Vol. 5, No. 12, December 2024

E-ISSN: 2723 - 6692

P-ISSN: 2723 - 6595

http://jiss.publikasiindonesia.id/

Journal of Indonesian Social Sciences, Vol. 5, No. 12, December 2024 3159

KEYWORDS

ABSTRACT

Stunting; LBW; Toddlers; East

Nusa Tenggara

Stunting is a chronic nutritional problem in children under five years

of age characterized by shorter height than their peers. Low birth

weight (LBW) is a public health indicator because it is closely related

to mortality, morbidity and the incidence of malnutrition in children,

one of which is stunting. Reducing the prevalence of stunting is one

of the goals in the Sustainable Development Goals (SDGs). The

prevalence of stunting in East Nusa Tenggara Province is 42.6% and

the highest in Indonesia. This researche aims to determine socio-

demographic factors, especially maternal characteristics and child

characteristics, on the incidence of stunting with a history of LBW in

toddlers aged 6-59 months in East Nusa Tenggara Province. The

sample of this study was toddlers with a history of LBW who came

from the 2018 riskesdas data. Data were analyzed using bivariate

analysis with chisquare test and multivariate with binary logistic

regression. Logistic regression results revealed that toddlers aged

12-36 months had a 0.27 times higher risk of stunting, while

mothers working as farmers had a 0.29 times higher risk compared

to other occupations. The research found significant associations

between the mother's education (p=0.048), mother's occupation

(p=0.023), and toddler's age (p=0.006) with stunting incidence.

Maternal age and child gender showed no significant effects. These

findings highlight the need for targeted nutritional interventions

focusing on identified socio-demographic risk factors.

Attribution-ShareAlike 4.0 International (CC BY-SA 4.0)

Introduction

Malnutrition stunts child development and has a long-term negative impact, even increasing

the risk of death. Investing in children's health and nutrition is like investing in the progress of a

nation because it prepares better human resources early on (Hunt, 2001). Malnutrition can be

identified by various indicators. These indicators are underweight measured by weight for age

(BB/U), wasting measured by weight for height (BB/TB) and stunting measured by height for age

The Influence of Maternal and Child Characteristics with a

History of Low Birth Weight (LBW) on Stunting Incidence in

Toddlers in East Nusa Tenggara Province

(Analysis of Riskesdas 2018 Data)

Inna Viva Sa’adah

Universitas Gadjah Mada, Yogyakarta, Indonesia

Email: [email protected]

Correspondence: [email protected]*

e-ISSN: 2723-6692 p-ISSN: 2723-6595

Journal of Indonesian Social Sciences, Vol. 5, No. 12, December 2024 3160

(TB/U). Of the three indicators above, underweight and wasting are the result of acute malnutrition,

while stunting is a manifestation of chronic malnutrition (Kementerian Kesehatan, 2010).

Stunting is a developmental disorder due to poor nutrition, repeated infections and

psychosocial stimulation that affects brain development. Children can be categorized as stunted if the

height z-score value is less than -2 median standard deviations based on WHO standards (World

Health Organization, 2010). Stunting in children under five years of age (toddlers) is generally less

recognized because in plain sight the difference in height with normal age children is less visible.

Stunting begins to appear when children enter puberty or adolescence, so it needs to be handled early

so that it is easier to overcome (Candra et al., 2011). In addition to stunted height growth and lagging

brain development, children with stunting conditions have a tendency to have low cognitive abilities

and are more susceptible to various diseases. This situation has been interpreted as a state of acute

malnutrition (Gibney, 2008).

Stunted children are at greater risk of lower health status and lower socioeconomic status.

Stunting causes long-term effects on the economy including low work capacity leading to lower per

capita income, lower economic productivity and more prone to poverty. Poor posture and poorly

developed cognitive abilities and physical stamina mean that people with a history of stunting receive

8-46% lower wages (Mc.Govern, et al., 2017).

Referring to child growth based on WHO standards, globally there are approximately 162

million infants under the age of five (under five) who are stunted (World Health Organization, 2014).

Asia and Africa have the highest prevalence of stunted children in the world (UNSC, 2004). According

to data on the prevalence of stunted children under five years old collected by the World Health

Organization (WHO) Indonesia is the third country with the highest prevalence in the South-East Asia

Region (SEAR).

Stunting is a serious multifactorial problem, so reducing the risk of stunting is one of the

Sustainable Development Goals (SDGs) 2015-2030 agenda. Since 2016, the SDGs are a follow-up

agenda to the Millennium Development Goals (MDGs) that have been implemented since 2000. SDGs

is a sustainable development program in accordance with the agreement and shared vision of UN

member states on world problems that are targeted to be achieved in 2030 with 17 goals and 169

targets. Stunting reduction is the second target contained in the SDGs along with other nutrition and

health problems. (Ministry of Health, 2018).

A public health problem is considered severe if the prevalence is 30-39% and serious if the

prevalence is more than 40%. With this reference, the national stunting prevalence rate is classified

in the severe category (WHO, 2010). Indonesia is ranked 108 out of 132 countries with regard to

stunting prevalence based on the 2018 Global Nutrition Report. As for the Southeast Asian region,

Indonesia's stunting prevalence is the second highest after Cambodia. Results from Riskesdas show

that the national stunting prevalence rate has decreased by 6.4% from 37.2% in 2013 to 30.8% in

2018. This figure is still far from the standard set by WHO that a country's stunting prevalence should

not exceed 20%. Reducing stunting rates has been established as a national priority program. The

government through the 2020-2024 National Medium-Term Development Plan (RPJMN) set a target

for the national stunting rate to reach 14% (Kemepppa, 2020).

The trend of stunting prevalence tends to decrease in most provinces in Indonesia. Except for

East Kalimantan Province, which experienced an increase of 1.6%. There were 20 provinces with

stunting prevalence above the national rate (37.2 percent) in 2013. East Nusa Tenggara had the

e-ISSN: 2723-6692 p-ISSN: 2723-6595

Journal of Indonesian Social Sciences, Vol. 5, No. 12, December 2024 3161

highest stunting rate at 51.7%, meaning that more than half of the children under five in the area were

stunted. Meanwhile, the lowest stunting prevalence based on Riskesdas 2013 was Riau Islands at

26.3%. (Riskesdas, 2018).

Research conducted by Budiastutik and Rahfiludin (2019) highlighted that the incidence of

stunting in developing countries is influenced by maternal education, as highlighted by Budiastutik

et al (2019). Research shows that the higher the education of parents, the better the protection of

children (Semba et al., 2008). Maternal literacy (Chopra, 2003), maternal formal education (Sakisaka

et al., 2006) and completion of primary education (Wamani et al., 2006) are associated with reduced

risk of stunting.

Stunting is also associated with poverty, lack of nutritious food, poor sanitation, and parental

mental state (Grantma, 2017). Teenage pregnancy increases the risk of stunting due to competition

for nutrients between mother and fetus (Stephenson & Schiff, 2019). Non-working mothers are at

higher risk of having stunted children (Agustiningrum, 2016; Laksono & Megatsari, 2020)..

Low birth weight (LBW) increases the risk of stunting up to 3 times, with the prevalence of

stunting in LBW infants reaching 75% (Anisa, 2012). Less than normal birth length also increases the

risk of stunting by up to 2.4 times (L. S. Rahayu & Sofyaningsih, 2011)..

The age of toddlers influences the incidence of stunting, with the highest prevalence at 6-23

months. (Riskesdas, 2018; Sekarini, 2022). Males are more at risk of stunting than females, with a

prevalence of 12.1% very short and 19.6% short in males (Febriani et al., 2018; Riskesdas, 2018).

The prevalence of stunting in East Nusa Tenggara is the highest in Indonesia based on the 2018

Basic Health Research data. Stunting results in a decline in the quality of Indonesian human resources,

both in productivity and the nation's competitiveness. (Ministry of Village, 2017). This will hamper

economic growth, increase poverty and widen inequality. International experience has shown that

stunting can reduce labor market productivity (Tnp2k, 2017).

Chronic nutritional problems, especially in the high-risk group of under-fives, are caused by

various factors. One of them is the increasingly complex socio-demographic factors. According to data

from the Central Bureau of Statistics, the education level in East Nusa Tenggara Province is low. Most

of the population has an elementary to junior high school education (BPS, 2021). This includes the

last education completed by a mother. Referring to the WHO in the first international conference on

Health promotion held in Ottawa 1986, it was stated that in general, educational status is one of the

important aspects in the concept of healthy prerequisites. Including the incidence of stunting, the

aspect of maternal education plays an important role in its prevention.

The causes of stunting in East Nusa Tenggara are complex and multifactorial. Stunting is not

only influenced by factors directly related to health but is also influenced by socio-demographic issues

in this case related to maternal characteristics and child characteristics.

Based on the problem description above, this study formulates two main questions. First, what

are the characteristics of mothers and children with a history of low birth weight (LBW) in East Nusa

Tenggara Province? Second, how do these characteristics affect the incidence of stunting among

children under five in the region? This question was raised to understand the factors that influence

stunting, especially those related to LBW, which is one of the indicators of child health risk.

The purpose of this study was to determine the characteristics of mothers and children with a

history of low birth weight (LBW) in East Nusa Tenggara Province. In addition, this study also aims

to analyze the influence of these characteristics on the incidence of stunting in children under five

e-ISSN: 2723-6692 p-ISSN: 2723-6595

Journal of Indonesian Social Sciences, Vol. 5, No. 12, December 2024 3162

years of age in the region. By understanding these two aspects, it is hoped that the study can provide

a comprehensive picture of the risk factors for stunting associated with LBW conditions, so that it can

be a reference in public health prevention and intervention efforts.

Research Methods

Data Source

This research uses secondary data from the 2018 Basic Health Research (Riskesdas) conducted

by the Research and Development Agency of the Indonesian Ministry of Health with a sampling frame

from the Central Bureau of Statistics. The independent variable was the incidence of stunting, while

the independent variables included maternal and child characteristics such as mother's education,

mother's occupation, mother's age, toddler's age, gender, and history of low birth weight.

Riskesdas 2018 collects public health data such as nutritional status, maternal and child health,

communicable and non-communicable diseases, and socioeconomic characteristics. This data is used

to calculate the Community Health Development Index (CHI) which reflects the achievement of

national health development.

Unit of Analysis

The unit of analysis of this study was children aged 6-59 months in East Nusa Tenggara

Province with the inclusion criteria of having a history of LBW (birth weight < 2500 grams) and

biological mothers aged 18-45 years. From the initial 3,862 data, screening was carried out according

to the inclusion criteria so that the final number of respondents was 139 children.

Analysis Method

This research uses descriptive and inferential analysis. Descriptive analysis describes the

research variables without drawing broad conclusions, while inferential analysis tests the

relationship between variables based on hypotheses.

1. Univariate analysis provides an overview of variables such as the incidence of stunting,

characteristics of mothers (education, occupation, age) and children (age, sex) in the form of

percentage distribution and data tables.

2. Bivariate Analysis

The chi-square test was used to test the association between the independent variable and the

dependent variable (incidence of stunting). The hypotheses tested were:

- H0: There is no relationship between the independent variables and stunting.

- H1: There is a relationship between the independent variables and stunting.

H0 is accepted if Sig. ≥ 0.05 and rejected if Sig. < 0.05.

3. Multivariate Analysis, Logistic regression models are used to analyze binary dependent variables

(stunting: stunted/normal) with categorical or continuous independent variables. This model

helps identify factors that influence the incidence of stunting.

e-ISSN: 2723-6692 p-ISSN: 2723-6595

Journal of Indonesian Social Sciences, Vol. 5, No. 12, December 2024 3163

Results and Discussion

Relationship between Maternal and Child Characteristics with a History of Low Birth Weight

(LBW) and the Incidence of Stunting in East Nusa Tenggara Province

1. The Relationship between Education of Mothers with LBW Children and the Incidence of

Stunting in East Nusa Tenggara Province

The statistical test used was Chi-square, with a 0.05 percent confidence level. If the p-value is

smaller than 0.05, it means that there is a significant relationship from the independent variable to

the dependent. If the p-value is greater than 0.05, it means that there is no significant relationship

between the independent variable and the dependent variable. Table 4.3 shows that the mother's

education variable in children with a history of low birth weight in East Nusa Tenggara who did not

graduate from high school had a stunting toddler of 60.7% with a frequency of 51 and a normal

toddler of 39.3% with a frequency of 33.

Mothers who graduated from high school had 43.6% stunted toddlers with a frequency of 24

and normal toddlers of 55.4%. The significance value of maternal education is 0.048 which means

that there is a significant relationship between maternal education and the incidence of stunting in

toddlers aged 6-49 months with a history of low birth weight in East Nusa Tenggara Province. The

results of this study are in accordance with research conducted by Nadiyah et al. (2014), both

mother's education and father's education are significantly associated with stunting in children

(p<0.05). Rahayu, et al. (2014) explained that mothers with low education levels had a 5.1 times

greater risk of having stunted children. Research conducted by Fitri (2013) showed that the incidence

of stunting in toddlers on the island of Sumatra was more prevalent in low maternal education than

in high maternal education.

Figure 2. Maternal Education on the Incidence of Stunting in Toddlers Aged 6-59 Months with

a History of LBW (<2500grams) in East Nusa Tenggara Province

Source: Riskesdas 2018 (processed)

Toddlers with low education mothers have a risk of being stunted by 1.4 times compared to

toddlers who have high maternal education.Education is needed to get information such as health-

related matters so as to improve the quality of life. The higher a person's level of education, the better

60,70%

39,30%

Low Education (Did not finish high school)

Stunting Normal

e-ISSN: 2723-6692 p-ISSN: 2723-6595

Journal of Indonesian Social Sciences, Vol. 5, No. 12, December 2024 3164

the knowledge that will be obtained. In addition, education greatly influences both a person's

behavior and knowledge of lifestyle such as in preparing nutritious food for his family (Notoadmodjo,

2014). Research conducted by Hizni et al. (2010) in Cirebon showed that mothers who have low

education are at risk of having stunted children 2.22 times greater. The level of education, especially

the mother's education level, affects health status.

2. The Relationship between the Occupation of Mothers with LBW Children and the

Incidence of Stunting in East Nusa Tenggara Province

Maternal occupation shows that children with a history of low birth weight aged 6-49 months

in East Nusa Tenggara whose mothers are housewives have stunted toddlers 48.1% with a frequency

of 25 and normal toddlers 51.9% with a frequency of 27. This can be interpreted that housewives

have a lower potential to have stunted toddlers. Mothers who work as farmers have stunted toddlers

by 69.4% with a frequency of 34 and normal toddlers by 30.6% with a frequency of 15. Mother's work

as a farmer has a higher chance of stunting in toddlers.

Research by Astuti et al (2021) found that there is a relationship between maternal work and

the incidence of stunting and mothers who work have a risk of 2.6 times stunting compared to

mothers who do not work. This is in line with the research of Afzwar et al (2021) showed that there

is a relationship between work and the incidence of stunting. The factor of working mothers is not

the main cause of nutritional problems in children but this work is more referred to as an influencing

factor in feeding. This is because not all working mothers can divide their time between work and

time to care for children and tend to mothers who work outside the home have little time for their

children so that parenting is given to other people such as grandmothers, other relatives who do not

necessarily have good enough knowledge about parenting and nutritional status.

Table 1. Relationship between Maternal and Child Characteristics with a History of Low Birth Weight

(LBW) and the Incidence of Stunting in East Nusa Tenggara Province (<2500grams) in East Nusa

Tenggara Province

Variables

Stunting

Normal

Pearson χ2

Sig.

Mother's education

3,902

0,048

Not graduated from

high school

60,7%

39,3%

High school graduate

43,6%

56,4%

Mother's Occupation

7,569

0,023

Housewife

48,1%

51,9%

Farmers

69,4%

30,6%

42,1%

57,9%

Mother's age

0,139

0,710

At risk (<20 and >35

years old)

50%

Not at Risk (20-35

years old)

55,2%

44,8%

Age of child

10,249

0,006

Infants (<12 months)

40%

60%

e-ISSN: 2723-6692 p-ISSN: 2723-6595

Journal of Indonesian Social Sciences, Vol. 5, No. 12, December 2024 3165

Toddler (12-36

months)

68,2%

31,8%

Pre-school (37-59

months)

41,5%

58,5%

Gender

0,224

0,636

Male

56,1%

43,9%

Female

52,1%

47,9%

Source: Riskesdas 2018 (processed)

Working mothers have fewer stunted children than non-working mothers, this is because

working mothers will help the economic status so that family needs are met and can also be influenced

by mothers who can carry out dual roles such as mothers can divide time between working and caring

for children so that both roles can run well. Work is an important factor in determining the quality

and quantity of food, because work is related to income, if income increases, health and family

problems related to nutritional status will improve, but a child aged 0-5 years is still very dependent

on his mother. Toddlers still need help from their parents to do their personal tasks so that work can

be referred to as an influencing factor in the provision of food, nutrients, care and child care.

Figure 2. Maternal Occupation on the Incidence of Stunting in Toddlers Aged 6-59

Source: Riskesdas 2018 (processed)

Months with a History of LBW (<2500grams) in East Nusa Tenggara Province

Other maternal occupations (non-agricultural) the incidence of stunting in toddlers is 42.1%

with a frequency of 16 and normal toddlers 57.9% with a frequency of 22. The significance value in

maternal occupation is 0.023 which means that there is a significant relationship between maternal

occupation and the incidence of stunting in toddlers aged 6-49 months with a history of low birth

weight in East Nusa Tenggara Province.

3. The Relationship between the Age of Mothers with LBW Children and the Incidence of

Stunting in East Nusa Tenggara Province

Based on table 1 shows that the variable age of the mother in children with a history of low

birth weight in East Nusa Tenggara has a risk age of less than 20 years and above 35 years of stunting

toddlers by 50% with a frequency of 17 and normal toddlers by 50% with a frequency of 17. This

means that mothers who are at risk age have the same chance of having stunted or normal toddlers.

The age of mothers who are not at risk, namely between the ages of 20-35 years, has stunted

toddlers with a percentage of 55.2% with a frequency of 58 and normal bslits 44.8% with a frequency

of 47. The significance value in maternal work is 0.710, which means that there is no significant

69,40%

30,60%

Farmers

Stunting Normal

e-ISSN: 2723-6692 p-ISSN: 2723-6595

Journal of Indonesian Social Sciences, Vol. 5, No. 12, December 2024 3166

relationship between maternal age and the incidence of stunting in toddlers aged 6-49 months with

a history of low birth weight in East Nusa Tenggara Province. This is in line with research conducted

in Bandar Lampung where no significant relationship was found between maternal age and the

incidence of stunting. (Sumardilah & Rahmadi, 2019). Likewise, it can also occur because the

nutritional status of the mother is good so that it requires additional calories in small amounts

because there will be natural adjustments such as increasing the body's metabolic efficiency and

reducing physical activity during pregnancy. (Dattilo, 2017; Saavedra, 2017). In addition, young

mothers do not necessarily have poor parenting because in this age of technology, young people are

more adept at finding information than older people.

4. Relationship between Age of Children with LBW History and Incidence of Stunting in East

Nusa Tenggara Province

The age variable of children with a history of low birth weight in East Nusa Tenggara who are

categorized as infants or less than 12 months has a chance of stunting by 40% with a frequency of 8

and normal by 6% with a frequency of 12. In the toddler age category, the risk of stunting in toddlers

reached 68.2% with a frequency of 45 and normal was 31.8% with a frequency of 21. At pre-school

age, namely between the ages of 37-59 months, the risk of stunting in toddlers was 41.5% with a

frequency of 22 and normal toddlers was 58.5% with a frequency of 31. The significance value at the

age of the child is 0.006, which means that there is a significant relationship between the age of the

child and the incidence of stunting in toddlers aged 6-49 months with a history of low birth weight in

East Nusa Tenggara Province.

Supriyanto, Y., et al. (2018), where the number of 6-11 month olds who were stunted was less

than 12-24 month olds. This may occur because the Basal Metabolic Rate (BMR) is higher in older

children than younger children (Kleinman & Coletta, 2016).

Figure 3. Age of the Child on the Incidence of Stunting in Toddlers Aged 6-59 Months with a History of

LBW (<2500grams) in East Nusa Tenggara Province

Source: Riskesdas 2018 (processed)

68,20%

31,80%

Toddler (12-36 months)

Stunting Normal

e-ISSN: 2723-6692 p-ISSN: 2723-6595

Journal of Indonesian Social Sciences, Vol. 5, No. 12, December 2024 3167

5. Relationship between Sex of Children with LBW History and Incidence of Stunting in East

Nusa Tenggara Province

The gender variable in children with a history of low birth weight in East Nusa Tenggara in

toddlers with male gender the risk of stunting is 56.1% with a frequency of 37 and normal toddlers

are 43.9% with a frequency of 29. In female toddlers the risk of stunting is 52.1% with a frequency of

28 and normal is 47.9% with a frequency of 35. The significance value at the age of the child is 0.224

which means that there is no significant relationship between the gender of toddlers and the

incidence of stunting in toddlers aged 6-49 months with a history of low birth weight in East Nusa

Tenggara Province.

This is in line with research conducted by Wurisastuti and Suryaningtyas (2017), the

significance of the chisquare test is 0.056, indicating that there is no difference in the level of stunting

against gender differences. Similarly, Devi's research showed that there was no significant

relationship between gender and the nutritional status of toddlers (Devi M, 2010).

Influence of Maternal and Child Characteristics with a History of Low Birth Weight on the

Incidence of Stunting in East Nusa Tenggara Province

A binary logistic regression model was used to analyze the effect of independent variables on

the probability of a toddler being stunted, with normal toddlers as the comparison group. The

independent variables used were those that were significant in the chi-square test (p-value <0.05),

such as mother's education, mother's occupation, and child's age.

The analysis was conducted using SPSS 25 to facilitate data processing and determine the

variables that most significantly affect stunting. The G statistical test was used to test the effect of

variables jointly, while the Wald test measured the significance of each variable partially. The results

of the analysis yielded the best model that fit the research data.

ln [π(x)

1−π(x)] Z = 1.271 + 0.215 Umur_Balita(1) - 1.1316 Umur_Balita(2)

- 0.0458 Education_Mother(1) - 0.407 Occupation_Mother(1)

- 1,256 Job_Mother(2)

Where:

Z : The probability of a toddler experiencing a stunting event

Age_Infant(1) : Infant (<12 months)

Age_Infant(2) : Toddler (12-36 months)

Education_Mother(1) : Not graduated from high school

Job_Mother(1) : Housewife

Job_Mother(2) : Farmer

The G test results show that the independent variables together or simultaneously significantly

affect the tendency of stunting. Next is the partial test using the Wald test. To interpret each

statistically significant variable in the equation is through the coefficient value (B) and the Exp(B)

value of each variable. The Exp(B) value or also known as the odd ratio is used to show the difference

in the risk of stunting according to each category in the independent variable, so that it can explain

the tendency of toddlers to experience stunting. After the G test is carried out, the wald test is then

carried out.

e-ISSN: 2723-6692 p-ISSN: 2723-6595

Journal of Indonesian Social Sciences, Vol. 5, No. 12, December 2024 3168

1. The Effect of Education of Mothers with a History of LBW on the Incidence of Stunting in

East Nusa Tenggara Province

In the partial test of the last education completed by the mother, namely in the category of not

graduating from high school, the result of the wald test significance value is 0.272 where the value is

higher than the significance level of 0.05 so that education does not graduate from high school

partially or separately does not have a significant effect on the incidence of stunting with a history of

low birth weight in toddlers aged 6-59 months in East Nusa Tenggara Province. The education of

mothers who have toddlers with a history of low birth weight does not affect the incidence of stunting

among toddlers in NTT. High maternal education does not guarantee that a mother has sufficient

knowledge to properly care for and fulfill the nutrition of toddlers. Likewise, low maternal education

will not always have stunted toddlers.

The era of advanced technological development with information that is increasingly accessible

through smartphones, makes it easier for mothers to increase understanding and knowledge about

good parenting and nutrition for toddlers. So that mothers with low education can also have good

knowledge and good parenting as long as the mother wants to continue to learn and seek information.

Table 2. Logistic Regression Multivariate Analysis Results

S.E

Wald

Sig.

Exp(B)

Age of toddler

12,576

0,002

Infants (<12

months)

0,215

0,566

0,144

0,704

1,240

Toddler (12-36)

-1,316

0,413

10,136

0,001

0,268

Not graduated from

high school

-0,458

0,417

1,204

0,272

0,633

Mother's occupation

5,913

0,052

Housewife

-0,407

0,473

0,739

0,390

0,666

Farmers

-1,256

0,535

5,509

0,019

0,285

Count

1,272

0,468

7,397

0,007

3,568

Source: Riskesdas 2018 (processed)

2. The Effect of Maternal Occupation with a History of LBW on the Incidence of Stunting in

East Nusa Tenggara Province

Based on table 2 partial test results mother's work obtained the results of the wald test

significance value of 0.052 where the value is higher than the significance level of 0.05 so that the

mother's work partially or separately does not have a significant effect on the incidence of stunting

with a history of low birth weight in toddlers aged 6-59 months in East Nusa Tenggara Province. The

results of the partial test of maternal employment category housewives obtained the results of the

wald test significance value of 0.390 where the value is higher than the significance level of 0.05 so

that maternal employment category housewives partially or individually does not have a significant

effect on the incidence of stunting with a history of low birth weight in toddlers aged 6-59 months in

East Nusa Tenggara Province.

Table 2 shows the results of the partial test of the work of mothers of toddlers as farmers, the

result of the wald test significance value is 0.019 where the value is lower than the significance level

of 0.05 so that the work of mothers of toddlers as farmers partially or individually has a significant

effect on the incidence of stunting. The Exp(B) or odd value is 0.285. This means that the work of

e-ISSN: 2723-6692 p-ISSN: 2723-6595

Journal of Indonesian Social Sciences, Vol. 5, No. 12, December 2024 3169

mothers of toddlers as farmers will tend to have stunted toddlers by 0.285 compared to other jobs

with a history of low birth weight in toddlers aged 6-59 months in East Nusa Tenggara Province. This

is in accordance with research by Ningrum (2019) which examines stunting toddlers in rural

agricultural areas in Klaten. The mother's work as a farmer, especially farm laborers with an average

of 8 hours spent working per day so that the care of toddlers is left to the closest family who lives in

the same village. But even though they work for a long duration, the ability to fulfill nutrition in

toddlers is not sufficient because the income from the agricultural sector is relatively low even with

a long duration of work. So that mothers are busy working as farm laborers, toddlers do not get proper

care coupled with nutrition related to the economy.

3. The Effect of Age of Children with LBW History on the Incidence of Stunting in East Nusa

Tenggara Province

In the results of the partial test of the age of toddlers in the infant category (<12 months)

showed a wald test significance value of 0.704 where the value is higher than the 0.05 significance

level so that the age of infants (<12 months) partially or individually does not have a significant effect

on the incidence of stunting with a history of low birth weight in toddlers aged 6-59 months in East

Nusa Tenggara Province. The results of the partial test of toddler age obtained the results of the wald

test significance value of 0.002 where the value is lower than the significance level of 0.05 so that the

age of toddlers partially or individually has a significant effect on the incidence of stunting with a

history of low birth weight in toddlers aged 6-59 months in East Nusa Tenggara Province.

The results of the partial test of the age of toddlers in the toddler age category (12-36 months)

obtained the results of the wald test significance value of 0.001 where the value is lower than the

significance level of 0.05 so that the age of toddlers in the toddler age category (12-36 months)

partially or individually has a significant effect on the incidence of stunting. The Exp(B) or odd value

is 0.268 . These results indicate that toddler age children (12-36 months) will tend to experience

stunting by 0.268 compared to infant and pre-school age groups with a history of low birth weight in

East Nusa Tenggara Province. Schoenbuchner (2016) also showed similar results that the peak

incidence of wasting occurred at the age of 10-12 months as much as 12-18%, while 37-39% at the

age of 24 months experienced stunting. This means that the incidence of stunting is more prevalent

at toddler age (12-36 months). As age increases, the incidence of stunting decreases.

Research conducted by Narendra et al. (2002), this condition is due to the fact that children

under three years of age (toddlers) are more susceptible to infections and recurrent infections,

making them more likely to experience malnutrition. Although pre-school children are less stunted,

at this age they experience more stable growth and development than children under three years old.

Increased physical and motor abilities cause these children to experience a decrease in appetite,

making them prone to malnutrition, although not as much as children under the age of three. The

results of Wahdah et al. (2016) research risk factors for stunting at the age of 6 36 months in the

Inland Region of Silat Hulu District, Kapuas Hulu, West Kalimantan. The results showed the highest

prevalence of stunting at the age of 25-36 months (57.9%) and a little at the age of 6-36 months

(46.7%). The same study showed that the great chance of stunting in Bangladesh at the age of 36-47

months and in rural areas (38.1%) compared to the age of 6-12 months. (Akram et al., 2018).

The incidence of stunting in toddlers is likely due to the age of 24-59 months. Children have

become active consumers, they can already choose the food they like such as random snacks without

e-ISSN: 2723-6692 p-ISSN: 2723-6595

Journal of Indonesian Social Sciences, Vol. 5, No. 12, December 2024 3170

paying attention to the type of food chosen and the cleanliness of the food. Toddlers aged > 24 months

also do not understand about personal hygiene and in an environment that does not apply healthy

living behavior. Lack of hygiene can cause toddlers to become easily ill, if a toddler is sick, there can

be a decrease in appetite and that can result in a lack of nutrients entering the body, thus causing

toddler growth to be disrupted resulting in stunting. The process of becoming short or stunting in

children in a poor area starts from the age of about 6 months and appears mainly in the first 2 to 3

years of life. Stunting that occurs within the first 36 months of life is usually accompanied by long-

term effects (Wahdah et al., 2016).

The findings of this study underscore the significance of socio-demographic factors in

predicting stunting incidence among toddlers with a history of LBW. Specifically, maternal education,

occupation, and child age were identified as key risk factors. Public health interventions must focus

on improving maternal education, providing economic alternatives to farming mothers, and ensuring

adequate child nutrition during early childhood.

Limitations of the research

This research has several limitations. First, the use of secondary data from Riskesdas 2018 may

limit the depth of variable measurement and accuracy due to potential reporting biases. Second, the

cross-sectional design restricts the ability to establish causality between socio-demographic factors

and stunting. Finally, certain socio-economic and environmental variables, such as household income

and access to healthcare services, were not included in the analysis, which could have provided a

more comprehensive understanding of stunting determinants.

Conclusion

The results of the analysis have shown that socio-demographics in the form of maternal and

child characteristics affect the incidence of stunting in toddlers aged 6-59 months with a history of

low birth weight (LBW) in East Nusa Tenggara Province. These results are in accordance with the

results of previous studies that have been conducted. The summary of the results of research on

factors that influence the incidence of stunting in children under 5 years of age 6-59 months with a

history of low birth weight (LBW) in East Nusa Tenggara Province is as follows: Based on univariate

analysis, the percentage of stunting reached 54 percent or more than half of toddlers suffered from

stunting. There are differences in the magnitude of the incidence of stunting. The percentage of

stunting is greater in mothers of toddlers who do not finish high school or have low education,

mothers of toddlers who work as farmers, the age of mothers of toddlers is not at risk (20-35 years),

the age of toddlers (12-36 months) and in toddlers who are female. Maternal education, maternal

occupation and age of toddlers have a significant relationship with the incidence of stunting in East

Nusa Tenggara Province. The results of the binary logistic regression analysis are toddler age (12-36

months) has a tendency to be stunted 0.27 percent compared to other ages. In addition, mothers of

toddlers who work as farmers have a tendency to be stunted 0.28 percent compared to other

occupations.

e-ISSN: 2723-6692 p-ISSN: 2723-6595

Journal of Indonesian Social Sciences, Vol. 5, No. 12, December 2024 3171

References

Agustiningrum, T. (2016). Hubungan Karakteristik Ibu Dengan Kejadian Stunting Pada Balita Usia 24-

59 Bulan di Wilayah Kerja Puskesmas Wonosari I [Universitas ’Aisyiyah Yogyakarta].

http://digilib.unisayogya.ac.id/id/eprint/2146

Akram, R., Sultana, M., Ali, N., Sheikh, N., & Sarker, A. R. (2018). Prevalence and Determinants of

Stunting Among Preschool Children and Its Urban–Rural Disparities in Bangladesh. Food and

Nutrition Bulletin, 39(4), 521–535. https://doi.org/10.1177/0379572118794770

Ardian, D., & Utami, E. D. (2021). Pengaruh Karakteristik Demografi terhadap Kejadian Stunting pada

Balita di Provinsi Sulawesi Barat. Seminar Nasional Official Statistics, 2020(1), 397–406.

https://doi.org/10.34123/semnasoffstat.v2020i1.365

BPS. (2021). Tingkat Penyelesaian Pendidikan Menurut Jenjang Pendidikan dan Provinsi, 2018-2020.

Badan Pusat Statistika. https://www.bps.go.id/id/statistics-table/2/MTk4MCMy/tingkat-

penyelesaian-pendidikan-menurut-jenjang-pendidikan-dan-provinsi.html

Budiastutik, I., & Rahfiludin, M. Z. (2019). Faktor Risiko Stunting pada anak di Negara Berkembang.

Amerta Nutrition, 3(3), 122–126.

Candra, A., Puruhita, N., & Susanto, J. C. (2011). Risk factors of stunting among 1-2 years old children

in Semarang City. Media Medika Indonesiana, 45(3), 206–212.

Chopra, M. (2003). Risk factors for undernutrition of young children in a rural area of South Africa.

Public Health Nutrition, 6(7), 645–652. https://doi.org/10.1079/PHN2003477

Dattilo, A. M. (2017). Programming Long-Term Health: Effect of Parent Feeding Approaches on Long-

Term Diet and Eating Patterns. In Early Nutrition and Long-Term Health (pp. 471–497). Elsevier.

https://doi.org/10.1016/B978-0-08-100168-4.00018-5

Febriani, C. A., Perdana, A. A., & Humairoh, H. (2018). Faktor Kejadian Stunting Balita Berusia 6-23

bulan di Provinsi Lampung . Jurnal Dunia Kesmas, 7(3), 127–134.

Fitri, F. (2013). Berat Lahir Sebagai Faktor Dominan Terjadinya Stunting pada Balita (12-59 Bulan) di

Sumatera (Analisis Data Riskesdas 2010). Photon: Jurnal Sain Dan Kesehatan, 4(1), 77–88.

Gibney, M. (2008). Gizi Kesehatan Masyarakat.

Hizni, A., Julia, M., & Gamayanti, I. L. (2010). Status stunted dan hubungannya dengan perkembangan

anak balita di wilayah pesisir Pantai Utara Kecamatan Lemahwungkuk Kota Cirebon. Jurnal Gizi

Klinik Indonesia, 6(3), 131. https://doi.org/10.22146/ijcn.17721

Hunt, J. M. (2001). Investasing in Children : Child Protection And Economic Growth. Social Protection

in Asia And Pasific, Asian Develompment Bank. .

Kemenkes. (2018). Pemerintah Fokus Cegah Stunting Di 100 Kabupaten/Kota. Kementerian

Kesehatan Republik Indonesia. https://www.kemkes.go.id/id/%20pemerintah-fokus-cegah-

stunting-di-100-kabupatenkota

Kementerian Desa. (2017). Buku Saku Desa dalam Penanganan Stunting. Kementrian Desa

Pembangunan Daerah Tertinggal, Transmigrasi.

Kementerian Kesehatan. (2010). Laporan Hasil Riset Kesehatan Daasar (Riskesdas) Indonesia Tahun

2010. Departemen Kesehatan Republik Indonesia.

Kleinman, R. E., & Coletta, F. A. (2016). Historical Overview of Transitional Feeding Recommendations

and Vegetable Feeding Practices for Infants and Young Children. Nutrition Today, 51(1), 7–13.

https://doi.org/10.1097/NT.0000000000000137

Laksono, A. D., & Megatsari, H. (2020). Determinan Balita Stunting di Jawa Timur: Analisis Data

Pemantauan Status Gizi 2017. Amerta Nutrition, 4(2), 109.

https://doi.org/10.20473/amnt.v4i2.2020.109-115

Nadiyah, N., Briawan, D., & Martianto, D. (2014). Faktor risiko stunting pada anak usia 0—23 bulan di

Provinsi Bali, Jawa Barat, dan Nusa Tenggara Timur. Jurnal Gizi Dan Pangan, 9(2).

Narendra, M. B., Sularyo, T. S., Soetjiningsih, S. S., Ranuh, I., & Wiradisuria, S. (2002). Tumbuh kembang

anak dan remaja. Jakarta: Sagung Seto, 100–104.

e-ISSN: 2723-6692 p-ISSN: 2723-6595

Journal of Indonesian Social Sciences, Vol. 5, No. 12, December 2024 3172

Ningrum, V. (2019). Akses Pangan dan Kejadian Balita Stunting: Kasus Pedesaan Pertanian Di Klaten

Food Access And Stunting Incidence: A Case Study Of Rural Agriculture In Klaten. Pusat

Penelitian Kependudukan, Lembaga Ilmu Pengetahuan Indonesia.

Rahaya, A., & Khairiyati, L. (2014). Risiko Pendidikan Ibu terhadap Kejadian Stunting pada Anak 6-23

Bulan . Penelitian Gizi Dan Makanan (The Journal of Nutrition and Food Research), 37(2), 129–

136.

Rahayu, L. S., & Sofyaningsih, M. (2011). Pengaruh BBLR (berat badan lahir rendah) dan pemberian

ASI eksklusif terhadap perubahan status stunting pada balita di Kota dan Kabupaten Tangerang

Provinsi Banten. Prosiding Seminar Nasional “Peran Kesehatan Masyarakat Dalam Pencapaian

MDG’s Di IndonesiaProsiding Seminar Nasional “Peran Kesehatan Masyarakat Dalam

Pencapaian MDG’s Di Indonesia. Vol. 12.

Riskesdas. (2018). Laporan Hasil Riset Kesehatan Daasar (Riskesdas) Indonesia Tahun 2018.

Departemen Kesehatan Republik Indonesia.

Saavedra, J. M. (2017). Early Nutrition and its Effect on the Development of Obesity. In Early Nutrition

and Long-Term Health (pp. 277–299). Elsevier. https://doi.org/10.1016/B978-0-08-100168-

4.00011-2

Sakisaka, K., Wakai, S., Kuroiwa, C., Flores, L. C., Kai, I., Mercedes Arago´n, M., & Hanada, K. (2006).

Nutritional status and associated factors in children aged 0–23 months in Granada, Nicaragua.

Public Health, 120(5), 400–411. https://doi.org/10.1016/j.puhe.2005.10.018

Sekarini, S. (2022). Kejadian Stunting Pada Balita Ditinjau Dari Karakteristik Umur Dan Jenis Kelamin.

Jurnal Ilmu Kesehatan MAKIA, 12(1), 8–12. https://doi.org/10.37413/jmakia.v12i1.186

Semba, R. D., de Pee, S., Sun, K., Sari, M., Akhter, N., & Bloem, M. W. (2008). Effect of parental formal

education on risk of child stunting in Indonesia and Bangladesh: a cross-sectional study. The

Lancet, 371(9609), 322–328.

Stephenson, T. J., & Schiff, W. J. (2019). Human Nutrition Science For Healthy Living ((2and Edition)).

Mcgraw-Hill.

Sumardilah, D. S., & Rahmadi, A. (2019). Risiko Stunting Anak Baduta (7-24 bulan). Jurnal Kesehatan,

10(1), 93–104.

Tnp2k. (2017). 100 Kabupaten/Kota Prioritas Untuk Intervensi Anak Kerdil (Stunting). Sekretariat

Wakil Presiden Republik Indonesia.

Wahdah, S., Juffrie, M., & Huriyati, E. (2016). Faktor risiko kejadian stunting pada anak umur 6-36

bulan di Wilayah Pedalaman Kecamatan Silat Hulu, Kapuas Hulu, Kalimantan Barat. Jurnal Gizi

Dan Dietetik Indonesia (Indonesian Journal of Nutrition and Dietetics), 3(2), 119.

https://doi.org/10.21927/ijnd.2015.3(2).119-130

Wamani, H., Åstrøm, H. N., Peterson, S., Tumwine, J. K., & Tylleskär, T. (2006). Predictors of poor

anthropometric status among children under 2 years of age in rural Uganda. Public Health

Nutrition , 9(3), 320–326.

WHO. (2010, July 7). Global Database on Child Growth and Malnutrition. Who.Int.

WHO. (2018). World Health Statistics data visualizations dashboard: Child stunting.

World Health Organization. (2014). Wha Global Nutrition Target 2025: Stunting Policy Brief, S.L.

Worlf Health Organization.

Wurisastuti, T., & Suryaningtyas, N. H. (2017). Perbedaan Karakteristik Demografi dan Riwayat

Infeksi Malaria Menurut Status Gizi Balita di Provinsi Nusa Tenggara Timur. Buletin Penelitian

Sistem Kesehatan, 20(1), 10–15.