Determinants of Stunting, Wasting, and Underweight Among Indonesian Children Under Five: A Complex Survey Analysis of the 2024 Indonesian Nutritional Status Survey
Anwar Lubis, Firmansyah Ibrahim, Hardyanti Pratiwi, Jufrinaldi Jufrinaldi, R. ArifuddinABSTRACT
Objectives
Stunting, wasting, and underweight are widely used anthropometric indicators of child growth in Indonesia, but they are often equated with undernutrition although they also reflect social, economic, and other contextual conditions. We estimated their national prevalence and tested whether maternal, pregnancy, child health, and health‐service factors are associated with each indicator among children aged 0–59 months.
Methods
We conducted a cross‐sectional secondary analysis of the 2024 Indonesian Nutritional Status Survey (SSGI), a nationally representative multistage complex survey. Among 300 143 children with valid anthropometric data, height/length‐for‐age, weight‐for‐age, and weight‐for‐height/length z ‐scores were calculated using the World Health Organization (WHO) Child Growth Standards. Weighted logistic regression with primary sampling unit‐clustered robust standard errors was used to estimate adjusted odds ratios (AORs) and 95% confidence intervals (CIs). Collinearity among covariates was assessed with variance inflation factors.
Results
Weighted prevalence was 20.4% for stunting (4.4% severe), 16.9% for underweight, and 7.4% for wasting. Maternal age < 20 years at conception was associated with stunting (AOR 1.50), underweight (AOR 1.46), and wasting (AOR 1.12). Recent diarrhea was associated with all three outcomes (AOR range 1.19–1.30). Attendance at four or more antenatal care visits (AOR range 0.66–0.75) and routine growth‐monitoring attendance (AOR range 0.69–0.74) were associated with lower odds of all three outcomes. Rural residence was associated with higher odds of stunting (AOR 1.26) and underweight (AOR 1.17), but not wasting.
Conclusions
Stunting, wasting, and underweight among Indonesian children were associated with maternal age, antenatal care, recent diarrhea, growth‐monitoring attendance, and residence. Because household wealth, parental education, and dietary intake were not included in the models, these associations should not be read as evidence that nutrient intake explains the observed growth deficits, and residual socioeconomic and contextual confounding is likely.