The Role of Fathers in the Incidence of Stunting among Toddlers in Rural Areas
Peran Ayah terhadap Kejadian Stunting pada Balita di Pedesaan
Downloads
Background: Stunting is an unresolved health problem in the world. There were 21.6% of stunted toddlers in Indonesia in 2022, with a higher proportion in rural areas than in urban areas. The mother's role mainly caused stunting. On the other hand, the role of fathers had not been reviewed much in previous research.
Objectives: This study aims to analyze the role of fathers towards stunting among toddlers in rural areas.
Methods: The study had a case-control design conducted from April to October 2019. This research involved two populations, namely the control population and the cases. The control population was all non-stunted toddlers aged 24-59 months who lived in Jombang Regency, while the case population was all stunted toddlers aged 24-59 months who lived in Jombang Regency. The authors applied a multistage random sampling. The sample consisted of 79 controls and 79 cases calculated based on the two-population proportion formula. Data were analyzed using the chi-square test, fisher exact test, and logistic regression with α = 5%.
Results: Fathers with low education increased the risk of toddlers becoming stunted 2.407 times higher than fathers with high education (p = 0.010; OR = 2.407; 95% CI = 1.231-4.705). Fathers from large families were 1.971 times more likely to have stunted toddlers than fathers from small families (p = 0.042; OR = 1.971; 95% CI = 1.026-3.785).
Conclusions: Stunting in toddlers was significantly influenced by father's education. The size of the family also affected a toddler's risk of stunting. Increasing school age should be a priority program for preventing stunting in rural areas. In addition, health campaigns regarding pregnancy planning and birth control need to be carried out on an ongoing basis to reduce the incidence of stunting.
Chakravarty, N., Tatwadi, K. & Ravi, K. Intergenerational effects of stunting on human capital : Where does the compass point ? Int. J. Med. Public Heal. 9, 105–111 (2019).
de Onis, M. & Branca, F. Childhood stunting: A global perspective. Matern. Child Nutr. 12, 12–26 (2016).
UNICEF/WHO/World Bank Group. Levels and trends in child malnutrition. (UNICEF/WHO/World Bank Group, 2023).
Kemenkes. Laporan nasional riskesdas 2018. (Badan Penelitian dan Pengembangan Kesehatan, 2019).
Kemenkes. Buku saku hasil survei status gizi Indonesia (SSGI) 2022. (Badan Kebijakan Pembangunan Kesehatan, Kemenkes RI, 2022).
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. 10, 115–130 (2019).
Tesema, G. A., Yeshaw, Y., Worku, M. G., Tessema, Z. T. & Teshale, A. B. Pooled prevalence and associated factors of chronic undernutrition among under-five children in East Africa: A multilevel analysis. PLoS One 16, (2021).
Bangoura, S. T. et al. Factors associated with the nutritional status of children under 5 years of age in Guinea between 2005 and 2018. Public Health Nutr. 26, 540–549 (2022).
Campos, A. P. & Hawkins, S. S. Household and regional determinants of child stunting in Rural Mexico. Glob. Soc. Welf. 9, 169–177 (2022).
Elmighrabi, N. F. et al. Childhood undernutrition in North Africa : systematic review and meta-analysis of observational studies. Glob. Health Action 16 (1), (2023).
Gaiser, M. L., Winkler, A. S., Klug, S. J., Nkurunziza, S. & Stelzle, D. Determinants of stunting among children under age five in Burundi : Evidence from the 2016 – 2017 Burundi Demographic and Health Survey (BDHS 2016-17). Food Sci. Nutr. 11, 4100–4112 (2023).
Jiang, S. et al. The determinants of growth failure in children under five in 25 low- and middle-income countries. J. Glob. Health 13, (2023).
Soofi, S. B. et al. Determinants of stunting among children under five in Pakistan. Nutrients 15, (2023).
Sserwanja, Q., Kamara, K., Mutisya, L. M., Musaba, M. W. & Ziaei, S. Rural and urban correlates of stunting among under- five children in Sierra Leone : A 2019 Nationwide Cross- Sectional Survey. Nutr. Metab. Insights 14, 1–10 (2021).
Kemenkes. Laporan Provinsi Jawa Timur Riskesdas 2018. (Badan Penelitian dan Pengembangan Kesehatan, 2019).
Demirchyan, A., Petrosyan, V., Sargsyan, V. & Hekimian, K. Predictors of stunting among children ages 0 to 59 months in a Rural Region of Armenia. J. Pediatr. Gastroenterol. Nutr. 62, 150–156 (2016).
Permatasari, T. A. E., Chadirin, Y., Elvira, F. & Putri, B. A. The association of sociodemographic, nutrition, and sanitation on stunting in children under five in rural area of West Java Province in Indonesia. J. Public health Res. 12, 1–14 (2023).
Astuti, D. K. & Sumarmi, S. Keragaman konsumsi pangan pada balita stunting di wilayah pedesaan dan perkotaan Kabupaten Probolinggo. Media Gizi Indones. 15, 14–21 (2020).
Mauludyani, A. V. R. & Khomsan, A. Maternal nutritional knowledge as a determinant of stunting in West Java : Rural-urban disparities. Amerta Nutr. 6, 8–12 (2022).
Cruz, L. M. G., Azpeitia, C. G., Suarez, D. R., Rodriguez, Alfredo SantanaFerrer, J. F. & Serra-Majem, L. Factors associated with stunting among children aged 0 to 59 months from the Central Region of Mozambique. Nutrients 9, (2017).
Hossain, B. & Khan, H. R. Role of parental education in reduction of prevalence of childhood undernutrition in Bangladesh. Public Health Nutr. 21, 1845–1854 (2018).
Bogale, B., Gutema, B. T. & Chisha, Y. Prevalence of stunting and its associated factors among children of 6-59 months in Arba Minch Health and Demographic Surveillance Site (HDSS), Southern Ethiopia: A community-based cross-sectional study. J. Environ. Public Health (2020).
Balitbang Prov Jatim. Analisis faktor sosial ekonomi, gizi, dan kesehatan terhadap kejadian stunting di pedesaan dan perkotaan. (Badan Penelitian dan Pengembangan Provinsi Jawa Timur, 2019).
Tafesse, T., Yoseph, A., Mayiso, K. & Gari, T. Factors associated with stunting among children aged 6–59 months in Bensa District, Sidama Region, South Ethiopia: unmatched case-control study. BMC Pediatr. 21, 1–11 (2021).
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 14(6), (2019).
Kahssay, M., Woldu, E., Gebre, A. & Reddy, S. Determinants of stunting among children aged 6 to 59 months in pastoral community, Afar region, North East Ethiopia: Unmatched case control study. BMC Nutr. 6, (2020).
Mansur, M., Afiaz, A. & Hossain, M. S. Sociodemographic risk factors of under-five stunting in Bangladesh : Assessing the role of interactions using a machine learning method. PLoS One 16 (8), (2021).
Sk, R., Banerjee, A. & Rana, J. Nutritional status and concomitant factors of stunting among pre-school children in Malda , India : A micro-level study using a multilevel approach. BMC Public Health 21, (2021).
Rakhmahayu, A., Lanti, Y., Dewi, R. & Murti, B. Logistic regression analysis on the determinants of stunting among children aged 6-24 months in Purworejo Regency, Central Java. J. Matern. Child Heal. 4, 158–169 (2019).
Roba, A. A., Elena, H. & Bliznashka, L. Prevalence and determinants of concurrent wasting and stunting and other indicators of malnutrition among children 6 – 59 months old in Kersa , Ethiopia. Matern. Child Nutr. 17, (2021).
Ezeh, O. K. et al. Trends of stunting prevalence and its associated factors among Nigerian children aged 0–59 months residing in the Northern Nigeria, 2008–2018. Nutrients 13, (2021).
Manggala, A. K., Kenwa, M. K. W., Kenwa, M. me L., Sakti, A. A. G. D. P. J. & Sawitri, A. A. S. Risk factors of stunting in children aged 24-59 months. Paediatr. Indones. 58, 205–212 (2018).
Wali, N., Agho, K. E. & Renzaho, A. M. N. Factors associated with stunting among children under 5 years in five South Asian Countries ( 2014 – 2018 ): Analysis of demographic health surveys. Nutrients 12, (2018).
Piniliw, M. B., Africa, L. S. & Agne, J. P. Factors associated with stunting among 24"’35-month-old Kalinga indigenous children in Pinukpuk, Kalinga, Philippines: A case-control study. J. Gizi Pangan 16, 81–90 (2021).
Dhami, M. V., Ogbo, F. A., Osuagwu, U. L., Ugboma, Z. & Agho, K. E. Stunting and severe stunting among infants in India: the role of delayed introduction of complementary foods and community and household factors. Glob. Health Action 12, (2019).
Gebreayohanes, M. & Id, A. D. Prevalence of stunting and its associated factors among children 6–59 months of age in pastoralist community, Northeast Ethiopia: A community-based cross-sectional study. 1–15 (2022).
Yushananta, P. & Ahyanti, M. Risk Factors of stunting in children aged 6 – 59 months : A case-control study in horticulture area. Open Access Macedonian Journal of Medical Sciences, 10, 1–5 (2022).
Abeway, S., Gebremichael, B., Murugan, R., Assefa, M. & Adinew, Y. M. Stunting and its determinants among children aged 6-59 Months in Northern Ethiopia: A cross-sectional study. J. Nutr. Metab. 2018, (2018).
Mengiste, L. A., Worku, Y., Aynalem, Y. A. & Shiferaw, W. S. Prevalence of stunting and its associated factors among children aged 6–59 months in Angolela Tera District, Northeast Ethiopia. Nutr. Diet. Suppl. 12, 311–319 (2020).
Wicaksono, R. A. et al. Risk factors of stunting in Indonesian children aged 1 to 60 months. Paediatr. Indones. 61, 12–19 (2021).
Semali, I. A., Tengia-kessy, A., Mmbaga, E. J. & 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 15, (2015).
Chowdhury, M. R. K. et al. Differences in risk factors associated with single and multiple concurrent forms of undernutrition (stunting, wasting or underweight) among children under 5 in Bangladesh: a nationally representative cross- sectional study. BMJ Open 11, (2021).
Lee, W. S. et al. Prevalence of undernutrition and associated factors in young children in Malaysia : A nationwide survey. Front. Pediatr. 10, (2022).
Sari, K., Ayu, R. & Sartika, D. The Effect of the physical factors of parents and children on stunting at birth among newborns in Indonesia. J. Prev. Med. Public Heal. 54, 309–316 (2021).
Li, H. et al. Prevalence and associated factors for stunting , underweight and wasting among children under 6 years of age in rural Hunan Province , China : a community-based cross-sectional study. BMC Public Health 22, 1–12 (2022).
Muchlis, N. et al. Cigarette smoke exposure and stunting among under- five children in rural and poor families in Indonesia. Environ. Health Insights 17, (2023).
Bella, A. et al. Do parental smoking behaviors affect children's thinness, stunting, and overweight status in Indonesia? Evidence from a Large "‘ scale longitudinal survey. J. Fam. Econ. Issues 44, 714–726 (2023).
Samarasekara, G. S., Mettananda, S. & Punchihewa, P. Analysis of nutritional status and factors associated with undernutrition in children aged 6-59 months in a rural area of Sri Lanka. Sri Lanka J. Child Heal. 48, 105–110 (2019).
Mallan, K. M. et al. Child : The role of fathers in child feeding : perceived responsibility and predictors of participation. Child care, Heal. Dev. 40, 715–722 (2013).
Sharma, A. J. & Subramanyam, M. A. Intersectional role of paternal gender-equitable attitudes and maternal empowerment in child undernutrition : a sectional national study from India. BMJ Open 11, 1–7 (2021).
Wu, H., Ma, C., Yang, L. & Xi, B. Association of parental height with offspring stunting in 14 low- and middle-income countries. Front. Nutr. 8, (2021).
Ahmed, F. F. & Abah, P. O. Determinants of food security among low-income households in Maiduguri Metropolis of Borno State, Nigeria. Asian J. Soc. Sci. Humanit. 3, 74–86 (2014).
Agidew, A. A. & Singh, K. Nd. Determinants of food insecurity in the rural farm households in South Wollo Zone of Ethiopia: the case of the Teleyayen sub- watershed. Agric. Food Econ. 6, (2018).
Ahamada, H. & Sunguya, B. F. The burden of undernutrition and its associated factors among children below 5 years of age in Bambao. Front. Nutr. 9, (2022).
Fufa, D. A. Determinants of stunting in children under five years in dibate district of Ethiopia : A case-control study. Hum. Nutr. Metab. 30 (2022), (2022).
Mengesha, A., Hailu, S., Birhane, M. & Belay, M. M. The prevalence of stunting and associated factors among children under five years of age in Southern Ethiopia : Community based cross-sectional study. Ann. Glob. Heal. 87 (1), 1–14 (2021).
Pratiwi, R., Pramono, A. & Hardaningsih, G. Risk factor of growth faltering in infants aged 2-12 months. J. Gizi Indones. 10, 72–79 (2021).
Susiloretni, K. A. et al. The psychological distress of parents is associated with reduced linear growth of children: Evidence from a nationwide population survey. PLoS One 16, (2021).
Kundu, S. et al. Determinants of household food security and dietary diversity during the COVID-19 pandemic in Bangladesh. Public Health Nutr. 24, 1079–1087 (2020).
Kusumawati, E., Rahardjo, S. & Sari, H. P. Model pengendalian faktor risiko stunting pada anak bawah tiga tahun. Kesmas Natl. Public Heal. J. 9, 249–256 (2015).
Shaka, M. F., Woldie, Y. B., Lola, H. M., Olkamo, K. Y. & Anbasse, A. T. Determinants of undernutrition among children under-five years old in southern Ethiopia: does pregnancy intention matter? A community-based unmatched case-control study. BMC Pediatr. 20, (2020).
Kim, C. et al. Multisector nutrition gains amidst evidence scarcity: scoping review of policies, data and interventions to reduce child stunting in Afghanistan. Heal. Res. Policy Syst. 18, 1–28 (2020).
Das, S. et al. Determinants of stunting among children under 2 years in urban informal settlements in Mumbai, India: evidence from a household census. J. Heal. Popul. Nutr. 39, 1–13 (2020).
Gebru, K. F., Haileselassie, W. M., Temesgen, A. H., Seid, A. O. & Mulugeta, B. A. Determinants of stunting among under-five children in Ethiopia : a multilevel mixed- effects analysis of 2016 Ethiopian demographic and health survey data. 1–14 (2019).
Mahmood, T., Abbas, F., Kumar, R. & Somrongthong, R. Why under five children are stunted in Pakistan? A multilevel analysis of Punjab Multiple Indicator Cluster Survey (MICS-2014). BMC Public Health 20, (2020).
Geberselassie, S. B., Abebe, S. M., Melsew, A., Mutuku, S. M. & Wassie, M. M. Prevalence of stunting and its associated factors among children 6-59 months of age in Libo-Kemekem district , Northwest Ethiopia ; A community based cross sectional study. PLoS One 13, 1–11 (2018).
Soekatri, M. Y. E., Sandjaja, S. & Syauqy, A. Stunting was associated with reported morbidity, parental education and socioeconomic status in 0.5–12-year-old Indonesian children. Int. J. Environ. Res. Public Health 17, 1–9 (2020).
Das, S. & Gulshan, J. Different forms of malnutrition among under five children in Bangladesh : a cross sectional study on prevalence and determinants. BMC Nutr. 3, (2017).
Agabiirwe, C. N., Dambach, P., Methula, T. C. & Phalkey, R. K. Impact of floods on undernutrition among children under five years of age in low "‘ and middle "‘ income countries : a systematic review. Environ. Heal. 21, (2022).
Alderman, H. & Headey, D. D. How important is parental education for child nutrition ? World Dev. 94, 448–464 (2017).
Rahman, A. et al. Risk factors of chronic childhood malnutrition : an analysis of the Bangladesh demographic and health survey 2014 data. J. Public Heal. Theory to Pract. 30, 309–321 (2022).
Alim, K. Y., Rosidi, A. & Suhartono, S. Birth length, maternal height and pesticide exposure were predictors of child stunting in agricultural area. Indones. J. Nutr. Diet. 6, 89–98 (2018).
Fikadu, T., Assegid, S. & Dube, L. Factors associated with stunting children of age 24 to 59 months in Meskan district, Gurage Zone, South Ethiopia: a case-control study. BMC Public Health 14, 1–7 (2014).
Wondemagegn, A. T., Cheme, M. & Gerbi, E. Predictors of chronic undernutrition (stunting) among under five children in rural East Wollega, Oromiya Region, West Ethiopia : A community based unmatched case - control study. J. Nutr. Heal. Food Eng. 7(2), (2017).
Masrin, Paratmanitya, Y. & Aprilia, V. Ketahanan pangan rumah tangga berhubungan dengan stunting pada anak usia 6-23 bulan. J. Gizi dan Diet. Indones. 2, 103–115 (2014).
Titaley, C. R., Ariawan, I., Hapsari, D. & Muasyaroh, A. Determinants of the stunting of children under two years old in Indonesia : A multilevel analysis of the 2013 Indonesia Basic Health Survey. Nutrients 11, (2019).
Sunardi, K. S. & Martha, E. Positive deviance behavior in the low economic status family with non-stunting incidence in Sleman Regency, Yogyakarta, Indonesia. Univers. J. Public Heal. 9, 353–359 (2021).
Copyright (c) 2024 Amerta Nutrition
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
AMERTA NUTR by Unair is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
1. The journal allows the author to hold the copyright of the article without restrictions.
2. The journal allows the author(s) to retain publishing rights without restrictions
3. The legal formal aspect of journal publication accessibility refers to Creative Commons Attribution Share-Alike (CC BY-SA).
4. The Creative Commons Attribution Share-Alike (CC BY-SA) license allows re-distribution and re-use of a licensed work on the conditions that the creator is appropriately credited and that any derivative work is made available under "the same, similar or a compatible license”. Other than the conditions mentioned above, the editorial board is not responsible for copyright violation.