Factors associated with stunting in ethnic children aged 0-5 years and synthesis of district health system guidelines for stunting growth management in Hod District, Chiang Mai Province

Abstract

The purpose of this study was to examine the causes of stunting and compile recommendations for the district health system to address stunting among ethnic children aged 0–5 years in Hot District, Chiang Mai Province. The study was conducted in two phases. In Phase 1, factors contributing to stunting among 261 ethnic children were investigated. Data were collected using questionnaires and analyzed using two-group logistic regression. In Phase 2, district health system guidelines were developed based on input from seven stakeholders. Data were gathered through in-depth interviews guided by the Six Building Blocks framework, and content analysis was employed for interpretation. The findings revealed that children who consumed only 1–2 boxes or glasses of milk per day had a 4.875- and 2.785-fold higher risk of stunting, respectively, compared to children who consumed 5–6 boxes or glasses daily (p-values = 0.05 and 0.03). Children fed a diet of rice and vegetables were 2.159 times more likely to experience stunting compared to those whose diets included rice, vegetables, and meat (p-value = 0.02). Additionally, children who slept only 6–8 hours per night had a 2.967 times higher likelihood of stunting compared to those who slept more than 10 hours per night (p-value = 0.03). Based on these findings, guidelines for the district health system were developed. Recommendations included clearly defining stakeholders’ roles and responsibilities, such as educating health workers, using the information and technology system to assess children's nutritional status, and strengthening service systems to reduce stunting among ethnic children. Local administrative organizations were encouraged to support health-related expenses, communicate effectively via online media, and implement and manage systems with an emphasis on providing proper models for raising ethnic children.