, and the completeness of immunization.

CONCLUSION: Stunting main risk factors are household income, size, history of breastfeeding, father’s education and occupation. Factors which are not significantly related to stunting include household nutritional awareness and behavior, hygiene, socio-economic status, energy and micronutrients intake, toddler’s food and vitamin A compliment, toddler’s status and characteristics, and maternal health services.

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References

Mustika W, Syamsul D. Analysis of Malnutritional Status Problems on Toddlers in Primary Healthcare Center South Teupah of Simeuleu Regency. J Kesehat Glob. 2018;1(3):127-36. DOI: https://doi.org/10.33085/jkg.v1i3.3952

P2PTM Kemenkes RI. 1 Dari 3 Balita Indonesia Derita Stunting- Direktorat P2PTM. Kemkes.Go.Id; 2018. p. 18-21. Available from: https://www.p2ptm.kemkes.go.id/artikel-sehat/1-dari-3- balita-indonesia-derita-stunting [Last accessed on 2022 Sep 26].

TNP2K. 100 Priority Districts/Cities for Stunting Intervention Volume 2. 2017. Available from: https://www.tnp2k.go.id/ downloads/100-kabupatenkota-prioritas-untuk-intervensi-anak- kerdil-stunting-volume-2 [Last accessed on 2022 Sep 26].

Kementerian Kesehatan RI Badan Penelitian dan Pengembangan. “RISKESDAS 2018, Kementerian Kesehatan. Ris Kesehat Dasar. Vol. 53. Indonesia: Kementerian Kesehatan RI Badan Penelitian dan Pengembangan; 2018. Available: ht t ps: / / www. persi. or. id/ images/ 017/ lit bang/ riskes das_ launching.pdf [Last accessed on 2022 Sep 26].

Astarani K, Poernomo DI, Idris DN, Oktavia AR. Prevention of stunting through health education in parents of pre-school children. Strada J Ilmiah Kesehatan. 2020;9(1):70-7. https://doi.org/10.30994/sjik.v9i1.270 DOI: https://doi.org/10.30994/sjik.v9i1.270

Lapenangga F, Ginting KB. Application of logistic regression in case factors causing stunting (case study at primary care center puskesmas eimadake, sabu raijua regency. J Difer. 2021;3(1):28-38. DOI: https://doi.org/10.35508/jd.v3i1.4875

Maulidiana AR, Sutjiati E. Low intake of essential amino acids and other risk factors of stunting among under-five children in Malang City, East Java, Indonesia. J Public Health Res. 2021;10(2):2161. https://doi.org/10.4081/jphr.2021.2161 PMid:33855394 DOI: https://doi.org/10.4081/jphr.2021.2161

Sholihah NF, Adelina R. Acceptance and nutritional value of pompom potato formula as toddler’s complimentary feeding. Med Gizi Pangan. 2021;28:9-16.

Illahi RK. The effect of family income, birth weight and birth height on stunting incidents in 24-59 months old todddlers in Bangkalan. J Manaj Kesehat Yayasan RS.Dr. Soetomo. 2017;3(1)1. https://doi.org/10.29241/jmk.v3i1.85 DOI: https://doi.org/10.29241/jmk.v3i1.85

Nurmalasari Y, Anggunan A, Febriany TW. The effect of mother’s education and family income on stunting events in

-59 months old toddlers in Mataram Ilir Village of Seputih Sur Sub District. J Kebidanan Malahayati. 2020;6(2):205-11. https://doi.org/10.33024/jkm.v6i2.2409 DOI: https://doi.org/10.33024/jkm.v6i2.2409

Setiawan E, Machmud R, Masrul M. Factors influencing stunting events in 24-59 months old toddlers in primary care center puskesmas andalas of padang Timur sub district of padang city year 2018. J Kesehatan Andalas. 2018;7(2):275-284. https://doi.org/10.25077/jka.v7.i2 DOI: https://doi.org/10.25077/jka.v7.i2.p275-284.2018

Purnamasari M, Rahmawati T. The effect of exclusive breastfeeding on stunting incidents in 24-59 months old toddlers. J Ilam Kesehatan Sandi Husada. 2021;10(1):290-9. https://doi.org/10.35816/jiskh.v10i1.490 DOI: https://doi.org/10.35816/jiskh.v10i1.490

Sampe SA, Toban RC, Madi MA. The Effect of Exclusive Breastfeeding on Toddlers Stunting Incidents. J Ilmiah Kesehatan Sandi Husada. 2020;11(1): 448-55. https://doi.org/10.35816/jiskh.v10i2.314 DOI: https://doi.org/10.35816/jiskh.v11i1.314

Handayani S, Kapota WN, Oktavianto E. The Effect of Exclusive Breastfeeding on 24-36 Months Old Toddlers Stunting in Watugajah Village of Gonungkidul Regency. J Ilmiah Kesehatan Med Respati. 2019;14(4):287. https://doi.org/10.35842/mr.v14i4.226 DOI: https://doi.org/10.35842/mr.v14i4.226

Uwiringiyimana V, Ocké MC, Amer S, Veldkamp A. Predictors of stunting with particular focus on complementary feeding practices: A cross-sectional study in the northern province of Rwanda. Nutrition. 2019;60:11-8. https://doi.org/10.1016/j.nut.2018.07.016 PMid:30508763 DOI: https://doi.org/10.1016/j.nut.2018.07.016

World Health Organization. Global Strategy for Infant and Young Child Feeding. Fifty-fourth World Health Assembly. Geneva: World Health Organization; 2003. p. 8.

Kawulusan M, Walalangi RG, Sineke J, Mokodompit RC. The Effect of Child Care Pattern and Family Income on Stunting Incidents in 2-5 years old Children in Primary Care Center Bohabak. Gizide. 2019;11(2):88-95. DOI: https://doi.org/10.47718/gizi.v11i2.778

Utami RA, Setiawan A, Fitriyani P. Identifying causal risk factors for stunting in children under five years of age in South Jakarta, Indonesia. Enferm Clin. 2019;29:606-11. https://doi.org/10.1016/j.enfcli.2019.04.093 DOI: https://doi.org/10.1016/j.enfcli.2019.04.093

Lestari EF, Dwihestie LK. Exclusive breastfeeding affects toddler’s stunting incident. J Ilmiah Permas. 2020;10(2):129-36.

Zumrotun A, Wigati A, Kusumastuti D, Andriani D, Nurul KF. Panduan Praktis Keberhasilan Menyusui. Indonesia: Pustaka Pelajar; 2018. p. 1-138. Available from: https://118.97.240.83:5758/inlislite3/opac/detail-opac?id=85823

Rakotomanana H, Gates GE, Hildebrand D, Stoecker BJ. Determinants of stunting in children under 5 years in Madagascar. Matern Child Nutr. 2017;13(4):e12409. https://doi.org/10.1111/mcn.12409 PMid:28032471 DOI: https://doi.org/10.1111/mcn.12409

Ntshebe O, Channon AA, Hosegood V. Household composition and child health in Botswana. BMC Public Health. 2019;19:1-13. DOI: https://doi.org/10.1186/s12889-019-7963-y

Sarma H, Khan JR, Asaduzzaman M, Uddin F, Tarannum S, Hasan MM, et al. Factors Influencing the prevalence of stunting among children aged below five years in Bangladesh. Food Nutr Bull. 2017;38(3):291-301. https://doi.org/10.1177/0379572117710103 DOI: https://doi.org/10.1177/0379572117710103

Khattak UK, Iqbal SP, Ghazanfar H. The role of parents’ literacy in malnutrition of children under the age of five years in a semi- urban community of Pakistan: A case-control study. Cureus. 2017;9(6):e1316. https://doi.org/10.7759/cureus.1316 PMid:28690950 DOI: https://doi.org/10.7759/cureus.1316

Ika L, Ariati P. Faktor-faktor resiko penyebab terjadinya stunting pada balita usia 23-59 bulan risk factors causes of stunting in toddlers aged 23-59 months. J Oksitosn Kebidanan. 2019;6(1):28-37. DOI: https://doi.org/10.35316/oksitosin.v6i1.341

Walters CN, Rakotomanana H, Komakech JJ, Stoecker BJ. Maternal determinants of optimal breastfeeding and complementary feeding and their association with child undernutrition in Malawi (2015-2016). BMC Public Health. 2019;19(1):1-12. https://doi.org/10.1186/s12889-019-7877-8 DOI: https://doi.org/10.1186/s12889-019-7877-8

Habimana S, Biracyaza E. Risk factors of stunting among children under 5 years of age in the Eastern and Western provinces of Rwanda: Analysis of rwanda demographic and health survey 2014/2015. Pediatr Health Med Ther. 2019;10:115-30. https://doi.org/10.2147/phmt.s222198 DOI: https://doi.org/10.2147/PHMT.S222198

Hapsari W. Hubungan Pendapatan Keluarga, Pengetahuan Ibu Tentang Gizi, Tinggi badan Orang Tua dan Tingkat Pendidikan Ayah dengan Kejadian Stunting pada Anak Umur 12-59 Bulan. Thesis Ums Vol. 151, No. 2; 2018. p. 10-7. Available: https://www.eprints.ums.ac.id/58665 [Last accessed on 2022 Sep 26].

Gunardi H, Soedjatmiko S, Sekartini R, Medise BE, Darmawan AC, Armeilia R, et al. Association between parental socio-demographic factors and declined linear growth of young children in Jakarta. Med J Indones. 2017;26(4):286-92. https://doi.org/10.13181/mji.v26i4.1819 DOI: https://doi.org/10.13181/mji.v26i4.1819

Rahmawati NF, Fajar NA, Idris H. The effect of socio-economic factors and integrated health care post visits on toddlers stunting of poor beneficiary families in palembang. J Gizi Klin Indones. 2020;17(1):23. https://doi.org/10.22146/ijcn.49696 DOI: https://doi.org/10.22146/ijcn.49696

Prihutama NY, Rahmadi FA, Hardaningsih G. Early introduction of complementary foods as stunting risk factors in 2-3 years old babies. Diponegoro Med J. 2018;7(2):1419-30.

Sriyanti T, Sayekti ES, Kholida D. The effect of nutrition conscious family on stunting in 0-24 months old toddlers in primary care center singotrunan of banyuwang regency. J Healthy a sadar gizi (Kadarzi). 2017;5(2):56-71. https://www.ojsstikesbanyuwangi.com/index.php/healthy/article/view/28 [Last accessed on 2022 Sep 26].