Child stunting is associated with child, maternal, and environmental factors in Vietnam

Low serum lipase levels in mothers of children with stunted growth indicate the possibility of low calcium absorption during pregnancy: A cross-sectional study in North Sumatra, Indonesia

Stunting is caused by various factors, including low nutritional intake in the first two years of life. This study aimed to investigate the differences in sociodemographic factors and mineral, vitamin, and enzyme parameters in mothers associated with the occurrence of stunting in children. We conducted a cross-sectional study from September to November 2020 on North Sumatra Island, Indonesia. The data collected included sociodemographic characteristics, pregnancy history, birth history, food intake, and laboratory examinations, including measurements of calcium, iron, zinc, vitamin D, pancreatic amylase, and serum lipase levels. This study included 50 healthy mothers aged 18-50 years old with children aged 2 to 60 months. There was a significant difference in serum calcium levels between the groups of mothers of children with normal and stunted growth (p = 0.03, mean difference±standard error (SE) = 0.23±0.12, 95% CI: 0.19-0.45). All of the study subjects were categorized as vitamin D deficient. The mean lipase level in the group of mothers of children with stunted growth was significantly lower than that in the group of mothers of children with normal growth (p = 0.02, mean difference±SE = 4.34±1.83, 95% CI: 0.62-8.06). The conclusion was that serum lipase levels were significantly lower in mothers of children with stunted growth compared to mothers of children with normal growth. Serum lipase levels this low are likely to indicate that a mother is unable to meet her child's calcium needs during pregnancy, increasing the child's risk of stunted growth.

Stunting predictors among children aged 0-24 months in Southeast Asia: a scoping review

OBJECTIVE

To identify predictors of stunting among children 0-24 months in Southeast Asia.

METHODS

This scoping review focused on articles with observational study design in English published from 2012 to 2023 from five international databases. The primary keyword used were: "stunting" OR "growth disorder" AND "newborn" AND "predict" AND "Southeast Asia".

RESULTS

Of the 27 articles selected for the final analysis there are thirteen predictors of stunting in seven Southeast Asia countries. The thirteen predictors include the child, mother, home, inadequate complementary feeding, inadequate breastfeeding, inadequate care, poor quality foods, food and water safety, infection, political economy, health and healthcare, water, sanitation, and environment, and social culture factor.

CONCLUSION

All these predictors can lead to stunting in Southeast Asia. To prevent it, health service providers and other related sectors need to carry out health promotion and health prevention according to the predictors found.

Assessing the relationship of maternal short stature with coexisting forms of malnutrition among neonates, infants, and young children of Pakistan

Evidence from previous studies suggests a strong association between pediatric undernutrition and maternal stature. However, there's a scarcity of evidence regarding the relationship between maternal stature and pediatric coexisting forms of malnutrition (CFM). This study examined the prevalence and trends of CFM at the individual, household, and community levels, using data from the Demographic & Health Surveys (DHS) of Pakistan. Furthermore, this study assessed the association between pediatric CFM and short maternal stature while adjusting for multiple covariates. A panel cross-sectional analysis was conducted using data from the 2012-2013 and 2017-2018 Pakistan Demographic & Health Survey (PDHS). We included data from 6194 mother-child dyads aged 15-49 years and 0-59 months, respectively, while excluding data from pregnant mothers and dyads with incomplete anthropometric variables and anthropometric outliers. Across the two survey periods, our findings reveal a significant decline in pediatric malnutrition, including CFM, alongside a concurrent increase in maternal overweight/obesity. Three out of four households had either a malnourished mother, and/or a malnourished child, and/or both. Our study demonstrates that short maternal stature increased the odds of various forms of pediatric undernutrition by two-to-threefolds (p < .041), but we did not find an association with wasting, overweight/obesity, and nutritional paradox. This underscores the heightened vulnerability of children born to short-stature mothers to various forms of pediatric undernutrition. Addressing the high prevalence of pediatric undernutrition among children of short-stature mothers necessitates a comprehensive approach that considers an individual's nutritional status throughout their entire life cycle.

Outcome and factors associated with undernutrition among children with congenital heart disease

BACKGROUND

Congenital heart disease (CHD) is associated with high morbidity and mortality, especially among those with undernutrition. Evaluating risk factors associated with undernutrition is important to improve clinical outcomes. We aimed to evaluate the outcome and factors associated with undernutrition among children with CHD.

MATERIAL AND METHODS

A prospective cohort study was conducted among children with CHD at Dr. Sardjito Hospital, Yogyakarta, Indonesia during February 2016 to June 2018. Clinical and demographic data were collected at the time of diagnosis. Multivariate logistic regression analysis was used to identify independent factors associated with undernutrition using odds ratio (OR) and 95% confidence interval (CI). Significance was set as p<0.05.

RESULTS

We recruited 1,149 children with CHD, of those, 563 (49%) were underweight, 549 (47.8%) were stunting, and 361 (31.4%) were wasting. In the multivariate analysis, cyanotic CHD, delayed diagnosis, congestive heart failure, pulmonary hypertension, syndrome, young maternal age, history of low birth weight, and being first child were independently associated with undernutrition. Underweight and stunting were significantly associated with increased mortality with OR of 3.54 (95% CI: 1.62-7.74), p<0.001 and OR 3.31 (95% CI: 1.65-6.64), p<0.001, respectively.

CONCLUSIONS

About half of the children with CHD were categorized with undernutrition. An increased risk of undernutrition was associated with cyanotic CHD, delayed diagnosis, congestive heart failure, pulmonary hypertension, syndrome, low birth weight, and being first child. Underweight and stunting were significantly associated with increased risk of death.

Malnutrition among under-five children in St. Martin's Island, Bangladesh: A cross-sectional study on prevalence and associated factors

Objectives

Early childhood nutrition is critical for physical and mental development, and any hindrance (malnutrition) at this stage adversely affects adulthood which makes them more susceptible to a variety of communicable and non-communicable diseases. St. Martin's Island was the focus of this study, which examined the prevalence and risk factors for malnutrition among under-five children.

Methods

In this cross-sectional study, 256 children aged under five were assessed for anthropometry, and multiple logistic regression models were fitted to identify potential predictors of malnutrition. For analysis, SPSS and WHO Anthro software were used.

Results

The prevalence of stunting, wasting, underweight, and overweight were 34.4%, 17.6%, 18.9%, and 6.9% respectively among children under-five years of age in St. Martin's Island. An increase in child's age decreases their risk of being stunted (AOR = 0.97, p = 0.006). Males were more likely than females to be wasted (AOR = 2.03, p = 0.001). Both stunting (AOR = 2.42, p = 0.004) and wasting (AOR = 2.82, p = 0.015) rate were higher among the poorer section as compared to the richest. On the contrary, underweight was low among the poorest section (AOR = 0.37, p = 0.024). Other socio-economic factors, for example, household food insecurity, and parental occupation affect these forms of malnutrition significantly.

Conclusion

Prevalence of all forms of malnutrition except underweight was higher as compared to the national perspective in St. Martin's Island among the under-five children. Community-based approaches by the local government in collaboration with various non-government organizations should be taken to reduce and prevent malnutrition among children.

Stunting among children under two years in Indonesia: Does maternal education matter?

BACKGROUND

Measuring height for age is one of the essential indicators for evaluating children's growth. The study analyzes the association between maternal education and stunting among children under two years in Indonesia.

METHODS

The study employed secondary data from the 2017 Indonesia Nutritional Status Monitoring Survey. The unit of analysis was children under two years, and the study obtained weighted samples of 70,293 children. Besides maternal education, other independent variables analyzed in this study were residence, maternal age, maternal marital status, maternal employment, children's age, and gender. In the final stage, the study occupied a multivariate test by binary logistic regression test.

RESULTS

The results show the proportion of stunted children under two years in Indonesia nationally is 20.1%. Mothers in primary school and under education categories are 1.587 times more likely than mothers with a college education to have stunted children under two years (95% CI 1.576-1.598). Meanwhile, mothers with a junior high school education have a chance of 1.430 times more than mothers with a college education to have stunted children under two years (95% CI 1.420-1.440). Moreover, mothers with education in the senior high school category have 1.230 times more chances than mothers with a college education to have stunted children under two years (95% CI 1.222-1.238).

CONCLUSION

The study concluded that the maternal education level was associated with stunting children under two years in Indonesia. The lower the mother's level of education, the higher the chances of a mother having stunted children under two years.

The Indirect Impact of Smallholder Vegetable Production on Children's Nutrition Outcomes in Rural Vietnam

Childhood undernutrition, particularly stunting, wasting, and micronutrient deficiencies, remains a major health concern in rural Vietnam. While literature suggests leveraging agriculture to improve child nutrition via agricultural diversification, market engagement, and women's empowerment, very few studies have empirically explored how smallholder vegetable production can influence household nutrition. This paper examines the association of household-level vegetable diversity, market access, and market participation with nutrition outcome measures of children in smallholder households. We use a cross-sectional household dataset, collected in 2016 in northwest Vietnam, covering 234 children aged 6–60 months. We estimate and compare the results of regression models using three-stage least squares (3SLS), ordinary least squares (OLS), logistic regression, and seemingly unrelated regression (SUR), to explore variations in six nutrition outcome measures: height-for-age z-score (HAZ), weight-for-height z-score (WHZ), weight-for-age z-score (WAZ), stunting, wasting, and underweight. Our results suggest smallholder vegetable production has a significant indirect association with children's nutrition status via market participation. Market participation is an important factor in improving girls' HAZ and WHZ, and in reducing the probability of boys being stunted and underweight. The additional income from selling vegetables allows households to purchase nutritious food, which is likely to have a positive impact on children's nutrition outcomes.

Associations between PM2.5 exposure and infant growth: A mediation analysis of oral microbiota

BACKGROUND

Previous studies have linked growth retardation with ambient fine particulate matter (PM_2.5) exposure. However, few studies explored such association from the perspective of microbiota, such as oral microbiota. We aimed to identify the potential role of oral microbiota in the links between PM_2.5 exposure and infant growth.

METHODS

Baseline information of 335 recruited mother-child pairs was collected by structured questionnaires. Growth indicators (weight, length) of one-year-old infants were abstracted from medical records when they had physical examination and corresponding z scores were calculated. 16S rRNA gene amplicon sequencing was performed to assess oral microbiota of infants and co-abundance groups (CAGs) were further calculated. We assessed PM_2.5 levels by inverse distance weighting (IDW). Generalized linear regression and mediation analysis were performed to determine associations between PM_2.5 exposure, oral microbiota and growth indicators.

RESULTS

Per 10 μg m^-3 increment of PM_2.5 in the period of 10th month-examination was associated with decreased length z score (β = -1.97, 95%CI: -3.83, -0.11). Oral microbiota correlated with weight z score and body mass index (BMI) z score was identified by Spearman correlation analysis. CAG4 was statistically associated with increased weight z score (β = 3.40, 95%CI: 0.29, 6.51) and BMI z score (β = 5.44, 95%CI: 1.00, 9.87). Several bacteria in the level of genus and CAG associated with PM_2.5 exposure were additionally identified (P < 0.05). Mediation analysis revealed that PM_2.5 in the period of birth-3rd month impacted the z scores of weight and BMI by altering relative abundance of Megasphaera (P < 0.05).

CONCLUSION

PM_2.5 exposure from 10th to 12th month after birth could retard infant linear growth. PM_2.5 might impact oral microbiota of one-year-old infants. Growth-related bacteria and CAGs were identified. Megasphaera might function as mediator between PM_2.5 exposure during birth-3rd month and infant z scores of weight and BMI.

Does birth season correlate with childhood stunting? An input for astrological nutrition

INTRODUCTION

Chronic malnutrition is highly prevalent in Sub-Saharan Africa and a severe public health problem in Ethiopia.At country level in the past three decades,the prevalence of stunting is above 40%.Different researchs and intervention were implemented in the past;but the progresss is non-remarkable.Despite; the effect of birth season on childhood chronic malnutrition was not studied yet in Ethiopia.

METHODS

This research was extracted from the 2016 demographic health survey of Ethiopia. The data was collected based on national and international scientific protocols. A total of 645 enumeration areas were selected for the national survey.The surevey uses two stage stratified sampling technique to gather data from the sampling unit. After excluding non eligible children a total of 8855 participants were included for final analysis.Height and weight were measured based on the standards nutritional assessment procedure.SPSS version 20 was used to analyze the data.Descriptive statistics were used to present the data. Binary and multivariable logistic regression models were regressed to identify the potential predictors.A p-value of less than 0.05 with 95% CI were used to declare an association.

RESULT

The prevalence of stunting in Ethiopia was 38.7% (95% CI: 36.8, 40.6). Season of birth had a significant association with stunting. The odds of being stunted among children born in the spring season were decreased by 16% as compared to children born in the winter season.

CONCLUSION

Children born in the spring season were less likely to be stunted (the so called October effect). The clear scientific relation between the season of birth and child anthropometric indicator is not well understood. Nutritional interventions and policies are better to consider the birth season of the child.

Lifetime impact of being underweight or overweight/obese during childhood in Vietnam

BACKGROUND

There is limited evidence about lifetime burden of child malnutrition. This study aimed to estimate the lifetime impact of being underweight or overweight/obese during childhood in Vietnam.

METHODS

We developed a life table model in combination with a Markov model for Vietnamese children aged 5-19 years and simulated until they reached 75 years of age or died using published data. The starting year was 2019 and the model estimated number of deaths, years of life lived and quality-adjusted life years (QALY) with an annual discount rate of 3%. We performed scenario, one-way, and probabilistic sensitivity analyses to assess the impact of uncertainties in input parameters.

RESULTS

The model estimated 9.68 million deaths (6.44 million men and 3.24 million women), 622 million years of life lived (317 million men and 305 million women), and 601 million QALYs (308 million men and 293 million women). Scenario analyses showed that the reduction in either underweight or overweight/obesity alone, and reduction in both underweight and overweight/obesity resulted in fewer deaths, more years of life lived and more QALYs gained. In the scenario where everyone was a healthy weight, the model estimated 577,267 fewer deaths (6.0% less), 2 million more years of life lived (0.3% more), and 3 million QALYs gained (0.6% more) over base-case results which represents current situation in Vietnam.

CONCLUSIONS

Our results suggest that addressing underweight and overweight/obesity will contribute to reducing deaths and increasing years of life lived and QALYs. Policies and interventions in alignment with Sustainable Development Goals to address underweight and overweight/obesity are necessary to achieve health for all.

Disruptive Innovations for Well-Functioning Food Systems: The Data-Driven “Food and Nutrition Security Under Climate Evolution” Framework

The current climate crisis poses new uncertainties, risks, and vulnerabilities, and is leading to losses for millions of people depending on fragile food systems. Food systems are, however, vastly different across landscapes and communities, and their capacities to respond to climate impacts evolves and changes through time. Humanitarian and development organizations are struggling to keep pace with these changes. Monitoring a large number of diverse food systems during an evolving climate crisis can be expensive and time-consuming. This paper introduces a monitoring approach that uses a combination of open-source earth observations along with national data sources to produce highly contextualized metrics for monitoring Food And Nutrition Security under Climate Evolution (FANSCE). Entirely data-driven, the FANSCE approach has been designed to produce policy recommendations to help monitor, assess, and mitigate climatic impacts on food systems. We developed and tested this approach in Vietnam, where climate variability has become a growing threat to food systems. Our results show that predictors of food and nutrition security differ drastically with the intensity of climate variability. More specifically, our analyses suggest that in areas of high climate variability, levels of food and nutrition security can be significantly predicted based on economic activities, ethnicity, education, health of mothers, and the level of readiness and preparedness to climate impacts of villages and communities. On the other hand, in areas of low climate variability, food and nutrition security are mostly predictable based on the ability of households to access essential services (such as education, health) and communal resources (water, storage, etc.). To support the resilience of food systems, policymakers must regularly monitor how these dimensions react to the changing climate. Addition critical actions to increase food system sustainability in Vietnam include 1) enhanced coordination of institutional responses and capacities across governmental and non-governmental agencies, and 2) better integration of scientific knowledge into national and sub-national decision-making processes.

Identification and Analysis of Stunting Risk Factors in Children under Three Years of Age in the Area of Kampar Watershed

Growth and development that is not optimal is a form of chronic malnutrition, one of which is marked by height for age which is below the standard deviation (<-2 SD) and is called stunting. Stunting has a negative impact on children's motor development, reduces children's performance in school, increases the risk of excess nutrition, infectious diseases, and even death as well as reduces productivity in adulthood. The purpose of this study was to identify risk factors for stunting in people living in the Kampar watershed. This research is a mixed-method with an explanatory sequential design which is a modification of (1–3). The research was carried out on people living in the Kampar river basin. The priority areas for specific stunting reduction interventions in this study are the Work Areas of the Kampar Kiri Hulu II Health Center, the Koto Kampar XIII Health Center, and the Kampar Kiri Health Center. This study found that the dominant factors of the five variables were home sanitation and parenting, as both affected the incidence of stunting. The findings obtained are different from the results of data analysis obtained from interviews, observations, and descriptive statistics. Based on the results of data analysis from interviews, observations, and descriptive statistics, it was found that all variables of the three factors became the main factors that had a close relationship with the incidence of stunting in the community in the Kampar watershed.

Community support model on breastfeeding and complementary feeding practices in remote areas in Vietnam: implementation, cost, and effectiveness

Background

Poor access to healthcare facilities and consequently nutrition counseling services hinders the uptake of recommended infant and young child feeding (IYCF) practices. To address these barriers and improve IYCF practices, Alive & Thrive (A&T) initiated community support groups in remote villages across nine provinces in Vietnam.

Objective

This study examines the effectiveness of the support group model and related project costs for reaching underserved areas to improve IYCF practices.

Methods

To evaluate the model’s implementation and project costs, we reviewed implementation guidelines, expenditure and coverage reports, monitoring data, and budgets for the nine provinces. To evaluate the model’s effectiveness, we used a 3-stage sampling method to conduct a cross-sectional survey from April to May 2014 in three provinces entailing interviewing mothers of children aged 0–23 months in communes with (intervention; n = 551) and without support groups (comparison; n = 559).

Findings

Coverage: From November 2011 to November 2014, in partnership with the government, A&T supported training for 1513 facilitators and the establishing 801 IYCF support groups in 267 villages across nine provinces. During this period, facilitators provided ~ 166,000 meeting/support contacts with ~ 33,000 pregnant women and mothers with children aged 0–23 months in intervention villages. Costs: The average project costs for supporting the meetings, compensating village collaborators, and providing supportive supervision through staff in commune health stations were USD 5 per client and USD 1 per contact. After adding expenditures for training, supportive supervision, and additional administrative costs at central and provincial levels, the average project cost was USD 15 per client and USD 3 per contact. Effectiveness: Survey participants in intervention and comparison communes had similar maternal, child, and household characteristics. Multiple logistic regression models showed that living in intervention communes was associated with higher odds of early initiation of breastfeeding (OR: 1.7; 95% CI: 1.1, 2.7), exclusive breastfeeding from 0 to 5 months (OR: 12.5; 95% CI: 6.7, 23.4), no bottle feeding (OR: 2.69; 95% CI: 1.82, 3.99), and minimum acceptable diet (OR: 1.51; 95% CI: 0.98, 2.33) compared to those living in comparison communes.

Conclusion

The IYCF support group model was effective in reaching populations residing in remote areas and likely contributed to improved IYCF practices. The study suggests that the model could be scaled up to promote equity in breastfeeding support.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12939-021-01451-0.

Maternal factors associated with moderate and severe stunting in Ethiopian children: analysis of some environmental factors based on 2016 demographic health survey

Background

Stunting or chronic undernutrition is a significant public health problem in Ethiopia. In 2019, 37% of Ethiopian children under-5 were stunted. Stunting results from a complex interaction of individual, household and social (environmental) factors. Improving the mother’s overall care is the most important determinant in reducing the stunting levels in developing countries. We aimed to determine the most important maternal factors associated with stunting and quantify their effects.

Methods

This study used data from the nationally representative 2016 Ethiopian Demographic Health Survey (EDHS). Common maternal factors were first selected and analyzed using Pearson’s chi-square of association followed by multiple logistic regression. To quantify the effect of a unit change of a predictor variable a model for the continuous maternal factors was developed. All analyses were carried out using IBM SPSS© Version 23.

Results

Higher maternal educational level, better maternal autonomy, average or above maternal height and weight, having at least 4 antenatal care (ANC) clinic visits, and delivering in a health facility were significantly associated with lower severe stunting levels. Unemployed mothers were 23% less likely (p = 0.003) to have a stunted child compared with employed mothers. Mothers delivering at home had 32% higher odds of stunting (p = 0.002). We found that short mothers (< 150 cm) were 2.5 more likely to have stunted children when compared with mothers above 160 cm. Every visit to the ANC clinic reduces stunting odds by 6.8% (p <  0.0001). The odds of stunting were reduced by 7% (p = 0.028) for every grade a girl spent in school. A unit increase in Body Mass Index (BMI) reduced the odds of stunting by 4% (p = 0.014) and every centimeter increase in maternal height reduced the odds of stunting by 0.5% (p = 0.01).

Conclusion

Maternal education, number of antenatal care visits, and place of delivery appear to be the most important predictors of child stunting in Ethiopia.. Therefore, educating and empowering women, improving access to family planning and ANC services, and addressing maternal malnutrition are important factors that should be included in policies aiming to reduce childhood stunting in Ethiopia.

Determinan Balita Stunting di Jawa Timur: Analisis Data Pemantauan Status Gizi 2017

Background: Stunting in early life will have adverse functional consequences, including poor cognition and low levels of education. The study aimed to determine the determinants of stunting toddlers in East Java.Methods: The study uses secondary data from the 2017 PSG. Using the multi-stage cluster random sampling method, a sample of 10,814 toddlers aged 0-59 months was taken. The analyzed variables consisted of the dependent variable nutritional status of toddlers, 7 independent variables: residence, toddler age, mother's age, marital status of mothers, mother's education level, and working status of mothers. Determination of determinants using the Binary Logistic Regression test.Results: Toddlers living in urban areas were 0.855 times more at risk of stunting compared to toddlers living in rural areas (OR 0.885; 95% CI 0.798-0.980). Toddlers who have mothers with elementary education and below 2.206 times have more risk of stunting compared to toddlers who have mothers with college education (OR 2.206; 95% CI 1,835-12,651). Toddlers who have mothers with junior high school education were 1,676 times more likely to have stunting risk compared to toddlers who have mothers with tertiary education (OR 1.676; 95% CI 1.395-2.015). toddlers who have mothers with high school education are 1,266 times more likely to have stunting risk compared to toddlers who have mothers with tertiary education (OR 1,266; 95% CI 1,058-1,514).Conclusion: There were 4 variables that have proven to be significant as determinants of stunting in East Java Province, namely residence, age of toddler, age of toddler mother, and mother's level of educationABSTRAK Latar Belakang: Stunting dalam kehidupan awal akan mempunyai konsekuensi fungsional yang merugikan, termasuk kognisi yang buruk dan tingkat pendidikan yang rendah. Variabel ini perlu diperhatikan karena menurut Unicef, ada faktor sosial budaya yang berperan dalam terjadinya permasalahan stunting. Penelitian ditujukan untuk menentukan determinan balita stunting di Jawa Timur.Metode: Penelitian menggunakan data sekunder survei Pemantauan Status Gizi tahun 2017 (PSG 2017). Dengan metode multi-stage cluster random sampling, diambil sampel 10.814 balita berusia 0-59 bulan. Varibel yang dianalisis terdiri dari variabel dependen status gizi balita, 7 variabel independen: tempat tinggal, umur balita, umur ibu balita, status perkawinan ibu balita, tingkat pendidikan ibu balita, dan status bekerja ibu balita. Penentuan determinan dengan menggunakan uji Regresi Logistik Biner.Hasil: Balita yang tinggal di daerah perkotaan 0,855 kali lebih memiliki risiko stunting dibandingkan dengan balita yang tinggal di daerah pedesaan (OR 0,885; 95% CI 0,798-0,980). Balita yang memiliki ibu dengan pendidikan SD ke bawah 2,206 kali lebih memiliki risiko stunting dibandingkan dengan balita yang memiliki ibu dengan pendidikan perguruan tinggi (OR 2,206; 95% CI 1,835-12,651). Balita yang memiliki ibu dengan pendidikan SLTP 1,676 kali lebih memiliki risiko stunting dibandingkan dengan balita yang memiliki ibu dengan pendidikan perguruan tinggi (OR 1,676; 95% CI 1,395-2,015). balita yang memiliki ibu dengan pendidikan SLTA 1,266 kali lebih memiliki risiko stunting dibandingkan dengan balita yang memiliki ibu dengan pendidikan perguruan tinggi (OR 1,266; 95% CI 1,058-1,514).Kesimpulan: Ada 4 variabel yang terbukti signifikan sebagai determinan kejadian stunting di Provinsi Jawa Timur, yaitu tempat tinggal, umur balita, umur ibu balita, dan tingkat pendidikan ibu balita. 

“Anak ini kalau makan, ya apapun yang diminta…”: Eksplorasi Nilai Anak dan Pola Pengasuhan Anak pada Suku Jawa di Desa Besowo, Kediri, Jawa Timur

Background: Several studies have found that the nutritional status of children was much influenced by childcare patterns. While other studies reveal that parenting patterns were influenced by children's values. The higher the value of the child in the eyes of parents, the better the pattern of care provided is expected, including the habit of dietary given to the child. The study was aimed to explore the value of children (psychology, social, and economy) in Besowo.Methods: Qualitative research was carried out through an ethnographic approach. The researcher lived in Besowo for six months (June-November 2019). Informants were determined purposively on 23 women and 6 men. The main focus of the research was on the values of children and parenting patterns, including a child's diet.Results: The value of children psychologically, children were everything. This value makes parents try to be able to fulfill all the wishes of children. When the child did not want to eat, then whatever the child wants will be fulfilled, including eating snacks that were categorized as unhealthy. Value of children socially, children were considered as successors in the family, including those who were obliged to continue and maintain the good name of the family. Parents want children to follow in the footsteps of parents. Unconsciously the parents in question were male parents. The value of the child economically, the child was an investment or an asset. Children were where parents depend on old age. The pattern of parenting showed that even though the value of the child was considered very high, the pattern of care, especially the pattern of food intake in children, tend to be ignored.Conclusion: Javanese children in the village of Besowo have psychological, social and economic values. Although assessing children was everything, parenting patterns, including intake patterns, showed the opposite treatment.ABSTRAK Latar Belakang: Beberapa penelitian menemukan bahwa status gizi anak banyak dipengaruhi pola pengasuhan anak. Sementara penelitian lain mengungkap bahwa pola pengasuhan dipengaruhi oleh nilai anak. Semakin tinggi nilai anak di mata orang tua, maka diharapkan semakin baik pola pengasuhan yang diberikan, termasuk pola makan yang diberikan pada anak. Penelitian ditujukan untuk mengeksplorasi nilai anak (psikologi, sosial,  dan ekonomi) di Desa Besowo.Metode: Penelitian kualitatif dilakukan melalui pendekatan etnografi. Peneliti lived in di Desa Besowo selama enam bulan (Juni-November 2019). Informan ditentukan secara purposif pada 23 perempuan dan 6 laki-laki. Fokus utama penelitian pada nilai anak dan pola pengasuhan, termasuk pola makan.Hasil: Nilai anak secara psikologi, anak adalah segalanya. Nilai ini membuat orang tua berusaha untuk dapat memenuhi semua keinginan anak. Pada saat anak tidak mau makan, maka apapun maunya anak akan dipenuhi, termasuk makan jajanan yang masuk kategori tidak sehat. Nilai anak secara sosial, anak dianggap sebagai penerus dalam keluarga, termasuk yang berkewajiban untuk meneruskan dan menjaga nama baik keluarga. Orang tua menginginkan anak mengikuti jejak orang tua. Secara tidak sadar orang tua yang dimaksud adalah orang tua laki-laki. Nilai anak secara ekonomi, anak adalah investasi atau aset. Anak adalah tempat orang tua bergantung di hari tua. Pola pengasuhan anak menunjukkan bahwa meski menganggap nilai anak sangat tinggi, tetapi pola pangasuhan, terutama pola asupan makanan pada anak, cenderung diabaikan.Kesimpulan: Anak pada suku Jawa di Desa Besowo memiliki nilai psikologi, sosial dan ekonomi. Meski menilai anak adalah segalanya, tetapi pola pengasuhan, termasuk pola asupan, menunjukkan perlakuan yang bertolak belakang.

Child stunting is associated with child, maternal, and environmental factors in Vietnam

Child stunting in Vietnam has reduced substantially since the turn of the century but has remained relatively high for several years. We analysed data on children 6-59 months (n = 85,932) from the Vietnam Nutritional Surveillance System, a nationally representative cross-sectional survey. Multivariable Poisson regression models were used to estimate relative risk (RR) of stunting, stratified by child age and ecological region. Covariates at the child, maternal, household, and environmental levels were included based on available data and the World Health Organization conceptual framework on child stunting. Among children 6-23 months, the strongest associations with child stunting were child age in years (RR: 2.49; 95% CI [2.26, 2.73]), maternal height < 145 cm compared with ≥150 cm (RR: 2.04; 95% CI [1.85, 2.26]), living in the Northeast compared with the Southeast (RR: 2.01; 95% CI [1.69, 2.39]), no maternal education compared with a graduate education (RR: 1.77; 95% CI, [1.44, 2.16]), and birthweight < 2,500 g (RR: 1.75; 95% CI [1.55, 1.98]). For children 24-59 months, the strongest associations with child stunting were no maternal education compared with a graduate education (RR: 2.07; 95% CI [1.79, 2.40]), living in the Northeast compared with the Southeast (RR: 1.94; 95% CI [1.74, 2.16]), and maternal height < 145 cm compared with ≥150 cm (RR: 1.81; 95% CI [1.69, 1.94]). Targeted approaches that address the strongest stunting determinants among vulnerable populations are needed and discussed. Multifaceted approaches outside the health sector are also needed to reduce inequalities in socioeconomic status.