Beyond personal factors: Multilevel determinants of childhood stunting in Indonesia

<h4>Background</h4> Stunting is still a major public health problem in low- and middle-income countries, including Indonesia. Previous studies have reported the complexities associated with understanding the determinants of stunting. This study aimed to examine the household-, subdistric...

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Autores principales:	Tri Mulyaningsih, Itismita Mohanty, Vitri Widyaningsih, Tesfaye Alemayehu Gebremedhin, Riyana Miranti, Vincent Hadi Wiyono
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/43f8fc4a742a4cf28c06fff0c0d8dbe3
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spelling	oai:doaj.org-article:43f8fc4a742a4cf28c06fff0c0d8dbe32021-11-25T06:19:30ZBeyond personal factors: Multilevel determinants of childhood stunting in Indonesia1932-6203https://doaj.org/article/43f8fc4a742a4cf28c06fff0c0d8dbe32021-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8604318/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4> Stunting is still a major public health problem in low- and middle-income countries, including Indonesia. Previous studies have reported the complexities associated with understanding the determinants of stunting. This study aimed to examine the household-, subdistrict- and province-level determinants of stunting in Indonesia using a multilevel hierarchical mixed effects model. <h4>Methods</h4> We analyzed data for 8045 children taken from the 2007 and 2014 waves of the Indonesian Family and Life Surveys (IFLS). We included individual-, family-/household- and community-level variables in the analyses. A multilevel mixed effects model was employed to take into account the hierarchical structure of the data. Moreover, the model captured the effect of unobserved household-, subdistrict- and province-level characteristics on the probability of children being stunted. <h4>Results</h4> Our findings showed that the odds of childhood stunting vary significantly not only by individual child- and household-level characteristics but also by province- and subdistrict-level characteristics. Among the child-level covariates included in our model, dietary habits, neonatal weight, a history of infection, and sex significantly affected the risk of stunting. Household wealth status and parental education are significant household-level covariates associated with a higher risk of stunting. Finally, the risk of stunting is higher for children living in communities without access to water, sanitation and hygiene. <h4>Conclusions</h4> Stunting is associated with not only child-level characteristics but also family- and community-level characteristics. Hence, interventions to reduce stunting should also take into account family and community characteristics to achieve effective outcomes.Tri MulyaningsihItismita MohantyVitri WidyaningsihTesfaye Alemayehu GebremedhinRiyana MirantiVincent Hadi WiyonoPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Tri Mulyaningsih Itismita Mohanty Vitri Widyaningsih Tesfaye Alemayehu Gebremedhin Riyana Miranti Vincent Hadi Wiyono Beyond personal factors: Multilevel determinants of childhood stunting in Indonesia
description	<h4>Background</h4> Stunting is still a major public health problem in low- and middle-income countries, including Indonesia. Previous studies have reported the complexities associated with understanding the determinants of stunting. This study aimed to examine the household-, subdistrict- and province-level determinants of stunting in Indonesia using a multilevel hierarchical mixed effects model. <h4>Methods</h4> We analyzed data for 8045 children taken from the 2007 and 2014 waves of the Indonesian Family and Life Surveys (IFLS). We included individual-, family-/household- and community-level variables in the analyses. A multilevel mixed effects model was employed to take into account the hierarchical structure of the data. Moreover, the model captured the effect of unobserved household-, subdistrict- and province-level characteristics on the probability of children being stunted. <h4>Results</h4> Our findings showed that the odds of childhood stunting vary significantly not only by individual child- and household-level characteristics but also by province- and subdistrict-level characteristics. Among the child-level covariates included in our model, dietary habits, neonatal weight, a history of infection, and sex significantly affected the risk of stunting. Household wealth status and parental education are significant household-level covariates associated with a higher risk of stunting. Finally, the risk of stunting is higher for children living in communities without access to water, sanitation and hygiene. <h4>Conclusions</h4> Stunting is associated with not only child-level characteristics but also family- and community-level characteristics. Hence, interventions to reduce stunting should also take into account family and community characteristics to achieve effective outcomes.
format	article
author	Tri Mulyaningsih Itismita Mohanty Vitri Widyaningsih Tesfaye Alemayehu Gebremedhin Riyana Miranti Vincent Hadi Wiyono
author_facet	Tri Mulyaningsih Itismita Mohanty Vitri Widyaningsih Tesfaye Alemayehu Gebremedhin Riyana Miranti Vincent Hadi Wiyono
author_sort	Tri Mulyaningsih
title	Beyond personal factors: Multilevel determinants of childhood stunting in Indonesia
title_short	Beyond personal factors: Multilevel determinants of childhood stunting in Indonesia
title_full	Beyond personal factors: Multilevel determinants of childhood stunting in Indonesia
title_fullStr	Beyond personal factors: Multilevel determinants of childhood stunting in Indonesia
title_full_unstemmed	Beyond personal factors: Multilevel determinants of childhood stunting in Indonesia
title_sort	beyond personal factors: multilevel determinants of childhood stunting in indonesia
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/43f8fc4a742a4cf28c06fff0c0d8dbe3
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Beyond personal factors: Multilevel determinants of childhood stunting in Indonesia

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