Analyzing Nutritional Factors that Affect Toddler’s Stunting in Malang Regency, Indonesia

Abstract

BACKGROUND: The proportion of short and very short toddlers in Indonesia is 30.8%. East Java is among the 18 provinces with high prevalence (30%–<40%), having made Malang Regency included among the 100 regencies/cities prioritized for intervention. AIM: This study aimed to analyze sociodemographic and nutritional factors affecting toddler’s stunting in Malang Regency, Indonesia. DESIGN AND METHODS: A case–control analytic survey research with retrospective approach was used: An epidemiologic observation design to study the effect of exposures to diseases or other health problems occurrences. The investigation was conducted during July to August time period through observation, weight measurement and interview in order to collect the data about mother’s knowledge, childcare practices, household food security, healthcare services, access to clean water, economic and socio-cultural background, parenting practices, and causes of stunting. The data were processed using SPSS 16.0, bivariate analysis (Chi-square), and multivariate analysis using multiple logistic regression testing with odds ratio and confidence interval calculation. RESULTS: Parenting practices of the toddlers were not ideal, with only 60% of mothers had good knowledge about stunting. About 76% of the stunted toddlers’ households had insecure food availability and security. Up to 98% of the mothers with stunted toddlers received blood-boosting tablets during pregnancy from health-care services; however, interview results disclosed that they were not consumed. As many as, 98% of the households got access to clean water from Malang Municipal Waterworks and 2% from closed well. A total of 96% of the households made income fewer than Malang Regency’s minimum wage. The stunted toddlers’ households who had eating restrictions during pregnancy and breastfeeding were 13%. Most stunted toddlers as many as 76% were taken care of by their biological mothers, while the remaining 24% by grandmothers or other relatives. Thus, the causes of stunting from the most to the least dominant were as follows: Household’s income, exclusive breastfeeding, household size, father’s education, mother’s nutritional knowledge, household’s food security, mother’s level of education, toddler’s energy intake, appropriate feedings of weaning food, toddler’s fat intake, toddler’s history of infectious diseases, sociocultural background, toddler’s protein intake, mother’s occupation, household’s nutritional awareness behavior, and the completeness of immunization. CONCLUSION: Stunting main risk factors are household income, size, history of breastfeeding, father’s education and occupation. Factors which are not significantly related to stunting include household nutritional awareness and behavior, hygiene, socio-economic status, energy and micronutrients intake, toddler’s food and vitamin A compliment, toddler’s status and characteristics, and maternal health services.