Risk Of Stunting Research Articles

Analysis of Contributing Factors to Stunting in Poso Regency: A Perspective from the Special Stunting Handling Index

Introduction: The prevalence of stunting in children in Indonesia, including Poso Regency, remains relatively high despite a decrease in recent years. This study aims to analyze factors associated with stunting in Poso Regency. Methods: This study employed a cross-sectional analytical method with a sample size of 250 mothers and their children under 2 years old, using structured questionnaires and direct measurements to collect data. Univariate analysis, chi-square tests and binary logistic regression were performed with a final report of adjusted odds ratios (AORs) and 95% confidence intervals (CI). All of the analyses used Stata version 15. Results: Results indicate a significant association between stunting and the child's gender, maternal education, immunization, and breastfeeding. Boys face a 2.3 times higher risk of stunting, while children of mothers with primary education have a 4.7 times higher risk compared to those with higher education. Non-immunized and non-breastfed children also exhibit significantly higher stunting risks. Conclusion: The study underscores the impact of factors such as the child's sex, maternal education, immunization, and breastfeeding on stunting in Poso Regency. The study emphasizes the need for targeted educational programs by healthcare professionals, policy-driven nutritional support initiatives, and community-based awareness campaigns to effectively address stunting in Poso Regency.

Coparenting Approach to Being Successful Exclusively Breastfeeding

Breast milk is the first nutrient for infants because it contains essential nutrients for growth and development, so exclusive breastfeeding can prevent the risk of stunting and wasting in children. The lack of breastfeeding in infants is a threat to the long-term growth and development of children. Effective coparenting strongly impacts breastfeeding success rates because of its positive energy. Developing effective coparenting during the transition to becoming a parent is very helpful in the process of carrying out the role of parent, resolving conflict and supporting one's partner in raising children. The study aimed to analyze the success of Coparenting Approach to Being Successful Exclusively Breastfeeding. This research method is an observational study with an analytic cross-sectional design using a quantitative approach; the population in this study was 393 people in the Glagahagung Community Health Center Working Area sampling with a purposive sampling technique, based on inclusion and exclusion criteria where a number of respondents were exclusively breastfeeding with a total of 78 respondents. The results showed family support p value = 0.000, technological advances p value = 0.000, and lifestyle p value = 0.000. Based on the results show that the regression coefficient for family support is .716, this shows that increasing the family support variable will increase the coparenting approach variable in the success of providing EBF by .716, the trends and lifestyle regression coefficient is -.452, so this shows that trend and lifestyle variables reduce the influence on the coparenting approach in the success of providing EBF.

Malnutrition in infants aged 6-23 months in China’s poorest rural counties from 2016 to 2021: cross sectional study

ObjectivesTo assess trends and differences in child malnutrition by population subgroups among infants aged 6-23 months in China’s poorest rural counties.DesignSix consecutive cross sectional surveys were conducted annually.SettingThe study was...

Prevalence and determinants of stunting and anaemia in children aged 6-23 months: A multilevel analysis from rural Ethiopia.

Low- and middle-income countries shoulder the greatest burden of stunting and anaemia in children. This calls for prompt and effective intervention measures, while the contributing factors are not fully understood. This study evaluates determinants spanning from individual-, household- and community levels including agroecology and antinutrients as unique sets of predictors. Primary data were collected from 660 rural households representing the midland (ML), highland, and upper highland (UHL) agroecological zones from northern Ethiopia. The study relates several predictors to stunting and anaemia in children aged 6-23 months. We found 49.1% and 49.7% of children were stunted and anaemic, respectively. Children living in the ML are approximately twice more likely to be stunted adjusted odds ratio (AOR: 1.869; 95% CI: 1.147-3.043) than in the UHL. The risk of stunting increases by 16.3% and 41.9% for every unit increase in phytate-to-zinc and phytate-to-iron molar ratios, respectively. A 10% increase in mean aggregated crop yield was observed to reduce the likelihood of stunting occurrence by 13.6%. Households lacking non-farm income-generating opportunities, travel longer time to access the marketplace and poor health service utilisation were associated with increased risk of stunting. Low diversity of child's diet, age of the child (18-23 months) and mothers at a younger age are significantly associated with stunting. Risk of anaemia in children is high amongst households with unimproved water, sanitation, and hygiene practices, younger age (6-11 months) and mostly occurs amongst boys. Children in the ML had a 55% reduced risk of being anaemic (AOR: 0.446; 95% CI: 0.273-0.728) as compared to the UHL. Therefore, the influence of these factors should be considered to tailor strategies for reducing undernutrition in children of 6-23 months in rural Ethiopia. Interventions should go beyond the administrative boundaries into targeting agroecological variation.

Childhood stunting in Indonesia: assessing the performance of Bayesian spatial conditional autoregressive models.

Stunting continues to be a significant health issue, particularly in developing nations, with Indonesia ranking third in prevalence in Southeast Asia. This research examined the risk of stunting and influencing factors in Indonesia by implementing various Bayesian spatial conditional autoregressive (CAR) models that include covariates. A total of 750 models were run, including five different Bayesian spatial CAR models (Besag-York-Mollie (BYM), CAR Leroux and three forms of localised CAR), with 30 covariate combinations and five different hyperprior combinations for each model. The Poisson distribution was employed to model the counts of stunting cases. After a comprehensive evaluation of all model selection criteria utilized, the Bayesian localised CAR model with three covariates were preferred, either allowing up to 2 clusters with a variance hyperprior of inverse-gamma (1, 0.1) or allowing 3 clusters with a variance hyperprior of inverse-gamma (1, 0.01). Poverty and recent low birth weight (LBW) births are significantly associated with an increased risk of stunting, whereas child diet diversity is inversely related to the risk of stunting. Model results indicated that Sulawesi Barat Province has the highest risk of stunting, with DKI Jakarta Province the lowest. These areas with high stunting require interventions to reduce poverty, LBW births and increase child diet diversity.

The Analysis of Risk Factors in Toddlers on The Occurrence of Stunting In Pidie

Nutritional issues in toddlers continue to be a primary concern in population settings. Among these issues are stunting, wasting, and overweight (World Health Organization, 2020). Stunting remains a major nutritional problem in developing countries such as Indonesia. Stunting, or chronic malnutrition, is a nutritional issue resulting from prolonged inadequate nutrient intake from food (Andriani et al., 2017). Short stature in toddlers (stunting) is determined by body length or height that is less than -2 SD according to WHO global references for children compared to other children of the same age (World Health Organization, 2013). The global prevalence of stunted toddlers, according to WHO, is 21.9%. According to the Indonesian Nutrition Status Survey (SSGI) by the Ministry of Health, the prevalence of stunted toddlers in this province was 31.2% last year. The highest incidence of stunting in Aceh is in Kota Subulussalam, which had the highest prevalence of stunted toddlers in Aceh in 2022, reaching 47.9%. This number jumped 6.1 points from 41.8% in 2021. Pidie Regency, with 27.8%, ranks fifth highest in Aceh. This study used a cross-sectional design with a sample of 334 toddlers chosen using the Slovin formula. Sampling was conducted randomly among mothers of underweight toddlers in local health center in Pidie Regency, which has a toddler population of 1,979. Statistical software SPSS 23 with Chi-square was used for data analysis. The findings from this study, derived from bivariate statistical analysis using the Chi-square test at a 95% confidence level, yielded a p-value of 0.268 (p > 0.05). This indicates that the Antenatal Care variable does not affect the risk of stunting. For the immunization variable, the test results showed a p-value of 0.515 (p > 0.05), indicating no relationship between immunization and the risk of stunting. For the exclusive breastfeeding variable, a p-value of 0.038 (p < 0.05) was obtained, indicating that exclusive breastfeeding affects the risk of stunting. The maternal nutrition during pregnancy variable resulted in a p-value of 0.037 (p < 0.05), indicating that maternal nutrition affects the risk of stunting. As for the parenting pattern variable, the test resulted in a p-value of 0.007 (p < 0.05), indicating that parenting patterns greatly influence the risk of stunting.

Integrative Empowerment Of Health Cadres In Efforts To Monitor Stunting Risk Through The Use Of Smartphone-Based Electronic Child Card Applications In Ngiliran Village, Panekan District, Magetan Regency

ABSTRACT The Community Engagement activity, conducted from May to August 2024, aimed to empower various stakeholders, such as early childhood integrated health service cadres, prospective brides and grooms, pregnant women, and mothers of young children, in their endeavors to monitor early stunting effectively. It addressed the pressing issue of stunting prevalence in Ngiliran Village, which had reached an alarming 18.6%, surpassing the national target set for 2024, which is 14%. Partners, including integrated health service cadres, prospective brides and grooms, pregnant women, and mothers, faced challenges like limited knowledge in measuring children's nutritional status, inconsistent monitoring, and inadequate stunting prevention education. To address these issues, the activity utilized the Electronic Child Card (KARANEL) smartphone application. KARANEL accurately measured children's height and weight, stored data electronically, presented nutritional status visually, and offered guidance. It empowered partners to identify, prevent, and manage stunting effectively. The results demonstrated that KARANEL enhanced the knowledge, skills, and motivation of integrated health service cadres and partners. Conclusion: the smartphone-based KARANEL application proved highly beneficial for early stunting monitoring in Ngiliran Village, providing a practical solution to combat stunting

The Effect of Rainfall and Temperature Patterns on Childhood Linear Growth in the Tropics: Systematic Review and Meta-Analysis.

Despite existing research on child undernutrition in the tropics, a comprehensive understanding of how weather patterns impact childhood growth remains limited. This study summarizes and estimates the effect of rainfall and temperature patterns on childhood linear growth among under-fives in the tropics. A total of 41 out of 829 studies were considered based on preset inclusion criteria. Standardized regression coefficients (β) were used to estimate effect sizes, which were subsequently pooled, and forest plots were generated to visually represent the effect size estimates along with their 95% confidence intervals. Of the total reports, 28 and 13 research articles were included in the narrative synthesis and meta-analysis, respectively. The studies establish that patterns in rainfall and temperature either increase or decrease childhood linear growth and the risk of stunting. An increase in every one standard deviation of rainfall results in a 0.049 standard deviation increase in linear growth (β = 0.049, 95% CI: 0.024 to 0.073). This positive association is likely mediated by various factors. In countries where agriculture is heavily dependent on rainfall, increased precipitation can lead to higher crop yields which could in turn result in improved food security. The improved food security positively impacts childhood nutrition and growth. However, the extent to which these benefits are realized can vary depending on moderating factors such as location and socio-economic status. Temperature pattern showed a negative correlation with linear growth, where each standard deviation increase resulted in a decrease in linear growth by 0.039 standard deviations, with specific impacts varying by regional climates (β = -0.039, 95% CI: -0.065 to -0.013). Additionally, our meta-analysis shows a small but positive relationship of childhood stunting with temperature pattern in western Africa (β = 0.064, 95% CI: 0.035, 0.093). This association is likely due to temperature patterns' indirect effects on food security and increased disease burden. Thus, the intricate interaction between weather patterns and childhood linear growth requires further research to distinguish the relationship considering other factors in the global tropics. While our findings provide valuable insights, they are primarily based on observational studies from sub-Saharan Africa and may not be generalizable to other tropical regions.

Landscape Fire Air Pollution as a Mediator in Drought and Childhood Stunting Pathway in Low- and Middle-Income Countries.

Drought induces dry hazards, including wildfire, and increased air pollution from wildfire may be a mechanism by which drought increases health risks. We examined whether the drought-wildfire pathway increases the risk of childhood stunting. We analyzed all geocoded children under five across 44 low- and middle-income countries (LMICs). We first conducted mixed-effect regressions to examine the three pairwise associations between standardized precipitation evapotranspiration index (SPEI), fire-sourced PM2.5, and childhood stunting. We then employed a causal mediation analysis to determine whether compounding drought-wildfire (cascading or co-occurring) events significantly impact the drought-stunting pathway. We found that each 1-unit decrease in SPEI exposure was associated with a 2.16% [95% confidence interval (CI): 0.79, 3.49%] increase in stunting risk and 0.57 (95% CI 0.55, 0.59%) μg/m3 increase in fire-sourced PM2.5. Additionally, each 1 μg/m3 increase in 24 month average fire-sourced PM2.5 was associated with an increased risk of 2.46% (95% CI: 2.16, 2.76%) in stunting. Drought-mediated fires accounted for 26.7% (95% CI: 14.5, 36.6%) of the linkage between SPEI and stunting. Our study revealed fire-sourced PM2.5 is a mediator in the drought-stunting pathway in LMICs. To protect child health under increasing drought conditions, personal interventions against wildfire should be considered to enhance climate resilience.

Anthropometry relationship with duodenal histologic features of children with environmental enteric dysfunction: a multicenter cross-sectional study

BackgroundEnvironmental enteric dysfunction (EED) is a precursor of growth faltering in children living in impoverished conditions who are frequently exposed to environmental toxins and enteropathogens, leading to small bowel inflammatory, malabsorptive, and permeability derangements and low-grade chronic systemic inflammation. ObjectivesWe explored the association between anthropometrics and duodenal histologic features of EED among children from 3 lower middle-income country centers. MethodsIn this cross-sectional study, Pakistani children (n = 63) with wasting, Bangladesh children (n = 116) with stunting or at risk for stunting (height-for-age Z score [HAZ] <−1 but ≥−2), and Zambian children (n = 108) with wasting or stunting received nutritional intervention. Children with anthropometric status refractory to intervention underwent endoscopy. Linear regression models included anthropometric around endoscopy, scores of histology parameters, and a global index score of EED—the total score percent-5 (TSP-5). Multivariable models were adjusted for center, age, sex, and histology slide quality. ResultsIntersite variation was observed while exploring the association between anthropometrics and the TSP-5; for example, Pakistani children had the worst HAZ, yet their median TSP-5 score was lower than that of the other 2 centers. Even within each site, no overall pattern of higher TSP-5 score was observed with worsening HAZ. During univariate analysis, TSP-5 (coefficient: 0.01; 95% confidence interval [CI]: 0, 0.02), goblet cell depletion (coefficient: 0.22; 95% CI: 0.06, 0.37), and Paneth cell depletion (coefficient: 0.14; 95% CI: 0.01, 0.27) were associated with HAZ scores; however, they lost statistical significance in the multivariable models, with study center most strongly confounding the relationships seen in univariate models between anthropometry and histology. ConclusionsThis study contributes a crucial negative finding that duodenal morphological features did not associate with anthropometric phenotypes; hence, anthropometric measurements may not be a suitable outcome measure for use in EED trials. Trial outcomes may need to be defined by combining the functional and structural elements of the gut to monitor EED.

Hubungan ASI eksklusif dengan kejadian stunting pada balita 6-24 bulan pada tiga kecamatan kasus tertinggi stunting di Kabupaten Jeneponto, Sulawesi Selatan

Background: Stunting is a major issue with toddlers' eating habits, which are frequently linked to malnutrition during these crucial early years of development. The World Health Organization (WHO) defines stunting as a developmental failure characterized by a body length deficit about age, specifically a z-score of less than -2. A persistent problem with public health in some communities is the high rate of stunting. A few elements add to hindering, with selective breastfeeding being a basic determinant. Hindering, or weakened direct development, is a typical wholesome issue among babies that influences long-haul well-being, mental turn of events, and future efficiency. This study looks to evaluate whether selective breastfeeding is a gamble factor for hindering kids between the ages of 6 and two years in the Jeneponto region. Methods: An observational research design with a case-control approach was used. Children aged 6 to 24 months who were recorded in the posyandu (community health post) toddler register across three sub-districts—West Bangkala, Bontoramba, and Rumbia—were chosen for their high stunting rates. Findings: The review uncovered that 39.67% of kids were solely breastfed, while 60.33% were not. Bivariate examination demonstrated a remarkable connection between restrictive breastfeeding and hindering in this age bunch (p = 0.03; OR = 1.74), recommending that non-only breastfed youngsters had a 1.74 times higher gamble of hindering contrasted with the people who were solely breastfed. In any case, multivariate examination, which represented factors, for example, kid age, birth weight, mother's level, and breastfeeding status, uncovered that the connection between restrictive breastfeeding and hindering was as of now not huge (p = 0.49; OR = 1.23). This suggests that when these extra factors are thought of, the gamble of hindering non-solely breastfed youngsters was just 1.23 times higher than in only breastfed kids, a distinction not measurably huge. Conclusion: Although the initial data indicate that not exclusively breastfeeding increases the risk of stunting by 74%, this risk is reduced when other factors like maternal height, child age, birth weight, and overall breastfeeding status are taken into consideration. This demonstrates the complexity of stunting and the need for comprehensive interventions that address breastfeeding practices as well as broader factors affecting the health of mothers and children.

EFEKTIVITAS VIDEO KESEHATAN TERHADAP PENGETAHUAN DAN SIKAP IBU TENTANG STUNTING DI WILAYAH KERJA PUSKESMAS BANGEKO KANAN

Stunting is a major threat to human quality, as well as a threat to the nation's competitive ability (Ministry of Health, 2018). Because stunting will result in children's intelligence levels not being optimal, making children more vulnerable to disease and in the future could be at risk of decreasing productivity levels. Efforts to prevent stunting should start from the beginning of pregnancy to reduce the risk of stunting in children. The aim of this research is to determine the effectiveness of health videos on mothers' knowledge and attitudes about stunting in the Bangko Kanan Community Health Center Work Area. This research method uses a quasi experimental design. The population used in this research was pregnant women with a sample size of 82 people. The researchers' results were based on the Wilcoxon test with asymp values. The knowledge sig is 0.00 and the attitude is 0.01 (&lt;0.05), meaning that the health video has an impact on increasing mothers' knowledge and attitudes about stunting in the Bangko Kanan Community Health Center working area. It is hoped that the research can become a reference for health workers in providing health promotion to increase knowledge and attitudes of pregnant women about stunting

Parenting Self-Efficacy, Father Involvement, dan Stunting

This study aims to analyze the influence of parenting self-efficacy on father involvement in stunting prevention. The research is motivated by the high prevalence of stunting in Indonesia, despite recent declines. Further research is needed to explore the factors that contribute to reducing stunting, particularly the role of families in providing instrumental and emotional support. While co-parenting, where both fathers and mothers share responsibilities in raising and educating children, is ideal, the reality shows that father involvement in early childhood care remains very limited. This study employs a quantitative correlational method with a sample of 220 fathers in Semarang City, selected using convenience sampling. The study uses two measurement tools: the Self-Efficacy for Parenting Task Index (SEPTI) by Coleman &amp; Karraker, adapted into Indonesian with 36 items. The results of a simple linear regression analysis indicate that parenting self-efficacy has a positive impact on father involvement in stunting prevention. Parenting self-efficacy plays a crucial role in stunting prevention and improving child health. The study also demonstrates that parenting self-efficacy increases father involvement in caregiving, although social and cultural differences may influence this relationship. A lack of father involvement not only increases the risk of stunting but also places a greater burden on mothers, which can negatively impact child well-being.

Functional integration of services during the antenatal period can potentially improve childhood growth parameters beyond infancy: findings from a post-interventional follow-up study in West Bengal, India

BackgroundDespite progress, the prevalence of childhood undernutrition in India remains amongst the highest globally.ObjectiveWe aimed to evaluate the impact of a functional integration interventional package during the antenatal period on childhood growth parameters.MethodsThis is a post-interventional follow-up study of a maternal nutrition interventional study conducted between 2018 and 2019 among women in their first trimester of pregnancy from three districts in West Bengal, India. Pregnant women received a package of augmented interventions from study staff which supplemented those provided to them under the state-run programmes, that included body-mass-index measurement at pregnancy registration, monthly weight monitoring, targeted dietary counselling, supervised supplementary nutrition intake and iron-folic acid supplementation during daily anganwadi center visits. In the current follow-up study conducted in 2021, age-matched pregnant women from the same areas who were pregnant during the same period as in the original study and had received standard-of-care under the state-run programmes were recruited into a comparison group. Study staff collected data regarding maternal height and serial weights that were recorded at antenatal visits in 2018-19, and birth and infant characteristics. Child height and weight were measured during the follow-up visit in 2021, which were used to calculate the relative risks of stunting, wasting and underweight using generalized linear models, to understand the sustained impact of the intervention beyond infancy. Eight-hundred-nine mother-child dyads (406 intervention; 403 comparison) were followed.ResultsMedian age of women in the intervention and comparison group was 23 (IQR 20–25) and 25 (IQR 24–27) years respectively. Median gestational-weight-gain was higher amongst intervention group women (9 vs. 8 kg, p = 0.04). Low-birth-weight prevalence was 29.3% (119/406) and 32.0% (129/403) in the intervention and comparison group. At 12–35 months of age, children born to women in the intervention group had significantly reduced risk of stunting (RR = 0.65, 95% CI 0.44–0.94), wasting (RR = 0.57, 95% CI 0.33–0.97) and underweight (RR = 0.61, 95% CI 0.42–0.88).ConclusionsThese results indicate that functional integration and strengthening of routine antenatal care services including targeted nutritional counselling to expectant mothers can have distal beneficial effects on childhood undernutrition beyond the immediate post-natal period.

Hubungan Pemberian Asi Eksklusif Dengan Kejadian Stunting Pada Balita Di Desa Payaman Kecamatan Mejobo Kabupaten Kudus

Stunting is a child's growth disorder due to chronic malnutrition and recurrent infections, which characterized by a z-score value of less than -2.00 SD. Data on stunting toddlers in Payaman Village as of April 2023 are 18 cases. Stunting can be prevented through exclusive breastfeeding, where breast milk has higher levels of calcium and can be absorbed by the body well so that toddlers can avoid the risk of stunting. The aim of this research was to determine the relationship between exclusive breastfeeding and the incidence of stunting among toddlers in Payaman Village, Mejobo District, Kudus Regency. This type of research is quantitative research with a correlation design with cross sectional approach. Sampling technique used is purposive sampling with a total sample of 102 toddlers aged 13 – 59 months. The data collection method was carried out by interviews and observation. Data analysis used the Fisher Exact Test and Odds Ratio tests. Results of this study shows a significant relationship between exclusive breastfeeding and the incidence of stunting in toddlers with ρ value of 0,049 and OR = 3,267. One of the indirect factors that can influence stunting is the provision of exclusive breastfeeding. It is important to provide exclusive breastfeeding to babies up to the age of six months to maintain health and prevent stunting.

Stunting Prevention is Alan Effort to Reduce the Risk of Stunting

Stunting Prevention is Alan Effort to Reduce the Risk of Stunting

Communication to Accelerate Reduction of Stunting Among Health Personnel In The Hulu Sungai Tengah

According to WHO, stunting is short or very short based on height for age less than 2 standard deviations on the growth curve due to irreversible conditions resulting from inadequate nutritional intake within 1000 HPK. The government has accommodated stunting through the Stunting Reduction Acceleration Program with the National Action Plan using the Stunting Risk Family Approach. The aim of the research is to analyze the barriers to health communication carried out by Nutrition Workers, Midwives and Health Promotion in the Community and Health Representative as well as the Health Communication Strategy in Hulu Sungai Tengah Regency data using case studies, interviews, observations and documentation. The results show that the Health Communication has been implemented according to the program but the acceptance of information from the community is correlated with economic, educational and cultural levels turns out to have a big influence on the community's mindset in understanding the stunting.

Pendampingan Pencegahan Risiko Anak Stunting pada Masyarakat, Kader Kesehatan, dan Guru PAUD/TK

The risk of stunting in Batetangnga Village is elevated because a significant number of pregnant mothers and toddlers are malnourished and lack adequate maternal knowledge. Furthermore, cadres and PAUD/TK teachers have not received any training to identify children who are at risk of stunting. The aimed of this community services are to improve participants' knowledge, awareness, motivation, and skills in stunting risk detection, prevention, and management. The results will be accurately measured, evaluated, and interpreted by skilled officers. The support method entails the following: [1] educating pregnant mothers and young mothers, health officers, and PAUD/TK teachers about (a) pregnant women who may be causing the child to stunt; (b) the risk of stunting for young children; and [2] providing health cadres and teachers of PAUD/TTK with training on identifying stunting risks in young children. The results indicated that there was a rise in knowledge from 78.9% to 81.8%, a rise in awareness from 66.7% to 73.8%, and a rise in motivation from 54.5% to 57.6% in the context of the detection, prevention, and treatment of children with stunting risks. Skilled officers promptly identify the potential for stunting. Accompanying activities are advantageous in enhancing the community's, health cadres', and PAUD/TK teachers' ability to prevent stunting in children.

Sosialisasi Intervensi Anak yang Lahir dan Tumbuh dengan Stunting : Pemberian MP-Asi pada Anak Usia 6-24 Bulan

Interventions for children born and raised with stunting can be recaptured before 2 years of age. Giving complementary food at the right time with good and correct processing of complementary food will help maximize child growth and development so as to reduce the risk of stunting. Community service is carried out on baby mothers at Posyandu Melati, participants in community service totaled 10 people with community service methods namely lectures, questions and answers, discussions, and demonstrations. All community service participants know when to give complementary food to children and how to process complementary food correctly. This community service is important to reduce the incidence of stunting by one of the most important ways is to provide nutritious nutrition for children by giving complementary food optimally.

Association among Household Wealth, Maternal Employment, and Undernutrition in Children under Three Years of Age in Pakistan.

There is an abundance of studies explaining the separate impact of female employment and household wealth status in reducing malnutrition. However, our study has unraveled the combined impact of maternal employment and household wealth on undernutrition among children under three in Pakistan. Using a sample of 1093 children under three years of age from the Pakistan Demographic and Health Survey 2017-2018, a binary logistic model was employed to gauge factors influencing the children's undernutrition. Our results indicated that children up to a certain age (three years old) with residence in certain regions (Pakistan) and recent episodes of diarrhea had an increased risk of undernutrition. Conversely, secondary and higher maternal education, access to improved water sources, and sanitation facilities lowered the chances of undernutrition in children under three in Pakistan. The interaction between maternal employment and household wealth showed that maternal employment significantly lowered the risk of stunting, being underweight, and wasting among the average, rich, and richest households; however, it did not contribute to child nutrition among the poorer and poor households. Notably, regardless of whether the mother was employed, the wealth status of being rich and richest reduced the risk of stunting, being underweight, and wasting. In overcoming undernutrition, maternal employment significantly contributed to middle-income households. However, in the richer and richest households, the wealth status played a more crucial role compared to the maternal employment. This indicates that while employment plays a supportive role in household resources, the wealth status is overall more influential in reducing undernutrition.