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3,280 reports · page 319 of 328

Peer-reviewed articleCrossref30 Dec 2022

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

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.

Tri Siswati, Lukman Waris, Bunga Astria Paramashanti et al.

Peer-reviewed articleCrossref1 Nov 2018

Association between stunting and early childhood development among children aged 36–59 months in South Asia

Abstract Stunting (length‐for‐age z score < −2) before 2 years of age has shown associations with poor child developmental indicators, but information at the population level is scarce in South Asia, the region with the highest burden of stunting. We examined associations between z scores (i.e., height for age [HAZ], weight for age [WAZ], and weight for height [WHZ]) and undernutrition (i.e., stunting [HAZ < −2], wasting [WHZ < −2], and underweight [WAZ < −2]) with learning/cognition and social–emotional development among children 36–59 months of age. Data from Multiple Indicator Cluster Surveys in Bangladesh ( n = 8,659), Bhutan ( n = 2,038), Nepal ( n = 2,253), and Pakistan (Punjab n = 11,369 and Sindh n = 6,718) were used. Children were considered developmentally “on‐track” in learning/cognition or social–emotional domains if they met specific early child development criteria. Meta‐analysis was conducted to examine regional associations, adjusting for socio‐economic status, early childhood education, and quality of care. In a pooled sample, on‐track learning/cognition development was positively associated with HAZ ( OR = 1.17, 95% CI [1.07, 1.27]) and WAZ ( OR = 1.18, 95% CI [1.07, 1.31]) and negatively associated with stunting ( OR = 0.72, 95% CI [0.60, 0.86]) and underweight ( OR = 0.75, 95% CI [0.66, 0.86]) but not associated with WHZ or wasting. On‐track development of social–emotional domain was not associated with any z scores or undernutrition indicators. Across several countries of South Asia, stunted children were less likely to be developmentally “on track” for learning/cognition. It is likely that interventions that prevent stunting may benefit child development, leading to significant individual and societal gains given the large burden of child stunting in regions like South Asia.

Yunhee Kang, Víctor M. Aguayo, Rebecca K. Campbell et al.

SurvivalDevelopmentBDBTNPPKRead at source

Peer-reviewed articleCrossref23 May 2018

Understanding the geographical burden of stunting in India: A regression‐decomposition analysis of district‐level data from 2015–16

AbstractIndia accounts for approximately one third of the world's total population of stunted preschoolers. Addressing global undernutrition, therefore, requires an understanding of the determinants of stunting across India's diverse states and districts. We created a district‐level aggregate data set from the recently released 2015–2016 National and Family Health Survey, which covered 601,509 households in 640 districts. We used mapping and descriptive analyses to understand spatial differences in distribution of stunting. We then used population‐weighted regressions to identify stunting determinants and regression‐based decompositions to explain differences between high‐ and low‐stunting districts across India. Stunting prevalence is high (38.4%) and varies considerably across districts (range: 12.4% to 65.1%), with 239 of the 640 districts have stunting levels above 40% and 202 have prevalence of 30–40%. High‐stunting districts are heavily clustered in the north and centre of the country. Differences in stunting prevalence between low and high burden districts were explained by differences in women's low body mass index (19% of the difference), education (12%), children's adequate diet (9%), assets (7%), open defecation (7%), age at marriage (7%), antenatal care (6%), and household size (5%). The decomposition models explained 71% of the observed difference in stunting prevalence. Our findings emphasize the variability in stunting across India, reinforce the multifactorial determinants of stunting, and highlight that interdistrict differences in stunting are strongly explained by a multitude of economic, health, hygiene, and demographic factors. A nationwide focus for stunting prevention is required, while addressing critical determinants district‐by‐district to reduce inequalities and prevalence of childhood stunting.

Purnima Menon, Derek Headey, Rasmi Avula et al.

SurvivalDevelopmentProtectionINRead at source

Peer-reviewed articleCrossref1 Aug 2025

Contextual Determinants of Stunting in Indonesia: A Systematic Review of Nutritional Interventions and Antenatal Care

Background: Stunting is a significant global health issue, especially in Indonesia, where long-term malnutrition adversely affects children's growth and development, with prevalence rates still exceeding the WHO's recommended threshold. This study examines the contextual factors that influence the effectiveness of nutritional interventions and antenatal care (ANC) in combating stunting in Indonesia. Methods: A systematic review was conducted by the PRISMA guidelines. A comprehensive search across five major academic databases (Google Scholar, PubMed, ScienceDirect, Embase, and ProQuest) identified 3,690 articles. After a rigorous screening process, 13 studies published between 2019 and 2023 were included in the analysis, focusing on key contextual factors that impact stunting interventions in Indonesia. The quality appraisal utilized Joanna Briggs Institute checklists for analytical cross-sectional studies, cohort studies, quasi-experimental studies, qualitative research, systematic reviews, case reports, and text and opinion papers, each matched to the respective study design. Findings: The review identified four critical contextual factors shaping stunting interventions: (1) socioeconomic status, particularly household income and education, which significantly influence access to healthcare and nutrition; (2) cultural beliefs, including food taboos and misconceptions, which hinder optimal nutritional practices; (3) geographical disparities, with rural populations experiencing higher stunting rates due to limited access to healthcare and resources; and (4) government policies, highlighting the importance of strong political commitment, multisectoral collaboration, and localized programs. Conclusion: Nutritional interventions and ANC are more effective in reducing stunting among Indonesian children when tailored to local socioeconomic, cultural, and geographical contexts. These findings highlight the need for targeted, context-specific strategies to improve child growth outcomes in vulnerable populations.

Edward Kurnia Setiawan Limijadi, Katrin Setio Devi

SurvivalIDRead at source

Peer-reviewed articleCrossref15 Dec 2025

Applying Social Cognitive Theory to Understand Perspectives on Child Feeding Practices of Thai Female Caregivers With Young Children With Stunting

ABSTRACT Childhood stunting remains a public health challenge in Thailand. While national surveys provide prevalence estimates, there is limited understanding of the multilevel influences shaping child feeding practices. This qualitative study aimed to explore individual, familial, and socioenvironmental determinants of child feeding practices among Thai female caregivers of young children with stunting. In‐depth interviews, guided by Social Cognitive Theory, were conducted with 40 female caregivers (primarily mothers) of children under 5 years old with stunting. Participants were purposively selected from nutrition clinics in four hospitals across four regions of Thailand (Chiang Mai, Bangkok, Satun, and Ubon Ratchathani). Trained local dietitians and nutritionists conducted interviews within the clinics. Transcripts were thematically analysed by two independent researchers, triangulated by input from local interviewers. Children's age ranged from 1.0 to 4.9 years old (mean 3.0 ± 1.1 years). Results showed that caregivers understood the importance of healthful feeding but faced barriers such as financial constraints, low self‐efficacy, limited food acceptance, and misconceptions about nutrition. Permissive feeding practices were common due to concerns over picky eating. Family dynamics, food access and availability, and limited engagement with government nutrition programmes further shaped child feeding practices. This study highlights the complex interplay of multilevel factors that influence child feeding practices among Thai caregivers of young children with stunting. Addressing these challenges effectively requires a multifaceted approach for caregivers, including nutrition education, behavioural support, and policies to improve food access and affordability.

Thanit Vinitchagoon, Yaowalak Rooppat, Pornpan Sukboon et al.

SurvivalTHRead at source

Peer-reviewed articleCrossref16 May 2024

Maternal Behavior Regarding Nutrition and Eating Culture of Children Under Five in the Stunting Locus Area, Nusa Tenggara Timur

Background: Stunting has become a major nutritional problem for children under five in Indonesia. Since 2007 until now, the problem of stunting has been detected in Flobamora, including Rote Ndao Regency. The results of the weighing operation in 2023 reported that the prevalence of stunting in NTT province was 21.7%. Measurement data shows that in 2023 there will be 414 babies born, with 38 children experiencing stunting as measured using the baby's birth length. Mother's behavior regarding nutrition and culture of child eating patterns from the time the child is in the womb until the age of under five years plays an important role in shaping the quality of human resources, including preventing the problem of malnutrition, especially stunting. This study aimed to determine the relationship between maternal behavioral factors regarding nutrition and the eating culture of children under five in the stunting locus area, East Nusa Tenggara Province. Subjects and Method: This was a cross sectional study carried out in Mokdale Village, Lobalain District, Rote Ndao Regency, East Nusa Tenggara, Indonesia, from June to August 2023. A sample of 44 children aged 12 to 36 months, consisted of 22 stunted children and 22 normal height children was selected for this study. The dependent variable was stunting. The independent variables were maternal behavior, knowledge, attitude, and feeding practice, child’s eating behavior. The data were analyzed using Chi-square. Results: The incidence of stunting in children increased with maternal behavior regarding poor nutrition (OR = 2.72; 95% CI= 1.25 to 4.19; p= 0.001); maternal knowledge about poor nutrition (OR= 1.13; 95% CI= -1.06 to 2.37; p = 0.060); attitude = mother regarding poor nutrition (OR = 1.74; 95% CI=0.44 to 3.03; p =0.001); maternal actions regarding malnutrition (OR = 3.07; 95% CI = 1.50 to 4.64; p=0.001); and poor eating culture of children under five (OR= 3.03; 95% CI= 0.12 to 3.57; p= 0.001), and these result were statistically significant Conclusion: Maternal behavioral factors regarding good nutrition and good eating culture are closely related and can reduce the chances of problems with the nutritional status of toddlers in the stunting locus area, Lobalain District, Rote Ndao Regency, East Nusa Tenggara Province.

Intje Picauly

SurvivalIDRead at source

Peer-reviewed articleCrossref2 Dec 2023

A cluster randomized controlled trial of a community‐based initiative to reduce stunting in rural Indonesia

AbstractWe evaluate the impacts of a $120 million project in Indonesia conducted between 2014 and 2018 that sought to reduce stunting through a combination of (1) community‐driven development grants targeted at health and education outcomes, (2) training for health providers on infant and young child feeding and growth monitoring and (3) training for sanitarians on a local variation of community‐led total sanitation. This cluster randomized controlled trial involved 95 treatment and 95 control subdistricts across South Sumatra, West Kalimantan, and Central Kalimantan provinces. Overall, we find no significant impacts on stunting, the study's primary outcome measure (0.5 pp; 95% confidence interval [CI]: −3.0 to 4.1 percentage points [pp]), or other longer‐term undernutrition outcomes about 1 year after the end of the project. The project had a modest impact on some secondary, more proximal outcomes related to maternal and child nutrition, including the percentage of mothers consuming the recommended number of iron‐folic acid pills during pregnancy (8.7 pp; 95% CI: 4.1–13.3 pp), 0–5‐month‐olds being exclusively breastfed (8.7 pp; 95% CI: 1.8–15.6 pp) and 6–23‐month‐olds receiving the number of recommended meals per day (8.5 pp; 95% CI: 3.8–13.2 pp). However, there were no significant impacts on other proximal outcomes like the number of pre‐natal and post‐natal checkups, child dietary diversity, child vitamin A receipt or the incidence of child diarrhoea. Our findings highlight that successfully implementing an integrated package of interventions to reduce child stunting may be challenging in practice. Project design needs to consider implementation reality along with best practice—for example, by piloting the synchronous implementation of multifaceted interventions or phasing them in more gradually over a longer timeframe.

Amanda Beatty, Evan Borkum, William Leith et al.

SurvivalExperimentalIDRead at source

Every report we find, newest first.

How to use the reports

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

Association between stunting and early childhood development among children aged 36–59 months in South Asia

Study of Nutrition Food Access to Family With Stunting Toddlers in Stunting Countermeasures System in Lumajang Indonesia

NUTRITION AS A CONSTITUTIONAL RIGHT: ADDRESSING STUNTING AND LEARNING POVERTY THROUGH POLICY REFORM IN CHILD HEALTH AND EDUCATION

Understanding the geographical burden of stunting in India: A regression‐decomposition analysis of district‐level data from 2015–16

Contextual Determinants of Stunting in Indonesia: A Systematic Review of Nutritional Interventions and Antenatal Care

Applying Social Cognitive Theory to Understand Perspectives on Child Feeding Practices of Thai Female Caregivers With Young Children With Stunting

Maternal Behavior Regarding Nutrition and Eating Culture of Children Under Five in the Stunting Locus Area, Nusa Tenggara Timur

A cluster randomized controlled trial of a community‐based initiative to reduce stunting in rural Indonesia

Child stunting is associated with child, maternal, and environmental factors in Vietnam

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