Multifactorial Predictors of Stunting Among Children Under Five Years: Evidence from Batanghari District, Jambi, Indonesia
Keywords:
Stunting, Growth Disorders, Parenting style, Nutritional status, Environment QualityAbstract
Stunting is a public health problem with a high prevalence in Indonesia. The Batanghari District has a stunting rate of 26.3%, exceeding the national target; however, specific regional determinants have not been comprehensively identified. This study aimed to identify multifactorial predictors of stunting in children under five years in Batanghari District. A cross-sectional study was conducted in Batanghari District from August to October 2024, involving 64 children aged 0–60 months selected through purposive sampling. Data were collected via structured questionnaires, anthropometric measurements via WHO standards, and 24 h dietary assessment food recall. Stunting was defined as a height-for-age z score < -2 SD. For statistical analysis, binary logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs). The prevalence of stunting was 70.3% (n=45). Inadequate energy density was the strongest predictor (OR = 11.389; 95% CI: 2.906–44.627; p < 0.001), followed by poor drinking water quality (OR = 8.705; 95% CI: 1.668–45.445; p = 0.004), history of problematic pregnancy (OR = 8.250; 95% CI: 0.799–85.165; p = 0.041), poor type of food (OR = 5.123; 95% CI: 1.449–18.110; p = 0.011), calcium density (OR = 4.242; 95% CI: 1.181–15.234; p = 0.021), income below the regional minimum wage (OR = 3.681; 95% CI: 1.146–11.832; p = 0.025), and authoritarian parenting (OR = 3.523; 95% CI: 1.056–11.762; p = 0.036). These findings suggest that stunting in Batanghari District is associated with a complex interplay of nutritional deficiencies, socioeconomic factors, environmental conditions, maternal health, and behavioral factors
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References
Black RE, Victora CG, Walker SP, Bhutta ZA, Christian P, de Onis M, et al. Maternal and child undernutrition and overweight in low-income and middle-income countries. The Lancet. 2013 Aug;382(9890):427–51.
UNICEF/WHO/WORLD BANK. Levels and trends in child malnutrition UNICEF / WHO / World Bank Group Joint Child Malnutrition Estimates Key findings of the 2021 edition. 1st ed. World Health Organization. Geneva: World Health Organization; 2021. 1–32 p.
Kementrian Kesehatan RI. Buku Saku Hasil Studi Status Gizi Indonesia (SSGI) Tingkat Nasional, Provinsi, dan Kabupaten/Kota Tahun 2021. Jakarta; 2021.
Tim Percepatan Penurunan Stunting (TPPS) Provinsi Jambi. Laporan Tim Percepatan Penurunan Stunting (TPPS) Provinsi Jambi Semester I Tahun 2023. Tim Percepatan Penurunan Stunting (TPPS) Provinsi Jambi. Jambi; 2023.
Stewart CP, Iannotti L, Dewey KG, Michaelsen KF, Onyango AW. Contextualising complementary feeding in a broader framework for stunting prevention. Matern Child Nutr. 2013 Sep 18;9(S2):27–45.
van der Horst K, Sleddens EFC. Parenting styles, feeding styles and food-related parenting practices in relation to toddlers’ eating styles: A cluster-analytic approach. Aguilera AI, editor. PLoS One. 2017 May 24;12(5):e0178149.
UNICEF. Improving child nutrition: The achievable imperative for global progress. 1st ed. Vol. 18, NCSL legisbrief. United States: United Nations Children’s Fund (UNICEF); 2013. 132 p.
Likhar A, Patil MS. Importance of Maternal Nutrition in the First 1,000 Days of Life and Its Effects on Child Development: A Narrative Review. Cureus. 2022 Oct 8;14(10):e30083.
Soofi S, Khan GN, Ariff S, Chauhadry I, Sajid M, Ihtesham Y, et al. Effectiveness of Nutritional Supplementation During the First 1000-Days of Life to Reduce Child Stunting: Results From a Cluster Randomised Controlled Trial in Pakistan. Curr Dev Nutr. 2022 Jun;6:717.
Jalaludin MY, Fauzi MD, Sidiartha IGL, John C, Aviella S, Novery E, et al. Addressing Stunting in Children Under Five: Insights and Opportunities from Nepal, Bangladesh, and Vietnam—A Review of Literature. Children. 2025 May 16;12(5):641.
Suri S, Verlato G, Ray S. Editorial: The first 1000 days: window of opportunity for child health and development. Front Nutr. 2025 Aug 18;12:1673003.
Regassa R, Tamiru D, Duguma M, Belachew T. Environmental enteropathy and its association with water sanitation and hygiene in slum areas of Jimma Town Ethiopia. Parker A, editor. PLoS One. 2023 Jun 23;18(6):e0286866.
Korpe PS, Petri WA. Environmental enteropathy: critical implications of a poorly understood condition. Trends Mol Med. 2012 Jun;18(6):328–36.
Regassa R, Belachew T, Duguma M, Tamiru D. Factors associated with stunting in under-five children with environmental enteropathy in slum areas of Jimma town, Ethiopia. Front Nutr. 2024 Apr 8;11:1335961.
Beal T, Tumilowicz A, Sutrisna A, Izwardy D, Neufeld LM. A review of child stunting determinants in Indonesia. Matern Child Nutr. 2018 Oct 17;14(4):e12617.
Cumming O, Cairncross S. Can water, sanitation and hygiene help eliminate stunting? Current evidence and policy implications. Matern Child Nutr. 2016 May 17;12(S1):91–105.
Victora CG, de Onis M, Hallal PC, Blössner M, Shrimpton R. Worldwide Timing of Growth Faltering: Revisiting Implications for Interventions. Pediatrics. 2010 Mar 1;125(3):e473–80.
Torlesse H, Cronin AA, Sebayang SK, Nandy R. Determinants of stunting in Indonesian children: evidence from a cross-sectional survey indicate a prominent role for the water, sanitation and hygiene sector in stunting reduction. BMC Public Health. 2016 Dec 29;16(1):669.
Schneider EB. The determinants of child stunting and shifts in the growth pattern of children: A long‐run, global review. J Econ Surv. 2025 Apr 19;39(2):405–52.
Rahut DB, Mishra R, Bera S. Geospatial and environmental determinants of stunting, wasting, and underweight: Empirical evidence from rural South and Southeast Asia. Nutrition. 2024 Apr;120:112346.
Sastrawijayah J, Murti B, Ichsan B. Effect Size Estimation of Child Stunting Determinants in Surakarta, Central Java. Journal of Epidemiology and Public Health. 2024 Jan 16;9(1):1–10.
Seabrook JA. Powering Nutrition Research: Practical Strategies for Sample Size in Multiple Regression. Nutrients. 2025 Aug 18;17(16):2668.
Paulus AY, Sulaeman, Mayasari AC, Ayu JD, Musniati N, Sari MP, et al. Biostatistika Epidemiologi. 1st ed. Akbar H, editor. Bandung: CV. Media Sains Indonesia; 2023. 208 p.
Adnyana IMDM. Populasi dan Sampel. In: Darwin M, editor. Metode Penelitian Pendekatan Kuantitatif. 1st ed. Bandung: CV. Media Sains Indonesia; 2021. p. 103–16.
Robinson CC, Mandleco B, Olsen SF, Hart CH. Parenting Style & Dimensions Questionnaire- Short Version (PSDQ-Short Version) Contructs Scoring Key. Handbook of Family Measurement Techniques Vol 3. 2001;53(10):319–21.
Sorkhabi N, Mandara J. Are the effects of Baumrind’s parenting styles culturally specific or culturally equivalent? In: Authoritative parenting: Synthesizing nurturance and discipline for optimal child development [Internet]. 1st ed. Washington: American Psychological Association; 2013. p. 113–35. Available from: https://content.apa.org/books/13948-006
Susiloretni KA, Smith ER, Suparmi, Marsum, Agustina R, Shankar AH. The psychological distress of parents is associated with reduced linear growth of children: Evidence from a nationwide population survey. Cardoso MA, editor. PLoS One. 2021 Oct 26;16(10):e0246725.
Pradana Putri A, Rong JR. Parenting Functioning in Stunting Management: A Concept Analysis. J Public Health Res. 2021 Apr 15;10(2):2160.
WHO. Complementary feeding: Report of the global consultation Summary of guiding principles. In: Encyclopedia of Human Nutrition. Geneva: World Health Organization; 2005. p. 465–71.
A Catharine Ross, Christine L Taylor, Ann L Yaktine and HBDValle. Dietary Reference Intakes for Calcium and Vitamin D. Washington, D.C.: National Academies Press; 2011. 662 p.
Latifah HI, Suyatno S, Asna AF. Factors of Child Growth Failure Based on the Composite Index of Anthropometric Failure in West Sulawesi Province. Amerta Nutrition. 2024 Aug 30;8(1SP):1–8.
Siddiqui F, Salam RA, Lassi ZS, Das JK. The Intertwined Relationship Between Malnutrition and Poverty. Front Public Health. 2020 Aug 28;8:453.
Otiti MI, Allen SJ. Severe acute malnutrition in low- and middle-income countries. Paediatr Child Health. 2021 Aug;31(8):301–7.
Vilar-Compte M, Burrola-Méndez S, Lozano-Marrufo A, Ferré-Eguiluz I, Flores D, Gaitán-Rossi P, et al. Urban poverty and nutrition challenges associated with accessibility to a healthy diet: a global systematic literature review. Int J Equity Health. 2021 Dec 20;20(1):40.
Tanumihardjo SA, Anderson C, Kaufer-Horwitz M, Bode L, Emenaker NJ, Haqq AM, et al. Poverty, Obesity, and Malnutrition: An International Perspective Recognizing the Paradox. J Am Diet Assoc. 2007 Nov;107(11):1966–72.
Widyaningsih, Mulyaningsih, Rahmawati, Adhitya. Determinants of socioeconomic and rural-urban disparities in stunting: evidence from Indonesia. Rural Remote Health. 2022 Mar 21;22(1):7082.
Rosiyati E, Pratiwi EAD, Poristinawati I, Rahmawati E, Nurbayani R, Lestari S, et al. Determinants of Stunting Children (0-59 Months) in Some Countries in Southeast Asia. Jurnal Kesehatan Komunitas. 2019 Feb 2;4(3):88–94.
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 Health Popul Nutr. 2024 Oct 28;43(1):174.
Mutiarasari D, Miranti M, Fitriana Y, Pakaya D, Sari P, Bohari B, et al. A Determinant Analysis of Stunting Prevalence on Under 5-Year-Old Children to Establish Stunting Management Policy. Open Access Maced J Med Sci. 2021 Jan 19;9(B):79–84.
Nyarko MJ, van Rooyen D (RM), ten Ham-Baloyi W. Preventing malnutrition within the first 1000 days of life in under-resourced communities: An integrative literature review. Journal of Child Health Care. 2024 Dec 3;28(4):898–913.
Kamudoni P, Kiige L, Ortenzi F, Beal T, Nordhagen S, Kirogo V, et al. Identifying and understanding barriers to optimal complementary feeding in Kenya. Matern Child Nutr. 2024 Jan 5;20(S3):13617.
Abdelmenan S, Worku A, Berhane HY, Berhane Y, Ekström EC. Affordability of family foods is associated with Nutritional Status of women with pre-school children in Addis Ababa, Ethiopia. Sci Rep. 2025 Jan 3;15(1):665.
Escher NA, Andrade GC, Ghosh-Jerath S, Millett C, Seferidi P. The effect of nutrition-specific and nutrition-sensitive interventions on the double burden of malnutrition in low-income and middle-income countries: a systematic review. Lancet Glob Health. 2024 Mar;12(3):e419–32.
Sari AA, Palimbo A, Ningrum NW, Salmarini DD, Jannah R. Birth history as a predictor of stunting incidence among toddlers. Health Sciences International Journal. 2025 Aug 23;3(2):209–19.
Deviatin NS, Feriyanti A, Devy SR, Sulistyowati M, Ratnawati LY, Andayani Q. Determinants that Contributes to Stunting Prevention Behavior in Pregnant Woman in Indonesia. Media Gizi Indonesia. 2022 Dec 15;17(1SP):168–74.
Sartika AN, Khoirunnisa M, Meiyetriani E, Ermayani E, Pramesthi IL, Nur Ananda AJ. Prenatal and postnatal determinants of stunting at age 0–11 months: A cross-sectional study in Indonesia. Wilunda C, editor. PLoS One. 2021 Jul 14;16(7):e0254662.
Kumar M, Saadaoui M, Al Khodor S. Infections and Pregnancy: Effects on Maternal and Child Health. Front Cell Infect Microbiol. 2022 Jun 8;12:873253.
Neiger R. Long-Term Effects of Pregnancy Complications on Maternal Health: A Review. J Clin Med. 2017 Jul 27;6(8):76.
Zhang Y, Ding W, Wu T, Wu S, Wang H, Fawad M, et al. Pregnancy with multiple high-risk factors: a systematic review and meta-analysis. J Glob Health. 2025 Feb 7;15:04027.
Rizaldi MA, Ali K, Rara SMH, Panjaitan BSR. Water, sanitation and hygiene (WASH) and its association with stunting in developing countries in Asia: A systematic review. Svāsthya: Trends in General Medicine and Public Health. 2025 Mar 4;2(2):e81.
Yuniarti E, Raharini H. The relationship between healthy behavior and environmental sanitation with water quality in stunting occurrence work area of Sikabu Community Health Center Padang Pariaman. IOP Conf Ser Earth Environ Sci. 2024 Mar 1;1317(1):012020.
Nizaruddin N, Ilham MI. The Effect of Sanitation on Stunting Prevalence in Indonesia. Populasi. 2022 Dec 14;30(2):34.
Kwami CS, Godfrey S, Gavilan H, Lakhanpaul M, Parikh P. Water, Sanitation, and Hygiene: Linkages with Stunting in Rural Ethiopia. Int J Environ Res Public Health. 2019 Oct 9;16(20):3793.
Woldesenbet B, Tolcha A, Tsegaye B. Water, hygiene and sanitation practices are associated with stunting among children of age 24-59 months in Lemo district, South Ethiopia, in 2021: community based cross sectional study. BMC Nutr. 2023 Jan 23;9(1):17.
Shrestha A, Six J, Dahal D, Marks S, Meierhofer R. Association of nutrition, water, sanitation and hygiene practices with children’s nutritional status, intestinal parasitic infections and diarrhoea in rural Nepal: a cross-sectional study. BMC Public Health. 2020 Dec 15;20(1):1241.
Wyasena PNTS, Sudaryati NLG, Sudiartawan IP, Adnyana IMDM. Evaluation of refillable drinking water quality based on MPN coliform and escherichia coli in Sesetan Village, South Denpasar, Bali. Journal of Vocational Health Studies. 2022 Nov 1;6(2):93–101.
Philips N, Sioen I, Michels N, Sleddens E, De Henauw S. The influence of parenting style on health related behavior of children: findings from the ChiBS study. International Journal of Behavioral Nutrition and Physical Activity. 2014 Dec 23;11(1):95.
De Sanctis V, Soliman A, Alaaraj N, Ahmed S, Alyafei F, Hamed N. Early and Long-term Consequences of Nutritional Stunting: From Childhood to Adulthood. Acta Biomed. 2021 Feb 16;92(1):e2021168.
Inzaghi E, Pampanini V, Deodati A, Cianfarani S. The Effects of Nutrition on Linear Growth. Nutrients. 2022 Apr 22;14(9):1752.
Mulyani AT, Khairinisa MA, Khatib A, Chaerunisaa AY. Understanding Stunting: Impact, Causes, and Strategy to Accelerate Stunting Reduction—A Narrative Review. Nutrients. 2025 Apr 29;17(9):1493.
Fahmida U, Pramesthi IL, Kusuma S, Sudibya ARP, Rahmawati R, Suciyanti D, et al. Problem nutrients in diet of under-five children and district food security status: Linear programming analyses of 37 stunting priority districts in Indonesia. Sunderland T, editor. PLoS One. 2024 Dec 19;19(12):e0314552.
Fitriani F, Yarmaliza Y, Farisni TN. Analyzing the Level of Knowledge, Food Consumption Diversity, and Nutritional Intake on Chronic Energy Deficiency among Pregnant Women in Stunting Prevention. European Journal of Medical and Health Sciences. 2024 Apr 30;6(2):62–6.
Morales F, Montserrat-de la Paz S, Leon MJ, Rivero-Pino F. Effects of Malnutrition on the Immune System and Infection and the Role of Nutritional Strategies Regarding Improvements in Children’s Health Status: A Literature Review. Nutrients. 2023 Dec 19;16(1):1.
Amoadu M, Abraham SA, Adams AK, Akoto-Buabeng W, Obeng P, Hagan JE. Risk Factors of Malnutrition among In-School Children and Adolescents in Developing Countries: A Scoping Review. Children. 2024 Apr 15;11(4):476.
Wardani LK, Aulia V, Hadhikul M, Kardila M. Risks of Stunting and Interventions to prevent Stunting. Journal of Community Engagement in Health. 2023 Sep 30;6(2):79–83.
Quarta A, Quarta MT, Mastromauro C, Chiarelli F, Giannini C. Influence of Nutrition on Growth and Development of Metabolic Syndrome in Children. Nutrients. 2024 Nov 6;16(22):3801.
Ilmiati F, Syauqy A, Noer ER, Margawati A, Kartini A. Energy Intake, Protein Intake, and Toddler Hygiene with the Incidence of Stunting in 24-59 Months Toddlers in Mentawai Islands. JURNAL INFO KESEHATAN. 2024 Dec 31;22(4):724–34.
Abeshu MA, Lelisa A, Geleta B. Complementary Feeding: Review of Recommendations, Feeding Practices, and Adequacy of Homemade Complementary Food Preparations in Developing Countries – Lessons from Ethiopia. Front Nutr. 2016 Oct 17;3.
Daradinanti M, Taufiqurrahman, Marina Pengge N, Nugroho RF. Association Between Exclusive Breastfeeding and Nutritional Status of Infants Aged 6–8 Months at Tambakrejo Health Center, Sidoarjo: A Cross-Sectional Study. Journal of Nutrition Explorations. 2025 Jul 7;3(3):224–34.
Abeshu MA, Adish A, Haki GD, Lelisa A, Geleta B. Assessment of Caregiver’s Knowledge, Complementary Feeding Practices, and Adequacy of Nutrient Intake from Homemade Foods for Children of 6–23 Months in Food Insecure Woredas of Wolayita Zone, Ethiopia. Front Nutr. 2016 Aug 15;3:32.
Ogunniran OP, Ayeni KI, Shokunbi OS, Krska R, Ezekiel CN. A 10‐year (2014–2023) review of complementary food development in sub‐Saharan Africa and the impact on child health. Compr Rev Food Sci Food Saf. 2024 Nov 8;23(6).
Abri N, Thaha AR, Jafar N. Relationship Between Economic Status, Infectious Diseases and Urinary Iodine Excretion with Stunting Incidence of Elementary School Children in IDD Endemic Areas, Enrekang Regency. Journal of Health and Nutrition Research. 2022 Nov 29;1(3):133–9.
Abri N. Identification of Socio-Demographic Factors with the Incidence of Stunting in Elementary School Children in Rural Enrekang. Journal of Health and Nutrition Research. 2022 Aug 30;1(2):88–94.
Abri N, Zakiah N, Risal AF. The Relationship Between Early Pregnancy, Birth Distance, and Resident Status with Stunting Incidence in Elementary School Children In Enrekang Rural. Journal of Health and Nutrition Research. 2023 Aug 20;2(2):70–8.
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