Department of Environmental Science and Policy, Program in International and Community Nutrition, University of California, Davis, Davis, California, USA.
Global Alliance for Improved Nutrition (GAIN), Geneva, Switzerland.
Matern Child Nutr. 2018 Oct;14(4):e12617. doi: 10.1111/mcn.12617. Epub 2018 May 17.
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.
儿童发育迟缓减少是全球 2025 年营养目标的 6 大目标之首，也是零饥饿可持续发展目标的关键指标。过去十年，印度尼西亚儿童发育迟缓的流行率一直居高不下，在国家层面约为 37%。目前减少儿童发育迟缓的方法是否符合印度尼西亚的科学证据尚不清楚。我们使用世界卫生组织儿童发育迟缓概念框架来审查现有文献，并确定在印度尼西亚，关于儿童发育迟缓的决定因素有哪些已经进行了研究，可以得出结论，以及哪些方面仍存在数据空白。一致的证据表明，在印度尼西亚，头 6 个月非纯母乳喂养、家庭社会经济地位低、早产、出生长度短、母亲身高和教育程度低等因素对儿童发育迟缓的影响尤为重要。来自未改善厕所和未处理饮用水家庭的儿童也面临更高的风险。社区和社会因素——特别是，获得医疗保健和生活在农村地区的机会有限——与儿童发育迟缓反复相关。关于教育、社会和文化、农业和粮食系统以及水、环境卫生如何促进儿童发育迟缓的研究尚未发表。本研究对印度尼西亚儿童发育迟缓决定因素的现有证据进行了全面综合，概述了哪些人最容易发育迟缓，哪些干预措施最成功，以及需要哪些新的研究来填补知识空白。
