Peer-reviewed article

Gross domestic product and geographic area as social determinants of child stunting and severe stunting in Indonesia: A multilevel analysis

Tri Siswati, Lukman Waris, Bunga Astria Paramashanti, Hari Kusnanto, Joko Susilo · 30 Dec 2022

Summary

Written by AI, not yet AICS's view · claude-sonnet-5-5

This study looked at social factors linked to stunting and severe stunting among Indonesian children. It used 2013 national survey data plus government statistics on economic and fiscal indicators, covering 3,953 children aged 6-23 months and 10,215 children aged 24-59 months. Areas with higher gross domestic product had a slightly lower risk of stunting and severe stunting in both age groups. Tax ratio was linked to lower severe stunting only among children aged 24-59 months. Stunting also differed by geographic area.

Key points

Higher gross domestic product was associated with lower stunting risk in children aged 6-23 months (ARRR 0.99; 95% CI 0.98-1.00) and 24-59 months (ARRR 0.99; 95% CI 0.97-0.99).
Higher gross domestic product was also associated with lower severe stunting risk in both age groups (ARRR 0.99 in each).
Tax ratio was significant only for severe stunting among children aged 24-59 months (ARRR 0.98; 95% CI 0.96-0.99).
Stunting and severe stunting differed by geographic area.
The authors conclude that equitable economic growth is important for reducing stunting across Indonesia's geographic settings.

Limitations

The data are cross-sectional (2013), so the study shows associations and cannot show that economic growth causes lower stunting. The effect sizes are very small and the abstract does not describe the geographic differences in detail.

Abstract

Background: In Indonesia, socioeconomic disparities in childhood stunting is vast.Objectives: This study aimed to analyze the social determinants of stunting and severe stunting children in Indonesia.Methods: We analyzed data from cross-sectional surveys of Indonesia’s National Basic Health Research in 2013, the Central Bureau of Statistics, and the Ministry of Finance. Our samples were 3953 children aged 6-23 months and 10215 children aged 24-59 months. Dependent variables were the prevalence of child stunting and severe stunting. Independent variables covered factors at the social level while controlling structural and biological level-factors. Data were analyzed using multilevel analysis using generalized linear mixed models (GLMM).Results: Gross domestic product was associated with the reduced risk of stunting among children aged 6-23 months (ARRR= 0.99; 95%CI: 0.98-1.00) and 24-59 months (ARRR= 0.99; 95%CI: 0.97-0.99) as well as with the decreased risk of severe stunting among 6-23 months (ARRR= 0.99; 95%CI: 0.98-1.00) and 24-59 months (ARRR= 0.99; 95%CI: 0.97-0.99) old children. Tax ratio was a significant factor only for the severe stunting among 24-59 months old children (ARRR= 0.98; 95%CI: 0.96-0.99). There was also a geographical difference related to stunting and severe stunting.Conclusions: Equitable economic growth is an essential factor to improve the health and welfare of stunting and severe stunting children across the geographical setting in Indonesia.