INTRODUCTION: The role of providing nutrition to children aged 6-24 months who are stunted is related to the mother's ability to provide proper nutrition. Empowerment of mothers based on self-regulated learning is a nursing intervention that can be carried out by using the abilities, belief and individual capacities of mothers in completing tasks, managing and providing nutrition to children aged 6-24 months. Mother's characteristic are motivation, self-esteem, self-efficacy, knowledge, belief and ability to decisionmaking about providing nutrition to children, so it can be a learning process for the mother in using resources which improve the nutrition ability of the mother. This study aims to apply a women's empowerment model based on selfregulated learning in increasing the mother's ability to fulfill nutrition in stunted children aged 6-24 months. MATERIALS AND METHODS: The research design used a quasiexperiment. The sampling technique used cluster sampling with 76 respondents in intervention group and 76 respondents in control group. The research was conducted in the working area in Public Health Center, Malang Regency. Data analysis in this study used the Wilcoxon Signed Rank Test and Mann-Whitney. RESULTS: The results of the study found that there were differences in the ability of mothers to fulfill nutrition in stunted children between the intervention group and the control group (p = 0.000). There were mean differences in the ability of mothers to fulfill nutrition for stunted children before and after the intervention in the intervention group with indicators of breastfeeding, food preparation and processing, complementary- feeding and responsive feeding were increased (p = 0.000). However, in the control group, there were no differences in the ability of mothers to fulfill nutrition with indicator breastfeeding (p = 0.462), food preparation and processing (p = 0.721), complementary feeding (p = 0.721), complementary feeding (p = 0.462). (p = 0.054), responsive feeding (p = 0.465) and adherence to stunting therapy (p = 0.722). CONCLUSION: The women's empowerment model based on self-regulated learning is formed by individual mother factors, family factors, health service system factors, and child factors so that it can increase the mother's ability to fulfill nutrition in children aged 6-24 months who are stunted. The women's empowerment is a learning process about breastfeeding, food hygiene, infant and young children feeding, and responsive feeding by mothers to fulfill nutrition in children with stunting, with a goal and plan to achieve an improvement in mother's ability and nutritional status in children.
Apriyani Puji Hastuti, Tintin Sukartini, Yuni Sufyanti Arief et al.
India's National Food Security Act of 2013 (NFSA) led to one of the biggest expansions in food transfers in history, affecting over 500 million people. We use plausibly exogenous variation created by the NFSA to estimate the effect of food transfers on child nutrition. Using individual panel data across eight states in India over five years, we find that increased transfers significantly reduced stunting. The food transfers increased wage incomes and improved dietary diversity. Our results suggest that, in the states we study, the NFSA prevented approximately 1.8 million children from being stunted (JEL I12, I18, I38, J13, O12)
Nutrition education is an effective strategy to improve maternal knowledge regarding appropriate nutritional intake for toddlers, particularly in efforts to prevent stunting. This study aimed to analyze the effect of nutrition education on increasing the knowledge of mothers with stunted toddlers. A pre-experimental design with a one-group pre–post test approach was employed, involving 42 respondents selected using simple random sampling. The research instrument consisted of a 20-item knowledge questionnaire that had been tested for validity and reliability. Nutrition education was delivered through lectures and leaflet media, followed by assessments of maternal knowledge before and after the intervention. The results showed a significant increase in knowledge, as indicated by changes in knowledge categories from pre-test to post-test and the Wilcoxon test result with p = 0.000. These findings demonstrate that nutrition education plays an important role in enhancing maternal understanding of toddler nutrition as a preventive measure against stunting. Routine implementation of nutrition education in healthcare settings is recommended to strengthen promotive and preventive efforts related to child nutritional health. ABSTRAK Edukasi gizi merupakan salah satu upaya efektif untuk meningkatkan pengetahuan ibu mengenai pemenuhan nutrisi balita sebagai bagian dari pencegahan stunting. Penelitian ini bertujuan menganalisis pengaruh edukasi gizi terhadap peningkatan pengetahuan ibu yang memiliki balita stunting. Metode penelitian menggunakan desain pre-eksperimental one group pre–post test dengan melibatkan 42 responden yang dipilih melalui teknik simple random sampling. Instrumen penelitian berupa kuesioner pengetahuan sebanyak 20 item yang telah diuji validitas dan reliabilitasnya. Edukasi gizi diberikan melalui ceramah dan media leaflet, kemudian dilakukan pengukuran pengetahuan sebelum dan sesudah intervensi. Sebelum intervensi, sebagian besar ibu berada pada kategori pengetahuan kurang (50,0%) dan cukup (47,6%), dengan hanya 2,4% yang memiliki pengetahuan baik, setelah edukasi, proporsi pengetahuan baik meningkat menjadi 64,3%, sementara kategori pengetahuan kurang menjadi 9,5% dan kategori cukup menjadi 26,2%. Hal ini menunjukkan adanya peningkatan pengetahuan yang signifikan, ditandai dengan perubahan kategori pengetahuan ibu dari pre-test ke post-test serta hasil uji Wilcoxon dengan nilai p = 0,000. Temuan ini menunjukkan bahwa edukasi gizi berperan penting dalam meningkatkan pemahaman ibu terkait pemenuhan nutrisi balita sebagai langkah pencegahan stunting. Penelitian ini merekomendasikan penerapan edukasi gizi secara rutin di fasilitas pelayanan kesehatan untuk memperkuat upaya promotif dan preventif terkait kesehatan gizi anak.
Stunting is a chronic nutritional problem in toddlers that remains a global concern, including in Indonesia. This condition is characterized by height that is not appropriate for age due to long-term malnutrition, repeated infections, and environmental and social factors. The impact of stunting not only affects physical growth but also cognitive development, future productivity, and increases the risk of degenerative diseases in adulthood. Various factors contribute to stunting, including biological factors such as the child's gender and behavioral factors such as maternal knowledge about nutrition and health. This study aims to analyze the relationship between child gender and maternal knowledge and the incidence of stunting in toddlers. The research design used a quantitative cross-sectional approach. A sample of 73 respondents was selected using a stratified proportional sampling technique. Data collection was conducted through structured interviews using questionnaires and anthropometric measurements of toddlers. Data analysis was performed using univariate analysis to describe frequency distributions, and bivariate analysis using the chi-square test with a 95% confidence level. The results showed no significant association between child gender and stunting (p > 0.05). This indicates that biological factors such as gender are not the primary determinant of stunting in the study area. Conversely, there was a significant relationship between maternal knowledge and the incidence of stunting in toddlers (p < 0.05), indicating that mothers with low levels of knowledge are at greater risk of having stunted children. These findings emphasize the importance of improving maternal knowledge through ongoing nutrition education programs, health counseling, and promotive-preventive activities at community health centers. These interventions are expected to prevent stunting and other health problems in toddlers and support the achievement of the national stunting reduction target.
Stunting is a health problem that is very urgent to be addressed. This is associated with increased morbidity, mortality, development of cognitive impairment and an increased risk of various chronic diseases in the future. The research method uses a qualitative approach. With the literature review method, which includes activities related to library data collection methods, reading and recording, and managing research materials. The results of the study show that the treatment of stunting can be divided into 2 methods. First, specific interventions that contribute 30% to the success of treatment, are aimed at children within the First 1,000 Days of Life (HPK), are generally carried out by the health sector and are short-term in nature. This can be done through the target group of adolescents and women of childbearing age, pregnant women, nursing mothers and children 0-23 months, children 24-59 months through priority, important and conditional interventions. The two sensitive interventions, which contribute 70%, are aimed at various development activities outside the health sector targeting the general public. The types of interventions that can be carried out are increasing the supply of drinking water and sanitation, increasing access to and quality of nutrition and health services, increasing awareness, commitment, parenting practices, maternal and child nutrition, increasing access to nutritious food.
There have been steep falls in rates of child stunting in much of Sub-Saharan Africa (SSA). Using Demographic and Health Survey data, we document significant reductions in stunting in seven SSA countries in the period 2005-2014. For each country, we distinguish potential determinants that move in a direction consistent with having contributed to the reduction in stunting from those that do not. We then decompose the change in stunting and in proximal determinants into a part that can be explained by changes in distal determinants and a residual part that captures the impact of unmeasured factors, such as vertical nutrition programs. We show that increases in coverage of child immunization, deworming medication and maternal iron supplementation often coincide with a fall in stunting. The magnitudes and directions of changes in two other proximal determinants -- age-appropriate feeding and diarrhea prevalence -- suggest that these have not been strong contributors to the fall in stunting. Utilization of maternity care emerges from the decomposition analysis as the most important distal determinant associated with reduced stunting, and also with increased coverage of iron supplementation, and, to a lesser extent, with child immunization and deworming medication. This circumstantial evidence is strong enough to warrant more detailed investigation of the extent to which maternity care is an effective channel through which to target further attacks on the blight of undernourished children.
Leander R. Buisman, Ellen Van de Poel, Owen O’Donnell et al.
This issue of Abstract Digest brings to you a set of interesting articles on stunting burden, drivers, and learnings from countries that have been successful in reducing stunting, including a case study on Chhattisgarh. In addition, there are studies on anthropometric data quality assessment, and a study describing the health system components required for the delivery of nutrition-specific interventions. This issue also includes studies on COVID-19 and its implications for child nutrition. In this edition, we have included a Call for Action issued by leaders of four UN agencies to protect children's right to nutrition in the face of the COVID-19 pandemic. In India, a diverse group of nutrition stakeholders have pledged their renewed Commitment to Action for supporting efforts by the government and all of society.
BACKGROUND: Child stunting remains a persistent public health challenge in Peru. Although women's empowerment has been linked to improved child health, evidence on its domain-specific relationship with stunting remains limited. The objective of this study was to assess the association between women's empowerment, across attitudes towards violence, social independence, and decision-making, and child stunting in Peru. METHODS: We conducted an analytical cross-sectional study using nationally representative data from the 2021 Demographic and Family Health Survey (ENDES), including 16,650 mother-child pairs. Analyses of women's empowerment were conducted in a sub-sample with complete SWPER data (n = 12,696). Stunting was defined as height-for-age below - 2 standard deviations of WHO standards. Women's empowerment was measured using the SWPER Global index and categorised into tertiles. All analyses accounted for the complex survey design, including sampling weights. Crude and adjusted logistic regression models estimated odds ratios (ORs) with 95% confidence intervals (CIs). RESULTS: The overall prevalence of child stunting was 11.3%. Stunting disproportionately affected disadvantaged groups, particularly children living in rural areas and from lower wealth quintiles. In adjusted analyses, higher maternal decision-making was associated with lower odds of stunting (medium vs. low: aOR 0.65; 95% CI 0.46-0.92; high vs. low: aOR 0.48; 95% CI 0.34-0.69). No significant associations were found for attitudes towards violence or social independence after adjustment. CONCLUSIONS: Maternal decision-making empowerment is associated with lower odds of child stunting in Peru. These findings suggest that strategies aimed at improving child nutrition may benefit from incorporating interventions that strengthen women's agency within household decision-making.
Marisella Chumán-Sánchez, Brando Ortiz-Saavedra, Leonardo J. Uribe-Cavero et al.
Abstract Child malnutrition persists globally. While progress in reducing stunting has been witnessed over the last six years, this progress is not sufficient to meet Sustainable Development Goal targets on stunting. In Africa, child malnutrition is estimated to result in between 1.6 to 16% losses in gross domestic product. Undernutrition is also attributed as a cause of death for 11% of African children aged five years and below. Men and women play distinct roles in supporting a child's nutrition. Women frequently carry the bulk of the workload related to food, care, and health, all of which are critical factors in child nutrition. Using focus group discussions and individual interviews with communities in rural Central Malawi, we sought to understand the roles played by men and women in achieving child nutrition in this qualitative study. We found that both men and women were involved in productive, reproductive, and community work. However, consistent with the literature, women carried a disproportionate workload in supporting child nutrition compared to men. Women's heavier workloads often prevented them from being able to meet children's food needs. Nevertheless, shifts in gender roles were observed in some of the sampled communities, with men taking up responsibilities that have been typically associated with women. This undoing of gender roles did not necessarily increase women's power within the household. Improving gender equality and child nutrition will require efforts to redistribute gendered work and encourage men to move towards shared power over household decision-making and control over income with women.
Elizabeth Mkandawire, Clement Bisai, Elizabeth Dyke et al.
The main objective of this paper is to examine the effects of household shocks on the nutrition status of children between 0–59 months in Tanzania. The study employed the national panel survey data of Tanzania collected in three waves: 2008/09, 2010/11, and 2012/13. The study used the panel random-effects probit model to estimate the effects of household shocks on child nutrition status, measured by binary variables: stunting, wasting, and underweight. Findings indicated that weather shocks increase the probability of a child being stunted and underweight. Moreover, the results revealed that food price rise shocks and the death of a family member increase the probability of child-stunting. In addition, the findings indicated that food assistance reduces the probability of a child being stunted and underweight. These findings suggest the need for the government to improve food assistance programs to reach many people,especially the poor and marginalized households in a period of shocks. In addition, agricultural policies that aim at increasing productivity, such as irrigation schemes,should also be enhanced to enable food availability in the country; and protect children from malnutrition even after the occurrence of shocks.Galiano, A. & M. Vera-Hernandez. 2008. Health Shocks, Household Consumption, and Child Nutrition. Instituto Valenciano De Investigaciones Economicas.Gaydosh, L. 2015. Childhood Risk of Parental Absence in Tanzania. Demography, 52(4): 1121–1146. https: //doi.org/10.1007/s13524–015–0411–4.Groot, R. De, T. Palermo, S. Handa, L. Peter & R. Amber. 2017. Cash Transfers and Child Nutrition : Pathways and Impacts. May 2015, 621–643. https: //doi.org/10.1111/dpr.12255.Halmdienst, N. & R. Winter-Ebmer. 2014. Long-Run Relations Between Childhood Shocks and Health in Late Adulthood — Evidence from the Survey of Health, Ageing, and Retirement in Europe. 60(April): 402–434. https: //doi.org/10.1093/cesifo/ifu015.Hoddinott, J. & B. Kinsey. 2001. Child Growth in the Time of Drought. Oxford Bulletin of Economics and Statistics, 63(4): 409–436.Johnston, F. E., S. M. Low, Y. De Baessa & R. B. Macvean. 1987. Interaction of Nutritional and Socioeconomic Status as Determinants of Cognitive Development in Disadvantaged Urban Guatemalan Children. American Journal of Physical Anthropology, 73(4): 501–506. https: //doi.org/ 10.1002/ajpa.1330730412.Kousky, C. 2016. Impacts of Natural Disasters on Children. The Future of children, 73–92.Kumar, S., R. Molitor & S. Vollmer. 2016. Drought and Early Child Health in Rural India Population Council. Population and Development Review. https: //www.popcouncil.org/research/drought-andearly-child-health-in-rural-india.Leroy, J. 2011. ZSCORE06: Stata Module to Calculate Anthropometric Z-Scores Using the 2006 WHO Child Growth Standards. https: //econpapers.repec.org/repec: boc: bocode: s457279.Martin, W. & M. Ivanic. 2016. Food Price Changes, Price Insulation, and Their Impacts on Global and Domestic Poverty. in Food Price Volatility and Its Implications for Food Security and PolicySpringer International Publishing. https: //doi.org/10.1007/978–3–319–28201–5,_pp. 101–113. Martorell, R., L. K. Khan & D. G. Schroeder. 1994. Reversibility of Stunting: Epidemiological Findings in Children from Developing Countries. European Journal of Clinical Nutrition, 48(SUPPL. 1): S45–57. http: //europepmc.org/article/med/8005090.Martorell, R. 1999. The Nature of Child Malnutrition and Its Long-Term Implications. Food and Nutrition Bulletin. 20(3): 288–292.Mbegalo, T. 2016. The Impact of Food Price Changes and Land Policy Reforms on Household Welfare in Rural Tanzania (No. 217). Discussion Papers.Michaelsen, M. M. & S. Tolan. 2012. Children at Risk: The Effect of Crop Loss on Child Health in Rural Mexico #376. RUHR Economic Papers.Mikalitsa, S. M. 2015. Intrahousehold Allocation, Household Headship, and Nutrition of Under-Fives: A Study of Western Kenya | African Journal of Food, Agriculture, Nutrition and Development.Mkonda, M. Y. & He, X. 2018. Agricultural History Nexus Food Security and Policy Framework in Tanzania. Agriculture & Food Security, 1–12.Nsabimana, A. & J. T. Mensah,2020. WIDER Working Paper 2020 / 57 Weather Shocks and Child Nutrition Evidence from Tanzania. May.Ogasawara, K. & M. Yumitori. 2019. Early-Life Exposure to Weather Shocks and Child Height: Evidence from Industrializing Japan. SSM - Population Health, 7(November 2018): 100317.
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Monica Sebastian Kauky, Martin Chegere, Razack Bakari Lokina
