Life Course Factors Associated with Stunting in Children Aged 2-5 Years: A Path Analysis

Abstract

Background: Worldwide, in 2014, 23.8% of the children under-five years of age were stunted following the WHO definition, 7.5% were wasted but 6.1% had overweight or were obese. Developing countries host the bulk of the global stunting and child mortality rate. This study aimed to examine life course factors associated with stunting in children aged 2-5 years, using path analysis model. Subjek dan Metode: A case control study was conducted in Tulungagung, East Java, from October to November 2018. A sample of 200 children under five was selected by fixed disease sampling. The dependent variable was stunting. The independent variables were maternal mid-upper arm circumference (MUAC), maternal height, exclusive breastfeeding, complementary feeding, birth weight, birth length, infection disease, and clean water supply and sanitation. Data on maternal height was measured by microtoise. The other data were collected by maternal and child health book and questionnaire. The data were analyzed by path analysis. Results: Stunting directly decreased with maternal MUAC (b= 2.47; 95% CI= 0.33 to 2.86; p= 0.013), maternal height (b=3.10; 95% CI= 0.79 to 3.54; p= 0.002), exclusive breastfeeding (b= 4.78; 95% CI= 2.05 to 4.91; p<0.001), complementary feeding (b= 2.35; 95% CI= 0.25 to 2.83; p= 0.019), normal birth weight (b= 3.64; 95% CI= 1.26 to 4.21; p<0.001), normal birth length (b= 4.10; 95% CI= 1.63 to 4.62; p<0.001), no infection disease (b= 3.28; 95% CI= 0.87 to 3.47; p= 0.001), and clean water supply (b= 2.99; 95% CI= 0.72 to 3.49; p<0.001). Stunting indirectly affected with infection disease and birth weight. Conclusion: Stunting directly decreases with maternal MUAC, maternal height, exclusive breastfeeding, complementary feeding, normal birth weight, normal birth length, no infection disease, and clean water supply. Stunting indirectly affects with infection disease and birth weight. Keywords: stunting, determinants, path analysis Correspondence : Ayu Rosita Dewi. Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami 36 A, Surakarta 57126, Central Java. Email: ayrost2014@gmail.com. Mobile: +6285856852680. Journal of Maternal and Child Health (2019), 4(5): 358-367 https://doi.org/10.26911/thejmch.2019.04.05.09