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Analysis of Factors Affecting the Prevalence of Stunting on Children Under Five Years

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Analysis of Factors Affecting the Prevalence of Stunting on Children Under Five Years EurAsian Journal of BioSciences Eurasia J Biosci 14, 6725-6735 (2020) Analysis of factors affecting the prevalence of stunting on children under five years Laili Rahayuwati 1*, Ikeu Nurhidayah 2, Nur Oktavia Hidayati 3, Sri Hendrawati 2, Habsyah Saparidah Agustina 3, Rindang Ekawati 4, Alette Suzy Setiawan 5 1 Department of Community Nursing, Faculty of Nursing Universitas Padjadjaran, INDONESIA 2 Department of Pediatric Nursing, Faculty of Nursing Universitas Padjadjaran, INDONESIA 3 Department of Psychiatric Nursing, Faculty of Nursing Universitas Padjadjaran, INDONESIA 4 National Population and Family Planning Board (BKKBN), Bandung, INDONESIA 5 Department of Dentistry, Faculty of Dentistry Universitas Padjadjaran, INDONESIA *Corresponding author: [email protected] Abstract Introduction: Stunting is a latent problem indicating a chronic malnutrition status during the child’s growth since birth. The prevalence of stunting is caused by multiple factors. This research aims at analyzing the factors affecting the prevalence of stunting on children in the area of West Java Province, including the demographic social of the mother, the child, and the child’s health status. Method: The research applies quantitative method. The number of respondents is 810. The research took place in 6 regencies/cities whose villages support family planning (Kampung Keluarga Berencana) such as Bandung City, Bandung Regency, West Bandung Regency, Subang Regency, Sumedang Regency, and Garut Regency. The quantitative analysis consists of a univariate using frequency percentage and distribution, as well as bivariate analysis using correlation test. Result: The result of this research shows that nearly all toddlers have a normal body height as much as 73.1%, while 23.8% others fall into the category of “short” or “very short.” Based on the factor analysis, there exists a relevance in such factors as mother’s occupation (p = 0.010; OR = 0,532), delivery complications (p = 0,010; OR = 2,072), completeness of immunization distribution (p = 0,000; OR = 3,111), immunization schedule (p = 0,000; OR = 3,289), exclusive ASI (ASI) provision (p = 0,041; OR = 1,486), and child medical records (p = 0,044; OR = 1,649), while other factors are considered irrelevant. Conclusion: The suggestion for this research is that it requires cross-sectoral cooperation and improvement of the role of healthcare staff in educating mothers regarding complete immunization distribution on schedule, exclusive breastfeeding distribution, and prevention of contagious illness to children. Originality of the study is firstly observation on the stunting related to the prevalence and management in several regency/city in West Java Province. Keywords: children, prevalence, quality of life, stunting Rahayuwati L, Nurhidayah I, Hidayati NO, Hendrawati S, Agustina HS, Ekawati R. Setiawan AS (2020) Analysis of factors affecting the prevalence of stunting on children under five years. Eurasia J Biosci 14: 6725-6735. © 2020 Rahayuwati et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License. INTRODUCTION Nadhiroh, 2015). This condition is represented by a high z-score of the body height based on age (TB/U) with less The setback of low-quality population is indicated by than -2 of SD and on growth standards according to the prevalence of nutrition and stunting that will affect WHO (WHO, 2010). WHO (2011), in 2010, claimed that the quality of human resource. This results in youth 171 million children worldwide were suffering from degeneration and in the condition of future economy stunting, 167 millions of whom lived in underdeveloped (Fauzi, 2012). WHO has articulated SDGs with countries. Basic Health Research (Riset Kesehatan eradicating starvation as one of its objectives, and 2025 Dasar/Riskesdas) 2013 shared similar point of view, is the year expected where issues such as malnutrition lamenting the national prevalence of stunting in 2013 is and stunting are thoroughly overcome. In 2017, the 37.2% or nearly 9 million toddlers suffer from stunting. In Ministry of Health Republic of Indonesia (Kementerian Kesehatan Republik Indonesia/Kemenkes) stipulated the number of stunting cases in Indonesia, overlapping the limit set forth by WHO. Received: September 2019 Accepted: March 2020 Stunting is a latent problem. It depicts a chronic Printed: December 2020 malnutrition during a child’s growth since birth (Ni’mah & 6725 EurAsian Journal of BioSciences 14: 6725-6735 (2020) Rahayuwati et al. 2010, Riskesdas reported that Indonesia contributed to causes needed to reduce stunting further. This requires the 5th biggest stunting sufferers worldwide. diets diversity, which is influenced by several factors. In 2013, Indonesia National Planning Board (Badan The factors affected the stunting are economic Perencanaan Nasional/Bappenas) reported that the development, urbanization, providing access to a occurrence of stunting in toddlers is pertinent to the greater variety of foods, including processed and issue of body weight reaching up to <2500 grams enriched foods, parental education, and modernizing the (BBLR) at birth. The period of child under two years old, food system. Richer consumers are increasingly able to including their heyday (the first 1000 days of life) is a access more nutritious food, while poorer consumers highly environment-sensitive period; thus, attention to need support to improve access, and should be optimize bigger proportion of attention to nutrition level is dire the hygiene and sanitation (Shively, Sununtnasuk, & (Kurniasih, 2010). Issues such as stunting today may Brown, 2015). hamper the child’s growth, with negative impacts looming, such as intellectual breakdown, prone to METHOD degenerative and non-contagious illness, productivity Researcher applied quantitative method. The decline, causing poverty and the risk of having a low- population in this research included fertile couples, with weighted baby (UNICEF, 2012; WHO, 2010). Therefore, the criteria such as pregnant mother (first to third prevention during heyday is crucial and fundamental. trimester) and/or mother with toddlers. Both categories Stunting status during heydays may affect the quality were taken from 6 regencies and cities in West Java of health, intellect, and productivity in the future (USAID, Province, collected using questionnaire technique. 2014; Kemenkes, 2013). Mothers and children need The call on which regency/city to be taken as sufficient and quality nutrition to ensure the most optimal samples is based on the highest number of stunting amount and results; motoric, social, and cognitive occurrence in West Java (Bappenas, 2017), including abilities; learning skills and future productivity. Bandung Regency, Bandung City, Garut Regency, West Considering the urgency of nutrition during heydays, a Bandung Regency, Subang Regency, and Sumedang prevention and intervention of stunting is to be put top Regency, totalling up to 534.652 respondents. The priority to improve the life quality for future generations minimal number of samples is based on the number of (Bappenas, 2012). population according to the Isaac and Michael sample- Prevention and countermeasures of stunting must be determining table with significance rate as much as 1% aligned with the collateral factors There are 5 main for ±550.000 population. Therefore, the minimal number factors of stunting according to Kemenkes in Riskesdas thereof falls within a range of 665 to 810 respondents. (2013), including poverty, social and culture, increase on The final samples used in this research are 810 exposure of contagious illness, less nutritious food respondents. susceptibility and limited access to health care service. Sampling technique in this research uses cluster The collateral factors of stunting on children in rural and sampling from 6 regencies/cities consisting of 6 villages urban areas are strengthened by research from that have KB village, each represented by a 135- Aridiyan, Rohmawati, and Ririanty (2015), including respondent sample per village. 810 respondents of 6 KB mother’s education level, family income, mother’s villages in 6 regencies/cities in West Java. 735 of them knowledge about nutrition, exclusive ASI distribution, the include toddlers and mom with toddlers (89.3%), age during which solid food given to a child before 6 pregnant women (8.2%) or 67 people, and pregnant months old (MP-ASI) is distributed, level of zinc and iron women with toddlers (2.5%) or around 20 respondents. adequacy, medical records. The aim of this research is Data collecting is done through questionnaires to analyze the collateral factors of stunting on children, consisting of questions to measure: individual factor measured from the mother’s socio-demographic factor, (mother’s pregnancy history and medical records), the child’s socio-demographic factor, and the child’s socio-demographic factors (gender, age, educational health status. background, occupation, family income, health insurance, healthcare service access), and behavior LITERATURE REVIEW (knowledge and family action on health defense, Bloem, at al (2013) study about the relationship nutritional adequacy fulfillment for pregnant women, between different causes of stunting and stunting antenatal check-up, and secure delivery process, prevalence over time in Southeast Asia. The results of exclusive breastfeeding distribution, nutritional this study that between 1990-2011, mortality rates adequacy fulfillment for toddlers, immunization
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