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Major Stunting Determinants in Infants: a Prevention Model

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Major Stunting Determinants in Infants: a Prevention Model 2476 Indian Journal of Public Health Research & Development, March 2020, Vol. 11, No. 03 Major Stunting Determinants in Infants: A Prevention Model Teungku Nih Farisni1, Yarmaliza1, Fitriani1, Dewi Susanna2, Fitrah Reynaldi1, Zakiyuddin1, Safrizal S.A.1 1Lecturer, Department of Public Health, Teuku Umar University, Meulaboh, Indonesia-23615, 2Lecturer, Department of Environmental Health, Faculty of Public Health, Universitas Indonesia, Indonesia-16424 Abstract The number of stunting cases in West Aceh Regency increases every year. This study was an observational study with case-control design exexamine the dominant stunting factors among toddlers in West Aceh Regency amine the dominant stunting factors among toddlers in West Aceh Regency. This study was conducted from February 10 to June 30, 2018, in Johan Pahlawan District of West Aceh Regency of Aceh Province. The location was chosen through a purposive sampling technique by observing the highest number of children under five experiencing stunting in West Aceh Regency. The number of samples in this study was 192 children. The results of this study showed that there was a significant relationship between the occurrence of stunting in children under five and the number of family members; parental height; Socioeconomic status (SES); low birth weight (LBW); nutritional knowledge; and food intake, where the p-value < 0.05. Keywords: Dominant factor, stunting, toddler, number of family members, socio-economic status. Introduction feeding practice that does not meet the nourishing needs. Indonesia positioned on the fifth for the In 2012, the World Health Assembly Resolution children with stunting conditions. More than 33% of 65.6 embraced a Comprehensive implementation Indonesian children under five years in Indonesia are plan on maternal, infant and young child nutrition1 underneath average height. The National Medium Term which indicated six worldwide nourishment targets for Development Plan or ‘Rencana Pembangunan Jangka 2025.2 This policy briefly achieves the first objective Menengah Nasional’ (RPJM) and Strategic Plan or of a 40% stunting decrease in children under five years ‘Rencana Strategis’ (RENSTRA) 2015-2019 has set the old1. Stunting during childhood is one of the massive goal to decrease stunting in children under five years obstacles to human improvement internationally old by 9.5%. Meanwhile, in 2013, the stunting rate is influencing around 162 million children under five years 37% implies that there is a 28.5% decrease in monetary old. Stunting, or being unreasonably short for one’s decline, and this should urgently be solved shortly.3 age, is characterized as a height that is in two standard deviations underneath the World Health Organization The Nutrition in the First 1,000 Days State of (WHO) child growth standards.1 the World’s Mothers (2012) elicits that the condition influenced the causes during 1000 days of a child’s life Stunting is an issue of perpetual malnourished beginning from the womb until their two years of age.4 health which is brought about by a long-time absence Specifically, the predominance of stunted children in of supplement consumption because of mistaken Aceh in Aceh area in 2016 was 41.5%, increasing from 2017, which was 37.2%.5 One of the indirect reasons for stunting cases is the number of members in the family. Corresponding Author: This number of a family is under recent research results Teungku Nih Farisni which have reasoned that the aspects influencing the Lecturer, Department of Public Health, Teuku Umar stunting case incorporated with the number of family University, Meulaboh, Indonesia-23615 members,6-7 parents’ height,8Socio-economic status 9 10 e-mail: [email protected] (SES), and history of LowBirth Weight (LBW). Indian Journal of Public Health Research & Development, March 2020, Vol. 11, No. 03 2477 In deliberation of the depiction narrated above, the was a 24-hour diet recall. A body length according to age objective of this study was to examine the dominant with a Z-score less than -2 SD was to determine stunting stunting factors among toddlers in West Aceh Regency. in children.11 The data analysis performed by univariate and bivariate analysis using the chi-square test. The test Materials and Method used the confidence intervals (95% CI) and significance This study is an observational study with a case- level p <0.05. The multivariate analysis was carried out control design. This study was conducted from February by a logistic regression test.The sample of this study was 10 to 30 June 2018 in Johan Pahlawan District of West 182 children who divided into two groups; 96 children Aceh Regency of Aceh Province. The location was chosen for the control group and 96 children for the case group. through a purposive sampling technique by observing Results the highest number of children under five experiencing stunting in West Aceh Regency. The number of samples Table 1 below explains that the food intake in this study was 192 children. The instrument used to and parental height (paternal and maternal) differed measure the variables was a structured questionnaire for significantly between the case group and the control interviews; to measure height was a height meter with group. a precision level of 0.1 cm, and to measure food intake Table 1. Frequency of Variable Distribution Cases (n=96) Control (n=96) Variable n % n % Number of Family Member a. >Three persons 73 76.56 30 31.25 b. Three persons 23 23.44 66 68.75 c. ≤ Three persons Paternal Height a. 155 cm 25 26.56 90 93.75 b. ≤ 155 cm 71 73.44 6 6.25 Maternal Height a. >145 cm 23 23.44 80 83.37 b. ≤ 145 cm 73 76.56 16 16.63 Socio-economic (SES) a. High (> UMP) 24 25 69 71.88 b. Low (< UMP) 74 75 27 28.12 Low Birth Weight (LBW) a. LBW 80 83.38 30 31.25 b. Normal 16 16.62 66 68.75 Nutritional Knowledge a. Good 32 33 63 65.62 b. Not Good 64 67 33 34.38 Food Intake a. Good 17 17.7 72 74.94 b. Not Good 79 82.3 24 25.06 * significant p < 0,05, PMW = Province Minimum Wage or UMP (Upah Minimum Provinsi) 2478 Indian Journal of Public Health Research & Development, March 2020, Vol. 11, No. 03 Table 1 explains that there was a significant relationship between the occurrence of stunting and the food intake; parental height; nutritional knowledge; SES; the history of LBW; and the number of family members. The highest OR found in food intake, with 8.09, which indicated that children who had poor food intake had an opportunity for 8.09 for stunting. It followed by maternal height (6.12), paternal height (5.43), nutritional knowledge (4.93), SES (4.79), LBW (3.78), and the number of family members (3.56). Table 2. Bivariate Analysis of Variables Toddler Height OR Variable Stunting Normal p-Value (95% CI) n % n % Number of Family Member a. >Three pesons 73 76.56 30 31.25 3.56 b. Three persons 23 23.44 66 68.75 0.03 (1.4-2.78) c. ≤ Three persons Paternal Heigh a. > 155 cm 25 26.56 90 93.75 5.43 0.002 b. ≤ 155 cm 71 73.44 6 6.25 (1.6-3.36) Maternal Heigh a. >145 cm 23 23.44 80 83.37 6.12 0.001 b. ≤ 145 cm 73 76.56 16 16.63 (1.03-7.23) Socio-economic (SES) a. High (>PMW) 24 25 69 71.88 4.79 0.007 b. Low (<PMW) 74 75 27 28.12 (2.01-4.82) Birth Weight (LBW) a. LBW 80 83.38 30 31.25 3.78 0.03 b. Normal 16 16.62 66 68.75 (1.2-3.12) Nutritional Knowledge a. Good 32 33 63 65.62 4.93 0.005 b. Not Good 64 67 33 34.38 (1.97-3.89) Food Intake a. Good 17 17.7 72 74.94 8.09 0.00001 b. Not Good 79 82.3 24 25.06 (2.82-9.67) *Significantp< 0,05, PMW=Province Minimum WageorUMP (Upah Minimum Provinsi) Table 3. Logistic regression analysis Model 1 Model 2 Model 3 Model 4 Model 5 Variable OR OR OR OR OR 95% CI 95% CI 95% CI 95% CI 95% CI Number of Family Member a. >three persons 2.77 2.04 3.02 2.67 3.19 b. ≤ 3 people (0.22-7.98) (0.33-7.82) (0.68-10.05) (0.43-7.56) (0.95-10.98) High of Father a. > 155 cm 5.60 4.73 4.54 5.54 4.83 b. ≤ 155 cm (1.03-12.96) (0.98-10.86) (0.84-10.95) (1.08-12.76) (1.30-12.01) High of Mother a. >145 cm 6.70 5.73 4.03 6.54 5.83 b. ≤ 145 cm (1.53-13.96) (1.09-12.86 (0.64-11.94 (1.48-13.85) (1.10-12.31) Socio-economic a. high (>PMW) 3.88 3.57 4.05 3.57 4.85 b. Low (< PMW) (0.53-10.97) (0.68-9.86) (0.98-11.65) (0.73-11.56) (0.91-11.91) Indian Journal of Public Health Research & Development, March 2020, Vol. 11, No. 03 2479 Model 1 Model 2 Model 3 Model 4 Model 5 Variable OR OR OR OR OR 95% CI 95% CI 95% CI 95% CI 95% CI Birth Weight a. LBW 3.65 2.84 3.25 2.97 4.19 b. Normal (0.72-9.98) (0.38-8.82) (0.78-11.05) (0.43-8.56) (0.95-11.98) Nutritional Comprehension a.
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