Determinants of Stunting among Children in Urban Families in Palu, Indonesia
DOI:
https://doi.org/10.3923/pjn.2017.750.756Keywords:
Environmental sanitation, exclusive breast feeding, family income, maternal age, stunted children, urban areaAbstract
Background and Objective: The high incidence of stunting is a serious problem for the government of Palu. Thus, a study of the determinants of stunting in Palu is necessary. This study aimed to assess potential modifiable risk factors that lead to stunting among children. Materials and Methods: This study used a case-control research design with a 1:3 ratio of cases (children who were stunted) to controls (children who were not stunted) and conducted from September, 2016-March, 2017. The population included all stunted children aged 7-24 months in Petobo village, Palu. The number of cases was 36 as obtained by the total sampling method and the number of control children was 108, who were selected randomly. Univariate, bivariate and multivariate with logistic regression analyses were used. Results: The determinants of stunting were family income (p = 0.000), exclusive breast feeding (p = 0.002), immunization status (p = 0.147), environmental sanitation (p = 0.001) and maternal age during pregnancy (p = 0.003). The multivariate analysis results showed that family income [odds ratio(OR) = 6.24] was the highest risk factor for stunting. Exclusive breast feeding (OR = 4.33), environmental sanitation (OR = 4.60) and maternal age during pregnancy (OR = 3.05) were associated with the same risk of stunting. Conclusion: In Petobo village, Palu, the main modifiable risk factor that leads to stunting among children is family income, followed by environmental sanitation, exclusive breast feeding and maternal age during pregnancy.
References
Kusumawati, E., S. Rahardjo and H.P. Sari, 2015. [Model of stunting risk factor control among children under three years old]. J. Kesehatan Masyarakat Nasional, 9: 249-256, (In Indonesian).
Stewart, C.P., L. Iannotti, K.G. Dewey, K.F. Michaelsen and A.W. Onyango, 2013. Contextualising complementary feeding in a broader framework for stunting prevention. Maternal Child Nutr., 9: 27-45.
Win, K.M., M. van der Putten, N. Vajanapoom and K. Amnatsatsue, 2013. Early pregnancy and maternal malnutrition as precursors of stunting in children under two years of age among bhutanese refugees, in Nepal maternal precursors in stunting of children. Thammasat Int. J. Sci. Technol., 18: 35-42.
Baliwati, Y.F., A. Khomsan and C.M. Dwiriani, 2004. [Introduction to Food and Nutrition]. Penebar Swadaya, Jakarta, ISBN: 9789794898116, Pages: 120, (In Indonesian).
Onsomu, E.O., B.A. Abuya, I.N. Okech, D. Moore and J. Collins-McNeil, 2015. Maternal education and immunization status among children in Kenya. Maternal Child Health J., 19: 1724-1733.
AHRD., 2013. Basic Health Research 2013. Agency for Health Research and Development (AHRD), Ministry of Health of Republic of Indonesia, Jakarta, ISBN: 9786022354826.
Hidayat, T.S. and N. Fuada, 2011. [Relationship between environmental sanitation, morbidity and nutritional status of under-five children in Indonesia]. J. Nutr. Food Res., 34: 104-113, (In Indonesian).
Fall, C.H.D., H.S. Sachdev, C. Osmond, M.C. Restrepo-Mendez and C. Victora et al., 2015. Association between maternal age at childbirth and child and adult outcomes in the offspring: A prospective study in five low-income and middle-income countries (COHORTS collaboration). Lancet Global Health, 3: e366-e377.
Victora, C.G., L. Adair, C. Fall, P.C. Hallal, R. Martorell, L. Richter and H.S. Sachdev, 2008. Maternal and child undernutrition: Consequences for adult health and human capital. Lancet, 371: 340-357.
IFPRI., 2016. Global nutrition report 2016: From promise to impact ending malnutrition by 2030. International Food Policy Research Institute, Washington, DC., USA., pp: 1-156.
Directorate of Community Nutrition, 2016. Nutrition status monitoring and nutrition performance indicators. Ministry of Health of Republic of Indonesia.
UNICEF., 2009. Tracking progress on child and maternal nutrition: A survival and development priority. Annual Report, United Nations Children's Fund (UNICEF), New York, USA., November 2009.
Dahlan, M.S., 2015. Statistik untuk Kedokteran dan Kesehatan: Deskriptif, Bivariat, dan Multivariat. Salemba Empat, Jakarta, ISBN: 978-602-8570-41-1, Pages: 290.
UNICEF., 2014. Multi-sectoral approaches to nutrition: Nutrition-specific and nutrition-sensitive interventions to accelerate progress. United Nations Children's Fund (UNICEF), New York, USA. https://www.unicef.org/eapro/Brief_Nutrition_Overview.pdf.
Finlay, J.E., E. Ozaltin and D. Canning, 2011. The association of maternal age with infant mortality, child anthropometric failure, diarrhoea and anaemia for first births: Evidence from 55 low- and middle-income countries. BMJ Open, Vol. 1.
Reyes, H., R. Perez-Cuevas, A. Sandoval, R. Castillo, J.I. Santos, S.V. Doubova and G. Gutierrez, 2004. The family as a determinant of stunting in children living in conditions of extreme poverty: A case-control study. BMC Public Health, Vol. 4.
Vitolo, M.R., C.M. Gama, G.A. Bortolini, P.D.B. Campagnolo and M.L. Drachler, 2008. Some risk factors associated with overweight, stunting and wasting among children under 5 years old. J. Pediatria, 84: 251-257.
Sujendran, S., U. Senarath and J. Joseph, 2015. Prevalence of stunting among children aged 6 to 36 months, in the Eastern province of Sri Lanka. J. Nutr. Disord. Ther., Vol. 5.
Kavosi, E., Z.H. Rostami, A. Nasihatkon, M. Moghadami and M. Heidari, 2014. Prevalence and determinants of under-nutrition among children under six: A cross-sectional survey in Fars province, Iran. Int. J. Health Policy Manage., 3: 71-76.
Amin, N.A. and M. Julia, 2014. [Sociodemographic and height of parents and its relationship with the incidence of stunting in children aged 6-23 months]. Indonesian J. Nutr. Dietetics, 2: 170-177, (In Indonesian).
Kuchenbecker, J., I. Jordan, A. Reinbott, J. Herrmann and T. Jeremias et al., 2015. Exclusive breastfeeding and its effect on growth of Malawian infants: Results from a cross-sectional study. Paediatr. Int. Child Health, 35: 14-23.
Thurnham, D.I., 2012. Adequate nutrient intakes for infancy. Part 1: From 0 to 6 months. Sight Life, 26: 28-39.
Paudel, R., B. Pradhan, R.R. Wagle, D.P. Pahari and S.R. Onta, 2012. Risk factors for stunting among children: A community based case control study in Nepal. Kathmandu Univ. Med. J., 10: 18-24.
Schmidt, C.W., 2014. Beyond malnutrition: The role of sanitation in stunted growth. Environ. Health Perspect., 122: A298-A303.
Data and Information Center, 2016. [Situation of toddlers stunting]. Ministry of Health of Republic of Indonesia. http://www.depkes.go.id/resources/download/pusdatin/infodatin/infodatin-ASI.pdf, (In Indonesian).
Nadiyah, D. Briawan and D. Martianto, 2014. [Risk factors of stunting among 0-23 month old children in Bali province, West Java and East Nusa Tenggara]. J. Nutr. Food, 9: 125-132, (In Indonesian).
Cumming, O. and S. Cairncross, 2016. Can water, sanitation and hygiene help eliminate stunting? Current evidence and policy implications. Maternal Child Nutr., 12: 91-105.
Esfarjani, F., R. Roustaee, F. Mohammadi and A. Esmaillzadeh, 2013. Determinants of stunting in school-aged children of Tehran, Iran. Int. J. Prev. Med., 4: 173-179.
Raj, A., N. Saggurti, M. Winter, A. Labonte, M.R. Decker, D. Balaiah and J.G. Silverman, 2010. The effect of maternal child marriage on morbidity and mortality of children under 5 in India: Cross sectional study of a nationally representative sample. Br. Med. J., Vol. 340.
UNICEF., 2014. The state of the World's children 2014 in numbers: Every child counts-Revealing disparities, advancing children's rights. United Nations Children's Fund (UNICEF), New York, USA. https://www.unicef.org/publications/files/SOWC2014_In_Numbers_28_Jan.pdf.
Statistics Indonesia, 2015. [Delayed progress: Maternal child marriage data analysis in Indonesia]. Central Bureau of Statistics, Jakarta, Indonesia, pp: 1-86, (In Indonesian).
Mason, J.B., R. Shrimpton, L.S. Saldanha, U. Ramakrishnan and C.G. Victora et al., 2015. The first 500 days of life: Policies to support maternal nutrition. Global Health Action, Vol. 8.
Prentice, A.M., K.A. Ward, G.R. Goldberg, L.M. Jarjou, S.E. Moore, A.J. Fulford and A. Prentice, 2013. Critical windows for nutritional interventions against stunting. Am. J. Clin. Nutr., 97: 911-918.
Tim of Research, 2016. Primary data of stunting in Palu. https://drive.google.com/file/d/0B98nxyCqOWtpNzZzSU9xLXpvVTg/view.
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