Contextual Effect of Posyandu on the Risk of Stunting in Children Under Five, Klaten, Central Java

Abstract

Background: Stunting is a condition of failure to thrive in children under five as a result of chronic malnutrition. Environmental inter­ventions such as water, sanitation and hygiene behavior (WASH) can be used as a strategy to reduce the high incidence of stunting. This study aims to determine environmental factors and other factors on the incidence of stunting in toddlers. Subjects and Method: This study was an observational analytic study with a case-control approach. This research was conducted in July 2019 – August 2019 in Klaten Regency, Central Java. A total of 200 samples was selected by simple random sampling. The dependent vari­able was stunting. The independent variables were mother's education, family income, num­ber of family members, water sources, sanita­tion, history of infectious diseases, family diet, hand washing behavior and posyandu strata. The data collection technique used a question­naire and analyzed by a multiple multilevel logistic regression. Results: The risk of stunting increased with low maternal education <Senior high school (b= 3.43; 95% CI= 1.47 to 5.40; p <0.001), low family income (b= 2.72; 95% CI= 0.80 to 4.64; p= 0.005), family members ≥5 (b= 2.26; 95% CI= 0.65 to 3.87; p = 0.006), households with open water sources (b= 2.28 95% CI= 0.74 to 3.83; p= 0.004), inadequate sanitation (b= 2.66; 95% CI= 1.06 to 4.26; p <0.001), children had a history of infectious disease (b= 2.29; 95% CI= 0.70 to 3.88; p= 0.005), family diet (b= 2.39; 95% CI= 0.67 to 4.11; p= 0.006), and mothers did not wash their hands (b= 2.10; 95% CI= 0.63 to 3.56; p= 0.005). Posyandu strata had strong contextual effect on stunting in children under five with intra-class corre­la­tion (ICC) = 34.84%. Conclusion: The risk of stunting increases with low maternal education, low family income, family members ≥5, households with open water sources, inadequate sanitation, children had a history of infectious disease, family diet, and mothers did not wash their hands. Posyandu strata has strong contextual effect on stunting in children under five. Keywords: stunting, water sources, sanita­tion, history of infectious diseases Correspondence: Anna Mariyana. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta, Central Java. Email: annamariyana28.am@gmail.com. Journal of Maternal and Child Health (2020), 05(06): 725-736 https://doi.org/10.26911/thejmch.2020.05.06.12.