Determinants of Stunting in Children Under Five

Sari, Fikitri Marya
Wulandari, Wulandari
Sofais, Danur Azissah Roeliana
Novega, Novega
Ramlis, Ravika
Fauzi, Yusran
Pratiwi, Bintang Agustina
Sutriyawan, Agung

Media Publikasi Promosi Kesehatan Indonesia (MPPKI)
Vol. 9 No. 1: JANUARY 2026 - Media Publikasi Promosi Kesehatan Indonesia

Introduction: Stunting in children under five years old remains a major global health concern, affecting approximately 22.3% of children worldwide. It contributes to impairments in physical and cognitive development, reduced academic performance, lower economic productivity, and increased susceptibility to non-communicable diseases. This study aims to synthesize comprehensive evidence regarding the determinants associated with stunting in children under five. Methods: A systematic review and meta-analysis were conducted using data from 22 eligible studies retrieved from international databases (Scopus, PubMed, ScienceDirect, and Springer). Heterogeneity was assessed using the I² statistic, and a random-effects model was applied to estimate the odds ratio (OR) and 95% confidence interval (CI). Publication bias was evaluated using funnel plot visualization and Egger’s test. Results: Meta-analysis findings demonstrate that several determinants significantly increase the risk of stunting, including low maternal education (OR = 1.63; 95% CI: 1.11–2.41; I² = 84.64%), low paternal education (OR = 1.66; 95% CI: 1.05-2.61; I² = 55.64%), maternal occupation (OR = 1.59; 95% CI: 1.09-2.32; I² = 71.16%), low household income (OR = 1.83; 95% CI: 1.30-2.58; I² = 73.72%), and households with two or more young children (OR = 2.34; 95% CI: 1.65-3.30; I² = 23.89%). Additional factors such as inadequate antenatal care (OR = 1.62; 95% CI: 1.07-2.47; I² = 41.71%), non-exclusive breastfeeding (OR = 1.21; 95% CI: 1.60-3.03; I² = 80.25%), incomplete immunization (OR = 2.77; 95% CI: 1.48-5.19; I² = 63.58%), low birth weight (OR = 2.72; 95% CI: 1.61-4.66; I² = 65.71%), and a history of infectious diseases (OR = 1.96; 95% CI: 1.36-2.82; I² = 64.06%) were also strongly associated with stunting. No substantial publication bias was indicated by Egger’s test (p > 0.05). Conclusion:Stunting is influenced by a combination of sociodemographic factors and maternal-child health services, such as parental education, household income, and exclusive breastfeeding. Reducing the prevalence of stunting requires integrated policies that encompass education, health, and family economic empowerment.