JMIR Publications

ABSTRACT

Background:

The prevalence of stunting in Indonesia remains substantial at 21.5%, indicating that about one in five children under the age of five is affected, with the highest incidence observed among children aged 24 to 35 months. The cause-effect of stunting has known as a complex factor, including family, environmental, social and cultural factors, in stunting among children under five years. Yet, the latest update associated factors emphasizing on social and environmental factors are still limited.

Objective:

To analyse the latest evidence on the factors associated with stunting, with a particular focus on external and exposome factors, to provide actionable insights for reducing stunting in Indonesia.

Methods:

A secondary data analysis was conducted by extracting data from 2023 Indonesia Health Survey (Survey Kesehatan Indonesia- SKI 2023). This study analysed a total of 78,049 children under five years who had a complete response to all interest variables (sex, immunisation status, last months’ history of diarrhoea, place of residence, social benefit card ownership, household water sources, water quality, and geographical location). bivariate analysis using Pearson chi-square test was implemented with a p-value of <0.05 for determining a significant association. A multivariate analysis has been done to assess further association between the outcome and each predictor.

Results:

The prevalence of stunting in this study was 15,958 (19.69%). The unadjusted analysis showed that immunization status (aOR: 1.39 [1.22, 1.48]), KPS ownership (aOR: 1.13 [1.05, 1.21]), are significant factors associated to develop stunting. Meanwhile, wealthiest quintile (aOR: 0.47 [0.42, 0.52]) proved the less likely associated with stunting comparing to poorer family. In the adjusted model, the variables such as household water sources (aOR: 1.18 [1.00, 1.37]) and geographical location, particularly in Sulawesi (aOR: 1.23 [1.14, 1.33]), and Papua and Maluku (aOR: 1.20 [1.08, 1.33]), are partially associated with the development of stunting among children.

Conclusions:

Not receiving immunisation, social and environment factors, including KPS ownership, poor wealthy index, unimproved water sources, and living in Sulawesi, Papua and Maluku, are significantly increase the odds of stunting and considering as the latest update of associated factors with stunting. Improving multifaced and holistic intervention with focus on social and environmental factors requires to accelerate the target of stunting reduction. Clinical Trial: Not Applicable