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      Food consumption diversity and nutritional status among children aged 6–23 months in Indonesia: The analysis of the results of the 2018 Basic Health Research

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          Abstract

          Background

          Stunting among children under five years of age is among the highest in Indonesia. The objective of this study was to investigate the association between food consumption diversity and nutritional status among children aged 6–23 months in Indonesia.

          Methods

          The data used came from the results of the 2018 Basic Health Research. The main independent variable was the diversity of food consumption. Control variables included breastfeeding practices and demographic and socioeconomic factors. Using ordinal logistic regression, the role of food consumption diversity in influencing nutritional status was examined after controlling for breastfeeding practices and demographic and socioeconomic factors.

          Results

          The results of the study showed that the diversity of food consumption (AOR = 1.15; 95%CI: 1.07–1.24) significantly and statistically influenced nutritional status of children age 6–23 months in Indonesia even after controlling for the effects of breastfeeding practices and demographic and socioeconomic factors. Higher odds of having normal nutritional status compared to being stunted or severely stunted was associated with consuming food according to the dietary diversity. Higher odds of having normal nutritional status compared to being stunted or severely stunted was also significantly and statistically associated with being ever breastfed (AOR = 1.33; 95%CI: 1.22–1.46), aged 6–11 months (AOR = 3.07; 95%CI: 2.79–3.38), female (AOR = 1.35; 95%CI: 1.25–1.46), children of non-working mothers (AOR = 1.12; 95%CI: 1.04–1.21), children of higher educated mothers (AOR = 1.50; 95%CI: 1.30–1.72), children from higher wealth quintile households (AOR = 1.65; 95%CI: 1.44–1.85), children from smaller size family (AOR = 1.07; 95%CI: 1.05–1.10), and urban children (AOR = 1.16; 95%CI:1.08–1.25).

          Conclusion

          A profound percentage of children aged 6–23 months in Indonesia experienced stunting and severely stunting. Children who did not receive minimum dietary diversity were more likely to suffer from stunting. The findings from this study suggest that to ensure the achievement of national goal of preventing stunting and sustainable development goal of ending all forms of malnutrition in Indonesia, the strategy should promote the fulfillment of minimum food consumption diversity.

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          Most cited references21

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          Contextualising complementary feeding in a broader framework for stunting prevention.

          An estimated 165 million children are stunted due to the combined effects of poor nutrition, repeated infection and inadequate psychosocial stimulation. The complementary feeding period, generally corresponding to age 6-24 months, represents an important period of sensitivity to stunting with lifelong, possibly irrevocable consequences. Interventions to improve complementary feeding practices or the nutritional quality of complementary foods must take into consideration the contextual as well as proximal determinants of stunting. This review presents a conceptual framework that highlights the role of complementary feeding within the layers of contextual and causal factors that lead to stunted growth and development and the resulting short- and long-term consequences. Contextual factors are organized into the following groups: political economy; health and health care systems; education; society and culture; agriculture and food systems; and water, sanitation and environment. We argue that these community and societal conditions underlie infant and young child feeding practices, which are a central pillar to healthy growth and development, and can serve to either impede or enable progress. Effectiveness studies with a strong process evaluation component are needed to identify transdisciplinary solutions. Programme and policy interventions aimed at preventing stunting should be informed by careful assessment of these factors at all levels. © 2013 John Wiley & Sons Ltd.
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            A review of child stunting determinants in Indonesia

            Abstract 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.
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              Determinants of the Stunting of Children Under Two Years Old in Indonesia: A Multilevel Analysis of the 2013 Indonesia Basic Health Survey

              Indonesia is ranked fifth among countries with the highest burden of stunting in children under five. This study aims to examine the determinants of stunting in children aged 0–2 years in Indonesia using data derived from the 2013 Indonesia Basic Health Survey. Twenty potential predictors of stunting, categorized into household and housing characteristics; maternal and paternal characteristics; antenatal care services and child characteristics were analyzed. Multilevel analyses were performed to examine the role of cluster/district/provincial differences, as well as individual/household level characteristics and stunting status. Of 24,657 children analyzed, 33.7% (95%CI: 32.8%–34.7%) were stunted. The odds of stunting increased significantly among children living in households with three or more children under five-years-old (aOR = 1.33, 95%CI: 1.03–1.72), households with five to seven household members (aOR =1.11; 95%CI: 1.03–1.20), children whose mothers during pregnancy attended less than four antenatal care services (aOR = 1.22, 95%CI: 1.08–1.39), boys (aOR = 1.33, 95%CI: 1.22–1.45), children aged 12–23 months (aOR = 1.89; 95%CI: 1.54–2.32), and children who weighed <2500 g at birth (aOR = 2.55; 95%CI: 2.05–3.15). The odds also increased significantly with the reduction of household wealth index. Integrated interventions to address environment, an individual level associated with stunting in Indonesia, from the environment- to individual-level factors are important.
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                Author and article information

                Contributors
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: Funding acquisitionRole: InvestigationRole: MethodologyRole: Project administrationRole: ResourcesRole: SupervisionRole: ValidationRole: VisualizationRole: Writing – original draftRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: Funding acquisitionRole: InvestigationRole: MethodologyRole: Project administrationRole: ResourcesRole: Writing – original draftRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: Funding acquisitionRole: InvestigationRole: MethodologyRole: Project administrationRole: ResourcesRole: SoftwareRole: ValidationRole: VisualizationRole: Writing – original draftRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS One
                plos
                PLOS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                16 March 2023
                2023
                : 18
                : 3
                : e0281426
                Affiliations
                [001] Lembaga Demografi, Faculty of Economics and Business, Universitas Indonesia, Depok, West Java, Indonesia
                Health Social Science and Development Research Institute, NEPAL
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Author information
                https://orcid.org/0000-0001-8003-8583
                https://orcid.org/0000-0002-1250-2329
                Article
                PONE-D-21-39580
                10.1371/journal.pone.0281426
                10019667
                36927979
                b124a29d-19b0-4ef9-a6d9-8e32f3556bb5
                © 2023 Samosir et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 20 December 2021
                : 24 January 2023
                Page count
                Figures: 1, Tables: 4, Pages: 13
                Funding
                Funded by: the Ministry of Research and Technology/National Research and Innovation Board
                Award ID: NKB-006/UN2.RST/HKP.05.00/2021
                Award Recipient :
                This research was supported by the Government of Indonesia, which provided for funding for this research project through the Ministry of Research and Technology/National Research and Innovation Board Fiscal Year 2021 (No.: NKB-006/UN2.RST/HKP.05.00/2021). The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
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                Data cannot be shared publicly because the data belong to the National Institute of Health Research and Development (NIHRD) of the Ministry of Health of the Republic of Indonesia. Data request may be made to NIHRD through email with the address: tu.bkpk@litbang.kemkes.go.id

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