Determinants of stunting among children aged 6–23 months in Bandung City: the role of maternal and child health factors 10.55131/jphd/2026/240112
Article Sidebar
Main Article Content
Abstract
Stunting is a global health problem that impacts children's physical growth, cognitive development, and future economic well-being. In Indonesia, although the prevalence of stunting has decreased, the incidence rate is still high, including in Bandung City. Maternal and child health factors play an important role in the incidence of stunting, but there is limited research on the interaction of these factors in an urban context. This study aims to analyze the influence of maternal and child health factors on the incidence of stunting in children aged 6-23 months in Bandung City. This study used a community-based cross-sectional design, involving 412 randomly selected children aged 6-23 months in Bandung City. The sample was collected using a multi-stage sampling technique. Data were collected through interviews using structured questionnaires and anthropometric measurements. Multivariate logistic regression was used to identify associations between maternal factors, child health, and the incidence of stunting. The prevalence of stunting in Bandung City was 35.0%. Analysis showed that factors associated with an increased risk of stunting included: having less than 4 antenatal visits (AOR=2.23), not exclusively breastfed (AOR=1.38), low birth weight (AOR=1.52), and history of infectious diseases (AOR=3.30). In addition, socioeconomic factors, such as low family income, also contributed significantly to the incidence of stunting (AOR=3.15). A correlation has been demonstrated between maternal and child health factors and the incidence of stunting in Bandung City. Policy recommendations include improving access to and quality of maternal health services, promoting exclusive breastfeeding, and nutrition counselling for low-income families.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
References
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). doi: 10.1111/mcn.12617.
WHO. Levels and trends in child malnutrition: UNICEF/WHO/World Bank Group joint child malnutrition estimates: key findings of the 2023 edition [Internet]. World Health Organization. 2023 May [cited 2024 Dec 1]. Available from: https://www. who.int/publications/i/item/9789240073791
Kemenkes RI. Fortifying Children from Stunting. Ministry of Health of the Republic of Indonesia [Internet]. 2024 Jun [cited 2024 Dec 5]; Available from: https://link.kemkes.go.id/mediakom
Bandung Bergerak. The Growth of Stunting Rates in Bandung is Inseparable from the Economic Problems Faced by Underprivileged Citizens [Internet]. BandungBergerak. id. 2024 [cited 2024 Dec 10]. Available from: https://bandungbergerak.id/ article/detail/1597596/pertumbuhan-angka-stunting-di-bandung-tak-lepas-dari-masalah-ekonomi-yang-dihadapi-warga-kurang-mampu?utm_source= chatgpt.com
Amaha ND, Woldeamanuel BT. Maternal factors associated with moderate and severe stunting in Ethiopian children: analysis of some environmental factors based on 2016 demographic health survey. Nutr J. 2021 Dec 27;20(1):18. doi: 10.1186/ s12937-021-00677-6.
Meher C, Zaluchu F, Eyanoer PC. Local approaches and ineffectivity in reducing stunting in children: A case study of policy in Indonesia. F1000Res. 2023 Feb 27;12:217. doi: 10.12688/f1000research.130902.1.
Soekatri MYE, Sandjaja S, Syauqy A. Stunting Was Associated with Reported Morbidity, Parental Education and Socioeconomic Status in 0.5–12-Year-Old Indonesian Children. Int J Environ Res Public Health. 2020 Aug 27; 17(17):6204. doi: 10.3390/ijerph 17176204.
Rizal MF, van Doorslaer E. Explaining the fall of socioeconomic inequality in childhood stunting in Indonesia. SSM Popul Health. 2019 Dec;9:100469. doi: 10.1016/j.ssmph.2019.100469.
Flynn J, Alkaff FF, Sukmajaya WP, Salamah S. Comparison of WHO growth standard and national Indonesian growth reference in determining prevalence and determinants of stunting and underweight in children under five: a cross-sectional study from Musi sub-district. F1000Res. 2021 Mar 15;9:324. doi: 10.12688/f1000research.23156.4.
Samsudin M, Hapsari PW, Kartasurya MI, Syauqy A, Isnawati M, Wati EK, et al. Comparison of high and low stunting reduction groups using IFE-EFE matrix analysis in Central Java Province, Indonesia. Front Public Health. 2023 Nov 17;11. doi: 10.3389/fpubh.2023. 1191473.
Maulina R, Qomaruddin MB, Prasetyo B, Indawati R. Maternal Complications during Pregnancy and Risk Factors for Stunting. Iran J Nurs Midwifery Res. 2024 May;29(3):309–13. doi: 10.4103/ ijnmr.ijnmr_358_22.
Noor MS, Andrestian MD, Dina RA, Ferdina AR, Dewi Z, Hariati NW, et al. Analysis of Socioeconomic, Utilization of Maternal Health Services, and Toddler’s Characteristics as Stunting Risk Factors. Nutrients. 2022 Oct 18;14(20):4373. doi: 10.3390/nu1 4204373.
Mrema JD, Elisaria E, Mwanri AW, Nyaruhucha CM. Prevalence and Determinants of Undernutrition among 6- to 59-Months-Old Children in Lowland and Highland Areas in Kilosa District, Tanzania: A Cross-Sectional Study. J Nutr Metab. 2021 Apr 11; 2021:1–9. doi: 10.1155/2021/6627557.
Mutapi F, Pfavayi L, Osakunor D, Lim R, Kasambala M, Mutemeri A, et al. Assessing early child development and its association with stunting and schistosome infections in rural Zimbabwean children using the Griffiths Scales of Child Development. PLoS Negl Trop Dis. 2021 Aug 11;15(8):e0009660. doi: 10.1371/ journal.pntd.0009660.
Putri LD, Agustin H, Bakti I, Suminar JR. Genetic Perception Versus Nutritional Factors: Analyzing the Indigenous Baduy Community’s Understanding of Stunting as a Health Issue. Int J Environ Res Public Health. 2025 Jan 22;22(2):145. doi: 10.3390/ijerph22020145.
Laksono AD, Izza N, Trisnani T, Paramita A, Sholikhah HH, Andarwati P, et al. Determination of appropriate policy targets to reduce the prevalence of stunting in children under five years of age in urban-poor communities in Indonesia: a secondary data analysis of the 2022 Indonesian national nutritional status survey. BMJ Open. 2024 Sep 20;14(9):e089531. doi: 10.1136/ bmjopen-2024-089531.
WHO. Prevalence of stunting in children under 5 (%). World Health Organization [Internet]. 2024 [cited 2025 Feb 13]; Available from: https:// data.who.int/indicators/i/A5A7413/5F8A486
Danso F, Appiah MA. Prevalence and associated factors influencing stunting and wasting among children of ages 1 to 5 years in Nkwanta South Municipality, Ghana. Nutrition. 2023 Jun;110:111996. doi: 10.1016/j.nut. 2023.111996
Tamir TT, Gezhegn SA, Dagnew DT, Mekonenne AT, Aweke GT, Lakew AM. Prevalence of childhood stunting and determinants in low and lower-middle income African countries: Evidence from standard demographic and health survey. PLoS One. 2024 Apr 25;19(4):e0302212. doi: 10.1371/ journal.pone.0302212.
Riskiah DM, Sekriptini AY, Judijanto L, Khariri K, Sutriyawan A, Elvina A. Impact of maternal behavior and history of infectious diseases during pregnancy on the prevalence of stunting among children under five years. Journal of Public Health and Development. 2025 Jan 1;23(1):196–206. doi: 10.55131/ jphd/2025/230115.
Jokhu LA, Syauqy A, Lin LY, Dieny FF, Rahadiyanti A. Determinants of stunting among children 6–23 months: a population-based study in Indonesia. Nutr Food Sci. 2024 Oct 25;54(8): 1369–82. doi: 10.1108/NFS-01-2024-0025.
Kustanto A, Rachmat O, Setyadi S. The Prevalence of Stunting in Indonesia: An Examination of the Health, Socioeconomic Status, and Environmental Determinants. Journal of Iranian Medical Council. 2024 Nov 24. doi: 10.18502/jimc.v8i1.17062.
Guja H, Belgiu M, Baye K, Stein A. Prevalence and determinants of stunting and anaemia in children aged 6–23 months: A multilevel analysis from rural Ethiopia. Matern Child Nutr. 2025 Jan 8;21(1). doi: 10.1111/mcn. 13736.
Mulyaningsih T, Mohanty I, Widyaningsih V, Gebremedhin TA, Miranti R, Wiyono VH. Beyond personal factors: Multilevel determinants of childhood stunting in Indonesia. PLoS One. 2021 Nov 19;16(11):e0260265. doi: 10.1371/ journal.pone.0260265.
Yani DI, Rahayuwati L, Sari CWM, Komariah M, Fauziah SR. Family Household Characteristics and Stunting: An Update Scoping Review. Nutrients. 2023 Jan 2;15(1):233. doi: 10.3390/nu15010233.
Ahmed M, Zepre K, Lentero K, Gebremariam T, Jemal Z, Wondimu A, et al. The relationship between maternal employment and stunting among 6–59 months old children in Gurage Zone Southern Nation Nationality People’s region, Ethiopia: A comparative cross-sectional study. Front Nutr. 2022 Oct 6;9. doi: 10.3389/fnut.2022.964124.
Nankinga O, Kwagala B, Walakira EJ. Maternal employment and child nutritional status in Uganda. PLoS One. 2019 Dec 19;14(12):e0226720. doi: 10.1371/journal.pone.0226720.
de Amorim JF, Cavalcante CG, de Amorim Santos LV, Solymos GMB, Toledo Florêncio TM de M, de Paffer AT, et al. Influence of family environment on childhood stunting. Matern Child Nutr. 2014 Apr 24;10(2): 313–4. doi: 10.1111/mcn.12121.
Kishore S, Thomas T, Sachdev H, Kurpad A V, Webb P. Modeling the potential impacts of improved monthly income on child stunting in India: a subnational geospatial perspective. BMJ Open. 2022 Apr 5;12(4):e055098. doi: 10.1136/bmjopen-2021-055098.
Agho KE, Mukabutera C, Mukazi M, Ntambara M, Mbugua I, Dowling M, et al. Moderate and severe household food insecurity predicts stunting and severe stunting among Rwanda children aged 6–59 months residing in Gicumbi district. Matern Child Nutr. 2019 Jul 13;15(3). doi: 10.1111/mcn.12767.
Berger LM. Income, family structure, and child maltreatment risk. Child Youth Serv Rev. 2004 Aug;26(8):725–48. doi: 10.1016/j.childyouth.2004. 02.017.
Miller JE, Korenman S. Poverty and Children’s Nutritional Status in the United States. Am J Epidemiol. 1994 Aug 1;140(3):233–43. doi: 10.1093/ oxfordjournals.aje.a117242.
Goode A, Mavromaras K, zhu R. Family income and child health in China. China Economic Review. 2014 Jun;29:152–65. doi: 10.1016/j.chieco. 2014.04.007.
Safitri HO, Fauziningtyas R, Indarwati R, Efendi F, McKenna L. Determinant factors of low birth weight in Indonesia: Findings from the 2017 Indonesian demographic and health survey. J Pediatr Nurs. 2022 Mar;63:e102–6. doi: 10.1016/j.pedn.2021.10.005.
Titaley CR, Ariawan I, Hapsari D, Muasyaroh A, Dibley MJ. Determinants of the Stunting of Children Under Two Years Old in Indonesia: A Multilevel Analysis of the 2013 Indonesia Basic Health Survey. Nutrients. 2019 May 18;11(5):1106. doi: 10.3390/nu11051106.
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. PLoS One. 2021 Jul 14;16(7):e0254662. doi: 10.1371/ journal.pone.0254662.
Wulandari F, Mahmudiono T, Rifqi MA, Helmyati S, Dewi M, Yuniar CT. Maternal Characteristics and Socio-Economic Factors as Determinants of Low Birth Weight in Indonesia: Analysis of 2017 Indonesian Demographic and Health Survey (IDHS). Int J Environ Res Public Health. 2022 Oct 26;19(21):13892. doi: 10.3390/ijerph192113892.
Hadi H, Fatimatasari F, Irwanti W, Kusuma C, Alfiana RD, Asshiddiqi MIN, et al. Exclusive Breastfeeding Protects Young Children from Stunting in a Low-Income Population: A Study from Eastern Indonesia. Nutrients. 2021 Nov 26;13(12):4264. doi: 10.3390/nu13124264.
Thahir AIA, Li M, Holmes A, Gordon A. Exploring Factors Associated with Stunting in 6-Month-Old Children: A Population-Based Cohort Study in Sulawesi, Indonesia. Nutrients. 2023 Aug 1;15(15):3420. doi: 10.3390/ nu15153420.
Mulyaningsih T, Mohanty I, Widyaningsih V, Gebremedhin TA, Miranti R, Wiyono VH. Beyond personal factors: Multilevel determinants of childhood stunting in Indonesia. PLoS One. 2021 Nov 19;16(11):e0260265. doi: 10.1371/ journal.pone.0260265.
Nugrohowati N, Purwani LE, Kristanti M, Simanjuntak K, Nurcita B, Wahyuni YP, et al. Risk factors for 6-to-24-month-old toddlers in district of Tanara: survey of hygiene sectors, worm infection, and complementary feeding to reduce stunting. F1000Res. 2023 Sep 7;12:1114. doi: 10.12688/f1000 research.139679.1.
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. doi: 10.1186/ s12889-016-3339-8.
Danaei G, Andrews KG, Sudfeld CR, Fink G, McCoy DC, Peet E, et al. Risk Factors for Childhood Stunting in 137 Developing Countries: A Comparative Risk Assessment Analysis at Global, Regional, and Country Levels. PLoS Med. 2016 Nov 1;13(11):e1002164. doi: 10.1371/journal.pmed.1002164.
Halli SS, Biradar RA, Prasad JB. Low Birth Weight, the Differentiating Risk Factor for Stunting among Preschool Children in India. Int J Environ Res Public Health. 2022 Mar 22;19(7): 3751. doi: 10.3390/ijerph19073751.
