Risk Factors for Stunting among Children under Five Years in the Province of East Nusa Tenggara (NTT), Indonesia

Stop stunting-A misguided campaign by well-meaning nutritionists

OBJECTIVE

"Stop stunting" is the central focus of the national Indonesian campaign to improve child health. We provide an autoethnographic statement on the currently practiced strategy that commits 23 ministries and an estimated $3.9 billion per year to coordinating nutrition interventions that are supposed to address the underlying causes of stunting.

METHODS

We visited six community health posts (posyandus) in West Timor and in Java and participated in routine child health examinations. We documented our impressions and discussed them with Indonesian colleagues, health officials, and local physicians.

RESULTS

Routine health checks for children include anthropometry (height, weight, head, and mid-upper arm circumference), immunizations, and documentation in the children's health records. The examinations do not include a physical examination, vision and hearing tests of the child, health questionnaires, or information on nutrition. No specific information or recommendations are given to the mothers.

CONCLUSION

Stunting is highly prevalent in Indonesia and "Stop-stunting" campaigns have become a national issue. Yet, their impact is disillusioning. Stunting is associated with a way of life that differs from that in developed Western countries today and was prevalent in feudal and other nondemocratic societies. We do not want to throw away policies that try to improve growth in children, but instead of spending money for dubious interventions as we have encountered in Indonesia, we rather suggest spending thoughts on the political and emotional causes of poor growth in otherwise healthy Indonesian children.

Prevalence of stunting and its correlates among children under 5 in Afghanistan: the potential impact of basic and full vaccination

BACKGROUND

Child stunting is prevalent in low and middle-income countries (LMICs), but an information gap remains regarding its current prevalence, correlates, and the impact of vaccination against this condition in Afghanistan. This study aimed to determine the prevalence and correlates of moderate and severe stunting and the potential impact of basic and full vaccination among children under five in Afghanistan.

METHODS

This is a secondary analysis of the 2022-23 Afghanistan Multiple Indicators Cluster Survey (MICS) including 32,989 children under 5. Descriptive statistics were employed to describe the distribution of independent variables and the prevalence of stunting across them. Chi-square analysis was used to examine the association between each independent variable with stunting. Multinomial logistic regression was used to examine the risk of stunting across different independent variables.

RESULTS

A total of 32,989 children under 5 years old were included in this study. Of those 44.7% were stunted with 21.74% being severely stunted. Children aged 24-35 and 36-47 months faced the highest risk as compared to those aged 1-5 months. The prevalence was lower in female children and they were less likely to experience severe stunting. Stunting was more prevalent in rural areas, with children there 1.16 to 1.23 times more likely to be affected than urban counterparts. Lower wealth correlated with higher stunting. Younger maternal age at birth (≤ 18) correlated with increased stunting risks, particularly in severe cases. Parental education was inversely related to stunting; higher education levels in parents, especially fathers, were associated with lower stunting rates. Households with more than seven children showed a 25% and 44% higher risk of moderate and severe stunting, respectively, compared to families with 1-4 children. Improved sanitation, but not drinking water sources, was linked to reduced stunting in the adjusted model. Vaccination had a protective effect; in the adjusted analysis, basic and full vaccinations significantly lowered the risk of severe stunting by 46% and 41%, respectively.

CONCLUSION

In this nationally representative study, the prevalence of stunting was substantial (44.7%) in Afghan children. Additionally, the findings emphasize the critical factors associated with child stunting and underscore the protective role of vaccination against this condition, which provides policymakers with directions for policy efforts and intervention strategies to reduce child stunting in Afghanistan.

Stunting Among Children Under Two Years in the Islands Areas: A Cross-sectional Study of the Maluku Region in Indonesia, 2021

BACKGROUND

The Maluku region encompasses thousands of islands. The study analyzed factors related to stunting among children under two years old in the Maluku Region of Indonesia. Study Design: A cross-sectional study.

METHODS

This cross-sectional study examined 4764 children under two years. In addition to nutritional status (stature), the study analyzed ten independent variables (province, residence, maternal age, marital status, maternal education, employment, wealth, children's age, gender, and early initiation of breastfeeding [EIBF]). Finally, the contribution of various factors to stunting was examined using logistic regression.

RESULTS

Children in Maluku province were 1.13 times more likely than those in North Maluku province to become stunted. In addition, children aged 12-13 months were 4.09 times more likely than<12 months, and boys were 1.87 times more likely than girls to have the patterns of stunting. Children in rural areas were 1.10 times more likely to become stunted than those in urban areas (95% confidence interval: 1.06, 1.14). Divorced/widowed mothers were 1.88 times more likely than married mothers. Mothers of all education levels were more likely than those without formal education, and unemployed mothers were 1.07 times more likely than employed mothers to have stunted children. The possibility of becoming stunted was lower when the children were wealthier.

CONCLUSION

Nine variables were related to stunted incidence, including province, residence, maternal age, marital status, maternal education, employment, wealth, children's age, and gender.