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A review of child stunting determinants in Indonesia
Ty Beal, Alison Tumilowicz, Aang Sutrisna and 2 more
Maternal & Child Nutrition · 2018 · Systematic review · CC BY
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.
References 46
- 1.
Adu‐Afarwuah, S., Lartey, A., Brown, K. H., Zlotkin, S., Briend, A., & Dewey, K. G. (2007 ). Randomized comparison of 3 types of micronutrient supplements for home fortification of complementary foods in Ghana: Effects on growth and motor development. The American Journal of Clinical Nutrition, 86(2), 412–420.
Not in our library10.1093/ajcn/86.2.412
- 2.
Agustina, R., Bovee‐Oudenhoven, I. M. J., Lukito, W., Fahmida, U., van de Rest, O., Zimmermann, M. B., … Kok, F. J. (2013 ). Probiotics Lactobacillus reuteri DSM 17938 and Lactobacillus casei CRL 431 modestly increase growth, but not iron and zinc status, among Indonesian children aged 1–6 years. The Journal of Nutrition, 143(7), 1184–1193.
Not in our library10.3945/jn.112.166397
- 3.
Aitchison, T. C., Durnin, J. V., Beckett, C., & Pollitt, E. (2000 ). Effects of an energy and micronutrient supplement on growth and activity, correcting for non‐supplemental sources of energy input in undernourished children in Indonesia. European Journal of Clinical Nutrition, 54(Suppl 2), S69–S73.
Not in our library10.1038/sj.ejcn.1601007
- 4.
Anwar, F., Khomsan, A., Sukandar, D., Riyadi, H., & Mudjajanto, E. S. (2010 ). High participation in the Posyandu nutrition program improved children nutritional status. Nutrition Research and Practice, 4(3), 208–214.
Not in our library10.4162/nrp.2010.4.3.208
- 5.
Ashorn, P., Alho, L., Ashorn, U., Cheung, Y. B., Dewey, K. G., Gondwe, A., … Maleta, K. (2015 ). Supplementation of maternal diets during pregnancy and for 6 months postpartum and infant diets thereafter with small‐quantity lipid‐based nutrient supplements does not promote child growth by 18 months of age in rural Malawi: A randomized controlled trial. The Journal of Nutrition, 145(6), 1345–1353.
Not in our library10.3945/jn.114.207225
- 6.
Barber, S. L., & Gertler, P. J. (2009 ). Health workers, quality of care, and child health: Simulating the relationships between increases in health staffing and child length. Health Policy (Amsterdam, Netherlands), 91(2), 148
Not in our library10.1016/j.healthpol.2008.12.001
- 7.
Bardosono, S., Sastroamidjojo, S., & Lukito, W. (2007 ). Determinants of child malnutrition during the 1999 economic crisis in selected poor areas of Indonesia. Asia Pacific Journal of Clinical Nutrition, 16(3), 512–526.
Not in our library
- 8.
Berger, S. G., de Pee, S., Bloem, M. W., Halati, S., & Semba, R. D. (2007 ). Malnutrition and morbidity are higher in children who are missed by periodic vitamin A capsule distribution for child survival in rural Indonesia. The Journal of Nutrition, 137(5), 1328–1333.
Not in our library10.1093/jn/137.5.1328
- 9.
Best, C. M., Sun, K., de Pee, S., Sari, M., Bloem, M. W., & Semba, R. D. (2008 ). Paternal smoking and increased risk of child malnutrition among families in rural Indonesia. Tobacco Control, 17(1), 38–45.
Not in our library10.1136/tc.2007.020875
- 10.
Bork, K. A., & Diallo, A. (2017 ). Boys are more stunted than girls from early infancy to 3 years of age in rural Senegal. The Journal of Nutrition, 147(5), 940–947.
Not in our library10.3945/jn.116.243246
- 11.
Dijkhuizen, M. A., Winichagoon, P., Wieringa, F. T., Wasantwisut, E., Utomo, B., Ninh, N. X., … Berger, J. (2008 ). Zinc supplementation improved length growth only in anemic infants in a multi‐country trial of iron and zinc supplementation in South‐East Asia. The Journal of Nutrition, 138(10), 1969–1975.
Not in our library10.1093/jn/138.10.1969
- 12.
Fahmida, U., Rumawas, J. S. P., Utomo, B., Patmonodewo, S., & Schultink, W. (2007 ). Zinc‐iron, but not zinc‐alone supplementation, increased linear growth of stunted infants with low haemoglobin. Asia Pacific Journal of Clinical Nutrition, 16(2), 301–309.
Not in our library
- 13.
Fernald, L. C. H., Kariger, P., Hidrobo, M., & Gertler, P. J. (2012 ). Socioeconomic gradients in child development in very young children: Evidence from India, Indonesia, Peru, and Senegal. Proceedings of the National Academy of Sciences of the United States of America, 109(Suppl 2), 17273–17280.
Not in our library10.1073/pnas.1121241109
- 14.
Giles, J., & Satriawan, E. (2015 ). Protecting child nutritional status in the aftermath of a financial crisis: Evidence from Indonesia. Journal of Development Economics, 114, 97–106.
Not in our library10.1016/j.jdeveco.2014.12.001
- 15.
Hadi, H., Stoltzfus, R. J., Dibley, M. J., Moulton, L. H., West, K. P., Kjolhede, C. L., & Sadjimin, T. (2000 ). Vitamin A supplementation selectively improves the linear growth of Indonesian preschool children: Results from a randomized controlled trial. The American Journal of Clinical Nutrition, 71(2), 507–513.
Not in our library10.1093/ajcn/71.2.507
- 16.
Hess, S. Y., Abbeddou, S., Jimenez, E. Y., Somé, J. W., Vosti, S. A., Ouédraogo, Z. P., … Brown, K. H. (2015 ). Small‐quantity lipid‐based nutrient supplements, regardless of their zinc content, increase growth and reduce the prevalence of stunting and wasting in young Burkinabe children: A cluster‐randomized trial. PLoS ONE, 10(3), e0122242
Not in our library10.1371/journal.pone.0122242
- 17.
Julia, M., van Weissenbruch, M. M., Delemarre‐van de Waal, H. A., & Surjono, A. (2004 ). Influence of socioeconomic status on the prevalence of stunted growth and obesity in prepubertal Indonesian children. Food and Nutrition Bulletin, 25(4), 354–360.
Not in our library10.1177/156482650402500405
- 18.
Lembaga Penerbitan Balitbangkes Kementerian Kesehatan Republik Indonesia. (2013 ). Riskesdas 2013. Retrieved September 28, 2017, from http://terbitan.litbang.depkes.go.id/penerbitan/index.php/lpb/catalog/series/rkd2013
Not in our library
- 19.
Muslihah, N., Khomsan, A., Briawan, D., & Riyadi, H. (2016 ). Complementary food supplementation with a small‐quantity of lipid‐based nutrient supplements prevents stunting in 6‐12‐month‐old infants in rural West Madura Island, Indonesia. Asia Pacific Journal of Clinical Nutrition, 25(Suppl 1), S36–S42.
Not in our library10.6133/apjcn.122016.s9
- 20.
National Institute of Research and Development (NHRD), Ministry of Health (MOH) (2013 ). Basic health research survey (Riset kesehatan dasar). Jakarta, Indonesia: National Institute of Research and Development, Ministry of Health.
Not in our library
- 21.
Neufeld, L. M., Haas, J. D., Grajéda, R., & Martorell, R. (2004 ). Changes in maternal weight from the first to second trimester of pregnancy are associated with fetal growth and infant length at birth. The American Journal of Clinical Nutrition, 79(4), 646–652.
Not in our library10.1093/ajcn/79.4.646
- 22.
NHRD, MOH (2009 ). Changes in malnutrition from 1989 to 2007 in Indonesia. Jakarta, Indonesia: National Institute of Research and Development, Ministry of Health.
Not in our library
- 23.
Oddo, V. M., Rah, J. H., Semba, R. D., Sun, K., Akhter, N., Sari, M., … Kraemer, K. (2012 ). Predictors of maternal and child double burden of malnutrition in rural Indonesia and Bangladesh. The American Journal of Clinical Nutrition, 95(4), 951–958.
Not in our library10.3945/ajcn.111.026070
- 24.
Paknawin‐Mock, J., Jarvis, L., Jahari, A. B., Husaini, M. A., & Pollitt, E. (2000 ). Community‐level determinants of child growth in an Indonesian tea plantation. European Journal of Clinical Nutrition, 54(Suppl 2), S28–S42.
Not in our library10.1038/sj.ejcn.1601003
- 25.
Prawirohartono, E. P., Nurdiati, D. S., & Hakimi, M. (2016 ). Prognostic factors at birth for stunting at 24 months of age in rural Indonesia. Paediatrica Indonesiana, 56(1), 48–56.
Not in our library
- 26.
Rachmi, C. N., Agho, K. E., Li, M., & Baur, L. A. (2016a ). Stunting coexisting with overweight in 2·0–4·9‐year‐old Indonesian children: Prevalence, trends and associated risk factors from repeated cross‐sectional surveys. Public Health Nutrition, 19(15), 2698–2707.
Not in our library10.1017/s1368980016000926
- 27.
Rachmi, C. N., Agho, K. E., Li, M., & Baur, L. A. (2016b ). Stunting, underweight and overweight in children aged 2.0–4.9 years in Indonesia: Prevalence trends and associated risk factors. PLoS ONE, 11(5), e0154756
Not in our library10.1371/journal.pone.0154756
- 28.
Ramli, C. N., Agho, K. E., Inder, K. J., Bowe, S. J., Jacobs, J., & Dibley, M. J. (2009 ). Prevalence and risk factors for stunting and severe stunting among under‐fives in North Maluku province of Indonesia. BMC Pediatrics, 9, 64
Not in our library10.1186/1471-2431-9-64
- 29.
Sandjaja, S., Budiman, B., Harahap, H., Ernawati, F., Soekatri, M., Widodo, Y., … Khouw, I. (2013 ). Food consumption and nutritional and biochemical status of 0·5–12‐year‐old Indonesian children: The SEANUTS study. British Journal of Nutrition, 110(S3), S11–S20.
Not in our library10.1017/s0007114513002109
- 30.
Sari, M., de Pee, S., Bloem, M. W., Sun, K., Thorne‐Lyman, A. L., Moench‐Pfanner, R., … Semba, R. D. (2010 ). Higher household expenditure on animal‐source and nongrain foods lowers the risk of stunting among children 0–59 months old in Indonesia: Implications of rising food prices. The Journal of Nutrition, 140(1), 195S–200S.
Not in our library10.3945/jn.109.110858
- 31.
Schmidt, M. K., Muslimatun, S., West, C. E., Schultink, W., Gross, R., & Hautvast, J. G. A. J. (2002 ). Nutritional status and linear growth of Indonesian infants in West Java are determined more by prenatal environment than by postnatal factors. The Journal of Nutrition, 132(8), 2202–2207.
Not in our library10.1093/jn/132.8.2202
- 32.
Semba, R. D., de Pee, S., Berger, S. G., Martini, E., Ricks, M. O., & Bloem, M. W. (2007 ). Malnutrition and infectious disease morbidity among children missed by the childhood immunization program in Indonesia. Southeast Asian Journal of Tropical Medicine and Public Health, 38(1), 120–129.
Not in our library
- 33.
Semba, R. D., de Pee, S., Hess, S. Y., Sun, K., Sari, M., & Bloem, M. W. (2008 ). Child malnutrition and mortality among families not utilizing adequately iodized salt in Indonesia. The American Journal of Clinical Nutrition, 87(2), 438–444.
Not in our library10.1093/ajcn/87.2.438
- 34.
Semba, R. D., de Pee, S., Kraemer, K., Sun, K., Thorne‐Lyman, A., Moench‐Pfanner, R., … Bloem, M. W. (2009 ). Purchase of drinking water is associated with increased child morbidity and mortality among urban slum‐dwelling families in Indonesia. International Journal of Hygiene and Environmental Health, 212(4), 387–397.
Not in our library10.1016/j.ijheh.2008.09.001
- 35.
Semba, R. D., de Pee, S., Sun, K., Sari, M., Akhter, N., & Bloem, M. W. (2008 ). Effect of parental formal education on risk of child stunting in Indonesia and Bangladesh: A cross‐sectional study. The Lancet, 371(9609), 322–328.
Not in our library10.1016/s0140-6736(08)60169-5
- 36.
Semba, R. D., Kalm, L. M., de Pee, S., Ricks, M. O., Sari, M., & Bloem, M. W. (2007 ). Paternal smoking is associated with increased risk of child malnutrition among poor urban families in Indonesia. Public Health Nutrition, 10(1), 7–15.
Not in our library10.1017/s136898000722292x
- 37.
Semba, R. D., Moench‐Pfanner, R., Sun, K., de Pee, S., Akhter, N., Rah, J. H., … Kraemer, K. (2011 ). Consumption of micronutrient‐fortified milk and noodles is associated with lower risk of stunting in preschool‐aged children in Indonesia. Food and Nutrition Bulletin, 32(4), 347–353.
Not in our library10.1177/156482651103200406
- 38.
Smuts, C. M., Lombard, C. J., Benadé, A. J. S., Dhansay, M. A., Berger, J., Hop, L. T., … Group, I. R. on I. S. (IRIS) S (2005 ). Efficacy of a foodlet‐based multiple micronutrient supplement for preventing growth faltering, anemia, and micronutrient deficiency of infants: The four country IRIS trial pooled data analysis. The Journal of Nutrition, 135(3), 631S–638S.
Not in our library10.1093/jn/135.3.631s
- 39.
Stewart, C. P., Iannotti, L., Dewey, K. G., Michaelsen, K. F., & Onyango, A. W. (2013 ). Contextualising complementary feeding in a broader framework for stunting prevention. Maternal & Child Nutrition, 9, 27–45.
Not in our library10.1111/mcn.12088
- 40.
Torlesse, H., Cronin, A. A., Sebayang, S. K., & Nandy, R. (2016 ). Determinants of stunting in Indonesian children: Evidence from a cross‐sectional survey indicate a prominent role for the water, sanitation and hygiene sector in stunting reduction. BMC Public Health, 16, 669
Not in our library10.1186/s12889-016-3339-8
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