Case Study of Internal and External Dimensions Causes of Stunting in Children Under Five in Jombang, East Java

Abstract

Background: Stunting is the result of chronic and recurrent malnutrition in both mother and child. Globally in 2020, 149.2 million (144.4 to 154.2 million) children under the age of 5, or 22.0% (21.3 to 22.7) of all children under five, are estimated to be stunted (too short for their age). The cause of children experiencing stunting is a multidimensional factor, namely malnutrition experienced by pregnant women and toddlers. This study aims to describe the causes of stunting in toddlers. Subjects and Method: This was a qualitative study with a case study approach. This study was conducted at the Health Office of Jombang Regency, East Java, and Mayangan Health Center. A total of 5 key informants, 9 mothers of toddlers as main informants, 1 supporting informant were selected purposively and snowball. Data collection was carried out using interviews, observation, and documentation. Data were analyzed using the Miles and Huberman. Results: Parents' education level, toddler's age, toddler's weight, toddler's height, role of health personals in terms of services, exclusive breastfeeding, provision of complementary foods, level of food diversity, sanitation, infectious diseases are factors causing stunting cases in Jombang Regency, East Java. Things that are less related to the incidence of stunting are the sex of the toddler, the type of parent's job, asset ownership, social protection card, health insurance, health institutions, mother class for toddlers, early childhood education, family planning participation, food insecurity, clean water, ownership of MCH books, complete basic immunization, treatment of sick toddlers, growth monitoring, deliveries at health facilities, and deliveries at health personnel. The visible impact of stunting is that they physically look small when compared to children of their age. Conclusion: There are several internal dimensions and external dimensions that are factors causing the incidence of stunting in Jombang Regency, East Java, including parents' education level, toddler's age, toddler's weight, toddler's height, the role of health personal in terms of services, exclu¬sive breastfeeding, provision of complementary foods, diversity in food, sanitation, and infectious diseases. Keywords: stunting, internal dimention, external dimention, toddler.