Risk factors associated with childhood stunting in Indonesia: A systematic review and meta-analysis.

Background and objectives: In Indonesia, stunting is one of the most public health concerns. This study aims to systematically review and meta-analyze childhood stunting risk factors in the country.

Methods and study design: We did a systematic review and meta-analysis of observational (cross-sectional and longitudi-nal) studies on stunting risk factors published between 2010 and 2021 based on available publications in online databases of PubMed, ProQuest, EBSCO, and google scholar. The quality of the publications was evaluated using the Newcastle-Ottawa Quality Assessment Scale and organized according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. Publication bias was examined using Egger's and Begg's tests.

Results: A total of 17 studies from the literature search satisfied the inclusion criteria, with 642,596 subjects. The pooled stunting prevalence was 30.9% (95% CI 25.0%-36.8%). Children born with low birth weight (POR 2.39, 2.07-2.76), female (POR 1.05, 1.03-1.08), and did not get the deworming program (1.10, 1.07-1.12) are the primary child characteristics that contributed to stunting. Meanwhile, maternal age ≥ 30 years (POR 2.33, 2.23-2.44), preterm birth (POR 2.12, 2.15-2.19), and antenatal care <4 times (POR 1.25, 1.11-1.41) were among mother characteristics consistently associated with stunting. The primary household and community risk factors for stunting were food insecurity (POR 2.00, 1.37-2.92), unimproved drinking water (POR 1.42, 1.26-1.60), rural residence (POR 1.31, 1.20-1.42), and unimproved sanitation (POR 1.27, 1.12-1.44).

Conclusions: A diverse range of risk factors associated with childhood stunting in In-donesia demonstrates the need to emphasize nutrition programs by scaling up to more on these determinants.