Evaluation report
Interconnected Maternal and Child Determinants of Under-Five Morbidity in Indonesia: A Cross-Sectional Study for a Holistic Care Model to Achieve SDG 3
Widyawati W, Ristandiati HM, Widyatami CCK ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This cross-sectional study in Indonesia examined how maternal and child health factors together predict illness in children aged 12–59 months. Researchers found that maternal anemia and inadequate prenatal visits increased disease risk, but child factors like stunting, incomplete immunization, and developmental delay were even stronger predictors of childhood illness. The study proposes a holistic care model integrating physical, psychological, social, and spiritual dimensions to reduce childhood morbidity and achieve SDG 3.
Key points
- Maternal anemia (48.3% prevalence) increased disease risk 2.15-fold in children
- Inadequate antenatal care (fewer than 6 visits) associated with 1.78-fold increased risk of child illness
- Stunting was the strongest child predictor, with stunted children showing over 5 times the odds of illness
- Incomplete immunization increased disease risk 2.28-fold; developmental delay increased it 1.92-fold
- The multivariate model explained 42% of the variance in childhood illness
Limitations
This cross-sectional design can identify associations but not establish causation. The study was conducted in one regency in Indonesia, so findings may not generalize to other regions or countries with different health systems and epidemiologies.
Abstract
Abstract Background High childhood morbidity from infectious diseases in Indonesia remains a significant barrier to achieving Sustainable Development Goal (SDG) 3, Target 3.2. A holistic maternal-child care approach that integrates physical, psychological, social, and spiritual dimensions is essential. However, current care models are often fragmented, failing to address the complex interplay of risk factors across the continuum from pregnancy through early childhood. Methods This cross-sectional study was conducted in Sleman Regency, Indonesia, involving 450 children aged 12–59 months selected via multistage cluster sampling. Guided by the Holistic Maternal and Child Health Continuum of Care Model, data on maternal factors (anemia, pre-eclampsia, ANC utilization) and child factors (immunization status, stunting, developmental delay) were extracted from health records, including Maternal and Child Health (KIA) books and integrated service posts records. Multivariate logistic regression was used to assess predictors of childhood illness, controlling for socioeconomic confounders (p < 0.05). Results Maternal anemia (48.3% prevalence) significantly increased disease risk (aOR = 2.15; 95% CI: 1.38–3.35). Inadequate ANC (< 6 visits) was associated with a 1.78-fold increased risk (aOR = 1.78; 95% CI: 1.15–2.75). Child factors emerged as the strongest predictors: stunting was the most significant (aOR = 2.45; 95% CI: 1.58–3.80), with stunted children showing over five times the odds of illness (crude OR = 5.20; 95% CI: 3.44–7.86). Incomplete immunization (aOR = 2.28; 95% CI: 1.48–3.51) and developmental delay (aOR = 1.92; 95% CI: 1.05–3.51) were also significant independent predictors. The model explained 42% of the variance in childhood illness (Nagelkerke R²=0.42). Conclusion To reduce childhood illness and advance SDG 3 targets, a nurse/midwife-coordinated holistic care model is critical. This model must address interconnected physical, psychological, social, and spiritual determinants. Practical implementation requires integrated maternal-child health records, family-centered care, and continuity from preconception through early childhood. Such a model offers a pathway to improve child health outcomes and accelerate progress toward SDG 3 in Indonesia and similar settings.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- Proposed holistic maternal-child care model integrating physical, psychological, social, and spiritual dimensions with nurse/midwife coordination, integrated records, family-centered care, and continuity from preconception through early childhood
- Population
- 450 children aged 12–59 months in Sleman Regency, Indonesia, selected via multistage cluster sampling
Key finding
Maternal anemia increased disease risk with aOR = 2.15 (95% CI: 1.38–3.35)
W et al. · Europe PMC · 9 Jul 2026