Determinants of Stunting in Children Aged 12 to 60 Months in Kota Waingapu District, East Nusa Tenggara, Indonesia
Abstract
Background: Stunting is a problem that is often not recognized in the community because short stature is so common and often considered normal. In Indonesia, the incidence of stunting under five is a major nutritional problem, with an average prevalence from 2015-2017 of around 36.4%. This study aimed to investigate the determinants of stunting in children aged 12 months - 60 months in the Waingapu District.
Subjects and Method: This was a cross-sectional study conducted at Posyandu, Waingapu District, in December 2020. A total of 105 samples were selected based on inclusion and exclusion criteria using non-probability consecutive sampling. The dependent variable was stunting. The independent variables were exclusive breastfeeding, birth weight, household income, maternal education, maternal nutritional status, and maternal age. The data were collected by questionnaire and analyzed by Chi-square.
Results: The prevalence of stunting in children aged 12 to 60 months in the Waingapu District was 24.8%. The bivariate analysis elucidated that the incidence of stunting was significantly increased by poor maternal education (OR= 3.40; 95% CI= 1.29 to 8.97; p= 0.011), poor maternal nutritional status (OR= 3.06; 95% CI= 1.05 to 8.89; p= 0.034), and low household income (p = 0.002).
Conclusion: Poor maternal education, poor maternal nutritional status, and low household income significantly increase the incidence of stunting.
Keywords: stunting, determinant, nutritional status, children
Correspondence: Samuel Bungaran Partahi Saud Manalu. Faculty of Medicine, Universitas Sumatera Utara. Email: samuel.manalu.4th@gmail.com
Indonesian Journal of Medicine (2021), 06(02): 220-229
https://doi.org/10.26911/theijmed.2021.06.02.11
References
Aryastami NK, Shankar A, Kusumawardani N, Besral B, Jahari AB, Achadi E (2017). Low birth weight was the most dominant predictor associated with stunting among children aged 12-23 months in Indonesia. BMC Nutrition. 3(1): 1–6. doi: 10.1186/s40795-017-0130-x.
Bachour P, Yafawi R, Jaber F, Choueiri E, Abdel-Razzak Z (2012). Effects of smoking, mother's age, body mass index, and parity number on lipid, protein, and secretory immunoglobulin a concentrations of human milk. Breastfeed Med. 7(3): 179–188. https://doi.org/10.1089/bfm.2011.0038.
Baldassarre ME, Di Mauro A, Salvatore S, Tafuri S, Bianchi FP, Dattoli E, Morando L, et al. (2020). Birth weight and the development of functional gastrointestinal disorders in infants. Pediatr Gastroenterol Hepatol Nutr. 23(4): 366–376. https://doi.org/10.5-223/pghn.2020.23.4.366.
Barir B, Murti B, Pamungkasari EP (2019). The associations between exclusive breastfeeding, complementary feeding, and the risk of stunting in children under five years of age: A path analysis evidence from Jombang East Java. J Matern Child Health.
(6): 486–498. https://doi.org/10.2-6911/thejmch.2019.04.06.09.
Black RE, Victora CG, Walker SP, Bhutta ZA, Christian P, De Onis M, Ezzati M, et al. (2013). Maternal and child undernutrition and overweight in low-income and middle-income countries. The Lancet. 382(9890): 427–451. https://doi.org/10.1016/s0140-6736(13)60937-x.
Carter BM (2012). Feeding intolerance in preterm infants and standard of care guidelines for nursing assessments. Newborn and Infant Nurs Rev. 12(4): 187–201. https://doi.org/10.1053/j.nainr.2012.09.007.
Casey PH, Szeto K, Lensing S, Bogle M, Weber J (2001). Children in food-insufficient, low-income families. Arch Pediatr Adolesc Med. 15(4): 508–514. https://doi.org/10.1001/archpedi.155.4.508.
Cetin I, Buhling K, Demir C, Kortam A, Prescott SL, Yamashiro Y, Yarmolins-kaya M, et al. (2019). Impact of micronutrient status during pregnancy on early nutrition program-ming. Ann of Nutr Metab. 74(4): 269–278. https://doi.org/10.1159/0-00499698.
Cetin I, Laoreti A (2015). The Importance of maternal nutrition for health. J Pediatric Neonatal Individ Med. 4(2). https://doi.org/10.7363/040220.
Daniels L, Gibson RS, Diana A, Haszard JJ, Rahmannia S, Luftimas DE, Hampel D, et al. (2019). Micronutrient intakes of lactating mothers and their association with breast milk concentrations and micronutrient adequacy of exclusively breastfed Indonesian
infants. Am J Clin Nutr. 110(2): 391–400. https://doi.org/10.1093/ajcn/nqz047.
Fitriani H, Setya RA, Nurdiana P (2020). Risk factors of maternal nutrition status during pregnancy to stunting in toddlers aged 12-59 months. Jurnal Keperawatan Padjadjaran. 8(2): 183–191. https://doi.org/10.24198/jkp.v8-i2.1305.
Gibbs CM, Wendt A, Peters S, Hogue CJ (2012). The impact of early age at first childbirth on maternal and infant health. Paediatr Perinat Epidemiol. 26(01): 259–84. https://doi.org/10.1111/j.1365-3016.2012.01290.x.
Glewwe P (2014). Why does mother's schooling raise child health in developing countries? Evidence from Morocco. J Hum Resour. 34(1):124–159. http://www.jstor.org/stable/pdf-plus/146305.
Gordon JR, Maule CJ (1989). What's at stake. Can Pharm J. 122(2): 74–76. https://doi.org/10.1007/0-306-4820-8-8_8.
Horton S (2015). The economics of poor nutrition: Patterns, consequences and costs acknowledgments. Available at: http://www.who.int.gho/health_equity/outcomes/stunting_children/en.
Huang Z, Hu YM (2020). Dietary patterns and their association with breast milk macronutrient composition among lactating women. Int Breastfeed J. 15(1): 1–10. https://doi.org/10.1186/-s13006-020-00293-w.
Kemenkes RI (2018). Buletin Stunting. Kementerian Kesehatan RI. 301(5): 1163–1178.
Laksono AD, Ibad M, Mursita A, Kusrini I, Wulandari RD, et al. (2019). Charac-teristics of mother as predictors of stunting in toddler. Pak J Nutr. 18 (12): 1101–1106. doi: 10.3923/pjn.2019.1101.1106.
Lestari ED, Hasanah F, Nugroho NA (2018). Correlation between non-exclusive breastfeeding and low birth weight to stunting children. Paediatr Indones. 58(3): 123–127. doi: 10.142-38/pi58.3.2018.123-7.
Makoka D (2013). The impact of maternal education on child nutrition: Evidence from Malawi, Tanzania and Zimbabwe. DHS Working Papers. 84: 1–32. Available at: www.dhsprogram.com/pubs/pdf/WP84/WP84.pdf.
Morton DL, Hawthorne KM, Moore CE (2017). Growth of infants with intestinal failure or feeding intolerance does not follow standard growth curves. J Nutr Metab. 2017: 8052606. doi: 10.1155/2017/8052606.
Nommsen LA, Lovelady CA, Heinig MJ, Lonnerdal B, Dewey KG (1991). Determinants of energy, protein, lipid, and lactose concentrations in human milk during the first 12 mo of lactation: The DARLING Study. Am J Clin Nutr. 53(2): 457–465. doi: 10.1093/ajcn/53.2.457.
Nshimyiryo A, Hedt-Gauthier B, Mutaganzwa C, Kirk CM, Beck K, Ndayisaba A, Mubiligi J, et al. (2019). Risk factors for stunting among children under five years: A cross-sectional population-based study in Rwanda using the 2015 Demographic and Health
Survey. BMC Public Health. 19(1): 1–10. doi: 10.1186/s12889-019-6504-z.
De Onis M, Branca F (2016). Childhood stunting: A global perspective. Matern Child Nutr. 12(1): 12–26. https://doi.org/10.1111/mcn.12231.
Prendergast AJ, Humphrey JH (2014). The stunting syndrome in developing countries. Paediatr Int Child Health. 34(4): 250–265. doi: 10.1179/20469-05514Y.0000000158.
Ramayulis, Kresnawan T, Iwaningsih, Rochani NS (2018). Stop stunting dengan konseling gizi. Jakarta: Penebar Plus.
Riset Kesehatan Dasar (Riskesdas) (2018). Badan Penelitian dan Pengembangan Kesehatan. Kementerian Kesehatan RI.
Rusmil VK, Prahastuti TO, Luftimas DE, Hafsah T (2019). Exclusive and non-exclusive breastfeeding among stunted and normal 6–9 month-old-children in Jatinangor Subdistrict, Indonesia. Althea Med J. 6(1): 35–41. doi: 10.15850/amj.v6n1.1598.
Shariff ZM, Lin KG, Sariman S, Lee HS, Siew CY, Yusof BNM, Mun CY, et al. (2015). The relationship between household income and dietary intakes of 1-10 year old urban Malaysian. Nutr Res Pract. 9(3): 278–287. doi: 10.4162/nrp.2015.9.3.278.
SSGBI (2019). Laporan akhir penelitian studi status gizi balita di Indonesia tahun 2019.
Sumiaty S, Pont AV, Sundari S (2017). Relationship of mother factors, breastfeeding and stunting pattern in Central Sulawesi. Int J Sci: Basic Appl Res. 35(3): 413–420. https://core.ac.uk/reader/249336030.
Susilowati, Setiawan YA, Budiana TA (2019). Relationship of mother factors and stunting incidence in children (24-59 months) in Buniwangi Village, work area of Pagelaran Public Health Center, Cianjur Regency, 2018. Third International Seminar on Global
Health (3rd ISGH). 3(1): 115–123.
Unicef/ WHO/The World Bank (2019). Levels and trends in child malnutrition - Unicef WHO The World Bank Joint Child Malnutrition Estimates, key findings pf the 2019 edition. Unicef. 4. Available at: http://www.unicef.org/media/files/JME_2015_edition_Sept_2015.pdf%0Ahttps://pubmed.ncbi.nlm.nih.gov/30430613/.
UNICEF (2014). First 1000 Days. Why?. Available at: http://www.neurodege-nerationresearch.eu/about/why/.
Vir SC (2016). Improving women's nutrition imperative for rapid reduction of childhood stunting in South Asia: Coupling of nutrition specific interventions with nutrition sensitive measures essential. Matern Child Nutr. 12: 72–90. doi: 10.1111/mcn.12255.
Wemakor A, Garti H, Azongo T, Garti H, Atosona A (2018). Young maternal age is a risk factor for child undernutrition in Tamale Metropolis, Ghana. BMC Res Notes. 11(1): 1–5. doi: 10.1186/s13104-018-3980-7.
