Research Center for Public Health and Nutrition, Research Organization for Health, National Research and Innovation Agency, Republic of Indonesia, Jakarta, Indonesia.
Department of Nutrition, School of Public Health, Hasanuddin University, Makassar, Indonesia.
PLoS One. 2023 May 11;18(5):e0281962. doi: 10.1371/journal.pone.0281962. eCollection 2023.
The prevalence of stunting in South Sulawesi and West Sulawesi Province is relatively high. Studies reveal various household, parental, and child factors are associated with stunting. This paper aimed to determine the determinants of stunting among children under five in South and West Sulawesi Province using the 2013 and 2018 Indonesia Basic Health Survey.
This study was a secondary data analysis using the 2013 and 2018 Indonesian Basic Health Surveys. The unit of analysis was children under five years, and the study obtained 3641 and 4423 children in South Sulawesi Province from the 2013 and 2018 Indonesia Basic Health Survey, respectively, and 804 and 1059 children from the 2013 and 2018 Indonesia Basic Health Survey in West Sulawesi Province, respectively. The multivariable poisson regression model was conducted to determine the determinants of stunting.
The results showed that the mean age of children in South Sulawesi and West Sulawesi Province was 31.1 months and 30.8 months, respectively, on 2013 survey compare to 29.6 months and 29.1 months on the 2018 survey. The determinants of stunting in children under five in South Sulawesi Province in 2013 survey were household with two children under five (APR:1.24; 95% CI: 1.1-1.3; p-value = 0.006), maternal BMI (APR: 1.1; 95% CI: 1.03-1.1; p-value = <0.001), maternal weight (APR: 0.9; 95% CI: 0.94-0.97; p-value = <0.001), children aged 12-23 months (APR: 2.2; 95% CI: 1.7-2.7; p-value = <0.001), children aged 24-59 months (APR: 2.2; 95% CI: 1.8-2.7; p-value = <0.001), birthweight (APR: 1.9; 95% CI: 1.5-2.5; p-value = <0.001). In the 2018 survey, the determinants were maternal weight (APR: 0.9; 95% CI: 0.98-0.99; p-value = 0.005), mothers with no education or with education in primary school (APR: 1.5; 95% CI: 1.3-1.9; p-value = <0.001), mothers with education in middle school (APR: 1.3; 95% CI: 1.1-1.6; p-value = 0.014), mothers with a height less than 151 cm (APR: 1.3; 95% CI: 1.5-3.1; p-value = <0.001), mothers with a height of 151-160 cm (APR: 1.3; 95% CI: 1.1-1.6; p-value = 0.014), children aged 12-23 months (APR: 2.2; 95% CI: 1.7-2.8; p-value = <0.001), children aged 24-59 months (APR: 2.5; 95% CI: 2.0-3.2; p-value = <0.001)., birthweight (APR: 1.5; 95% CI: 1.2-1.9; p-value = <0.001). The determinants of stunting in children under five in West Sulawesi Province in 2013 survey were children under five years living in poor households (APR: 1.9; 95% CI: 1.1-3.3; p-value = 0.021), children under five who lived in a household with three or more children under five (APR:1.8; 95% CI: 1.2-2.7; p-value = 0.002), children aged 12-23 months (APR: 1.8; 95% CI: 1.2-2.6; p-value = 0.006), children aged 24-59 months (APR: 1.9; 95% CI: 1.3-2.7; p-value = 0.001). On the 2018 survey, the determinants were maternal BMI (APR: 1.02; 95% CI: 1.01-1.03; p-value = 0.004), maternal weight (APR: 0.9; 95% CI: 0.95-0.98; p-value = <0.001), mothers with no education or with education in primary school (APR: 1.9; 95% CI: 1.3-2.7; p-value = 0.001), mothers with education in middle school (APR: 1.9; 95% CI: 1.3-2.7; p-value = 0.001), mothers with education in high school (APR: 1.8; 95% CI: 1.2-2.6; p-value = 0.004), children aged 12-23 months (APR: 2.1; 95% CI: 1.4-3.0; p-value = <0.001), children aged 24-59 months (APR: 2.6; 95% CI: 1.9-3.6; p-value = <0.001), male (APR: 1.2; 95% CI: 1.01-1.4; p-value = 0.035), and acute respiratory infection (ARI) (APR: 1.6; 95% CI: 1.04-2.5; p-value = 0.030).
The determinants of stunting in children under five in South Sulawesi Province are number of children under five in the household, maternal education, maternal weight, maternal height, maternal BMI, child's age, and birthweight. Meanwhile, the determinants of stunting in children under five in West Sulawesi were wealth, maternal education, maternal weight, maternal BMI,, child's age, child's sex, and history of acute respiratory infection. Hence, intervention on household and child levels as well as maternal sociodemographic factors need to be addressed.
南苏拉威西省和西苏拉威西省的发育迟缓患病率相对较高。研究表明，各种家庭、父母和儿童因素与发育迟缓有关。本文旨在使用 2013 年和 2018 年印度尼西亚基本健康调查，确定南苏拉威西省和西苏拉威西省五岁以下儿童发育迟缓的决定因素。
本研究是对 2013 年和 2018 年印度尼西亚基本健康调查进行的二次数据分析。分析单位为五岁以下儿童，2013 年和 2018 年从印度尼西亚基本健康调查中分别获得了南苏拉威西省的 3641 名和 4423 名儿童，以及 2013 年和 2018 年从印度尼西亚基本健康调查中获得了西苏拉威西省的 804 名和 1059 名儿童。采用多变量泊松回归模型确定发育迟缓的决定因素。
2013 年调查中，南苏拉威西省和西苏拉威西省儿童的平均年龄分别为 31.1 个月和 30.8 个月，而 2018 年调查中的平均年龄分别为 29.6 个月和 29.1 个月。2013 年调查中，南苏拉威西省五岁以下儿童发育迟缓的决定因素有：家中有两个五岁以下的孩子（APR：1.24；95%CI：1.1-1.3；p 值=0.006）、母亲 BMI（APR：1.1；95%CI：1.03-1.1；p 值<0.001）、母亲体重（APR：0.9；95%CI：0.94-0.97；p 值<0.001）、12-23 个月的儿童（APR：2.2；95%CI：1.7-2.7；p 值<0.001）、24-59 个月的儿童（APR：2.2；95%CI：1.8-2.7；p 值<0.001）、出生体重（APR：1.9；95%CI：1.5-2.5；p 值<0.001）。2018 年调查中，决定因素为母亲体重（APR：0.9；95%CI：0.98-0.99；p 值=0.005）、母亲没有接受教育或接受过小学教育（APR：1.5；95%CI：1.3-1.9；p 值<0.001）、母亲接受过中学教育（APR：1.3；95%CI：1.1-1.6；p 值=0.014）、母亲身高小于 151cm（APR：1.3；95%CI：1.5-3.1；p 值<0.001）、母亲身高在 151-160cm 之间（APR：1.3；95%CI：1.1-1.6；p 值=0.014）、12-23 个月的儿童（APR：2.2；95%CI：1.7-2.8；p 值<0.001）、24-59 个月的儿童（APR：2.5；95%CI：2.0-3.2；p 值<0.001）、出生体重（APR：1.5；95%CI：1.2-1.9；p 值<0.001）。2013 年调查中，西苏拉威西省五岁以下儿童发育迟缓的决定因素为生活在贫困家庭的五岁以下儿童（APR：1.9；95%CI：1.1-3.3；p 值=0.021）、家中有三个或三个以上五岁以下儿童的儿童（APR：1.8；95%CI：1.2-2.7；p 值=0.002）、12-23 个月的儿童（APR：1.8；95%CI：1.2-2.6；p 值=0.006）、24-59 个月的儿童（APR：1.9；95%CI：1.3-2.7；p 值=0.001）。2018 年调查中，决定因素为母亲 BMI（APR：1.02；95%CI：1.01-1.03；p 值=0.004）、母亲体重（APR：0.9；95%CI：0.95-0.98；p 值<0.001）、母亲没有接受教育或接受过小学教育（APR：1.9；95%CI：1.3-2.7；p 值=0.001）、母亲接受过中学教育（APR：1.9；95%CI：1.3-2.7；p 值=0.001）、母亲接受过高中教育（APR：1.8；95%CI：1.2-2.6；p 值=0.004）、12-23 个月的儿童（APR：2.1；95%CI：1.4-3.0；p 值<0.001）、24-59 个月的儿童（APR：2.6；95%CI：1.9-3.6；p 值<0.001）、男性（APR：1.2；95%CI：1.01-1.4；p 值=0.035）和急性呼吸道感染（ARI）（APR：1.6；95%CI：1.04-2.5；p 值=0.030）。
南苏拉威西省五岁以下儿童发育迟缓的决定因素是家中五岁以下儿童的数量、母亲教育程度、母亲体重、母亲身高、母亲 BMI、儿童年龄和出生体重。同时，西苏拉威西省五岁以下儿童发育迟缓的决定因素为家庭财富、母亲教育程度、母亲体重、母亲 BMI、儿童年龄、儿童性别和急性呼吸道感染史。因此，需要针对家庭和儿童层面以及母亲社会人口学因素进行干预。
