A review of child stunting determinants in Indonesia

Abstract

Child stunting reduction is the first of 6 goals in the Global Nutrition Targets for 2025 and a key indicator in the second Sustainable Development Goal of Zero Hunger. The prevalence of child stunting in Indonesia has remained high over the past decade, and at the national level is approximately 37%. It is unclear whether current approaches to reduce child stunting align with the scientific evidence in Indonesia. We use the World Health Organization conceptual framework on child stunting to review the available literature and identify what has been studied and can be concluded about the determinants of child stunting in Indonesia and where data gaps remain. Consistent evidence suggests nonexclusive breastfeeding for the first 6 months, low household socio‐economic status, premature birth, short birth length, and low maternal height and education are particularly important child stunting determinants in Indonesia. Children from households with both unimproved latrines and untreated drinking water are also at increased risk. Community and societal factors—particularly, poor access to health care and living in rural areas—have been repeatedly associated with child stunting. Published studies are lacking on how education; society and culture; agriculture and food systems; and water, sanitation, and the environment contribute to child stunting. This comprehensive synthesis of the available evidence on child stunting determinants in Indonesia outlines who are the most vulnerable to stunting, which interventions have been most successful, and what new research is needed to fill knowledge gaps.

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

“…The variables with the strongest relationships with stunting among children 6–59 months were maternal height and education, and region—child stunting risk was roughly double among children of stunted mothers (height < 145 cm) compared with those not stunted (height ≥ 150 cm), mothers with no education or primary school only compared with those with a graduate education, and living in the Northeast compared with the Southeast. Maternal height and education have been shown to be strongly associated with child growth in Vietnam (P. H. Nguyen et al, ; Young et al, ) and other countries in South and Southeast Asia (Beal et al, ; Ikeda, Irie, & Shibuya, ; P. H. Nguyen et al, ) as well as globally (Black et al, ; Danaei et al, ). About 15% of Vietnamese mothers had no education or primary school only, highlighting the need to improve access to education for women, which has potential to reduce stunting and provides other benefits (Black et al, ).…”

High proportions of children under 3 years of age consume commercially produced snack foods and sugar‐sweetened beverages in Bandung City, Indonesia

“…Suboptimal infant and young child feeding practices persist in Indonesia, and child undernutrition continues to be a national concern (Beal, Tumilowicz, Sutrisna, Izwardy, & Neufeld, ; Ministry of Health [MOH], ; Ng, Dibley, & Agho, ). One‐third (36.6%) of children 6–23 months meet World Health Organization (WHO) recommendations for a minimum acceptable diet for infants and young children (Badan Pusat Statistik [BPS], National Population and Family Planning Board [BKKBN], Kementerian Kesehatan [Kemenkes], & ICF International, ; WHO, ), and the country has one of the highest rates of child stunting in the world (Black et al, ; White et al, ).…”

“…1 | INTRODUCTION Suboptimal infant and young child feeding practices persist in Indonesia, and child undernutrition continues to be a national concern (Beal, Tumilowicz, Sutrisna, Izwardy, & Neufeld, 2018; Ministry of Health [MOH], 2015;Ng, Dibley, & Agho, 2012 International, 2013;WHO, 2010), and the country has one of the highest rates of child stunting in the world (Black et al, 2008;White et al, 2016). In 2013, 37.2% of under-five children were stunted, 19.6% were underweight, and 12.1% were wasted, with little improvement from previous years (MOH, 2014).…”

Promotions of breastmilk substitutes, commercial complementary foods and commercial snack products commonly fed to young children are frequently found in points‐of‐sale in Bandung City, Indonesia

“…Infant and young child feeding practices in Indonesia do not meet WHO and UNICEF recommendations for optimal nutrition and development (Beal, Tumilowicz, Sutrisna, Izwardy, & Neufeld, ; Ng, Dibley, & Agho, ). Only 41.5% of children nationwide are exclusively breastfed for the first 6 months of life, and just over half of children (55.3%) are still breastfeeding at 20–23 months (Badan Pusat Statistik [BPS], National Population and Family Planning Board [BKKBN], Kementerian Kesehatan [Kemenkes], & ICF International, ).…”