Disparities in Stunting Prevalence in Central Sulawesi: A Comparative Analysis of Determinants and Interventions in Two Districts
Keywords:
stunting, children under two, determinants, innovation, Dapur Sehat Atasi Stunting (DASHAT)Abstract
Stunting among children under two years old remains a major public health issue in Indonesia, particularly in Central Sulawesi, where the 2024 prevalence reached 26.1%, exceeding the national rate of 19.8%. This study aimed to analyze disparities in stunting determinants and identify effective innovations for reduction using an ecological analytic design combining quantitative and qualitative approaches. Data were derived from the 2024 Indonesian Nutritional Status Survey (SSGI), district stunting dashboards, and in-depth interviews with key stakeholders in Sigi District (high prevalence, 33.0%) and Tojo Una-Una District (low prevalence, 16.5%). Results showed that stunting in Sigi was associated with limited access to health services, low immunization coverage, poor sanitation, low maternal education, minimal funding for specific programs (1.33%), and post-disaster challenges. In contrast, Tojo Una-Una achieved >90% essential service coverage, strong family mentoring by Family Assistance Teams (TPK), and adequate program allocation (15.03%) through innovations such as the Dapur Sehat Atasi Stunting (DASHAT) program and mobile clinics. Effective stunting reduction requires integrating specific nutrition actions with sensitive interventions addressing sanitation, education, and economic empowerment. Strengthening cross-sectoral collaboration, digital data monitoring (e-PPGBM), and replication of Tojo Una-Una’s best practices are critical to achieving the 2024 RPJMN target and supporting the 2030 Sustainable Development Goals
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Hafid F, Taqwin T, Linda L, Nasrul N, Ramadhan K, Bohari B. Specific Interventions to Prevent Stunting in Children Under 2 Years after the Natural Disaster. Open Access Maced J Med Sci [Internet]. 2021 Feb 12;9(E):64–9. Available from: https://oamjms.eu/index.php/mjms/article/view/5677
Nurfatimah N, Ramadhan K, Entoh C, Longgupa LW, Hafid F. Continuity of Midwifery Care Implementation to Reduce Stunting. Open Access Maced J Med Sci [Internet]. 2021 Dec 1;9(E):1512–6. Available from: https://oamjms.eu/index.php/mjms/article/view/7062
Taqwin T, Ramadhan K, Hadriani H, Nasrul N, Hafid F, Efendi F. Prevalence of Stunting among 10-Year Old Children in Indonesia. J Glob Pharma Technol [Internet]. 2020;12(2 (Suppl.)):768–73. Available from: http://www.jgpt.co.in/index.php/jgpt/article/view/3375/2658
Nasrul N, Hafid F, Faisal TI, Taufiqurrahman T, Ramadhan K. The Determinants of Stunting in Stunting Focus Areas of Sigi Regency: A Study of Risk Factors and Recommendations for Intervention. Nutr Clínica y Dietética Hosp [Internet]. 2024 Jul 17;44(3). Available from: https://revista.nutricion.org/index.php/ncdh/article/view/646
Hafid F, Nasrul N, Amsal A, Ramadhan K, Taufiqurahman T, Sariman S. Low Birth Weight, Child Gender, Number of Children, and Maternal Education as Risk Factors for Stunting in Palu City - Indonesia. Amerta Nutr [Internet]. 2024 Dec 30;8(2SP):75–84. Available from: https://e-journal.unair.ac.id/AMNT/article/view/63654
Nurcahyani L, Widiyastuti D, Estuti W, Iman AT, Fitrianingsih Y, Hafid F. Design of Stunting Prevention Education Media Package Based on Technology and Local Wisdom. Amerta Nutr [Internet]. 2024 Dec 30;8(2SP):9–14. Available from: https://e-journal.unair.ac.id/AMNT/article/view/64051
Wahyuni Azis ASF, Darmawansyah D, Razak A, Arifin A, Syafar M, Mallongi A. Analysis of Policy Implementation of The First 1000 Days of Life Program in Overcoming Stunting in Maros District. Pharmacogn J [Internet]. 2023 Jun 30;15(3):405–10. Available from: https://phcogj.com/article/2048
Soofi SB, Khan GN, Sajid M, Hussainyar MA, Shams S, Shaikh M, et al. Specialized nutritious foods and behavior change communication interventions during the first 1000 d of life to prevent stunting: a quasi-experimental study in Afghanistan. Am J Clin Nutr [Internet]. 2024 Sep;120(3):560–9. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0002916524006038
Pudjirahaju A, Soelistyorini D, Mustafa A, Kristianto Y. Intervensi Gizi Spesifik pada 1000 Hari Pertama Kehidupan oleh Agen Perubahan untuk Mencegah Stunting, Meningkatkan Perkembangan dan IQ Anak di Kabupaten Trenggalek. Amerta Nutr [Internet]. 2025 Mar 14;9(1):101–8. Available from: https://api.elsevier.com/content/abstract/scopus_id/105000550405
Nur R, Jusman Rau M, Dwi Larasati R, Bengan Laba S, H MR, Rahmawati, et al. Maternal Care Behavior and Care for Children Under Two during the First 1000 Days of Life in Relation to Stunting Incidence in Simoro Village, Sigi Regency. Jan C, Anwer I, Li L, Ferse S, Nishi M, Puangprakhon P, editors. E3S Web Conf [Internet]. 2025 Jan 24;609:04004. Available from: https://www.e3s-conferences.org/10.1051/e3sconf/202560904004
Akseer N, Tasic H, Nnachebe Onah M, Wigle J, Rajakumar R, Sanchez-Hernandez D, et al. Economic costs of childhood stunting to the private sector in low- and middle-income countries. eClinicalMedicine [Internet]. 2022 Mar;45:101320. Available from: https://linkinghub.elsevier.com/retrieve/pii/S2589537022000505
Azriani D, Masita, Qinthara NS, Yulita IN, Agustian D, Zuhairini Y, et al. Risk factors associated with stunting incidence in under five children in Southeast Asia: a scoping review. J Heal Popul Nutr [Internet]. 2024 Oct 28;43(1):174. Available from: https://jhpn.biomedcentral.com/articles/10.1186/s41043-024-00656-7
Perpres RI. Peraturan Presiden Republik Indonesia Nomor 18 Tahun 2020 Tentang Rencana Pembangunan Jangka Menengah Nasional 2020-2024. Sekr Pres Republik Indones. 2020;1–7.
Badan Kebijakan Pembangunan Kesehan KR. Survei Status Gizi Indonesia (SSGI) 2024 dalam Angka. Vol. 1. Jakarta; 2025.
Direktorat Jenderal Pembangunan Daerah KR. EMONEV STUNTING 8 Aksi Konvergensi Percepatan Penurunan Stunting Kabupaten Sigi [Internet]. Jakarta; 2024. Available from: Direktorat Jenderal Pembangunan Daerah, Kemendagri RI
Direktorat Jenderal Pembangunan Daerah KR. EMONEV STUNTING 8 Aksi Konvergensi Percepatan Penurunan Stunting Kabupaten Tojo Una-una [Internet]. Jakarta; 2024. Available from: Direktorat Jenderal Pembangunan Daerah, Kemendagri RI
Musheiguza E, Mahande MJ, Malamala E, Msuya SE, Charles F, Philemon R, et al. Inequalities in stunting among under-five children in Tanzania: decomposing the concentration indexes using demographic health surveys from 2004/5 to 2015/6. Int J Equity Health [Internet]. 2021 Dec 23;20(1):46. Available from: https://equityhealthj.biomedcentral.com/articles/10.1186/s12939-021-01389-3
Kustanto A, Rachmat O, Setyadi S. The Prevalence of Stunting in Indonesia: An Examination of the Health, Socioeconomic Status, and Environmental Determinants. J Iran Med Counc [Internet]. 2024 Nov 24;8(1):67–79. Available from: https://publish.kne-publishing.com/index.php/JIMC/article/view/17062
Cumming O, Cairncross S. Can water, sanitation and hygiene help eliminate stunting? Current evidence and policy implications. Matern Child Nutr [Internet]. 2016 May 17;12(S1):91–105. Available from: https://onlinelibrary.wiley.com/doi/10.1111/mcn.12258
Cumming O, Arnold BF, Ban R, Clasen T, Esteves Mills J, Freeman MC, et al. The implications of three major new trials for the effect of water, sanitation and hygiene on childhood diarrhea and stunting: a consensus statement. BMC Med [Internet]. 2019 Dec 28;17(1):173. Available from: https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-019-1410-x
Mu’arif Z, Afriza DA, Aulia F, Anggelina E MP, Gamayanti NF. Analysis of Priority Areas for Handling Stunting Cases In Sigi Regency Using The Topsis Method Based on Web Dashboard. BAREKENG J Ilmu Mat dan Terap [Internet]. 2024 Jul 31;18(3):1411–22. Available from: https://api.elsevier.com/content/abstract/scopus_id/85216963891
Nasrul N, Hafid F, Faisal TI, Taufiqurrahman T, Ramadhan K. The Determinants of Stunting in Stunting Focus Areas of Sigi Regency: A Study of Risk Factors and Recommendations for Intervention. Nutr Clínica y Dietética Hosp [Internet]. 2024 Jul 17;44(3):227–34. Available from: https://revista.nutricion.org/index.php/ncdh/article/view/646
Hafid F, Nasrul N, Adhyanti A, Bohari B. Social and Health Determinants of the Families of Children Under Two Years of Age with Stunting in Sigi District. Poltekita J Ilmu Kesehat [Internet]. 2023 May 31;17(1):137–46. Available from: https://jurnal.poltekkespalu.ac.id/index.php/JIK/article/view/2252
Hafid F, Ansar A, Nasrul N, Ramadhan K, Ardiansyah A. Prevalence and Determinants Stunting Among Children Under Two Years in Indonesian District. Poltekita J Ilmu Kesehat [Internet]. 2023 Feb 28;16(4):553–63. Available from: https://jurnal.poltekkespalu.ac.id/index.php/JIK/article/view/2246
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