Prevalence Of Stunting In Children Research Articles

The Impact of Trade Openness, Tariff, and Globalization on Food Security in the ASEAN Region

In 2023, many crises hit the world due to heated geopolitical conditions resulting from the war in Russia and Ukraine; the world situation was fragmented because of competition between the USA and PRC blocs, economic recovery due to COVID-19 was shaken again, and food inflation was soaring high. The leading cause of food insecurity in ASEAN, which consists of most developing countries, is the lack of distribution access due to the affordability of logistics and food supplies. Most investors shift their investment preferences from the primary sector to manufacturing due to the volatility and high risk of assets. In 2020, in Asia, there were 78.7 million toddlers who were stunted, with the second majority in Southeast Asia (27.40%). Although most of the ASEAN member countries are connected geographically, the market share of ASEAN member countries in world trade is only 8.8%, so intra-trade relations are considered not optimal enough. This study aims to analyze the effect of three different trade openness indicators (trade openness, tariffs, and globalization) on the food security of Southeast Asian people in 2000–2021. The method used in this research is panel data, which combines pool least squares (PLS) and fixed effect models (FEM) by developing Beck and Katz’s two panels corrected standard errors (PCSE): cross-section weights and SUR. Trade openness significantly affects the two pillars of food security: stability and utilization, with U-shaped results. Ad-valorem tariffs are significant and positive for the two pillars of food security: availability and utilization. Increasing taxes in Southeast Asia can improve the average dietary energy supply’s adequacy; however, this can also increase the prevalence of stunting in children under five. It happens because the availability of abundant food in terms of quantity differs from the quality and safety of its consumption. The increase in globalization from an economic, political, and social perspective in Southeast Asia is significant for the four pillars of food security; if globalization is increased, then this can positively impact reducing cases of stunting and malnutrition; on the other hand, increasing globalization has harmed food availability and stability. Increasing one policy has a different impact. In the first stage, policy improvements can positively impact a pillar of food security. However, after reaching a turning point, there is a possibility that the increased policy will harm the other pillars. Therefore, it is necessary to choose an integrative policy trade-off and be able to solve problems better. This study suggests several main policy implications, namely building a more assertive trade policy based on the WTO and food safety technical rules that comply with WHO rules, increasing intra-trade within the ASEAN group, maintaining food price stability, encouraging investment in agriculture, promoting governance reforms, and strengthening the regional food security system in terms of production, consumption, and distribution. Support policies are also needed regarding solid prevention efforts against stunting and malnutrition and digitalization (Agritech 4.0), which supports food availability. In addition, this research also suggests that ASEAN can continue to increase domestic food production for resilience to the global crisis. Keywords: trade openness, tariff, globalization, food security, ASEAN, dynamic panel

Factors associated with stunting in under-five children with environmental enteropathy in slum areas of Jimma town, Ethiopia.

Stunting is a major public health issue with a significant influence on the health and development of children in low-income countries, where it affects up to 32% of children. Nutritional intake is impacted by alterations in intestinal permeability and underlying chronic inflammation, which hinder children's normal linear growth. Environmental enteropathy is a poorly understood condition with chronic intestinal inflammation. The purpose of this study was to identify the magnitude of stunting, change in growth, and factors associated with stunting and change in height for the age Z-score of children with an elevated lactulose-to-mannitol ratio. An observational follow-up study was conducted to follow children with an elevated lactulose-to-mannitol ratio for changes in their linear growth. A lactulose-mannitol test was performed to identify children with elevated lactulose-to-mannitol ratios, indicative of environmental enteropathy. After a 1-year follow-up, anthropometry was repeated to assess their linear growth. A multivariable logistic regression analysis was performed to identify the independent predictors for stunting in children with elevated lactulose-to-mannitol ratios. All tests were two-sided, and a p-value of <0.05 was considered significant. The prevalence of stunting in children with an elevated L:M at baseline and end line was found to be 72.4% (95% CI: 60.3, 84.5) and 78.4% (95% CI: 66.7, 90.2), respectively. In a multivariate analysis, a low dietary diversity score (<4 food groups), presence of flies and insects in the toilet area, poor handwashing practices during a critical time, and MUAC z < -2 were significantly associated with stunting. Flies and insects in the toilet area and unsafe disposal of feces were significantly associated with changes in HAZ in children with elevated lactulose-to-mannitol ratios, an indicator of environmental enteropathy. Most of the children with an elevated lactulose-to-mannitol ratio in the study population were stunted, and no significant change in their linear growth was observed after 1-year follow-up. Therefore, further investigation and urgent intervention are needed to prevent environmental enteropathy and stunting among under-five children in this community who are exposed to very poor sanitary conditions and other risk factors for malnutrition.

Continuum of care for maternal and child health and child undernutrition in Angola

BackgroundContinuum of care (CoC) for maternal and child health provides opportunities for mothers and children to improve their nutritional status, but many children remain undernourished in Angola. This study aimed to assess the achievement level of CoC and examine the association between the CoC achievement level and child nutritional status.MethodsWe used nationally representative data from the Angola 2015–2016 Multiple Indicator and Health Survey. Completion of CoC was defined as achieving at least four antenatal care visits (4 + ANC), delivery with a skilled birth attendant (SBA), child vaccination at birth, child postnatal check within 2 months (PNC), and a series of child vaccinations at 2, 4, 6, 9 and 15 months of child age. We included under 5 years old children who were eligible for child vaccination questionnaires and their mothers. The difference in CoC achievement level among different nutritional status were presented using the Kaplan-Meier method and examined using the Log-Lank test. Additionally, the multivariable logistic regression analysis examined the associations between child nutritional status and CoC achievement levels.ResultsThe prevalence of child stunting, underweight and wasting was 48.3%, 23.2% and 5.9% respectively. The overall CoC completion level was 1.2%. The level of achieving CoC of mother-child pairs was 62.8% for 4 + ANC, 42.2% for SBA, 23.0% for child vaccination at birth, and 6.7% for PNC, and it continued to decline over 15 months. The Log-Lank test showed that there were significant differences in the CoC achievement level between children with no stunting and those with stunting (p < 0.001), those with no underweight and those with underweight (p < 0.001), those with no wasting and those with wasting (p = 0.003), and those with malnutrition and those with a normal nutritional status (p < 0.001). Achieving 4 + ANC (CoC1), 4 + ANC and SBA (CoC 2), and 4 + ANC, SBA, and child vaccination at birth (CoC 3) were associated with reduction in child stunting and underweight.ConclusionsThe completion of CoC is low in Angola and many children miss their opportunity of nutritional intervention. According to our result, improving care utilization and its continuity could improve child nutritional status.

Overcoming Maternal and Child Health Problems in Rw 16 Citatah Village, Cipatat District, West

Based on the analysis of the situation from the initial survey data of community service activities, several health problems were obtained in RW 16, it can be concluded that there are 3 maternal and child health problems that are priorities for the community service team to overcome, namely: The prevalence of stunting in children under five years old, low coverage of immunization in children, and nutritional problems in pregnant women. The purpose of this service is to solve maternal and child health problems by providing health education to the community. This service activity employs the extension approach as its methodology. Data collection using questionnaire sheets that become material for evaluation. The outcomes of this service include the assessment of counseling participants' comprehension by oral questioning at the beginning and conclusion of the session. The community seemed enthusiastic about providing responses and answers and was actively involved during the counseling process. So it can be concluded that there is a social change in the form of changes in the way people think about health, especially maternal and child health, tracking the development and growth of children, early detection of diseases, and many other benefits that cause changes in the way people view health.

Determinants of Stunting Among Children Under Five Years in Indonesia: Evidence from the 2021-2022 Demographic and Health Survey

At the global level, the prevention of stunting is one of the Sustainable Development Goals (SDGs). Indonesia is currently working towards achieving the second Sustainable Development Goal, which entails ending hunger, ensuring food security, improving nutrition, and supporting sustainable agriculture. As a part of this objective, efforts are being made to decrease the prevalence of stunting in children by 2025. Attention towards stunting is crucial as it can adversely affect children's physical and cognitive development well into adulthood if not addressed appropriately. This paper conducted a literature review from various sources, with a focus on google scholar and prioritizing sources from the last five years, as well as research on the population in Indonesia. It was determined through the analysis of several sources that maternal, child, and environmental factors pose various risks for stunting in Indonesia. Maternal factors that may play a role in child development include the mother's age, upper arm circumference, height, breastfeeding or complementary feeding practices, early initiation of breastfeeding and food quality during pregnancy. A history of low birth weight or prematurity, male sex, neonatal illness, frequent and recurrent diarrhea, infectious diseases, and lack of immunization are among the child factors associated with developmental outcomes. Factors such as living in a low socio-economic environment, limited family education, especially maternal education, insufficient household income, open defecation in rivers, gardens or inadequate latrines, consumption of untreated drinking water and high exposure to pesticides are also associated with the prevalence of stunting.

Functional Food Processing Application as PMT (Providing Additional Food) for BADUTA in the Program to Support the Movement to Prevent Stunting in Medan Deli District

Stunting is a form of growth failure due to the accumulation of inadequate nutrition that lasts for a long time starting from pregnancy until the age of 24 months, characterized by body length or height being below standard, based on the PB/U or TB/U index, the results of these measurements are at the threshold &lt; -2 SD, =-3 SD (short) and &lt;-3 SD (very short). Based on WHO data (2020), the prevalence of stunting in children under five in the world is 149.2 million or around 22%, the national prevalence of stunting in 2022 is 21.6%, the prevalence of stunting in North Sumatra (January 2023) reaches 21.1%, ranked 17th from 34 provinces with the highest number of stunted children in Indonesia. The prevalence of stunting in Medan City (as of April 1 2023) is 298 children under five. Data obtained from the Medan Deli District Family Planning Coordinator, currently there are 28 stunted toddlers and 30 stunted toddlers, of the 28 stunted toddlers, 1 toddler has 'graduated' from stunting. The aim of this service is to apply functional food processing as PMT (Supplemental Food Provision) for BADUTA as an effort to support the Stunting Prevention Movement Program in accordance with PERPRES (2021) No. 72. In the outreach activities, pretest and posttest evaluation activities were carried out to determine the level of knowledge of participants regarding the provision of additional protein-rich functional food (PMT) in the form of cereal cookies to stunted toddlers and those at risk of stunting by providing simple choice questions that they had to answer. The results of the service obtained are functional stunting food products in the form of cookies containing porang flour and moringa

Does Corruption Affect the Reduction in Children's Stunting Rate Caused by Foreign Aid?

Recent empirical evidence has indicated a potential avenue for ameliorating the nutritional status of children in developing nations through focused interventions in the realms of food and agriculture. This research delves into the issue of child stunting prevalence in developing countries, scrutinizing the impact of corruption on the efficacy of such interventions. Utilizing comprehensive data derived from the Organization for Economic Cooperation and Development (OECD) and the World Bank, this study meticulously analyzed evolving trends. Notably, the investigation revealed a diminishing prevalence of child stunting among both genders but the role of total aid emerged as inconsequential in contributing to this positive trend. Furthermore, an intriguing revelation surfaced, indicating that the battle against child malnutrition hinges not solely on the optimized distribution of foreign aid but significantly on the curbing of corruption. The research uncovered a notable improvement in children's nutrition correlated not with the augmentation of foreign aid but with the augmentation of public health expenditures, thereby emphasizing the pivotal role of corruption control. This discernment underscores the imperative need for targeted aid and robust governance mechanisms to effectively combat the formidable challenge of child malnutrition.

Animal-Based Protein Intake is Associated with Stunting in Children in Primary Health Care of Minggir

Background: Stunting in children under fives years of age still become crucial problem. One of the factors that influenced directly to stunting is lack of nutritional intake especially protein. Most of protein consumed by under-fives children must be in high quality such as animal-based protein because it has more complete composition of essential amino acids than plant-based protein. Objectives: The study aimed to analyzed the association between animal-based protein and stunting in children in Primary Health Care of Minggir. Methods: This study was analytical observational with cross-sectional design. A total of 50 mothers that have 24–59 months old children were involve in this study and taken by using purposive sampling. Data of animal-based protein intake were collected by SQ-FFQ for the last three months. Height-for-age in z-score was used to determine stunting that were obtained from the last measurement and recorded in Maternal and Child Book. The association between stunting and the animal-based protein intake was analyzed descriptively through cross-tabulation. Results: More than half of under-five children were stunting (56%). Inadequate animal-based protein intake was observed in 46% of under-fives children. Sources of animal-based protein were eggs, chicken, catfish, ice cream and UHT milk. Children who have adequate animal-based protein intake were not stunted (67%), however children who have inadequate animal-based protein intake were stunted (83%). The prevalence of stunting in children who consume inadequate animal-based protein is 2 times greater than in children who consume adequate animal-based protein (PR: 2.478). Conclusions: Based on this study, animal-based protein intake is associated with stunting in under-fives children in Primary Health Care of Minggir. Mothers should improve their children’s animal-based protein intake by local food sources supplied from side dishes to prevent stunting.

Patterns of Providing Complementary Food with Incidents of Stunting in Toddlers in Kupang City, Ages 6-24 Months

The province of East Nusa Tenggara has a high rate of malnutrition, particularly stunting. The development of toddlers is significantly influenced by complementary foods. Inappropriate supplementation of food may increase the risk of stunting. The purpose of this study is to ascertain how supplemental feeding practices affect the prevalence of stunting in children in Kupang City between the ages of 6 and 24 months. An analytical survey with a cross-sectional design was employed in this kind of study. The population was all toddlers in Kupang City, with a total of 25.266 children. A multistage random sample technique was used to choose 394 children between the ages of 6 and 24 months to participate in the study. Chi-square test was utilized in the data analysis. The results showed that there was a significant relationship between the number of complementary foods (p-value=0,001, OR 2,691), the texture of complementary foods (p-value=0,025, OR 1,907), and the frequency of complementary foods (p-value=0,000, OR 3,945) and the incidence of stunting among children aged 6–24 months in Kupang City.

Dairy trade liberalization and child stunting: Evidence from low- and middle-income countries

Despite the well-studied nutritional benefits of dairy for child linear growth, dairy is less consumed in low- and middle-income countries (LMICs) where the prevalence of child stunting is high. Previous studies have suggested the cost of dairy as a potential barrier to increased dairy consumption in these countries. Surprisingly, little research on the association between dairy consumption and child stunting in LMICs focuses on the role of trade policies, particularly the liberalization of dairy trade. To explore this, we use representative cross-country individual data on child stunting from 2006 to 2020 and link it with country-level dairy trade data. We find that a 10% decline in dairy tariff rates reduces the risk of stunting by 7.78%. Our results are robust to a subsample analysis excluding countries which joined the WTO after 2000 and to an alternative clustering method. As a falsification test, our results show child stunting is not linked with tariffs for coffee and tea. Heterogeneity analysis indicates the associations are more pronounced for boys, children aged 3–5, and children from households with lower socioeconomic status. Although we did not find significant rural–urban differences, the associations are indeed stronger for households without cattle and for countries in Western Africa, South East Asia and Europe and Central Asia. Mechanism analysis suggests that dairy tariffs are positively correlated with milk prices, while they are negatively associated with dairy import values. Lower dairy tariffs are also found to be linked with higher probability of child dairy consumption. Our findings highlight the importance of removing tariff barriers in reducing the cost of dairy and promoting dairy consumption in LMICs. This study has implications for repurposing dairy trade policies in creating nutrition-sensitive agriculture.

Determinant factors of stunting in children 2-5 years in West Aceh District, Indonesia

The prevalence of stunting in children under five years of age in Indonesia, and Aceh in particular, is still very high. This condition affects the quality of human resources and future economic growth. This study examined the determinants of stunting among children under five years of age 24-59 months in West Aceh District, Aceh Province, Indonesia. The research method was a cross-sectional study design, using secondary data from the EPPGBM and PIS-PK data from the Health Center in 2020. The sample comprised 386 families with children under five. Data were collected through documentation studies from PIS-PK data and stunting data from the E-PPGBM data. Family data matching was performed using the National Identity Number (NIN). Statistical analysis was performed using a Multiple Logistic Regression test with 95% confidence interval (CI). The results showed a significant association between exclusive breastfeeding (OR= 2,81; p= 0,010), latrine use (OR=1,73; p= 0,043), and smoking (OR= 1,62; p= 0,022) with the prevalence of stunting. Furthermore, exclusive breastfeeding was a determining factor for the incidence of stunting in toddlers (OR= 2,36; p= 0,010).  In conclusion, exclusive breastfeeding practices are a determinant factor of stunting in children under five in West Aceh, so structured efforts need to be made to increase exclusive breastfeeding coverage by strengthening nutrition counseling and breastfeeding preparation for pregnant women up to two years.

Risk of Stunting in Children: Links to Internal and Social Family Interactions in Central Buton District (a Case Study)

With a high prevalence of stunting in children in the Central Buton District. This study aims to explore the relationship between internal family dynamics and external social relationships affecting children's nutrition. The study was based on the hypothesis that more frequent and qualitative family interactions and involvement in social activities would correlate with a lower risk of stunting. This study used a cross-sectional study design. Analyzing secondary data from the 2021 Family Data Collection (PK21). The study included 6,586 target families as a sample, the analysis included family dynamics as an exposure variable and used the family happiness index formula to identify family interaction and social interaction. The study used logistic regression from Scikit-learn to evaluate the data in the final stage. Data analysis revealed that internal family interactions, although important, showed no statistically significant association with stunting risk (p=0.3699). However, social interaction had a highly significant association with reduced risk of stunting, with a regression coefficient of -1.9934 and Odds Ratio (AOR) of 0.1362 (95% CI: 0.0739 - 0.2510, p&lt;0.0001) in logistic regression analysis. These findings confirm that strong social engagement and community support are key factors in reducing the prevalence of stunting among children in the Mawasangka sub-district. This study concludes that engagement in community social activities has a significant impact on reducing the risk of stunting in children. The findings suggest that interventions aimed at reducing stunting should go beyond intra-family interventions and include increased social interaction and community support to achieve optimal outcomes in stunting prevention.

Pendampingan Pembuatan Soft Candy Semangka, Nutrisi Halal Pemenuhan Zat Besi Sebagai Upaya Pencegahan Stunting

Prevalence of stunting in children in Indonesia at the national level is around 37%. Various efforts are made to reduce and prevent the incidence of stunting, one of the efforts to overcome this is the fulfillment of nutrition in children. one of the efforts to overcome this is the fulfillment of nutrition in children. One of One of the micronutrients that is important for child growth is iron. Lack of iron deficiency can cause stunting and impaired cognitive development in children. children. Iron is found in many foods, including watermelon. At Some people dislike the consumption of fruit directly. This becomes a challenge in itself where there needs to be an effort to process watermelon fruit into a dosage form that is favored by children, namely soft candy. One of one of the main ingredients for making soft candy is gelatin which needs to be considered its halalness. Therefore, there is assistance in making watermelon soft candy as halal nutrition to meet the iron needs of children as an effort to prevent stunting in MT Annisa, MT Annisa, MT Annisa, MT Annisa, MT Annisa. to prevent stunting in MT Annisa, Madiun City. The method in this activity begins with a pretest, then socialization and workshops, and ends with a posttest. The pretest results showed that only 9.09%, while the posttest results were 54.55% of residents who understood the knowledge and process of making halal watermelon soft candy for making halal watermelon soft candy for stunting prevention nutrition. This shows an increase in community knowledge after attending socialization and workshop looks different.

Eating behavior of adolescent girls in countries with a high prevalence of stunting under five: a systematic review

BackgroundAdolescence is critical for physical and psychological growth, making healthy dietary behavior essential. Several countries face nutritional challenges due to a high prevalence of stunting in children under five, which can impact adolescent girls’ eating behavior. This systematic review aims to provide evidence on the eating behavior of adolescent girls in such countries, offering insights for stunting prevention programs.MethodsWe conducted a systematic review following PRISMA guidelines and registered it in PROSPERO. We employed a comprehensive search strategy across multiple databases. Study selection involved three stages: deduplication, title/abstract screening, and full-text review, with inter-reviewer agreement assessment.ResultsThe search identified 15 eligible studies from various countries, primarily utilizing cross-sectional designs. The studies focused on age ranges within adolescence and varied in sample size and assessment tools. The primary objective of these studies was to assess eating behavior, with outcomes related to dietary patterns, eating disorders, body image, and nutritional knowledge. The results revealed diverse eating behaviors among adolescent girls, including restrained eating, dieting for weight loss, craving-induced eating, and unhealthy dietary patterns. Many girls exhibited low dietary diversity, contributing to micronutrient deficiencies.SuggestionsTo address these issues effectively, stunting prevention programs and policies should prioritize the following strategies: implementing comprehensive nutritional education programs to enhance adolescents’ knowledge of healthy eating habits and dietary diversity, providing resources and support for positive body image development to reduce the pressure for unhealthy dieting, improving access to affordable, nutrient-rich foods in both urban and rural areas, raising awareness about eating disorders and emphasizing early identification and intervention, engaging parents, caregivers, and communities in promoting healthy eating behaviors, and maintaining rigorous research and monitoring to adapt strategies based on evolving trends in adolescent eating behaviors.ConclusionAdolescent girls in countries with high stunting prevalence exhibit diverse eating behaviors that can impact their nutritional status and overall health. Addressing these behaviors is essential to prevent stunting and its long-term consequences, emphasizing the importance of comprehensive strategies and support for this vulnerable population.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/#recordDetails, identifier CRD42023389909.

NutriTalk: Nutrition Intervention by Experts to Reduce the Impact of Stunting Through Mobile-Based Applications Using Agile Method

The prevalence of childhood stunting, a pervasive global health concern primarily attributed to persistent malnutrition, underscores an urgent need for intervention. In Indonesia, where stunting rates are alarmingly high, with approximately 27.6% of children under five affected, innovative solutions are imperative. This study introduces "Nutri Talk," a mobile application developed using Agile Methodology aimed at revolutionizing nutritional consulting services. The application facilitates seamless communication with nutrition specialists, offering evidence-based information and personalized consultations to empower parents in making informed dietary decisions for their children. Through rigorous testing, including Boundary Value Analysis (BVA) and User Acceptance Testing (UAT), the application demonstrates robust functionality and user satisfaction. "Nutri Talk" stands poised to mitigate the long-term impacts of stunting, leveraging technology to enhance nutritional outcomes. This research advocates for a comprehensive approach to combat stunting, combining technological advancements with targeted interventions, ultimately contributing to improved childhood nutrition and development.

Potential risk of stunting in children under five years living by the riverside: A systematic review

Introduction: Stunting, or linear growth failure, is defined by a height-for-age z-score of below -2SD according to WHO growth standard. Stunting can have short-, medium-, and long-term consequences. Rivers have an important role in human life. In several riverside areas, households still depend on the river for their livelihoods and health. This study aimed to explore the prevalence of stunting in children living by the riverside and its related factors. Methods: Epidemiological studies published from PUBMED, MEDLINE via EBSCOHost, Science Direct, ProQuest, and Research Gate databases were systematically searched. The publication period was not restricted. Only open-access and English articles were examined. Results: A total of 20 from 1200 studies were reviewed. The prevalence of stunting ranged from 20% to 48.3%. The other outcomes besides stunting were wasting and underweight status. There were 83 risk factors studied, and the most studied variables were age, gender, diarrhoea, water source, parent’s education, immunisation, and inappropriate complementary feeding practices (6 to 13 studies). Household water sources from rivers and economic status were consistently correlated with stunting. Majority of the risk factors studied were related to nutrition. From the environmental aspect, the most studied risk factors were water sources and sanitation. Conclusion: Children living by the riverside face a significant risk of stunting attributed to the consistent correlation between household water sources from rivers and economic status, affecting various aspects of daily life beyond drinking water. Future research is needed to examine the impact of environmental factors and the behaviours of riverside communities.

CORRELATION BETWEEN BIRTH WEIGHT AND STUNTING IN CHILDREN UNDER FIVE A CASE-CONTROL STUDY

Stunting is a condition in which children experience delayed growth and development due to poor nutrition, recurrent infections, and inadequate psychosocial stimulation. The prevalence of children under 5 affected by stunting in 2020 is 22.3% or 148.1 million children worldwide. The analytical case-control study was conducted to explore the prevalence of child stunting and determine the association between birth weight and stunting occurrence among children under 5 years. It shows statistically significant with a p-value of 0.009 (p-value 0.05). A history of birth weight 2500 gr babies have a 3,660 times greater risk of experiencing stunting compared to children under 5 who were born with birth weight ≥2500 gr (CI=95%). There was a significant association between birth weight and stunting incidence among children under 5 years.

Sensitive Intervention Policy Recommendations to Reduce Stunting Rates Based on Spatial Analysis of Sanitary Factors on the Prevalence of Stunting in DKI Jakarta Province in 2021

The purpose of this study was to describe the prevalence of stunting in children under five and the percentage of proper sanitation, as well as recommendations for priority areas for stunting control interventions in the Province of the Special Capital Region of Jakarta in 2021. This study used a descriptive approach to present an overview of the percentage of sanitation and prevalence of stunting in children under five by sub-district in 38 districts in DKI Jakarta. Data is displayed as a map to show distribution areas based on high, medium, and low categories. An overlay was made between the distribution map of the percentage of sanitation and the prevalence of stunting to determine the areas with the highest risk. Analysis was carried out on the area's characteristics obtained from the spatial mapping results to determine the recommended intervention program policies. Based on the results of the overlay on the distribution of stunting prevalence and sanitation percentage maps, the recommended areas for priority intervention are Tambora, Sawah Besar, Johar Baru, Senen, Menteng, Jatinegara, Tebet, and Mampang Prapatan sub-districts. The recommended program to be carried out is sensitive interventions consisting of improving sanitation facilities and increasing knowledge and perceptions about sanitation. Improving sanitation facilities means increasing access to gooseneck latrines with septic tanks and access to clean water. Increasing knowledge and perception of the importance of sanitation to prevent stunting is carried out intensively and routinely through community activities and optimizing the role of community leaders.

Machine Learning Algorithms for Predicting Stunting among Under-Five Children in Papua New Guinea.

Preventing stunting is particularly important for healthy development across the life course. In Papua New Guinea (PNG), the prevalence of stunting in children under five years old has consistently not improved. Therefore, the primary objective of this study was to employ multiple machine learning algorithms to identify the most effective model and key predictors for stunting prediction in children in PNG. The study used data from the 2016-2018 Papua New Guinea Demographic Health Survey, including from 3380 children with complete height-for-age data. The least absolute shrinkage and selection operator (LASSO) and random-forest-recursive feature elimination were used for feature selection. Logistic regression, a conditional decision tree, a support vector machine with a radial basis function kernel, and an extreme gradient boosting machine (XGBoost) were employed to construct the prediction model. The performance of the final model was evaluated using accuracy, precision, recall, F1 score, and area under the curve (AUC). The results of the study showed that LASSO-XGBoost has the best performance for predicting stunting in PNG (AUC: 0.765; 95% CI: 0.714-0.819) with accuracy, precision, recall, and F1 scores of 0.728, 0.715, 0.628, and 0.669, respectively. Combined with the SHAP value method, the optimal prediction model identified living in the Highlands Region, the age of the child, being in the richest family, and having a larger or smaller birth size as the top five important characteristics for predicting stunting. Based on the model, the findings support the necessity of preventing stunting early in life. Emphasizing the nutritional status of vulnerable maternal and child populations in PNG is recommended to promote maternal and child health and overall well-being.

Risk Factors Associated with Stunting among Children Under Five in Timor-Leste.

Undernutrition, including stunting, is the cause of almost 45% of all deaths among children under the age of five. It not only affects child growth but also has a long-term negative influence on cognitive and physical abilities. Timor-Leste has the highest prevalence of child stunting in Southeast Asia. Therefore, this study aimed to identify the prevalence of stunting and factors associated with it. This was a cross-sectional study conducted using the Demographic and Health Survey of 2016 for Timor-Leste. The prevalence of stunting among children under five years of age was examined, and bivariable and multivariable logistic regression analysis was conducted to identify the factors associated with stunting. Among 4,581 children under five years of age, growth in nearly 40% was stunted. The majority of the mothers with stunted children were of age 20-30 years with about 33% having their first baby at ≤19 years of age. Compared to women of <145 cm of height, those of ≥145 cm height had lower likelihood of having a stunted child (OR: 0.62, 95% CI: [0.48-0.80], p < 0.001). It was also interesting to note that the risk of stunting was lower among female children than male children [OR: 0.75, 95% CI: (0.64-0.88), p < 0.001] in our adjusted model. Similarly, other factors such as wealth index, postnatal care visits, currently breastfeeding, age of the child, and size of the child at birth were also associated with stunting. The present findings indicate that child stunting in Timor-Leste is mainly associated with maternal and child sociodemographic status. Hence, it is crucial to identify the quality of services provided by health facilities, the involvement of health workers and volunteers, and the intention of mothers to use the health services in Timor-Leste.