Gross domestic product and geographic area as social determinants of child stunting and severe stunting in Indonesia: A multilevel analysis

Siswati, Tri (PUI-NOVAKESMAS, Poltekkes Kemenkes Yogyakarta, Jalan Tata Bumi No. 3, Gamping, Sleman, Daerah Istimewa Yogyakarta, 55293 Poltekkes Kemenkes Yogyakarta, Jalan Tata Bumi No. 3, Gamping, Sleman, Daerah Istimewa Yogyakarta, 55293)
Waris, Lukman (Department of Public Health, Universitas Faletehan, Jalan Palamunan No. 72, Kramatwatu, Serang, Banten, 42161)
Paramashanti, Bunga Astria (Department of Nutrition, Faculty of Health Sciences, Universitas Alma Ata, Jalan Brawijaya No. 99, Kasihan, Bantul, Daerah Istimewa Yogyakarta, 55183)
Kusnanto, Hari (Faculty Medicine, Public Health and Nursing, Universitas Gadjah Mada, Jalan Farmako, Sekip Utara, Depok, Sleman, Daerah Istimewa Yogyakarta,55281)
Susilo, Joko (Poltekkes Kemenkes Yogyakarta, Jalan Tata Bumi No. 3, Gamping, Sleman, Daerah Istimewa Yogyakarta, 55293)

Jurnal Gizi dan Dietetik Indonesia (Indonesian Journal of Nutrition and Dietetics)
VOLUME 10 ISSUE 3, 2022

Background: In Indonesia, socioeconomic disparities in childhood stunting is vast.Objectives: This study aimed to analyze the social determinants of stunting and severe stunting children in Indonesia.Methods: We analyzed data from cross-sectional surveys of Indonesia’s National Basic Health Research in 2013, the Central Bureau of Statistics, and the Ministry of Finance. Our samples were 3953 children aged 6-23 months and 10215 children aged 24-59 months. Dependent variables were the prevalence of child stunting and severe stunting. Independent variables covered factors at the social level while controlling structural and biological level-factors. Data were analyzed using multilevel analysis using generalized linear mixed models (GLMM).Results: Gross domestic product was associated with the reduced risk of stunting among children aged 6-23 months (ARRR= 0.99; 95%CI: 0.98-1.00) and 24-59 months (ARRR= 0.99; 95%CI: 0.97-0.99) as well as with the decreased risk of severe stunting among 6-23 months (ARRR= 0.99; 95%CI: 0.98-1.00) and 24-59 months (ARRR= 0.99; 95%CI: 0.97-0.99) old children. Tax ratio was a significant factor only for the severe stunting among 24-59 months old children (ARRR= 0.98; 95%CI: 0.96-0.99). There was also a geographical difference related to stunting and severe stunting.Conclusions: Equitable economic growth is an essential factor to improve the health and welfare of stunting and severe stunting children across the geographical setting in Indonesia.