Factors associated with stunting among children below five years of age: A mixed method study

Mona Yulianti; Puji Nurfauziatul Hasanah; Sutisna Sutisna; Karwati Karwati; Cucum Suminar

doi:10.21927/ijnd.2022.10(2).61-70

Factors associated with stunting among children below five years of age: A mixed method study

Mona Yulianti, Puji Nurfauziatul Hasanah, Sutisna Sutisna, Karwati Karwati, Cucum Suminar

Abstract

ABSTRAK

Latar Belakang: Indonesia saat ini menghadapi beban ganda masalah gizi pada anak salah satunya masalah stunting pada balita. Desa Sukamukti menjadi lokus prioritas stunting 2019 di Kabupaten Sumedang dengan angka kejadian 33%. Eksplorasi faktor risiko stunting perlu dilakukan untuk merancang intervensi berkelanjutan .

Tujuan:Penelitian ini dilakukan untuk mengetahui faktor-faktor yang berhubungan dengan stunting pada balita di Desa Sukamukti Kabupaten Sumedang tahun 2020.

Metode: Penelitian ini merupakan penelitian mixed method dengan rancangan concurrent mixed method. Penelitian kuantitatif melibatkan 37 responden dan penelitian kualitatif melibatkan 2 partisipan yang merupakan ibu balita di Desa Sukamukti Kecamatan Tanjungmedar yang diambil dengan teknik Total Sampling pada bulan Juni 2020. Interpretasi status gizi diukur dengan kurva pertumbuhan WHO tinggi badan per usia pada balita. Pengumpulan data menggunakan kuesioner yang dikembangkan dari Faktor Risiko Stunting WHO tahun 2014. Data kuantitatif dianalisis menggunakan uji univariat, bivariat dan multivariat. Serta dielaborasikan dengan hasil penelitian kualitatif yang dianalisis dengan metode Coalizzi.

Hasil: Angka kejadian stunting di Desa Sukamukti Kabupaten Sumedang sebesar 37,8%. Faktor tinggi badan ibu merupakan faktor yang berhubungan dengan risiko stunting di Desa Sukamukti (OR= 8,55; CI95%=1,8 - 39,7; p=0,006). Tinggi badan ibu yang pendek (<150 cm) mempengaruhi kejadian risiko stunting sebesar 8,55 kali. Hasil kualitatif menghasilkan 7 tema diantaranya adalah: 1) Persepsi ibu tentang penyakit (stunting), 2) perkembangan kesehatan anak, 3). Riwayat kesehatan ibu, 4) perilaku adaptif dan maladaptif ibu selama merawat anak 5) bentuk dan sumber dukungan yang diperoleh ibu selama merawat anak, 6) Bentuk dan sumber hambatan yang ditemui ibu selama merawat anak, serta 7) respon psikologis yang ditunjukan ibu.

Kesimpulan: Tinggi badan ibu menjadi determinan faktor risiko stunting dalam penelitian ini. Intervensi gizi sensitif penting untuk dilakukan dengan upaya perbaikan gizi secara komprehensif dari hulu ke hilir. Pemberdayaan remaja putri dalam meningkatkan pola hidup sehat dan gizi seimbang dapat dilakukan sebagai upaya untuk mencegah stunting.

KATA KUNCI: anak; ibu; pengalaman; risiko; stunting

ABSTRACT

Background: Indonesia is currently facing a duble burden of nutritional problems in children. Stunting is one of them. Sukamukti Village became the priority locus of stunting, with the prevalence of 33% in 2019. Exploration on stunting risk factors is necessary to identify sustainable interventions.

Objective: This study was conducted to determine the factors associated with the risk of stunting in Sukamukti Village, Sumedang Regency, West Java, Indonesia.

Methods: This study is mixed-method research with concurrent mixed-method design. The quantitative study involved 37 respondents and the qualitative study involved 2 participants who are mothers of children under five years of age in Sukamukti Village, taken using the Total Sampling technique in June 2020. Interpretation of nutritional status was measured by th WHO growth curve for height per age in toddlers. Data collected using questionnaire developed from WHO Stunting Risk Factor in 2014. Quantitative data analyzed using univariate, bivariate and multivariate tests using logistic regression. Qualitative data analyzed using Coalizzi method.

Results: The quantitative study showed that 37.8% of children under five years of age were at risk of stunting. Maternal height is a factor associated with the risk of stunting in Sukamukti Village (OR = 8.55; 95% CI = 1.8 - 39.7; p = 0.006). The mother's short height (<150 cm) affects the incidence of stunting risk by 8.55 times. The qualitative results produced seven themes, including 1) Mother's perception of illness (stunting), 2) child health development, 3) Maternal health history, 4) mother's adaptive and maladaptive behavior during child care, 5) mother's form and source of support during child care, 6) mother's form and source of obstacles during child care, and 7) mother's psychological response.

Conclusion: Mother's height is a determinant factors for stunting in this study. Sensitive intervention such as nutrition must be carried out with comprehensive nutrition improvement efforts. Empowering teenagers to improve a healthy lifestyle and balanced nutrition is necessary to prevent stunting.

KEYWORDS: children; mother; experience; risk; stunting

Keywords

anak; ibu; pengalaman; risiko; stunting; children; mother; experience; risk; stunting

Full Text:

PDF

References

WHO, UNICEF & Group WB. Levels and Trends in Child Malnuutrition. 2018;1–16.

Feeding YC. Indonesia: Overview Burden classification The Global Nutrition Report. Glob Nutr Rep. 2018;1–4.

Islam MM, Sanin KI, Mahfuz M, Ahmed AMS, Mondal D, Haque R, et al. Risk factors of stunting among children living in an urban slum of Bangladesh: Findings of a prospective cohort study. BMC Public Health. 2018;18(1):1–13.

Berhe K, Seid O, Gebremariam Y, Berhe A, Etsay N. Risk factors of stunting (chronic undernutrition) of children aged 6 to 24 months in Mekelle City, Tigray Region, North Ethiopia: An unmatched case-control study. PLoS One. 2019;14(6):1–11.

Phiri T. Review of Maternal Effects on Early Childhood Stunting. GCC Work Pap Ser [Internet]. 2014;16–8. Available from: http://repository.upenn.edu/gcc_economic_returns%0Ahttp://repository.upenn.edu/gcc_economic_returns/18

Danaei G, Andrews KG, Sudfeld CR, Fink G, McCoy DC, Peet E, et al. Risk Factors for Childhood Stunting in 137 Developing Countries: A Comparative Risk Assessment Analysis at Global, Regional, and Country Levels. PLoS Med. 2016;13(11):1–18.

Habimana S, Biracyaza E.

Risk Factors Of Stunting Among Children Under 5 Years Of Age In The Eastern And Western Provinces Of Rwanda: Analysis Of Rwanda Demographic And Health Survey 2014/2015

. Pediatr Heal Med Ther. 2019;Volume 10:115–30.

Semali IA, Tengia-Kessy A, Mmbaga EJ, Leyna G. Prevalence and determinants of stunting in under-five children in central Tanzania: Remaining threats to achieving Millennium Development Goal 4. BMC Public Health [Internet]. 2015;15(1):4–9. Available from: http://dx.doi.org/10.1186/s12889-015-2507-6

Krishna A, Oh J, Lee JK, Lee HY, Perkins JM, Heo J, et al. Short-term and long-term associations between household wealth and physical growth: A cross-comparative analysis of children from four low- and middle-income countries. Glob Health Action. 2015;8(1).

van den Heuvel M. Metabolomics, stunting and neurodevelopment. EBioMedicine [Internet]. 2019;44:10–1. Available from: https://doi.org/10.1016/j.ebiom.2019.05.067

Aryastami NK, Shankar A, Kusumawardani N, Besral B, Jahari AB, Achadi E. Low birth weight was the most dominant predictor associated with stunting among children aged 12-23 months in Indonesia. BMC Nutr. 2017;3(1):1–6.

Sari YD, Rachmawati R. Penelitian gizi dan makanan. Nutr Food Res [Internet]. 2020;43(1):29–40. Available from: https://www.neliti.com/publications/223576/hubungan-asupan-energi-lemak-dan-serat-dengan-rasio-kadar-kolesterol-total-hdl

Wemakor A, Mensah KA. Association between maternal depression and child stunting in Northern Ghana: A cross-sectional study. BMC Public Health [Internet]. 2016;16(1):1–7. Available from: http://dx.doi.org/10.1186/s12889-016-3558-z

El-Tallawy HN, Farghaly WMA, Shehata GA, Rageh TA, Metwally NA, Badry R, et al. Cerebral palsy in Al-Quseir City, Egypt: Prevalence, subtypes, and risk factors. Neuropsychiatr Dis Treat. 2014;10:1267–72.

Mzumara B, Bwembya P, Halwiindi H, Mugode R, Banda J. Factors associated with stunting among children below five years of age in Zambia: Evidence from the 2014 Zambia demographic and health survey. BMC Nutr. 2018;4(1):1–8.

DOI: http://dx.doi.org/10.21927/ijnd.2022.10(2).61-70