Determinants of trends in stunting prevalence in Indonesia: An ecological study (2019–2022)

Stunting is a significant health concern that contributes to economic burden and increases the risk of future diseases. The government has been tackling stunting through sensitive and specific interventions. However, until now, the stunting prevalence in Indonesia remains relatively high (>20%), indicating a need for a deeper understanding of the determinants that influence the trend of stunting, so that they can provide more effective and sustainable policy recommendations and prevention programs. This research aims to investigate the determinants that influence the trends of stunting in Indonesia. This research employs an ecological study design, utilizing secondary data from the Health Research and Development Agency, the Ministry of Health of the Republic of Indonesia, the Ministry of Social Affairs, and Statistics Indonesia for 2019, 2021, and 2022. Multiple linear regression analysis was performed to identify the factors associated with the trend of stunting. The results indicate that diarrhea (r= -0.719, p<0.001), exclusive breastfeeding (r= -0.963, p<0.001), and postpartum family planning (r= -0.097, p=0.002) were negatively correlated with the trend of stunting. Conversely, female-headed households (r= 0.368, p= 0.011), food expenditure (r= 2.156, p<0.001), and supplementary feeding for pregnant women CED (r= 0.269, p=0.005) showed positive associations. This regression model indicates that these factors significantly influence 75.9% of the trend in stunting (Adjusted R²=0.759). Improving exclusive breastfeeding practices, preventing diarrhea, and promoting postpartum family planning are effective strategies to reduce stunting prevalence. In addition, special attention to female-headed households and nutrition intervention efforts for pregnant women has a positive impact on reducing stunting.