This study examines Community Health Center (Puskesmas) service innovations for stunting prevention and management in Kerinci Regency and explains their potential contribution to human capital formation and local development. The study employed a qualitative descriptive approach using a multiple-case study design. Eight innovations implemented across seven Community Health Centers were examined through document review of innovation proposals, activity reports, beneficiary data, and available implementation evidence. The analysis combined within-case analysis, cross-case thematic analysis, life-cycle mapping, and a Theory of Change framework. Innovation maturity scores were used descriptively to indicate implementation readiness rather than programme effectiveness. Four cross-case themes emerged: life-course prevention and early risk detection; maternal-risk monitoring and safe delivery; breastfeeding support and nutrition education; and local food-based supplementary feeding and child nutrition support. The innovation portfolio covered adolescent girls, pregnant women, childbirth, infants, and young children, with the strongest concentration of interventions during pregnancy and early childhood. Service mechanisms included home visits, monitoring of high-risk pregnancies, collaboration between midwives and traditional birth attendants, digital nutrition education, breastfeeding support, and local food-based supplementary feeding. The findings show complementary primary health-care responses to stunting risks. Nevertheless, the available documents primarily report activities and programme outputs; they do not yet provide sufficient evidence to establish causal effects on stunting prevalence.
Stunting is a linear growth disorder associated with chronic malnutrition. The development of snacks made from local food ingredients rich in protein and bioactive compounds can support food diversification. This study aims to analyze the protein and flavonoid content, as well as the acceptance level, of catfish (Clarias gariepinus) cakes supplemented with fern leaf flour (Diplazium esculentum). The laboratory phase used a completely randomized design with four formulations. The laboratory phase employed a completely randomized design with four formulations containing 0, 5, 10, and 15 g of fern leaf flour, each with three replicates. Protein content was analyzed using the Kjeldahl method, and flavonoid content was determined using UV-Vis spectrophotometry. Acceptability was assessed using a hedonic test involving 30 untrained child panelists aged 9–11 years. Laboratory data were analyzed according to their distribution; nonparametric comparisons were performed using the Kruskal Wallis test, followed by paired comparisons with multiple comparisons correction if differences were found. Acceptability data were analyzed using the Friedman test, followed by the Wilcoxon signed-rank test. Protein content increased from 11.67 to 15.31 g/100 g of cookies as the fern leaf flour content increased from 0 to 15 g. Flavonoid content also increased from 1.2 to 52.7 mg/100 g cookies. Formula P1, with the addition of 5 g of fern leaf flour, received the highest average acceptability ratings for taste, aroma, texture, color, and overall acceptability. The results of the study indicate that the addition of fern leaf flour can increase the measured protein and flavonoid content in catfish cookies, whereas adding too much can reduce sensory acceptability. The product still requires evaluation of its nutritional adequacy, safety, serving size, and suitability for the target group before it can be recommended as a dietary supplement.
Background: Indonesia reduced its national stunting prevalence from 21.5% in 2023 to 19.5% in 2024 through accelerated multisectoral interventions. However, evidence regarding the characteristics, implementation approaches, and outcomes of these interventions remains fragmented. Objective: This scoping review mapped the evidence on stunting reduction efforts implemented in Indonesia between 2020 and 2025, focusing on intervention characteristics, target populations, implementation approaches, reported outcomes, and research gaps. Methods: A scoping review was conducted following the Joanna Briggs Institute methodology and reported according to the PRISMA-ScR guidelines. Scopus and PubMed/MEDLINE were systematically searched for studies published between January 2020 and December 2025. Eligible studies were selected using the Population–Concept–Context framework, and findings were synthesized through narrative evidence mapping. Results: Thirty-one studies were included. Nutrition supplementation and complementary feeding were the most frequently reported interventions, followed by nutrition education, community empowerment, health cadre strengthening, governance, and multisectoral collaboration. Most interventions improved maternal knowledge, child feeding practices, health worker capacity, community participation, and child growth indicators. Successful implementation consistently depended on implementation capacity, interprofessional collaboration, community engagement, and supportive local governance. Limited evidence was identified regarding implementation fidelity, cost-effectiveness, scalability, and long-term sustainability. Conclusion: Indonesia's stunting reduction efforts have evolved toward integrated, multisectoral strategies addressing both immediate and underlying determinants of child growth. Strengthening implementation research and context-specific, evidence-informed approaches will be essential to sustain equitable reductions in childhood stunting
Toddlers are a vulnerable age group to various health problems and therefore require regular monitoring of their growth and development through Posyandu (Integrated Health Posts) activities. Toddlers’ visits to Posyandu are one of the indicators of the success of maternal and child health services. However, the coverage of toddlers’ visits to Posyandu in the working area of Satria Community Health Center, Tebing Tinggi, has not yet reached the established target. This study aimed to analyze the factors influencing toddlers’ visits to Posyandu in the working area of Satria Community Health Center, Tebing Tinggi, in 2026. This study employed an analytical survey with a quantitative approach and a cross-sectional design. The population and sample consisted of 52 mothers who had toddlers attending Posyandu in the working area of Satria Community Health Center, Tebing Tinggi. Data were analyzed using the Chi-square test and multiple binary logistic regression analysis. The results showed that education (p = 0.001), employment status (p = 0.039), distance from residence (p = 0.001), knowledge (p = 0.003), attitude (p = 0.002), and family head support (p = 0.000) were significantly associated with toddlers’ visits to Posyandu. The multivariate analysis showed that knowledge was the most dominant factor influencing toddlers’ visits to Posyandu (p = 0.003; Exp(B) = 71.005). The study concluded that education, employment status, distance from residence, knowledge, attitude, and family head support were factors influencing toddlers’ visits to Posyandu, with knowledge being the most dominant factor. Therefore, health workers should strengthen health education for mothers of toddlers and involve family members in efforts to improve regular attendance at Posyandu according to the scheduled visits.
Adolescence represents a critical stage of human development characterized by rapid physical growth and increased nutritional requirements.However, adolescents remain underrepresented in nutrition surveillance systems, particularly in low-and middle-income countries where the burden of malnutrition remains high.This study aimed to examine the current state of adolescent nutrition surveillance and identify key gaps in existing data systems that limit evidence-based policy and programming.We conducted a narrative literature review and policy analysis using scientific publications and authoritative institutional reports published between 2000 and 2025.Data sources included peer-reviewed journals and reports from major global health organizations.The analysis focused on measuring adolescent nutritional indicators and integrating these indicators into national health information systems.The findings reveal that current surveillance systems largely prioritize children under five years of age and women of reproductive age, leaving adolescents underrepresented in routine monitoring systems.Existing data sources, including household surveys and school-based health surveys, provide only partial and irregular information on adolescent nutritional status.Furthermore, adolescents are increasingly affected by the triple burden of malnutrition, including undernutrition, overweight and obesity, and micronutrient deficiencies such as anaemia.Strengthening adolescent nutrition surveillance by integrating standardized indicators into national health information systems is essential to support evidencebased decision-making, guide targeted interventions, and improve long-term health outcomes for adolescents.
Exclusive breastfeeding plays a vital role in improving infant health. However, the coverage of exclusive breastfeeding in some areas is still not optimal. One key factor influencing exclusive breastfeeding is maternal knowledge of proper breastfeeding practices. Health education using audio-visual media and booklets can be used as an effort to improve pregnant women's knowledge about breastfeeding practices. This study aims to determine the effect of audio-visual education and booklets on pregnant women's knowledge about breastfeeding practices in the Letis Community Health Center, East Sumba Regency. This study used a quasi-experimental design with a two-group pretest-posttest design. The study sample consisted of 60 pregnant women selected using a total sampling technique. The treatment group (n = 30 people) was given education using audio-visual media and booklets, while the control group (n = 30 people) was given education using booklets only. Data were collected carried out using a knowledge questionnaire about breastfeeding practices. Data analysis was carried out using statistical tests to see differences in knowledge before and after the intervention. The results showed that there was an increase in knowledge of pregnant women after being given education in both the treatment and control groups. Education using the combination of audio-visual and booklet media versus booklet-only are both effective in increasing pregnant women's knowledge about breastfeeding practices.
Paulina Winarastuti Bunga, Helga J. N. Ndun, Galuh Wiedani K.D. Larasati et al.
Introduction: Malnutrition remains a significant public health concern, particularly in low- and middle-income countries where children are disproportionately affected. In Indonesia, although various nutrition-specific and nutrition-sensitive interventions have been implemented, stunting, wasting, and growth faltering continue to pose major challenges. Most nutrition programs emphasize food or nutrient provision, yet the behavioural factors influencing feeding practices and intervention adherence often receive less attention. Nutritional education has increasingly been recognized as an important strategy to complement these interventions. This narrative review aims to examine the current evidence on the role of nutritional education in improving the effectiveness of nutrition interventions. Methods: A narrative literature review was conducted by searching PubMed, Scopus, Google Scholar, and ScienceDirect for English-language publications from 2014 to 2026. The review included studies that integrated nutritional education with nutrition interventions, such as food supplementation, complementary feeding, and community-based nutrition programs. Relevant reports from international organizations were also included to provide broader context. Results: The available evidence suggests that nutritional education strengthens the impact of nutrition interventions by improving caregivers' knowledge, infant and young child feeding practices, dietary diversity, adherence to intervention programs, and health-seeking behaviors. Overall, interventions that combined nutritional education with nutrition support showed more favorable improvements in child growth and nutritional outcomes than those focusing solely on nutrient provision. In addition, educational components contributed to more sustainable changes in health and nutrition behaviors. Conclusion: Nutritional education is a valuable complement to nutrition interventions because it addresses the behavioral and knowledge-related factors that influence nutritional outcomes. Integrating evidence-based educational approaches into nutrition programs has the potential to improve program effectiveness and contribute to more sustainable reductions in childhood malnutrition.
Saskia Piscesa, Al Ilham Ksatria Gagah Perkasa, Niken Salsabyla
Background: Iron deficiency anemia (IDA) remains the most common micronutrient deficiency globally and continues to represent a major public health concern among children younger than five years, particularly in low- and middle-income countries. Early identification of children at risk is essential to prevent adverse effects on growth, neurodevelopment, and long-term health outcomes. Methods: A narrative review was undertaken to synthesize evidence from observational studies indexed in Scopus and published between 2019 and 2026. The review focused on studies evaluating screening approaches beyond conventional hemoglobin measurement, with particular emphasis on risk-based and non-invasive strategies for improving the early detection of IDA among Indonesian children. Results: The available evidence indicates that, in settings where access to invasive laboratory investigations is constrained, validated risk-based screening instruments and non-invasive assessment methods may improve the identification of children at risk for IDA. These approaches contribute not only to more accurate estimation of disease burden but also to a broader understanding of the cognitive implications and nutritional determinants of iron deficiency, extending beyond reliance on biomarker-defined diagnostic thresholds. Conclusion: Incorporating a practical risk-based IDA screening tool into routine child growth monitoring has the potential to enhance the early identification of vulnerable children, facilitate appropriate referral for confirmatory testing and timely intervention, and support the integration of anemia prevention within Indonesia's existing child nutrition and growth promotion programs.
Background: Malnutrition in Africa presents an increasingly complex public health dilemma characterised by the coexistence of undernutrition, overnutrition, and micronutrient deficiencies, a phenomenon now recognised as the triple burden of malnutrition (TBM). Method: This narrative review synthesises evidence from demographic and health surveys, regional studies, and peer-reviewed research conducted across Sub-Saharan and North Africa to examine prevalence trends, determinants, and policy responses. Results: The findings reveal that while childhood stunting and wasting remain widespread in East and West Africa, adult overweight and obesity are rising sharply in urban centres such as Accra, Nairobi, Johannesburg, and Cairo. Micronutrient deficiencies, particularly anemia, vitamin A, and zinc deficiencies, continue to affect more than half of women and children across many African countries. Country-specific studies demonstrate distinct but overlapping patterns: in Ghana, TBM prevalence declined modestly from 7.6 % to 5 % between 2003 and 2022 in Ethiopia, spatial clustering of stunting, obesity, and micronutrient deficits indicates strong geo-ecological influences and in South Africa, stunting and obesity coexist in over one-third of households. Conclusions: The review identifies socioeconomic inequality, urbanisation, gender disparity, and weak food-system governance as common structural drivers. Without integrated, multisectoral interventions linking agriculture, health, education, and social protection, the continent risks deepening the nutrition inequality divide. Tackling the triple burden is essential to achieving Sustainable Development Goal 2 (Zero Hunger) and Goal 3 (Good Health and Well-Being) and to realising the African Union’s Agenda 2063 vision for a healthy and productive population.
Akinade Enoch Ogunniyi, Oluwadamilola Elizabeth Adetoro, Genevieve Awuah-Cobbinah et al.
Background: Adequate protein intake is essential for child growth, yet optimal growth depends not only on protein quantity but also on the efficiency of protein utilization. Multiple biological and environmental factors may impair the conversion of dietary protein into functional body proteins, contributing to growth faltering despite sufficient protein intake. Methods: This narrative review synthesized recent evidence published between 2020 and 2026 from PubMed, Scopus, ScienceDirect, and Google Scholar. Relevant peer-reviewed studies, systematic reviews, meta-analyses, and clinical guidelines were critically reviewed to identify determinants affecting protein digestion, absorption, metabolism, and tissue protein synthesis in children. Results: Protein utilization is influenced by dietary protein quality, digestive function, intestinal absorption, environmental enteric dysfunction, gut microbiota, infection, inflammation, micronutrient status, energy adequacy, and socioeconomic and environmental conditions. These factors interact to reduce amino acid bioavailability, suppress anabolic pathways, increase protein catabolism, and impair tissue protein synthesis, thereby limiting linear growth. Conclusions: Optimizing child growth requires integrated nutrition strategies that combine high-quality protein intake with interventions supporting intestinal health, adequate energy and micronutrient intake, infection prevention, and improved environmental conditions to maximize protein utilization.
