Keywords
Stunting
Wasting
Underweight
Sanitation
Socioeconomic factors
Survey-weighted analysis
Indonesia
Abstract
Background. Child undernutrition remains a major public health concern in Indonesia. Evidence on the roles of household environmental and socioeconomic factors, based on nationally representative data analyzed using appropriate complex survey methods, remains limited. This study examined the associations between these factors and stunting, wasting, and underweight among Indonesian children under five years.
Methods. A cross-sectional analysis was conducted using data from the 2022 Indonesian Nutrition Status Survey (SSGI), which represents approximately 17.1 million children under 5. Survey-weighted descriptive statistics, Rao-Scott adjusted χ² tests, and multivariable logistic regression accounting for the complex sampling design were performed to estimate adjusted odds ratios (AORs) and 95% confidence intervals (CIs).
Results. Regional disparities and parental socioeconomic characteristics were consistently associated with all three forms of undernutrition. Compared with Eastern Indonesia, children living in Western Indonesia had lower odds of stunting (AOR=0.63, 95% CI: 0.57-0.69), wasting (AOR=0.56, 95% CI: 0.50-0.62), and underweight (AOR=0.58, 95% CI: 0.51-0.66). Low parental education and parental unemployment were independently associated with higher odds of all three outcomes (all p<0.01). Unimproved sanitation and inadequate solid waste management were associated with stunting, whereas unimproved sanitation was also associated with wasting.
Conclusion. Child undernutrition in Indonesia is independently associated with regional inequalities, parental socioeconomic disadvantage, and selected household environmental conditions. Multisectoral interventions that target disadvantaged regions, improve parental socioeconomic conditions, and strengthen sanitation infrastructure are needed to reduce child undernutrition.
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