Main Article Content

Abstract

Highlights:
1. This study investigated the factors contributing to stunting in a remote area, which has not received sufficient attention from key stakeholders.
2. The findings of this study can serve as a reference for the government in addressing stunting through intervention strategies that incorporate paternal roles to improve children's nutritional status.


Abstract
Stunting is a community health problem with significant impacts. The estimated prevalence rate of stunting was 24.4% in Indonesia and 25.7% in the Berau Regency. Stunting is a growth disorder caused by chronic malnutrition during the first 1,000 days of life. It is characterized by a height-for-age Z-score below -2 standard deviations from the child growth standards median of the World Health Organization, an insufficient growth rate, and a reduced potential final height. The contributing factors to stunting include maternal variables, as mothers are the primary caregivers. The objective of this study was to determine the factors for stunting and specifically investigate if there is a relationship between maternal employment and stunting in the Maratua District of Berau, Indonesia. This study used a cross-sectional research design. The sample size was determined using the Sample Size Calculator from the World Health Organization for a two-sided test (α = 0.05; β = 0.2; p1 = 0.63; p2 = 0.25; 95% CI). The data were collected from the nutrition report and anthropometric measurements at Maratua Primary Healthcare Center. The research was carried out at the Integrated Health Posts (Pos Layanan Terpadu/ Posyandu) in the Maratua District. The toddlers (n = 56) were examined with their parental consent. Toddlers with overnutrition, obesity, and acute infectious diseases were excluded from this study. The data were processed using Chi-square and Fisher tests (p < 0.05). In the analysis, no significant relationship was found between stunting and maternal employment. However, the results revealed that fathers who were not fishermen had a 6.3 times greater risk of having stunted toddlers compared to fathers who worked as fishermen. Fathers with a junior high school degree showed a 6.1 times higher risk of having stunted toddlers than fathers with different educational levels. In conclusion, stunting in the Maratua District is associated with the fathers' educational attainment and employment.

Keywords

stunting public health Maratua social determinants of health nutrinitional status and parenting

Article Details

How to Cite
Risa Haryati Tambunan, & Elis Nurbaeti. (2024). Factors that Influence Stunting in the Maratua District of Berau, Indonesia. Folia Medica Indonesiana, 60(1), 78–84. https://doi.org/10.20473/fmi.v60i1.41142

References

  1. Andrade J, Gil J (2023). Maternal employment and child malnutrition in Ecuador. International Journal of Environmental Research and Public Health 20, 6253. doi: 10.3390/ijerph20136253.
  2. Asif M, Aslam M, Mazhar I, et al (2022). Establishing height-for-age Z-score growth reference curves and stunting prevalence in children and adolescents in Pakistan. International Journal of Environmental Research and Public Health 19, 12630. doi: 10.3390/ijerph191912630.
  3. Daracantika A, Ainin A, Besral B (2021). The negative effect of stunting on children's cognitive development. Jurnal Biostatistik, Kependudukan, dan Informatika Kesehatan 1, 113. doi: 10.51181/bikfokes.v1i2.4647.
  4. Datar A, Nicosia N, Shier V (2014). Maternal work and children's diet, activity, and obesity. Social Science & Medicine 107, 196–204. doi: 10.1016/j.socscimed.2013.12.022.
  5. Faiqotul M (2020). The relationship between employment status and the incident of stunting in toddler ages 24-59 months in the working area of the Puskesmas Bangkalan (thesis). Stikes Ngudia Husada Madura. Available at: https://repository. stikesnhm.ac.id/id/eprint/776/.
  6. Helmyati S, Atmaka DR, Wisnusanti SU, et al (2020). Stunting: Problems and how to deal with them. Gadjah Mada University Press, Yogyakarta. Available at: https://books.google.co.id/books?id =PK3qDwAAQBAJ&printsec=frontcover&hl=id#v=onepage&q&f=false.
  7. IBM Corp (2015). IBM SPSS Statistics for Windows, Version 23.0. Armonk, NY: IBM Corp. Available at: https://www.ibm.com/id-id/products /spss-statistics.
  8. Jakaria M, Bakshi RK, Hasan MM (2022). Is maternal employment detrimental to children's nutritional status? Evidence from Bangladesh. Review of Development Economics 26, 85–111. doi: 10.1111/rode.12819.
  9. Jesmin A, Yamamoto SS, Malik AA, et al (2011). Prevalence and determinants of chronic malnutrition among preschool children: A cross-sectional study in Dhaka City, Bangladesh. Journal of Health, Population and Nutrition. doi: 10.3329/jhpn.v29i5.8903.
  10. Lee HY, Song IH, Kawachi I (2022). Maternal and child social support and food availability in relation to child growth in four low- and middle-income countries. Scientific Reports 12, 5910. doi: 10.1038/s41598-022-09850-1.
  11. Lin JJ, Chang CH, Pal N (2015). A revisit to contingency table and tests of independence: Bootstrap is preferred to chi-square approximations as well as fisher's exact test. Journal of Biopharmaceutical Statistics 25, 438–458. doi: 10.1080/10543406.2014.920851.
  12. Lwanga SK, Lemeshow S (1991). Sample size determination in health studies : a practical manual. World Health Organization. Available at: https://iris.who.int/handle/10665/40062.
  13. Manggala AK, Kenwa KWM, Kenwa MML, et al (2018). Risk factors of stunting in children aged 24-59 months. Paediatrica Indonesiana 58, 205–212. doi: 10.14238/pi58.5.2018.205-12.
  14. Ministry of Health of the Republic of Indonesia (2021). Pocket book: Results of the study on Indonesia's nutritional status (SSGI) at national, provincial and district/city levels in 2021. Jakarta. Available at: https://drive.google.com/file/d/1p5 fAfI53U0sStfaLDCTmbUmF92RDRhmS/view.
  15. Nasser MS, Akhlaq A, Ali H, et al (2022). Evidence linking stunting to economic outcomes in the SAARC region: A systematic review. Pakistan Journal of Public Health 12, 88–101. doi: 10.32413/pjph.v12i2.978.
  16. Nurrizka RH, Ammar MI, Buntara A, et al. (2020). Indonesian under five years of age children's malnutrition: A case study of fisherman community in Jakarta Bay. In Proceedings of the International Conference of Health Development. Covid-19 and the Role of Healthcare Workers in the Industrial Era (ICHD 2020). Atlantis Press, Paris, France. Available at: https://www.atlantis-press.com/article/125946591.
  17. de Onis M, Branca F (2016). Childhood stunting: a global perspective. Maternal & Child Nutrition 12, 12–26. doi: 10.1111/mcn.12231.
  18. Rashad AS, Sharaf MF (2019). Does maternal employment affect child nutrition status? New evidence from Egypt. Oxford Development Studies 47, 48–62. doi: 10.1080/13600818.2018. 1497589.
  19. Statistics Indonesia of Berau (2019). State of the Berau Regency Labor Force 2018. Available at: https://beraukab.bps.go.id/publication/2019/12/26/ca355f0a778c8f748750fa55/angkatan-kerja-kabupaten-berau-2018.html.
  20. Statistics Indonesia of Berau (2022). Berau Regency in figures 2022. Available at: https://beraukab.bps .go.id/publication/2022/02/25/9d5237c3b54b98cc9fc0824e/kabupaten-berau-dalam-angka-2022.html.
  21. Wicaksono RA, Arto KS, Mutiara E, et al (2021). Risk factors of stunting in Indonesian children aged 1 to 60 months. Paediatrica Indonesiana 61, 12–19. doi: 10.14238/pi61.1.2021.12-9.
  22. WWirth JP, Rohner F, Petry N, et al (2017). Assessment of the WHO stunting framework using Ethiopia as a case study. Maternal & Child Nutrition. doi: 10.1111/mcn.12310.
  23. World Health Organization (2016). Childhood stunting: Context, causes and consequences. WHO. Available at: https://www.who.int/publicat ions/m/item/childhood-stunting-context-causes-and-consequences-framework.