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      Determinants of the Stunting of Children Under Two Years Old in Indonesia: A Multilevel Analysis of the 2013 Indonesia Basic Health Survey

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          Abstract

          Indonesia is ranked fifth among countries with the highest burden of stunting in children under five. This study aims to examine the determinants of stunting in children aged 0–2 years in Indonesia using data derived from the 2013 Indonesia Basic Health Survey. Twenty potential predictors of stunting, categorized into household and housing characteristics; maternal and paternal characteristics; antenatal care services and child characteristics were analyzed. Multilevel analyses were performed to examine the role of cluster/district/provincial differences, as well as individual/household level characteristics and stunting status. Of 24,657 children analyzed, 33.7% (95%CI: 32.8%–34.7%) were stunted. The odds of stunting increased significantly among children living in households with three or more children under five-years-old (aOR = 1.33, 95%CI: 1.03–1.72), households with five to seven household members (aOR =1.11; 95%CI: 1.03–1.20), children whose mothers during pregnancy attended less than four antenatal care services (aOR = 1.22, 95%CI: 1.08–1.39), boys (aOR = 1.33, 95%CI: 1.22–1.45), children aged 12–23 months (aOR = 1.89; 95%CI: 1.54–2.32), and children who weighed <2500 g at birth (aOR = 2.55; 95%CI: 2.05–3.15). The odds also increased significantly with the reduction of household wealth index. Integrated interventions to address environment, an individual level associated with stunting in Indonesia, from the environment- to individual-level factors are important.

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          Most cited references30

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          Maternal and child undernutrition and overweight in low-income and middle-income countries

          The Lancet, 382(9890), 427-451
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            Evidence-based interventions for improvement of maternal and child nutrition: what can be done and at what cost?

            The Lancet, 382(9890), 452-477
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              Estimating wealth effects without expenditure data--or tears: an application to educational enrollments in states of India.

              Using data from India, we estimate the relationship between household wealth and children's school enrollment. We proxy wealth by constructing a linear index from asset ownership indicators, using principal-components analysis to derive weights. In Indian data this index is robust to the assets included, and produces internally coherent results. State-level results correspond well to independent data on per capita output and poverty. To validate the method and to show that the asset index predicts enrollments as accurately as expenditures, or more so, we use data sets from Indonesia, Pakistan, and Nepal that contain information on both expenditures and assets. The results show large, variable wealth gaps in children's enrollment across Indian states. On average a "rich" child is 31 percentage points more likely to be enrolled than a "poor" child, but this gap varies from only 4.6 percentage points in Kerala to 38.2 in Uttar Pradesh and 42.6 in Bihar.
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                Author and article information

                Journal
                Nutrients
                Nutrients
                nutrients
                Nutrients
                MDPI
                2072-6643
                18 May 2019
                May 2019
                : 11
                : 5
                : 1106
                Affiliations
                [1 ]Faculty of Medicine, Pattimura University, Kampus Poka, Maluku Province, Ambon 97233, Indonesia
                [2 ]Center for Health Research, Faculty of Public Health Universitas Indonesia, West Java Province, Depok 16424, Indonesia; ariawan@ 123456dnet.net.id (I.A.); anifatun.muasyaroh@ 123456gmail.com (A.M.)
                [3 ]National Institute of Health Research and Development, Ministry of Health Republic of Indonesia, DKI Jakarta 10560, Indonesia; dhapsari1971@ 123456gmail.com
                [4 ]School of Public Health, The University of Sydney, Sydney, NSW 2006, Australia; michael.dibley@ 123456sydney.edu.au
                Author notes
                [* ]Correspondence: christiana_rialine@ 123456yahoo.com ; Tel.: +62-821-230-67572
                Author information
                https://orcid.org/0000-0002-3023-003X
                Article
                nutrients-11-01106
                10.3390/nu11051106
                6567198
                31109058
                9756e048-1431-44c6-b617-7ed147aae45a
                © 2019 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 29 March 2019
                : 15 May 2019
                Categories
                Article

                Nutrition & Dietetics
                stunting,child under two years old,indonesia,indonesia basic health survey

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