The role of household food insecurity in malnutrition among Indonesian children under 5 years of age: a systematic review and meta-analysis (2015-2025).

OBJECTIVE

To synthesise and quantify the association between household food insecurity (HFI) and various forms of malnutrition that include stunting, wasting, underweight, overnutrition and anaemia among Indonesian children under 5 years of age.

DESIGN

A systematic review and meta-analysis was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. The study included literature search, screening, data extraction, quality assessment using Joanna Briggs Institute (JBI) tools and meta-analysis using Review Manager 5.4.

SETTING

Studies conducted in Indonesia, covering urban, rural and mixed settings across multiple provinces.

PARTICIPANTS

Children under 5 years of age residing in Indonesia, from households assessed for food insecurity using validated tools.

RESULTS

A total of thirty-two studies met the inclusion criteria, of which twenty-six were eligible for meta-analysis. HFI was significantly associated with higher odds of stunting (case-control: OR = 4·66; 95 % CI: 3·39, 6·40; P < 0·001; cross-sectional: OR = 4·61; 95 % CI: 4·17, 5·11; P < 0·001), wasting (OR = 1·92; 95 % CI: 1·60, 2·32; P < 0·001), underweight (OR = 5·26; 95 % CI: 2·12, 13·04; P < 0·001) and overnutrition (OR = 1·66; 95 % CI: 1·49, 1·85; P < 0·001). Children in food-secure households had significantly lower odds of anaemia (OR = 0·41; 95 % CI: 0·30, 0·58; P < 0·001).

CONCLUSIONS

HFI is strongly associated with multiple forms of malnutrition among Indonesian children under 5 years of age. These findings highlight the urgent need for integrated, nutrition-sensitive strategies that address food security to improve child health and reduce malnutrition in Indonesia.