Monthida Sangruangake
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Stunting among Under‐Five Children in Semarang Regency: Evidence from a Case–Control Study on Maternal KAP, Sanitation, and Early Feeding Widyawati, Sigit Ambar; Yuliaji Siswanto; Kustiyono; Solikhah, Solikhah; Monthida Sangruangake
Jurnal Kesehatan Masyarakat Vol. 22 No. 1 (2026)
Publisher : Universitas Negeri Semarang in collaboration with Ikatan Ahli Kesehatan Masyarakat Indonesia (IAKMI Tingkat Pusat) and Jejaring Nasional Pendidikan Kesehatan (JNPK)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15294/kemas.v22i1.40103

Abstract

Stunting is a significant public health issue with enduring impacts on cognitive development, productivity, and susceptibility to chronic diseases.This study aimed to identify and quantify determinants of stunting among children aged 6–59 months in Semarang Regency, Central Java, Indonesia, through a case–control study design. A total of 251 children (49 stunted cases and 202 controls) aged 6–59 months were enrolled between September and October 2024 from two purposively selected primary health centers in Semarang Regency. Data included biological, environmental, and maternal knowledge-attitude-practice (KAP) variables. Chi-square tests were used for bivariate analysis, and variables with p<0.25 were included in a multivariable logistic regression model. Associations were quantified using adjusted odds ratios (AORs) with 95% confidence intervals (CI). Bivariate analysis indicated that diarrheal infection, short birth length, lack of exclusive breastfeeding, poor sanitation, inadequate feeding practices, low maternal knowledge, negative maternal attitudes, and poor preventive behaviors were significantly associated with increased odds of stunting (p<0.05). Multivariable analysis revealed that negative maternal attitude had the strongest association with stunting (AOR=2.4; 95% CI: 1.2–4.6), alongside other independently associated factors. These findings suggest that stunting in Semarang Regency is shaped by interconnected biological, environmental, and psychosocial factors. Interventions should integrate behavior change communication and WASH improvements with nutrition-specific actions. Results should be interpreted as associative, not causal, due to the case–control study design.