Effect of applying the health promotion model in stunting prevention and behavior control in Indonesia

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Abstract

BACKGROUND:

Stunting is a condition of failure to thrive in children, due to chronic malnutrition and recurrent infections. This study aimed to evaluate the effectiveness of implementing the health promotion model in stunting prevention and control behavior.

MATERIALS AND METHODS:

This cross-sectional quantitative analytic study was conducted using a survey method involving 228 mothers of stunted children in Indonesia. Cluster random sampling was used. Data were collected using a questionnaire with a Likert scale, and then, they were analyzed using univariate analysis, multiple linear regression, and pathway analysis to determine the direct and indirect effects.

RESULTS:

All respondents were of non-risk age (20–45 years), most had height >150 cm (83.8%), moderate weight (93.4%), multigravida parity (87.3%), middle education (70.2%), unemployed (91.7%), monthly income of less than 1,800,000 rupiahs (89.9%), and exclusive breastfeeding (97.4%). Sanitation, self-efficacy, and social support had a significant effect on stunting prevention and control behavior ( P < 0.05). Socioeconomic and sanitation effects through self-efficacy indirectly had a significant positive, while parenting through food or nutritional intake had a significant influence on the stunting incidence ( P < 0.05). Variables that had a significant positive effect on stunting prevention and behavior directly were perceived vulnerability, perceived severity, perceived obstacles, self-efficacy, social support, community organizing, and facilitator ( P < 0.05). Parenting through the health of diarrhea or acute respiratory infection (ARI) had no significant positive effect on the stunting incidence ( P = 0.121).

CONCLUSION:

Almost all variables have a significant direct and indirect effect on stunting prevention and control behavior, as well as the stunting incidence, except parenting through the health of diarrhea or ARI.

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Most cited references 32

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Health promotion by social cognitive means.

Albert Bandura (2004)

This article examines health promotion and disease prevention from the perspective of social cognitive theory. This theory posits a multifaceted causal structure in which self-efficacy beliefs operate together with goals, outcome expectations, and perceived environmental impediments and facilitators in the regulation of human motivation, behavior, and well-being. Belief in one's efficacy to exercise control is a common pathway through which psychosocial influences affect health functioning. This core belief affects each of the basic processes of personal change--whether people even consider changing their health habits, whether they mobilize the motivation and perseverance needed to succeed should they do so, their ability to recover from setbacks and relapses, and how well they maintain the habit changes they have achieved. Human health is a social matter, not just an individual one. A comprehensive approach to health promotion also requires changing the practices of social systems that have widespread effects on human health.

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Childhood stunting: a global perspective

Mercedes de Onis, Francesco Branca (2016)

Abstract Childhood stunting is the best overall indicator of children's well‐being and an accurate reflection of social inequalities. Stunting is the most prevalent form of child malnutrition with an estimated 161 million children worldwide in 2013 falling below −2 SD from the length‐for‐age/height‐for‐age World Health Organization Child Growth Standards median. Many more millions suffer from some degree of growth faltering as the entire length‐for‐age/height‐for‐age z‐score distribution is shifted to the left indicating that all children, and not only those falling below a specific cutoff, are affected. Despite global consensus on how to define and measure it, stunting often goes unrecognized in communities where short stature is the norm as linear growth is not routinely assessed in primary health care settings and it is difficult to visually recognize it. Growth faltering often begins in utero and continues for at least the first 2 years of post‐natal life. Linear growth failure serves as a marker of multiple pathological disorders associated with increased morbidity and mortality, loss of physical growth potential, reduced neurodevelopmental and cognitive function and an elevated risk of chronic disease in adulthood. The severe irreversible physical and neurocognitive damage that accompanies stunted growth poses a major threat to human development. Increased awareness of stunting's magnitude and devastating consequences has resulted in its being identified as a major global health priority and the focus of international attention at the highest levels with global targets set for 2025 and beyond. The challenge is to prevent linear growth failure while keeping child overweight and obesity at bay.

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Determinants of the Stunting of Children Under Two Years Old in Indonesia: A Multilevel Analysis of the 2013 Indonesia Basic Health Survey

Christiana R Titaley, Iwan Ariawan, Dwi Hapsari … (2019)

Indonesia is ranked fifth among countries with the highest burden of stunting in children under five. This study aims to examine the determinants of stunting in children aged 0–2 years in Indonesia using data derived from the 2013 Indonesia Basic Health Survey. Twenty potential predictors of stunting, categorized into household and housing characteristics; maternal and paternal characteristics; antenatal care services and child characteristics were analyzed. Multilevel analyses were performed to examine the role of cluster/district/provincial differences, as well as individual/household level characteristics and stunting status. Of 24,657 children analyzed, 33.7% (95%CI: 32.8%–34.7%) were stunted. The odds of stunting increased significantly among children living in households with three or more children under five-years-old (aOR = 1.33, 95%CI: 1.03–1.72), households with five to seven household members (aOR =1.11; 95%CI: 1.03–1.20), children whose mothers during pregnancy attended less than four antenatal care services (aOR = 1.22, 95%CI: 1.08–1.39), boys (aOR = 1.33, 95%CI: 1.22–1.45), children aged 12–23 months (aOR = 1.89; 95%CI: 1.54–2.32), and children who weighed <2500 g at birth (aOR = 2.55; 95%CI: 2.05–3.15). The odds also increased significantly with the reduction of household wealth index. Integrated interventions to address environment, an individual level associated with stunting in Indonesia, from the environment- to individual-level factors are important.

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Author and article information

Journal

Journal ID (nlm-ta): J Educ Health Promot

Journal ID (iso-abbrev): J Educ Health Promot

Journal ID (publisher-id): JEHP

Title: Journal of Education and Health Promotion

Publisher: Wolters Kluwer - Medknow (India )

ISSN (Print): 2277-9531

ISSN (Electronic): 2319-6440

Publication date Collection: 2023

Publication date (Electronic): 29 July 2023

Volume: 12

Electronic Location Identifier: 227

Affiliations

[1] Doctoral Program of Development Counseling and Community Empowerment-Health Promotion, Post-Graduate Schools of Sebelas Maret University, Surakarta, Indonesia

[1 ] Department of Public Health Sciences, Faculty of Medicine of Sebelas Maret University, Surakarta Regency, Central Java Province, Indonesia

[2 ] Department of Agriculture Extension and Communications, Faculty of Agriculture of Sebelas Maret University, Surakarta Regency, Central Java Province, Indonesia

[3 ] Faculty of Medicine of Sebelas Maret University, Surakarta Regency, Central Java Province, Indonesia

Author notes

Address for correspondence: Dr. Evi Soviyati, Jl. Ir. Sutami No. 36 Kentingan, 57126, Surakarta Regency, Central Java Province, Indonesia. E-mail: eviesofia73@ 123456gmail.com

Article

Publisher ID: JEHP-12-227

DOI: 10.4103/jehp.jehp_276_23

PMC ID: 10506787

PubMed ID: 37727411

SO-VID: 1e682ec1-51a8-4a83-b08d-d1c8b5c87961

License:

This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

History

Date received : 27 February 2023

Date accepted : 19 May 2023

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