Determinants of stunting among Indonesian children: a cross-sectional study on the role of child, maternal, and vaccination factors.

BACKGROUND

Stunting remains a significant public health challenge in Indonesia, impacting children's growth and development. This study aimed to identify child and maternal factors associated with stunting in children aged 0-59.

METHODS

This study employed a cross-sectional secondary data analysis using the Indonesia Family Life Survey-5 (2014). Variables were selected based on the United Nations International Children's Emergency Fund framework and prior evidence. Stunting was assessed using height-for-age z-scores (HAZ), with children classified as stunted if their HAZ was below -2 standard deviations. Descriptive statistics, bivariate analyses, and multivariable logistic regression were performed to explore associations between various factors and stunting, with adjusted odds ratios (aOR) and 95% confidence intervals (CI) calculated.

RESULTS

Of the 4,570 children included, 24.1% were classified as stunted. Factors that reduced the likelihood of stunting included older age, with children aged 12-23 months (aOR 0.111, CI 0.056-0.223) and 24-59 months (aOR 0.039, CI 0.021-0.075) at lower risk, likely due to improved dietary diversity and reduced vulnerability to early-life infections as children grow. Risk factors included low birth weight (< 2.5 kg, OR 3.556, CI 2.938-3.648) and incomplete immunization (aOR 1.511, CI 1.088-2.098). Maternal factors also played a role, with underweight mothers having a higher risk of stunting (aOR 2.122, CI 1.565-2.876), while overweight mothers (aOR 0.244, CI 0.105-0.570) and those who received tetanus toxoid injections (aOR 0.724, CI 0.561-0.935) had a lower risk.

CONCLUSIONS

These findings highlight the critical role of age, birth weight, and vaccination status in the prevention of stunting among Indonesian children. Policies and programs should focus on improving maternal nutrition, ensuring full childhood immunization, and promoting appropriate complementary feeding practices during early infancy to help prevent stunting and improve child growth outcomes.