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-, subdistrict...

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Autores principales: Tri Mulyaningsih, Itismita Mohanty, Vitri Widyaningsih, Tesfaye Alemayehu Gebremedhin, Riyana Miranti, Vincent Hadi Wiyono
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Publicado: Public Library of Science (PLoS) 2021
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Acceso en línea:https://doaj.org/article/77522921734845e1bc38f0c846ac6ad6
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spelling oai:doaj.org-article:77522921734845e1bc38f0c846ac6ad62021-12-02T20:12:35ZBeyond personal factors: Multilevel determinants of childhood stunting in Indonesia.1932-620310.1371/journal.pone.0260265https://doaj.org/article/77522921734845e1bc38f0c846ac6ad62021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0260265https://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, p e0260265 (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/77522921734845e1bc38f0c846ac6ad6
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