The Effect of Macroeconomics and Access to Health Service on Stunting in Indonesia

Abstract

Background: The prevalence of stunting in Indonesia is still above the World Health Organization standard. This study aims to analyze the effect of economic growth, income inequality, the Human Development Index (HDI), poverty, government spending on the health sector, and access to health services on the prevalence of stunting in Indonesia.Methods: The random effect technique is utilized to estimate the role of macroeconomic variables and access to health services on stunting in 34 provinces in Indonesia.Results: Economic growth has a positive effect on stunting, HDI and access to health services has a negative effect on stunting. Income inequality, poverty, and government spending on the health sector has no effect on stunting.Conclusion: Economic growth has a positive effect on stunting because the growth of income is not evenly distributed and income increases are not spent on nutrition. Increasing inclusive economic development and policies that lead to stunting reduction, especially in provinces with high stunting rates are very much needed. HDI and better access to health services are proven to lower stunting.  Some policy recommendations are improving access to health services and making sure that the services can reach all pregnant women. Optimizing nutrition services, consultations, and education for pregnant women through health service centers are very much needed. AbstrakLatar belakang: Prevalensi stunting di Indonesia masih di atas standar yang ditetapkan World Health Organization (WHO). Tujuan penelitian ini adalah menganalisis pengaruh pertumbuhan ekonomi, ketimpangan pendapatan, Indeks Pembangunan Manusia (IPM), kemiskinan, pengeluaran pemerintah sektor kesehatan, dan akses pelayanan kesehatan terhadap prevalensi stunting di Indonesia.Metode: Teknik random effect digunakan untuk mengestimasi pengaruh variabel makroekonomi dan akses pada pelayanan  kesehatan terhadap stunting di 34 provinsi di Indonesia.Hasil: Pertumbuhan ekonomi berpengaruh positif terhadap stunting, IPM dan akses pelayanan kesehatan berpengaruh negatif  terhadap stunting, ketimpangan pendapatan, kemiskinan, dan pengeluaran pemerintah sektor kesehatan tidak berpengaruh terhadap stunting.Kesimpulan: Pertumbuhan ekonomi berpengaruh positif terhadap stunting karena pertumbuhan pendapatan tidak merata dan peningkatan pendapatan tidak dibelanjakan untuk gizi. Peningkatan pembangunan ekonomi yang inklusif dan kebijakan yang mengarah pada pengurangan stunting terutama di provinsi dengan angka stunting yang tinggi sangat diperlukan. IPM dan akses pelayanan kesehatan yang lebih baik terbukti menurunkan prevalensi stunting. Beberapa rekomendasi kebijakan adalah meningkatkan akses terhadap layanan kesehatan dan memastikan bahwa layanan tersebut menjangkau seluruh ibu hamil.  Optimalisasi pelayanan gizi, konsultasi, dan edukasi ibu hamil melalui puskesmas sangat diperlukan