Determinants of Stunted Children in Indonesia: A Multilevel Analysis at the Individual, Household, and Community Levels

Abstract

This study aimed to examine the risk factors of childhood undernutrition in Indonesia. Determinants of childhood stunting were examined by using the 2013Indonesia Basic Health Research Survey dataset. A total of 76,165 children aged under 5 years were included in this study. The analysis used multivariatemultilevel logistic regression to determine adjusted odds ratios (aORs). The prevalence of stunting in the sample population was 36.7%. The odds of stunting increased significantly among the under-five boys, children living in slum area, and the increase of household member (aOR = 1.11, 95 %CI: 1.06–1.15; 1.09, 95%CI: 1.04–1.15; and 1.03, 95%CI: 1.02–1.04 respectively). The odds of stunting decreased significantly among children whose parents more educated (aOR = 0.87, 95 %CI: 0.83–0.91 and 0.87, 95%CI: 0.83–0.9, respectively), who live in urban area, in a province with higher Gross Domestic Product (GDP) per capita, and in a province with higher ratio of professional health worker per 1,000 population aged 0-4 years (aOR = 0.85, 95%CI: 0.81–0.89; 0.89; 95%CI: 0.79–1.00; and 0.99; 95%CI: 0.99–1.00, respectively). The study found that stunting was resulted from a complex interaction of factors, not only at the individual level, but also at household and community levels. The study findings indicate that interventions should implement multi-level approaches to address various factors from the community to the individual level.