Economic and Consumption Variables and Their Associations with Stunting Prevalence: A Provincial Analysis of the Indonesian Child Nutritional Status Survey 2019

Aldiza Intan Randani, Yayuk Farida Baliwati, Dadang Sukandar, Ikeu Tanziha

Abstract

The study aims to analyze the relationship between economic and food consumption variables with stunting prevalence among Indonesian children. The unit of analysis for this cross-sectional study was secondary data set from 2019 for 34 provinces obtained from Statistics Indonesia, the Food Security Agency, and the Ministry of Health of the Republic of Indonesia. In the majority of provinces (88.24%) the stunting prevalence was still categorized as serious public health problem with the prevalence of 30% or higher. The economic outlook in 2019 showed an economic growth, decrease in Gini ratio and the unemployment rate in 34 provinces. However, the poverty rate was very diverse between provinces and concentrated in eastern Indonesia. There were 17 provinces that had higher food than non-food expenditures. There were 31 provinces with normal energy adequacy level and 28 with normal protein adequacy level. However, there was no provinces reached maximum score in Desirable Dietary Pattern (DDP) as the indicator for food diversity, signaling that none of the provinces achieved adequate diversity in food consumption in 2019. The multivariate linear regression with backward elimination technique showed that seven of independent variables were qualified for the final model with R2 of 0.7406. The three variables significantly correlated with stunting prevalence (p<0.05) were food expenditure, protein adequacy level, and DDP score. Hence, these variables can be categorized as causal factors for stunting at provincial level analysis which can feed the food and nutrition policy and its monitoring and evaluation strategy. However, further analysis is needed to determine the direct and indirect relationship between economic factors, food expenditure, and food consumption with the prevalence of stunting among children in Indonesia so that stunting prevention and alleviation programs can be more precise and optimal.

References

[BKP] Badan Ketahanan Pangan. 2015. Panduan Penghitungan Pola Pangan Harapan (PPH). Jakarta (ID): BKP Kementerian Pertanian.
[BPS] Badan Pusat Statistik. 2019. Penghitungan dan Analisis Kemiskinan Makro Indonesia Tahun 2019. Jakarta (ID): BPS Indonesia.
Beal T, Tumilowicz A, Sutrisna A, Izwardy D, Neufeld LM. 2018. A review of child stunting determinants in Indonesia. Maternal & Child Nutr 14(4):e12617. https://doi.org/10.1111/mcn.12617
Black RE, Victora CG, Walker SP, Bhutta ZA, Christian P, de Onis M, Ezzati M, Grantham-McGregor S, Katz J, Martorell R et al. 2013. Maternal and child undernutrition and overweight in lowincome and middle-income countries. Lancet 382(9890):427−451. https://doi.org/10.1016/S0140-6736(13)60937-X
Bloem MW, de Pee S, Le Hop T, Khan NC, Laillou A, Minarto, Moench-Pfanner R, Soekarjo D, Soekirman, Solon JA et al. 2013. Key strategies to further reduce stunting in Southeast Asia: Lessons from the ASEAN countries workshop. Food Nutr Bull 34(2_suppl1):8−16. https://doi.org/10.1177/15648265130342S103
Breisinger C, Ecker O. 2014. Simulating economic growth effects on food and nutrition security in Yemen: A new macromicro modeling approach. Econ Model 43:100−113. https://doi.org/10.1016/j.econmod.2014.07.029
De Onis M, Branca F. 2016. Childhood stunting: A global perspective. Matern Child Nutr 12(1):12−26. https://doi.org/10.1111/mcn.12231
De Onis M, Borghi E, Arimond M, Webb P, Croft T, Saha K, De-Ragil LM, Thuita F, Heidkamp R, Krasevec J et al. 2019. Prevalence thresholds for wasting, overweight, and stunting in children under 5 years old. Public Health Nutr 22(1):175−179. https://doi.org/10.1017/S1368980018002434
DiSantis KI, Grier SA, Odoms-Young A, Baskin ML, Carter-Edwards L, Young DR, Lassiter V, Kumanyika SK. 2013. What "price" means when buying food: Insight from a multisite qualitative study with black americans. Am J Public Health 103(3):516−522. https://doi.org/10.2105/AJPH.2012.301149
Ernawati F, Syauqy A, Arifin AY, Soekatri MYE, Sandjaja S. 2021. Micronutrient deficiencies and stunting were associated with socioeconomic status in Indonesia chidren aged 6−59 months. Nutrients 13(6):1802. https://doi.org/10.3390/nu13061802
Faradina R, Iskandarini I, Lubis SN. 2018. Analisis faktor-faktor yang yang mempengaruhi pengeluaran konsumsi pangan rumah tangga (Studi kasus: Desa Karang Gading, Kecamatan Secanggang, Kabupaten Langkat). Talenta Conference Series 1(1):284−295. https://doi.org/10.32734/lwsa.v1i1.178
Fenta HM, Workie DL, Zike DT, Taye BW, Swain PK. 2020. Determinants of stunting among under-five years children in Ethiopia from the 2016 Ethiopia demographic and health survey: Application of ordinal logistic regression model using complex sampling designs. Clin Epidemiol Glob Health 8(2):404−413. https://doi.org/10.1016/j.cegh.2019.09.011
Ghosh S. 2018. India: Nutrition intake and economic growth, a causality analysis. Dev Stud Res 5(1):69−82. https://doi.org/10.1080/21665095.2018.1468791
Headey D, Hirvonen K, Hoddinott J. 2018. Animal sourced foods and child stunting. Amer J Agr Econ 100(5):1302−1319. https://doi.org/10.1093/ajae/aay053
Kementerian PPN/Bappenas. 2018. Analisis Wilayah Dengan Kemiskinan Tinggi. Jakarta (ID): Kedeputian Bidang Ekonomi, Kementerian PPN/Bappenas.
[MoH RI] Ministry of Health of Republic of Indonesia. 2018. Riset Kesehatan Dasar Tahun 2018. Jakarta (ID): MoH RI.
[MoH RI] Ministry of Health of Republic of Indonesia. 2019. Peraturan Menteri Kesehatan Republik Indonesia Nomor 28 Tahun 2019 Tentang Angka Kecukupan Gizi yang Dianjurkan untuk Masyarakat Indonesia. Jakarta (ID): MoH RI.
Mahmudiono T, Sumarmi S, Rosenkranz RR. 2017. Household dietary diversity and child stunting in East Java, Indonesia. Asia Pac J Clin Nutr 26(2):317−325.
Mazumdar S. 2010. Determinant of inequality in child malnutrition in India: The povertyundernutrition linkage. Asian Popul Stud 6(3):307−333. https://doi.org/10.1080/17441730.2010.512763
Rabbani A. Khan A, Yusuf S, Adams A. 2016. Trends and determinants of inequities in childhood stunting in Bangladesh from 1996/7 to 2014. Int J Equity Health 15(1):1−14. https://doi.org/10.1186/s12939-016-0477-7
Rashad AS, Sharaf MF. 2018. Economic growth and child malnutrition in Egypt: New evidence from national demographic and health survey. Soc Indic Res 135(2):769−795. https://doi.org/10.1007/s11205-016-1515-y
Reinhardt K, Fanzo J. 2014. Addressing chronic malnutrition through multi-sectoral, sustainable approaches: A review of the causes and consequences. Front Nutr 1(13):1−11. https://doi.org/10.3389/fnut.2014.00013
Renyeot BS, Martianto D, Sukandar D. 2016. Potensi kerugian ekonomi karena stunting pada balita di Indonesia tahun 2013. J Gizi Pangan 11(3):247−254. https://doi.org/10.25182/jgp.2016.11.3.%p
Rizal MF, van Doorslaer E. 2019. Explaining the fall of socioeconomic inequality in childhood stunting in Indonesia. SSMPopulation Health 9:100469. https://doi.org/10.1016/j.ssmph.2019.100469
Sekhampu TJ. 2012. Socio-economic determinant of household food expenditure in low income township in South Africa. Mediterr J Soc Sci 3(3):449−453. https://doi.org/10.5901/mjss.2012.v3n3p449
Subramanyam MA, Kawachi I, Berkman LF, Subramanian SV. 2011. Is economic growth associated with reduction in child undernutrition in India?. Plos Medicine 8(3):e1000424. https://doi.org/10.1371/journal.pmed.1000424
Titaley CR, Ariawan I, Hapsari D, Muasyaroh A, Dibley MJ. 2019. Determinants of the stunting of children under two years old in Indonesia: A multilevel analysis of the 2013 Indonesia basic health survey. Nutrients 11(5):1106. https://doi.org/10.3390/nu11051106
Vollmer S, Harttgen K, Subramanyam MA, Finlay J, Klasen S, Subramanian SV. 2014. Association between economic growth and early childhood undernutrition: Evidence from 121 demographic and health surveys from 36 low-income and middleincome countries. Lancet Glob Health 2(4):225−234. https://doi.org/10.1016/S2214-109X(14)70025-7
Weatherspoon DD, Steele-Adjognon M, Niyitanga F, Dushimumuremyi JP, Naseem A, Oehmke J. 2017. Food expenditure patterns, preferences, policy, and access of Rwandan households. Br Food J 119(6). https://doi.org/10.1108/BFJ-09-2016-0408
[WHO] World Health Organization. 2013. Childhood Stunting: Challenges and Opportunities: Report of A Webcast Colloquium on The Operational Issues Around Setting and Implementing National Stunting Reduction Agendas. Geneva (CH): WHO Press.
Wicaksono F, Harsanti T. 2020. Determinants of stunted children in Indonesia: A multilevel analysis at the individual, household, and community levels. Kesmas: Jurnal Kesehatan Masyarakat Nasional (National Public Health Journal)15(1):48−53. http

Authors

Aldiza Intan Randani
Yayuk Farida Baliwati
baliwati@apps.ipb.ac.id (Primary Contact)
Dadang Sukandar
Ikeu Tanziha
RandaniA. I., BaliwatiY. F., SukandarD., & TanzihaI. (2022). Economic and Consumption Variables and Their Associations with Stunting Prevalence: A Provincial Analysis of the Indonesian Child Nutritional Status Survey 2019 . Jurnal Gizi Dan Pangan, 17(1), 57-66. https://doi.org/10.25182/jgp.2022.17.1.57-66

Article Details

List of Cited By :

Crossref logo