Journal Of Health Science Vol IX.
No.
2 2024 | 19-28
Analysis Of Factors Related to The Incidence of Stunting Toddlers in The Region Gambah Health Center Nanda Citra Dewi1.
Ika Avrilina Haryono2.
Desilestia Dwi Salmarini3 BachelorAos Degree of Midwifery Program.
Faculty of Health.
Sari Mulia University Diploma of Midwifery Faculty of Health.
Sari Mulia University Email : nandacitra686@gmail.
com, ika.
avrilina@yahoo.
desilestiadwisalmarini@gmail.
Corresponding author : nandacitra686@gmail.
Article Information Article History Received: 21-07-24 Revised: 26-09-24 Accepted:02-11-24 Keywords:
Birth weight.
Exclusive breastfeeding.
Gestational age history Maternal nutritionsl status Stunting ABSTRACT Stunting is a condition of growth failure that occurs in toddlers.
The 2022 SSGI survey results show that stunting in Indonesia is at 21.
Data from the South Kalimantan Provincial Health Office in 2022 indicates a rate of 24.
Data from the HSS Health Office in 2022 shows a rate of 4.
Among the 21 Health Centers in the HSS area, the Gambah Health Center ranks first with the highest stunting rate Stunting is not caused by a single factor but by multiple This research aims to analyze the factors associated with the incidence of stunting in toddlers in the Gambah Health Center working area in 2022.
This study is a quantitative analysis using a case-control study method.
The study employs chi-square tests and odds ratios.
The sample consists of 120 toddlers, with 40 cases and 80 controls.
The results of this study indicate that the factors associated with the incidence of stunting in toddlers are birth weight .
-value 0.
OR 3.
, exclusive breastfeeding .
-value 0.
, mother's education level .
-value 0.
OR 5.
, history of pregnancy age .
-value 0.
OR 9.
, and maternal nutritional status .
-value 0.
OR 8.
The conclusion of this study is that factors associated with the incidence of stunting in toddlers in the Gambah Health Center working area in 2022 are birth weight, exclusive breastfeeding, mother's education level, history of gestational age, and maternal nutritional status during pregnancy.
Introduction needs during the first 1,000 days of life.
Stunting is a condition of impaired growth which spans from the fetal stage to when experienced by toddlers.
This condition occurs due to inadequate nutritional intake Additionally, stunting can be caused by or insufficient fulfillment of nutritional recurrent infections or a lack of stimulation 19 Journal Of Health Science Email : jurnalfik@wiraraja.
Analysis Of Factors Related to The Incidence ofa regarding nutritional intake.
Stunting is a In 2022, the number of stunted global nutritional issue and is more toddlers decreased to 40 out of 409, with a commonly found in developing countries.
prevalence rate of 9.
This indicates a According WHO 2% or around 150.
prevalence from 2021 to 2022.
million toddlers worldwide were stunted.
The impact of stunting on children can More than half of the global stunting cases, manifest both in the short term and long or 55%, originate from Asia, while over one-third .
%) occur in Africa (Kemenkes RI, 2.
intelligence (IQ), and a weakened immune The Based on the results of the 2022 system, making children more susceptible Indonesian Nutrition Status Survey (SSGI), to infections and illnesses.
In the long term, the prevalence of stunting in Indonesia was recorded at 21.
This figure shows a decreased productivity, higher healthcare decline compared to the 2021 SSGI results, costs, an increased risk of developing which reported a prevalence of 24.
chronic diseases such as diabetes and However, stunting remains a significant issue in Indonesia as the prevalence rate (Bagaswoto, 2.
still exceeds the WHO threshold of 20%.
According Stunting is not caused by a single factor South but results from multiple interrelated Kalimantan Provincial Health Office, the These include the absence of prevalence of stunting in South Kalimantan exclusive breastfeeding during the first six has also decreased.
In 2021, the SSGI months of life, premature birth, low reported a prevalence rate of 30%, which socioeconomic status in households, short dropped to 24.
6% in 2022 (Kemenkes RI, birth length in infants, short maternal stature, low levels of maternal education.
Based on data from the Hulu Sungai Selatan District Health Office.
Additionally, prevalence of stunting in Hulu Sungai drinking water in families further increases Selatan District, as recorded in the e- the risk of stunting in children (Beal et al.
PPGBM system, was 5.
37% in 2021 and Several factors contribute to the decreased to 4.
53% in 2022, reflecting a incidence of stunting, including maternal reduction of 0.
Similarly, data from the Gambah Health Center shows that in 2021, nutrition during pregnancy, short maternal out of 415 toddlers, 43 were identified as stature, and ineffective parenting practices, stunted, resulting in a prevalence rate of particularly in feeding behavior and child .
Journal Of Health Science Analysis Of Factors Related to The Incidence ofa nutrition management (Sukirno, 2.
Regency, with a stunting prevalence rate of Yanti.
Betriana, and Kartika .
state This shows that stunting in the that factors contributing to stunting during Puskesmas Gambah work area is still quite a child's golden age include parenting practices, maternal knowledge, economic preventing stunting have been pursued, status, low birth weight (LBW), and especially local governments that work inadequate nutritional intake.
with related cross-sectors such as providing In 2022, the Hulu Sungai Selatan District Government Roundtable Stunting local-based supplementary food to forming a family companion program (TPK) where assistance by cadres and health workers for To address stunting, the several periods which will be monitored district implemented various initiatives regularly regarding the nutritional status of aimed at improving nutrition during the the stunting toddler.
Based on preliminary first 1,000 days of life .
,000 HPK).
These studies, information was obtained that most include the Nutrition Awareness Movement of the stunted toddlers had mothers who were highly educated with a history of full- supplementary food made from local term pregnancy, the nutritional status of ingredients through the BAAS program the mother during pregnancy was normal, (Bapak Asuh Anak Stuntin.
, nutritional the birth weight of 40 stunted toddlers was only found to be 6 people with LBW, and nutrition packages, training for officers and exclusive breastfeeding was still low and cadres on Infant and Young Child Feeding the source of drinking water used PDAM/ (IYCF), exclusive breastfeeding counseling.
PamSIMAS where every house already had a toilet.
1,000
cross-program
Support
HPK,
cross-sector coordination for stunting reduction.
Other This study is a quantitative analysis with consolidation and convergence of cross-
a case-control design, conducted in the IYCF
METHODE
working area of the Gambah Health Center.
Kandangan District.
Hulu Sungai Selatan programs, and the provision of clean water Regency.
The study population consisted of and sanitation facilities and infrastructure 409 toddlers, of which 40 were identified as (Dinas Kesehatan Kab.
HSS, 2.
stunted and 369 were not stunted.
The According to the 2022 E-PPGBM data, sampling technique used was systematic Puskesmas Gambah ranks first among the 21 health centers in Hulu Sungai Selatan toddlers were selected as cases and 80 non- .
Journal Of Health Science Analysis Of Factors Related to The Incidence ofa stunted toddlers as controls.
The study employed the chi-square and odds ratio included in the case group.
tests for data analysis.
Univariate Analysis The first stage of data analysis is RESULTS AND DISCUSSION This research was conducted at the univariate analysis, which was performed Gambah Health Center area.
Hulu Sungai to describe each variable through frequency Selatan Regency.
Puskesmas Gambah is The independent variables in located on Jalan A.
Yani Km 4 Gambah Luar this study included birth weight, exclusive Village, breastfeeding, mother's education level.
Kandangan Sub-district.
Hulu Sungai Selatan Regency with the northern boundary bordering the working area of nutritional status of the mother, while Puskesmas Angkinang, the east bordering stunting served as the dependent variable.
the working area of Puskesmas Kandangan.
Based on the research conducted in the the south bordering the working area of Gambah Health Center area, the study Puskesmas Kandangan, and the west bordering the working area of Puskesmas Characteristics related to birth weight.
Kandangan.
Puskesmas Gambah from the exclusive breastfeeding, mother's education Puskesmas network in the village and level, history of gestational age, and Rukun Tetangga (RT) can be reached by maternal nutritional status in the Gambah Health Center region.
Administratively.
Puskesmas Gambah covers 4 village areas.
West Gambah Dalam Village.
Gambah Dalam Village.
Gambah Luar Muka Village, and Gambah Luar Village.
This study, titled "Analysis of Factors Associated with the Incidence of Stunting in Toddlers in the Gambah Health Center Working Area," was conducted in July 2023.
It employed a case-control design with a systematic random sampling technique, and was carried out in the Gambah Health Center working area.
The total sample size for this study was 120 participants, selected based on specific criteria.
Of these, 80 mothers with children under five were Tabel 1.
Frequency distribution of birth weight, exclusive breastfeeding, mother's education level, history of gestational age, nutritional status of mothers in the working area of the Gambah health center
Case
Control
Tota
No Category 1 Birth
Weight
LBW
Not LBW
Total
2 Exclusive breastfeeding 2 62,5 1
Yes
1 37,5 6
Total
included in the control group, while 40
Journal Of Health Science Analysis Of Factors Related to The Incidence ofa
MotherAos Education Level Low
7 17,5
High
110 3 82,5
Total
Gestatonal Age History Premature 1 27,5 Aterm
106 2 72,5
Total
Maternal Nutritional Status
Chronic
7 17,5
Not chronic
111 3 82,5
Total analysis utilizes the chi-square test with a significance level of p-value <0.
Confidence Interva.
If the p-value is less 05, it is concluded that there is a Table 2.
Relationship between birth weight
and the incidence of stunting among children
under five years old
Birth
Weight
LBW
LBW
Total
Yes
0,022
(CI=9
5,444
Source: Processed Secondary Data 2022 Based on the results in Table 3, the chisquare test analysis obtained a p-value of breastfeeding and the incidence of stunting.
With an OR value of 5.
741, it can be concluded that toddlers who do not receive exclusive breastfeeding have a 5.
741 times higher risk of experiencing stunting.
Table 4.
Relationship between gestational age
history and the incidence of stunting among children under five years old
Gestational Age
History Premature Aterm
Total
Stunting Yes
0,00
(CI=95
9,736
3,381
was found that one cell had an expected the chi-square test analysis yielded a pvalue of 0.
022 (<0.
with an Odds Ratio (OR) value of 3.
This indicates a weight and the incidence of stunting.
With .
Journal Of Health Science Low High Total Stunting Yes Source: Processed Secondary Data 2022 Based on the results in Table 2 above.
Education Level (CI=95 Source: Processed Secondary Data 2022 Table 3.
Relationship between mother's education level and the incidence of stunting among children under five years old value of 5.
This indicates a significant relationship between two variables.
This Stunting 381 times more likely to experience 000 (<0.
with an Odds Ratio (OR) Bivariate analysis is used to examine the that toddlers with low birth weight are Bivariate Analysis an OR value of 3.
381, it can be concluded Based on the results in Table 4 above, it frequency of less than 5, so the Fisher Exact Test was used.
The test yielded a p-value of 015 (<0.
with an Odds Ratio (OR) value of 5.
This indicates a significant relationship between maternal education level and the incidence of stunting.
With an OR value of 5.
444, it can be concluded that Analysis Of Factors Related to The Incidence ofa mothers with low education levels have a maternal education level, gestational age 444 times higher risk of having stunted history, and maternal nutritional status.
Birth Weight Table 5.
Relationship between maternal nutritional status and the incidence of stunting among children under five years old
Maternal Nutritional Status
Chronic
Not chronic
Total
Stunting Yes
(CI=
8,27
was found that one cell had an expected frequency of less than 5, so the Fisher Exact Test was applied.
The test yielded a p-value 000 (<0.
with an Odds Ratio (OR) value of 9.
This indicates a significant gestational age and the incidence of With an OR value of 9.
736, it can prematurely have a 9.
736 times higher risk of experiencing stunting.
Based on the results of the study, which used 120 samples divided into two groupsAi40 samples from parents with stunted toddlers and 80 samples from stuntedAithe research was conducted in the Gambah Health Center region of Hulu Sungai Selatan Regency.
The study found that stunting is not caused by a single factor, but by multiple factors, including stunting in toddlers, the results of the bivariate analysis in this study indicated a weight and the occurrence of stunting, with a p-value of 0.
022 and an Odds Ratio (OR) by Mila and Dyah .
, which also found Based on the results in Table 5 above, it between birth weight and the incidence of This finding aligns with research Source: Processed Secondary Data 2022 Based on Table 2, the relationship a significant relationship between birth weight and stunting, reporting a p-value of 007 and an OR of 4.
However, a study by Anggreani.
Zuhrotul Eka Yulis, et al.
concluded that there was no weight and the incidence of stunting, as the p-value Birth commonly linked to long-term growth and Low birth weight (LBW), defined as a baby born weighing less than 2500 grams, poses risks such as increased likelihood of death and impaired growth and development, including a greater risk of stunting if not managed appropriately (Tri Windiarto et al.
, 2.
Newborn weight is a key indicator used to assess the health of a baby.
Babies born with low birth weight are more vulnerable to various diseases and infections.
Over time, low birth weight can lead to delays in the childAos motor development.
While babies with low birth weight can still grow up healthy, they may face certain health .
Journal Of Health Science Analysis Of Factors Related to The Incidence ofa challenges, such as slower weight gain, calcium that is more efficiently absorbed by difficulty with the sucking reflex, and higher the baby compared to formula milk.
susceptibility to infections.
The ideal weight According to Zomratun et al.
, breast for a baby born at full term, between 38-40 milk significantly contributes to a child's weeks of pregnancy, is typically between growth and development, particularly in 7 and 4 kg, with an average length of 50- terms of height, as it ensures better calcium 53 cm, depending on genetics.
Births that absorption, thus reducing the risk of deviate from this full-term range, either premature or post-term, often lead to Mother's Education Level health complications for the baby.
Based on table 4, the relationship Exclusive breastfeeding between maternal education level and the Based on the analysis of the relationship incidence of stunting in children under five between exclusive breastfeeding and the years old, the results of bivariate analysis of incidence of stunting in toddlers, the maternal education level with the incidence bivariate analysis in this study revealed a of stunting in children under five years old significant relationship, with a p-value of obtained a p-value of 0.
015 and an OR value 000 and an Odds Ratio (OR) of 5.
This 444, which means that there is a finding is consistent with the research of significant relationship between maternal Barir et al.
, which also identified a education level and the incidence of significant relationship between exclusive stunting in children under five years old.
breastfeeding and stunting in toddlers, with This finding is consistent with research a p-value <0.
001 and an OR of 0.
However, a study by Ruswati et al.
Febriany .
, found no significant relationship between significant relationship between maternal exclusive breastfeeding and the incidence of education level and the incidence of stunting, with a p-value of 0.
603 (>0.
stunting in children under five, with a p- Nurmalasari.
Yesi.
Breast milk is known for its excellent value of 0.
000 and an OR value of 3.
nutritional content, which is crucial for a contrast, the study by Mila and Dyah .
baby's growth.
Exclusive breastfeeding did not show a significant relationship during the first six months of life provides between maternal education and stunting, the necessary nutrition to support the with a p-value of 0.
064 (>0.
infantAos growth and development.
Exclusive The level of maternal education plays a crucial indirect role in shaping a motherAos supports brain and physical development, ability to understand health-related issues, and enhances overall growth, particularly particularly those related to nutrition.
This is because breast milk contains mother with higher educational attainment .
Journal Of Health Science Analysis Of Factors Related to The Incidence ofa is more likely to be knowledgeable about and Rini .
found no significant nutritional health problems and can more relationship, as indicated by a p-value of effectively address them.
This knowledge is 303 (>0.
integral because mothers are primarily The typical gestational period for a responsible for managing their childrenAos healthy baby is between 37 and 40 weeks.
eating habits, including organizing the a baby is born prematurely .
efore 37 familyAos shopping, meal preparation, and week.
, it is more likely to have a low birth weight (LBW).
Premature babies face Noviyanti.
Rachmawati, & Sutajo .
, a greater health risks because their organs mother's education significantly influences are less developed, which increases the the health of the family, including the likelihood of long-term developmental and nutritional status of its members.
Education health complications.
The earlier a baby is also affects parenting styles, as mothers are born, the more likely it is that the child will the key caregivers and food managers, experience growth and developmental directly impacting their children's health and nutritional status.
Thus, maternal This aligns with the World Health education is a critical factor in promoting Organization's (WHO, 2.
findings, which state that a gestational age of less than 37 especially in terms of preventing stunting.
weeks can result in suboptimal fetal Gestational Age History As a result, premature babies Based on table 5, the relationship are at higher risk of being born with low between the history of gestational age and birth weight .
nder 2500 gram.
, which the incidence of stunting in children under can increase the likelihood of stunting and five years old, the results of bivariate other health issues later in life.
analysis showed a p-value of 0.
000 and an Maternal Nutritional Status OR value of 9.
736, which means that there Based on table 4 6, the relationship is a significant relationship between the between maternal nutritional status and history of gestational age and the incidence the incidence of toddler stunting, the of stunting in children under five years old.
results of bivariate analysis obtained a p- This study aligns with the findings of value of 0.
006 and an OR value of 8.
Ngainis which means that there is a significant significant relationship between the history relationship between maternal nutritional of gestational age and the incidence of status and the incidence of toddler stunting.
stunting in children under five, with a p- In the opinion of the researchers, maternal value of 0.
000 and an OR value of 37.
nutritional status plays a crucial role in fetal contrast, the study by Hamzah.
Haniarti, development and child growth.
Adequate .
, .
Journal Of Health Science Analysis Of Factors Related to The Incidence ofa insufficient nourishment for the fetus, ensures that the fetus receives sufficient which can hinder growth and development, nutrients to support proper growth and potentially leading to stunting after birth.
a pregnant woman has an upper arm pregnancy can lead to low birth weight, circumference of less than 23.
5 cm, it preterm birth, and stunted growth in indicates insufficient energy and protein When the mother does not consume intake, which could lead to poor fetal enough nutrients, such as protein, vitamins, and minerals, it can result in deficiencies that impair the development of the fetus, nutritionists, is crucial to address these thus increasing the risk of stunting after nutritional deficiencies.
Providing proper Maternal malnutrition can lead to undernutrition in children.
Poor maternal standards, and delivering health education nutrition can result in inadequate energy can prevent complications like premature and nutrient supply to the fetus, leading to labor and low birth weight, both of which compromised birth outcomes, such as low contribute to stunting.
Malnutrition birth weight, which is a known risk factor Furthermore.
This Early proposed by Manggabarani et al.
nutrition influences the quality of breast which states that the motherAos nutritional milk, which is essential for the growth and history before and during pregnancy can development of infants during the first few significantly influence fetal growth and months of life.
Therefore, maternal nutrition This research is in line with Alfarisi, plays a critical role in preventing stunting.
Ringgo, et al.
, who found a highlighting the need for early detection significant relationship between maternal and intervention to ensure better outcomes nutritional status and the incidence of for both mother and child.
stunting in children under five.
They reported a p-value of 0.
005 and an OR value CONCLUSION However, the study conducted by Birth weight, exclusive breastfeeding.
Elis Nurajizah .
did not find a mother's education level, pregnancy age significant relationship, as the p-value was history, and maternal nutritional status are 105 (>0.
factors that can cause the incidence of Stunting development, primarily due to the motherAos insufficient nutrition during pregnancy.
Inadequate maternal nutrition results in .
Journal Of Health Science stunting toddlers.
Analysis Of Factors Related to The Incidence ofa
REFERENCES