ENVIRONMENTAL FACTORS’ DETERMINANT OF CHILDHOOD STUNTING IN INDONESIA: A SYSTEMATIC REVIEW AND META-ANALYSIS

Authors

  • Hamzah Hasyim Faculty of Public Health, Sriwijaya University, Indonesia
  • Danny Kusuma Aerosta Faculty of Public Health, Sriwijaya University, Indonesia
  • Anggun Budiastuti Faculty of Public Health, Sriwijaya University, Indonesia
  • Rahmatillah Razak Faculty of Public Health, Sriwijaya University, Indonesia
  • Yeni Yeni Faculty of Public Health, Sriwijaya University, Indonesia
  • Misnaniarti Misnaniarti Faculty of Public Health, Sriwijaya University, Indonesia
  • Nur Alam Fajar Faculty of Public Health, Sriwijaya University, Indonesia
  • Fatmalina Febry Faculty of Public Health, Sriwijaya University, Indonesia
  • Fenny Etrawati Faculty of Public Health, Sriwijaya University, Indonesia
  • Widya Lionita Faculty of Public Health, Sriwijaya University, Indonesia
  • Annisa Rahmawaty Faculty of Public Health, Sriwijaya University, Indonesia
  • Muhammad Amin Arigo Saci Faculty of Public Health, Sriwijaya University, Indonesia
  • Indah Yuliana Faculty of Public Health, Sriwijaya University, Indonesia
  • Windi Indah Fajar Ningsih Faculty of Public Health, Sriwijaya University, Indonesia
  • Laura Pratiwi Faculty of Public Health, Sriwijaya University, Indonesia
  • Nyayu Yasyfi Nur Alfaini Faculty of Public Health, Sriwijaya University, Indonesia
  • Nadya Putri Faculty of Public Health, Sriwijaya University, Indonesia
  • Nenny Wahyuni Faculty of Agriculture, Musi Rawas University, Indonesia
  • Nely Murniati Faculty of Agriculture, Musi Rawas University, Indonesia
  • Susyani Susyani Poltekkes Palembang, Indonesia
  • Tien Yustini Faculty of Economy, Universitas Indo Global Mandiri, Indonesia
  • Haerawati Idris Faculty of Public Health, Sriwijaya University, Indonesia
  • Fadhilah Eka Maharani Faculty of Mathematics and Natural Science, IPB University

DOI:

https://doi.org/10.37268/mjphm/vol.25/no.2/art.2538

Abstract

Stunting is a severe consequence of intrauterine and early childhood malnutrition. Children who suffer from stunting fail to reach their full height potential, and their brains do not develop to their total cognitive capacity. This study aims to explore environmental factors associated with stunting in children under five years old in Indonesia. Systematic review study was conducted using the PubMed, Science Direct, BMC, and Google Scholar databases to identify eligible articles published between 2018 to 2022. Studies conducted in Indonesia were  reviewed using The Joanna Briggs Institute (JBI) Critical Appraisal Tools. 6,049 articles from the databases, and ten studies met the inclusion criteria, which—the most consistent factor associated with stunting was access to an unimproved latrines. Additional factors included poor hand-washing practices, use of unimproved water sources, consumption of unsafe drinking water, and smoking habits. Various environmental factors are associated with stunting. Addressing these issues through improved access to latrines, better water quality, and enhanced hand hygiene is crucial.

References

WHO, “Levels And Trends In Child Malnutrition.” 2020.

SSGI, Buku Saku Hasil Studi Status Gizi Indonesia (SSGI) Tingkat Nasional, Provinsi, dan Kabupaten/Kota Tahun 2021. 2021.

WHO, “Childhood Stunting: Context, Causes, and Consequences.” 2016.

PerPres, “Peraturan Presiden Republik Indonesia Nomor 72 Tahun 2021,” Peraturan Presiden. 2021.

D. Vilcins, P. D. Sly, and P. Jagals, “Environmental risk factors associated with child stunting: A systematic review of the literature,” Ann. Glob. Heal., vol. 84, no. 4, pp. 551–562, 2018, doi: 10.29024/aogh.2361.

T. Beal, A. Tumilowicz, A. Sutrisna, D. Izwardy, and L. M. Neufeld, “A review of child stunting determinants in Indonesia,” Matern. Child Nutr., vol. 14, no. 4, 2018, doi: 10.1111/MCN.12617.

JBI, “JBI’s Critical Appraisal Tools.” 2020, [Online]. Available: https://jbi.global/critical-appraisal-tools.

PRISMA, “PRISMA Flow Diagram.” 2020, [Online]. Available: https://prisma-statement.org/PRISMAStatement/FlowDiagram.

D. F. Ningsih, M. Ikhtiar, and A. Baharuddin, “Community-Led Total Sanitation (CTLS) to Prevent Stunting among Toddlers in Indonesia,” J. Aafiyah Heal. Res. 2021, vol. 2, no. 2, pp. 22–32, 2021, doi: 10.52103/jahr.v2i2.706.

J. H. Rah, S. Sukotjo, N. Badgaiyan, A. A. Cronin, and H. Torlesse, “Improved sanitation is associated with reduced child stunting amongst Indonesian children under 3 years of age,” Matern. Child Nutr., vol. 16, no. S2, 2020, doi: 10.1111/mcn.12741.

R. A. Wicaksono, K. S. Arto, E. Mutiara, M. Deliana, M. Lubis, and J. R. L. Batubara, “Risk factors of stunting in indonesian children aged 1 to 60 months,” Paediatr. Indones. Indones., vol. 61, no. 1, pp. 12–19, 2021, doi: 10.14238/pi61.1.2021.12-9.

L. Sulistyorini, R. Azizah, and H. Oktarizal, “Association Between Toilet Availability and Handwashing Habits and the Incidence of Stunting in Young Children in Tanjung Pinang City, Indonesia,” 2020.

N. Made Utami Dwipayanti, N. Ketut Sutiari, C. Istri Dewiyani, and K. Hari Mulyawan, “Potential Association of Sanitation Factors on Stunting Incidences Among Children Under Age 5 in Bali Province, Indonesia,” 2020.

L. G. Pradnyawati, D. A. P. R. Juwita, and N. Reviani, “Risk Factors of Stunting in Kedisan, Gianyar District, Bali, Indonesia,” J. Berk. Epidemiol., vol. 9, no. 3, p. 266, 2021, doi: 10.20473/jbe.v9i32021.266-274.

D. Suciyanti, G. Wangge, E. Iskandar, U. Fahmida, and T. Supali, “Social determinants and access to Water-Sanitation-Hygiene as dominant risk factors of stunting among under-five children in rural area of East Indonesia,” 2021, doi: 10.20944/preprints202107.0279.v1.

J. Sugiyanto et al., “The Effects of Exclusive Breastfeeding and Contextual Factor of Village on Stunting in Bontang, East Kalimantan, Indonesia,” J. Epidemiol. Public Heal., vol. 4, no. 3, pp. 222–233, 2019, doi: 10.26911/jepublichealth.2019.04.03.10.

D. D. Astuti, T. W. Handayani, and D. P. Astuti, “Cigarette smoke exposure and increased risks of stunting among under-five children,” Clin. Epidemiol. Glob. Heal., vol. 8, no. 3, pp. 943–948, 2020, doi: 10.1016/j.cegh.2020.02.029.

M. Tahangnacca, R. Amiruddin, Ansariadi, and A. Syam, “Model of stunting determinants: A systematic review,” Enfermería Clínica, vol. 30, pp. 241–245, 2020, doi: https://doi.org/10.1016/j.enfcli.2019.10.076.

O. Cumming and S. Cairncross, “Can water, sanitation and hygiene help eliminate stunting? Current evidence and policy implications,” Matern. Child Nutr., vol. 12, no. Suppl 1, p. 91, 2016, doi: 10.1111/MCN.12258.

J. Saxton et al., “Handwashing, sanitation and family planning practices are the strongest underlying determinants of child stunting in rural indigenous communities of Jharkhand and Odisha, Eastern India: a cross-sectional study,” Matern. Child Nutr., vol. 12, no. 4, pp. 869–884, 2016, doi: 10.1111/MCN.12323.

A. P. Verhagen and M. L. Ferreira, “Forest plots,” J. Physiother., vol. 60, no. 3, pp. 170–173, 2014, doi: 10.1016/j.jphys.2014.06.021.

J. Cuzick, “Forest plots and the interpretation of subgroups,” Lancet, vol. 365, no. 9467, p. 1308, Apr. 2005, doi: 10.1016/S0140-6736(05)61026-4.

J. R. Dettori, D. C. Norvell, and J. R. Chapman, “Seeing the Forest by Looking at the Trees: How to Interpret a Meta-Analysis Forest Plot,” Glob. Spine J., vol. 11, no. 4, pp. 614–616, 2021, doi: 10.1177/21925682211003889.

M. Egger, G. D. Smith, M. Schneider, and C. Minder, “Bias in meta-analysis detected by a simple, graphical test,” Br. Med. J., vol. 315, no. 7109, pp. 629–634, 1997, doi: 10.1136/bmj.315.7109.629.

D. J. Spiegelhalter, “Funnel plots for comparing institutional performance,” Stat. Med., vol. 24, no. 8, pp. 1185–1202, Apr. 2005, doi: https://doi.org/10.1002/sim.1970.

J. Copas and J. Q. Shi, “Meta-analysis, funnel plots and sensitivity analysis ,” Biostatistics, vol. 1, no. 3, pp. 247–262, Sep. 2000, doi: 10.1093/biostatistics/1.3.247.

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Published

2025-08-28

How to Cite

Hasyim, H., Kusuma Aerosta, D., Budiastuti, A., Razak, R., Yeni, Y., Misnaniarti, M., … Fadhilah Eka Maharani. (2025). ENVIRONMENTAL FACTORS’ DETERMINANT OF CHILDHOOD STUNTING IN INDONESIA: A SYSTEMATIC REVIEW AND META-ANALYSIS. Malaysian Journal of Public Health Medicine, 25(2), 11–19. https://doi.org/10.37268/mjphm/vol.25/no.2/art.2538