Urban-rural disparities and determinants of stunting among children under five in Indonesia
DOI: https://doi.org/10.33024/minh.v8i6.867
Children Under Five Rural and Urban Stunting
Abstract
Background: Stunting remains a significant public health issue in Indonesia, particularly among children under five. Various risk factors across rural and urban settings influence it. Understanding these factors is critical to designing effective interventions that support optimal child growth and development.
Purpose: To analyze the urban-rural gap and determinants of stunting in toddlers in Indonesia
Method: A cross-sectional study used secondary data from the 2021 Indonesian Nutritional Status Survey. A total of 11,715 children aged 0–59 months were included through total sampling. Independent variables examined included food insecurity, breastfeeding, maternal class participation, family planning, sanitation, drinking water access, dietary diversity, mother’s education, and place of residence. Chi-square tests were used for bivariate analysis, and statistical significance was determined at p < 0.05.
Results: Stunting prevalence was 28.6%. Bivariate analysis revealed that food insecurity, lack of breastfeeding, low maternal education, poor sanitation, absence of family planning, non-participation in mother’s classes, and rural residence were significantly associated with stunting (p < 0.05). Access to drinking water and dietary diversity were not significantly associated with stunting. Stunting was higher in rural areas (74.4%) than in urban areas (25.6%).
Conclusion: Socioeconomic, behavioral, and environmental factors influence stunting in children under five. Effective stunting prevention strategies should improve maternal education, access to health services, nutrition awareness, sanitation infrastructure, and rural health equity. A multisectoral, community-based approach is essential to reducing stunting and supporting healthy child development in Indonesia.
Downloads
References
Abate, B. B., Kassie, A. M., Kassaw, M. W., Zemariam, A. B., & Alamaw, A. W. (2020). Prevalence and determinants of stunting among adolescent girls in Ethiopia. Journal of pediatric nursing, 52, e1-e6.
Ademas, A., Adane, M., Keleb, A., Berihun, G., & Tesfaw, G. (2021). Water, sanitation, and hygiene as a priority intervention for stunting in under-five children in northwest Ethiopia: a community-based cross-sectional study. Italian journal of pediatrics, 47(1), 174.
Amaha, N. D., & Woldeamanuel, B. T. (2021). Maternal factors associated with moderate and severe stunting in Ethiopian children: analysis of some environmental factors based on 2016 demographic health survey. Nutrition Journal, 20(1), 18.
Amelia, W. S., Suryani, L., Harokan, A., & Ulfah, M. (2022). Analisis Perilaku Buang Air Besar Sembarangan (BABS) Di Kelurahan Batu Kuning Wilayah Kerja UPTD Puskesmas Tanjung Agung Kecamatan Baturaja Barat Kabupaten Oku Tahun 2022. Health Care: Jurnal Kesehatan, 11(2), 306-314.
Ashar, H., Laksono, A. D., Supadmi, S., Kusumawardani, H. D., Yunitawati, D., Purwoko, S., & Khairunnisa, M. (2024). Factors related to stunting in children under 2 years old in the Papua, Indonesia: Does the type of residence matter?. Saudi Medical Journal, 45(3), 273.
Berhanu, G., Mekonnen, S., & Sisay, M. (2018). Prevalence of stunting and associated factors among preschool children: a community based comparative cross sectional study in Ethiopia. BMC nutrition, 4(1), 28.
Berra, W. G. (2020). Household Food Insecurity Predicts Childhood Undernutrition: A Cross‐Sectional Study in West Oromia (Ethiopia). Journal of Environmental and Public Health, 2020(1), 5871980.
Campos, A. P., Vilar-Compte, M., & Hawkins, S. S. (2020). Association between breastfeeding and child stunting in Mexico. Annals of global health, 86(1), 145.
Das, M., Verma, M., Sahoo, S. S., & Gupta, M. (2022). Regional water availability and WASH indicators as predictors of malnutrition in under-5 children: analysis of the national family health survey, India (2015–16). Journal of Tropical Pediatrics, 68(3), fmac030.
Das, S., Fahim, S. M., Rasul, M. G., Afrin, S., Alam, M. A., Zaman, M. U., & Ahmed, T. (2023). Nutritional and dietary diversity status of under-5 children and adolescent girls among forcibly displaced Myanmar nationals living in Bhasan Char relocation camp, Bangladesh: a cross-sectional survey. BMJ open, 13(3), e068875.
Faizzah, H., Kurniawati, D., & Juliningrum, P. P. (2022). Gambaran Faktor yang Mempengaruhi Ibu Tidak Memberikan ASI Eksklusif di Wilayah Kerja Puskesmas Cakru, Kencong. Pustaka Kesehatan, 10(1), 32-38.
Flood, D., Petersen, A., Martinez, B., Chary, A., Austad, K., & Rohloff, P. (2019). Associations between contraception and stunting in Guatemala: secondary analysis of the 2014–2015 Demographic and Health Survey. BMJ paediatrics open, 3(1), e000510.
Gassara, G., Lin, Q., Deng, J., Zhang, Y., Wei, J., & Chen, J. (2023). Dietary diversity, household food insecurity and stunting among children aged 12 to 59 months in N’Djamena—Chad. Nutrients, 15(3), 573.
Girma, M., Hussein, A., Norris, T., Genye, T., Tessema, M., Bossuyt, A., & Samuel, A. (2024). Progress in water, sanitation and hygiene (WASH) coverage and potential contribution to the decline in diarrhea and stunting in Ethiopia. Maternal & Child Nutrition, 20, e13280.
Harvey, C. M., Newell, M. L., & Padmadas, S. (2022). Maternal socioeconomic status and infant feeding practices underlying pathways to child stunting in Cambodia: structural path analysis using cross-sectional population data. BMJ open, 12(11), e055853.
Hasan, M., Islam, M. M., Mubarak, E., Haque, M. A., Choudhury, N., & Ahmed, T. (2019). Mother's dietary diversity and association with stunting among children< 2 years old in a low socio‐economic envir
Hein, A. K., Hong, S. A., Puckpinyo, A., & Tejativaddhana, P. (2019). Dietary diversity, social support and stunting among children aged 6–59 months in an internally displaced persons camp in Kayin state, Myanmar. Clinical nutrition research, 8(4), 307-317.
Lufianti, A., Rahmawati, R., & Sari, E. M. (2020). Hubungan Riwayat Pemberian Asi Dan Pemberian Mp-Asi Dengan Kejadian Stunting Diwilayah Kerja Puskesmas Tawangharjo. The Shine Cahaya Dunia Ners, 5(2).
Lusita, A. P., Suyatno, S., & Rahfiludin, M. Z. (2017). Perbedaan karakteristik balita stunting di pedesaan dan perkotaan tahun 2017 (studi pada anak usia 24-59 bulan di wilayah kerja Puskesmas Gabus II dan wilayah kerja Puskesmas Pati II Kabupaten Pati). Jurnal Kesehatan Masyarakat, 5(4), 600-612.
Ministry of Health of the Republic of Indonesia. (2016). Inilah hasil pemantauan status gizi 2016. Retrieved from: https://kemkes.go.id/id/rilis-kesehatan/%EF%BB%BF%EF%BB%BFinilah-hasil-pemantauan-status-gizi-psg-2016
Ministry of Health of the Republic of Indonesia. (2021). Buku Saku Hasil Studi Status Gizi Indonesia (SSGI) Tahun 2021. Retrieved from: https://www.badankebijakan.kemkes.go.id/buku-saku-hasil-studi-status-gizi-indonesia-ssgi-tahun-2021/
Motbainor, A., Worku, A., & Kumie, A. (2015). Stunting is associated with food diversity while wasting with food insecurity among underfive children in East and West Gojjam Zones of Amhara Region, Ethiopia. PloS one, 10(8), e0133542.
Nasution, S. L. R., Limestan, E., Harianja, S. P., & Girsang, E. (2022). Faktor-Faktor Yang Memengaruhi Kejadian Stunting Pada Balita Usia 25-59 Bulan. Journal Of Telenursing (Joting), 4(2), 1047-1055.
Otzen, T., & Manterola, C. (2017). Sampling techniques on a population study. International journal of morphology, 35(1), 227-232.
Rahmah, A. A., Yani, D. I., Eriyani, T., & Rahayuwati, L. (2023). Hubungan pendidikan ibu dan keterpaparan informasi stunting dengan pengetahuan ibu tentang stunting. Journal of Nursing Care, 6(1), 1-10.
Reifsnider, E., Shin, C. N., Todd, M., Jeong, M., Gallagher, M., & Moramarco, M. (2016). How did they grow: an intervention to reduce stunted growth in low‐income Mexican‐American children. Research in Nursing & Health, 39(2), 105-120.
Saleh, A., Syahrul, S., Hadju, V., Andriani, I., & Restika, I. (2021). Role of maternal in preventing stunting: a systematic review. Gaceta sanitaria, 35, S576-S582.
Salsabila, S., Noviyanti, R. D., & Kusudaryati, D. P. D. (2022). Hubungan tingkat pendidikan ibu dan pola asuh orang tua dengan kejadian stunting pada balita usia 12-36 bulan di wilayah Puskesmas Sangkrah. Profesi (Profesional Islam): Media Publikasi Penelitian, 19(2), 143-152.
Secretariat of the Vice President. (2021). Ringkasan 100 Kabupaten/Kota Prioritas untuk Intervensi Anak Kerdil/Stunting. Retrieved from: stunting.go.id/ringkasan-100-kabupaten-kota-prioritas-untuk-intervensi-anak-kerdil-stunting/
Siswati, T., Hookstra, T., & Kusnanto, H. (2020). Stunting among children Indonesian urban areas: What is the risk factors. Jurnal Gizi dan Dietetik Indonesia (Indonesian Journal of Nutrition and Dietetics), 8(1), 1-8.
Sserwanja, Q., Kamara, K., Mutisya, L. M., Musaba, M. W., & Ziaei, S. (2021). Rural and urban correlates of stunting among under-five children in Sierra Leone: a 2019 nationwide cross-sectional survey. Nutrition and metabolic insights, 14, 11786388211047056.
Sugianto, M. A., Suyasa, I. K., Weta, I. W., Lestari, A. A. W., Bakta, I. M., Wirjatmadi, B., ... & Januraga, P. P. (2022). Determinant Factors Related to Decreasing Stunting Rates in Garbasari Village, Badung Regency, Bali Province. Universal Journal of Public Health, 10(6), 627-632.
Tebeje, D. B., Agitew, G., Mengistu, N. W., & Aychiluhm, S. B. (2022). Under-nutrition and its determinants among school-aged children in northwest Ethiopia. Heliyon, 8(11).
Teja, M. (2019). Stunting balita Indonesia dan penanggulangannya. Pusat Penelitian Badan Keahlian DPR RI, 11(22), 13-8.
Wantina, M., Rahayu, L. S., & Yuliana, I. (2017). Keragaman konsumsi pangan sebagai faktor risiko stunting pada balita usia 6-24 bulan. Journal Uhamka, 2(2), 89-96.
Wardani, D. W. S. R., Wulandari, M., & Suharmanto, S. (2020). Relationship of Social Economic and Food Security Factors on Stunting Incidence in Children under Five Years. J Kesehat, 11(2), 287.
Widyaningsih, V., Mulyaningsih, T., Nur Rahmawati, F., & Adhitya, D. (2022). Determinants of socioeconomic and rural-urban disparities in stunting: evidence from Indonesia. Rural and remote health, 22(1), 1-10.
Yaya, S., Oladimeji, O., Odusina, E. K., & Bishwajit, G. (2022). Household structure, maternal characteristics and children’s stunting in sub-Saharan Africa: evidence from 35 countries. International Health, 14(4), 381-389.
Yunitasari, E., Lee, B. O., Krisnana, I., Lugina, R., Solikhah, F. K., & Aditya, R. S. (2022). Determining the factors that influence stunting during pandemic in rural Indonesia: a mixed method. Children, 9(8), 1189.
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Evi Susanti Sinaga, Merita Yumna Nisrina

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.