Determinants of Stunting Prevention among Mothers with Children Aged 6–24 Months

Factors associated with infant and young child feeding practices in children aged 6-23 months in Indonesia: A nationwide study

INTRODUCTION

Children-related nutrition raises significant attention due to the low implementation of infant and young child feeding (IYCF) practices. However, the factors affecting the low implementation of IYCF remains limited globally. This study aimed to identify factors influencing IYCF in children aged 6-23 months in Indonesia.

METHODS

We conducted a cross-sectional study using data from the 2017 Indonesian Demographic and Health Survey. A total of 4943 responses were included. We employed binary logistic regression to determine the factors affecting IYCF practices in children aged 6-23 months. The results are reported as odds ratios (OR) with a 95% confidence interval (CI) and a significance level of p < 0.05.

RESULTS

Several factors significantly influenced IYCF practices among children aged 6-23 months, including the age of the child (OR: 0.42; 95% CI: 0.27-0.65), middle wealth index (OR: 1.85; 95% CI: 1.12-3.08), regional disparities (OR: 0.43; 95% CI: 0.23-0.77), place of residence (OR: 1.77; 95% CI: 1.17-2.68), and a history of childhood diseases like fever (OR: 1.65; 95% CI: 1.05-2.58).

CONCLUSION

This study highlights the significance of various factors related to IYCF practices among children aged 6-23 months. These factors include maternal aspects such as wealth index, child-related factors like age, a history of childhood illnesses such as fever, and environmental factors such as regional disparities and place of residence.

PRACTICE IMPLICATIONS

Paediatric nurses can contribute to enhancing maternal knowledge by providing education on the importance of infant and child feeding practices, beginning early in the child's life.

MIESRA mHealth: Marital satisfaction during pregnancy

The transition of a pregnant woman's role often causes emotional changes that have an impact on marital satisfaction. We develop MIESRA mHealth and evaluate its impact on satisfaction of husband-wife relationship during pregnancy. A quasi-experimental study was conducted on 82 couples of pregnant women and divided into control, single, and paired group. We implemented MIESRA mHealth for four weeks. In the couple group, the wife did mindfulness based on the information in the MIESRA mHealth together with her husband. In a single group, the wife sees the video as an initial guide to doing mindfulness. In the control group, respondents received programme interventions from hospitals which included education and consultation with obstetricians. Husband-wife relationship is evaluated using Compatibility of Husband-and-Wife Relationships / Kesesuaian Hubungan Suami Istri (KHSI) questionnaire and the generalised estimating equations (GEE) was used to analyse the data. The women's KHSI scores in the couple and single intervention groups (β = -7.46, p = 0.002; β = -9.11, p = 0.001) were better than the control group. The husbands' KHSI scores in the paired and individual intervention groups (β = -7.04, p<0.001; β = -3.74, p = 0.024) were better than the control group. Nursing interventions to build emotional bonds between parents and foetuses based on mHealth can be a promising intervention for marital harmony during the perinatal period. MIESRA m-Health is a promising intervention on marital satisfaction during pregnancy and can be implemented as a part of the antenatal care programme to increase marital satisfaction.

High prevalence of chronic malnutrition in indigenous children under 5 years of age in Chimborazo-Ecuador: multicausal analysis of its determinants

Background

Despite the multiple initiatives implemented to reduce stunting in Ecuador, it continues to be a public health problem with a significant prevalence. One of the most affected groups is the rural indigenous population. This study aimed to analyze the prevalence of chronic malnutrition in indigenous children under 5 years of age and its association with health determinants, focusing on one of the territories with the highest prevalence of stunting.

Methods

A cross-sectional study in 1,204 Kichwa indigenous children under the age of five, residing in rural areas of the counties with the highest presence of indigenous in the province of Chimborazo-Ecuador. A questionnaire on health determinants was applied and anthropometric measurements were taken on the child and the mother. Stunting was determined by the height-for-age z-score of less than 2 standard deviations, according to the World Health Organization´s parameters. Data were analyzed using bivariate and multivariate Poisson regression.

Results

51.6% (n = 646) of the children are stunted. Height-for-age z-scores were significantly better for girls, children under 12 months, families without overcrowding, and families with higher family income. The variables that were significantly and independently associated with stunting were: overcrowding (PR 1.20, 95% CI 1–1.44), the mother required that the father give her money to buy medicine (PR 1.33, 95% CI 1.04–1.71), the father did not give her money to support herself in the last 12 months (1.58, 95% CI 1.15–2.17), mother’s height less than 150 cm (PR 1.42, 95% CI 1.19–1.69) and the child was very small at birth (PR 1.75, 95% CI 1.22–2.5).

Conclusion

One out of every two rural indigenous children included in this study is stunted. The high prevalence of stunting in the indigenous and rural population is multicausal, and requires an intersectoral and multidisciplinary approach. This study identified three fundamental elements on which public policy could focus: (a) reduce overcrowding conditions, improving economic income in the rural sector (for example, through the strengthening of agriculture), (b) provide prenatal care and comprehensive postnatal care, and (c) promote strategies aimed at strengthening the empowerment of women.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-14327-x.

Factors Associated with National Health Insurance Coverage in Indonesia

Background: The National Health Insurance (NHI) program is the Indonesian government's national health program. However, health insurance coverage has not been maximized. This study aims to analyze the factors associated with health insurance coverage in Indonesia.   Methods: Retrospective cross-sectional data were obtained from the Indonesian Demographic and Health Survey 2017. A total of 39,580 respondents were selected using two-stage stratified cluster sampling. The data come from the DHS Questionnaire Phase 7. In this study, we explored age, education level, wealth quintiles, residence, the number of children who are alive, marital status, current employment status, earnings, and health insurance status in relation to health insurance coverage. Then, we analyzed the data using chi-squared and binary logistic analyses.   Results: The prevalence of health insurance coverage in the Indonesian population is 62.3%. Respondent aged 15-24 years [AOR=0.88; 95% CI=0.77-1.00], secondary education level [AOR=0.44; 95% CI=0.41-0.47], poorer wealth index [AOR=0.76; 95% CI=0.71-0.82], live in rural area [AOR=0.78; 95% CI=0.75-0.82], divorced [AOR=0.72; 95% CI=0.63-0.83] were less likelihood to have health insurance. Conversely, the respondent who received earnings [AOR=1.25; 95% CI=1.18-1.32] was more likely to have health insurance.  Conclusion: This finding pointed to education level, economic status, and demographic area such as respondents who lived in rural areas should more pay attention to NHI. Intervention through the provision of appropriate information about NHI should be promoted.

Prevalence and determinants of diarrhea among under-five children in five Southeast Asian countries: Evidence from the demographic health survey

PURPOSE

To describe the prevalence and the correlation between individual, environmental and household, health behavior, and source of information factors with diarrhea among under-five children in five Southeast Asian countries based on the National Health Survey.

DESIGN AND METHODS

Cross-sectional design conducted in five countries in Southeast Asia. Datasets from Demographic and Health Surveys and Multiple Indicator Cluster Surveys in five countries were analyzed.

RESULTS

A total of 12,447 children under 5 years of age from five countries in Southeast Asia (Indonesia 1807, Cambodia 2650, Myanmar 1717, the Philippines 3669, and Timor-Leste 2614) were included in this study. Binary logistic regression was performed to analyze the data. A total of 12,447 under-five children were included in the study. Overall, in five Southeast Asian countries, the prevalence of diarrhea is known from 8.39% in the Philippines to 18.21% in Indonesia. Several factors related to diarrhea are individual; environmental and household; health behavior such as stool disposal, breastfeeding mothers, and children's food history; and source of information factors.

CONCLUSION

The findings of this study indicate that diarrhea is a serious public health problem in the Southeast Asian region that must be addressed using preventive and curative approaches.

PRACTICE IMPLICATION

The results indicate the need for cross-collaboration among nurses, medical doctor, and sanitarian is needed to tackle the childhood diarrhea and minimize the severity based on those determinants.

The Role of Vitamin D in Stunting Prevention: A Literature Review

BACKGROUND: Nutritional problems in infants under the age of two can inhibit growth and development. This has a negative impact on their subsequent life, increasing the risk of stunting. Vitamins are essential micronutrients in the body’s metabolic processes and they have a multi-complex role. One of the micronutrients that affect stunting are vitamin D. It plays an important role in stunting prevention. Stunting countermeasures are carried out by fulfilling the need of adequate nutrition where both macronutrients and micronutrients are needed to avoid the risk of stunting. AIM: The aim of this literature review was to analyze the role of vitamin D in preventing stunting. METHODS: The articles were collected through the Google Scholar, PubMed, Proquest, and Ebsco databases using the keywords Vitamin D and Stunting, consisting of both quantitative and qualitative studies. The articles used were only articles with a full text available that were written in English and Indonesian published from 2015 to 2019. Fifteen articles were found that met the criteria. RESULTS: The literature review results indicate that vitamin D plays an important role in the metabolism of bone formation and growth. It also has the role of increasing the level of immunity in children. Both roles contribute to stunting prevention. Vitamin D is key in regulating the immune function during pregnancy regarding the fetus-mother interaction, representing an important target. Among its non-classical actions include the emphasis of strong immunomodulators, including the induction of antibacterial responses and the modulation of T-lymphocytes to suppress inflammation and increase tolerogenesis. Vitamin D plays an important role in the innate immune function in the decidua by promoting the infection response while simultaneously preventing the excessive elaboration of immune inflammation. The research to date has focused on the potential role of vitamin D in preventing infectious diseases such as tuberculosis, as well as possibly suppressing autoimmune diseases. CONCLUSION: Vitamin D can also affect the immune function in a manner that is not immediately related to the primary innate response. Stunting can be prevented early on through the adequate intake of macro and micronutrient nutrients. The need for micronutrients is especially important, inclusive of vitamin D as an important element in bone metabolism. It also increases the body’s defenses so as to prevent infectious diseases in children.

Stunting Prevention with Education and Nutrition in Pregnant Women: A Review of Literature

Background : Stunting is a major nutritional problem in children under five years old which has an impact on slowing growth by reducing the number and development of body cells, including brain cells and other organs. Pregnant women are one of the groups who are vulnerable to nutritional problems, related to the process of growth and development of the fetus in the womb. The role of education and nutrition is important during pregnancy because it has implications for the health of mothers and children in later life. The aimed of this review was to identify research about effect stunting prevention and education and nutrition to pregnant women. Methods : A database review undertaken using Pubmed, CHINAHL and Google Scholar from 2011-2021 to collect focused study on education and nutrition research on pregnant women to prevent stunting. A total of 1788 articles were identified. These were scaned and 18 articles were retrieved with 13 articles shortlisted for to in depth review. Results : Education with using audiovisual media, moringa leaf ice cream and early nutrition has proved effective in increasing pregnant women knowledge regarding stunting prevention. Providing nutritional supplements/nutrients for moringa oliefera, folic acid and iron, specific nutrition, LNS, PM2A PROCOMIDA, nutrition before pregnancy, supplements antenatal iron and folic acid, prenatal micronutrients have an effect on reducing children stunting. Conclusion: Audio visual education can convery health knowledge because easily to facilitate the reception of health message for pregnant women. Continuous education and monitoring of the of pregnant women diet every month during pregnancy classes at the posyandu are needed to prevent stunting in children.