Background
Methods
Study location
Study design
Selection of subjects
Stunting (Height-for-age)
Socioeconomic factors
Ethical permission
Statistical analyses
Results
Univariate Analyses
Characteristic | n | Stunted children 0-23 Months | Severely stunted children 0-23 Months | Stunted children 0-59 Months | Severely stunted children 0-59 Months |
---|---|---|---|---|---|
% (95% CI) | % (95% CI) | % (95% CI) | % (95% CI) | ||
Region
| |||||
Rural | 536 | 27.1 (21.0-34.3) | 13.8 (9.5-19.5) | 33.4 (28.6-38.6)* | 15.9 (12.4-20.1) |
Urban | 1632 | 29.6 (26.2-33.2) | 14.2 (11.4-17.6) | 40.0 (37.2-42.9) | 19.2 (16.4-22.3) |
District
| |||||
Ternate | 387 | 30.9 (23.8-39.1) | 14.2 (9.9-19.9) | 36.4 (31.0-42.2) | 16.0 (12.3-20.6) |
Tidore | 149 | 19.1 (10.4-32.5) | 12.8 (4.9-29.2) | 25.5 (18.9-33.4) | 15.4 (8.6-26) |
Central Halmahera | 280 | 32.3 (25.7-39.7) | 15.5 (11.3-21) | 42.9 (36.5-49.5) | 23.2 (18.1-29.3) |
East Halmahera | 280 | 37.0 (28.3-46.7) | 21.9 (13.2-34.3) | 42.5 (33.2-52.4) | 23.6 (14.6-35.8) |
West Halmahera | 178 | 23.7 (15.9-33.8) | 6.2 (3.1-12.0) | 38.2 (33.2-43.5) | 16.3 (12.5-21) |
North Halmahera | 279 | 31.1 (24.5-38.6) | 13.3 (9.1-19.1) | 41.6 (34.5-49.0) | 17.2 (12.6-23.0) |
South Halmahera | 446 | 24.7 (19.7-30.5) | 12.4 (8.2-18.2) | 38.6 (35.2-42.1) | 19.3 (15.1-24.3) |
Sula-Isles | 169 | 27.4 (20.7-35.3) | 10.7 (6.7-16.8) | 34.3 (29.6-39.4) | 11.2 (9-14.0) |
Household factors
| |||||
Father's education
| |||||
Completed Elementary School (aged 7-12) | 832 | 32.0 (27.2-37.2) | 16.2 (12.6-20.7) | 41.8 (37.8-45.9)* | 20.9 (17.6-24.7)* |
Completed Middle School (aged 13-15) | 557 | 28.4 (23.4-34.0) | 13.2 (9.7-17.6) | 39.3 (35.2-43.6) | 19.0 (15.5-23.2) |
Completed High School (aged 16-18) | 779 | 26.3 (22.0-31.2) | 12.6(9.2-17) | 34.0 (30.3-37.9) | 15.2 (12.1-18.8) |
Mother's education
| |||||
Completed Elementary School (aged 7-12) | 1163 | 30.8 (27.0-34.9) | 16.7 (13.6-20.30* | 41.6 (38.4-44.9)** | 20.9 (18.0-24.3)** |
Completed Middle School (aged 13-15) | 514 | 29.7 (24.5-35.5) | 11.5 (8-16.4) | 37.7 (32.8-43) | 15.8 (12.4-19.8) |
Completed High School (aged 16-18) | 491 | 24.5 (19.6-30.2) | 11.2 (7.7-16.1) | 31.4 (27.0-36.0) | 14.9 (11.7-18.8) |
Parental Education
| |||||
Both with high education | 871 | 26.2 (22.1-30.7) | 11.3 (8.4-14.9) | 33.6 (30-37.5)** | 15.4 (12.7-18.6)* |
Father with high education | 134 | 33.3 (22.7-46.0) | 12.0 (5.6-23.7) | 41.0 (32.6-50.1) | 14.9 (9.4-22.9) |
Mother with high education | 465 | 29.2 (23.5-35.7) | 16.1 (11.8-21.5) | 41.1 (37.1-45.1) | 19.4 (15.6-23.8) |
Neither with high education | 698 | 31.7 (26.9-37.1) | 17.1 (13.1-21.9) | 41.9 (37.7-46.4) | 22.1 (18.4-26.2) |
Provided with nutritional information during pregnancy (n = 2110)
| |||||
No | 729 | 29.9 (25.4-35.0) | 16.0 (12.8-19.9) | 42.0 (37.7-46.4) | 21.1 (17.6-25.1) |
Yes | 1381 | 28.2 (24.9-31.9) | 12.9 (10.1-16.3) | 36.6 (33.7-39.7) | 17.0 (14.3-20.1) |
Father's occupation
| |||||
Any Labour | 1396 | 29.3 (25.6-33.3) | 15.1 (12.2-18.7) | 40.0 (36.9-43.2) | 19.3 (16.7-22.3)** |
Fisher man | 355 | 27.9 (22.6-33.8) | 12.5 (8.5-18) | 35.5 (30.8-40.5) | 18.0 (14.5-22.1) |
No work | 60 | 35.9 (21.7-53.1) | 20.5 (10.4-36,5) | 45.0 (34.0-56.5) | 28.3 (18.5-40.5) |
Government private officer | 357 | 27.7 (20.9-35.7) | 10.8 (6.9-16.5) | 33.9 (29-39.2) | 13.2 (9.8-17.5) |
Mother's occupation
| |||||
Any Labour | 694 | 29.9 (25.3-34.9) | 14.4 (11.4-18.2) | 39.5 (35.4-43.8) | 18.4 (15.4-22) |
Fisher woman | 96 | 30.6 (20.6-42.8) | 18.4 (9.8-31.8) | 38.5 (30.8-46.9) | 22.9 (15.5-32.5) |
No work | 1302 | 28.4 (24.4-32.7) | 13.6(10.4-17.6) | 37.9 (34.5-41.4) | 18.1 (15.2-21.5) |
Government private officer | 76 | 29.2 (17.7-44.0) | 14.6 (8.0-25.0) | 36.8 (27.6-47.2) | 15.8 (10.2-23.7) |
Parental employment
| |||||
Both working | 838 | 29.8 (25.8-34.2) | 14.9 (11.9-18.6) | 38.7 (35.3-42.2) | 18.1 (15.4-21.3) |
Father only working | 1270 | 28.1 (24.1-32.4) | 13.2 (10.0-17.2) | 37.9 (34.5-41.4) | 18.0 (15.1-21.4) |
Mother only working | 28 | 33.3 (14.2-60.2) | 13.3 (2.8-44.8) | 53.6 (38.5-68.1) | 35.7 (19.7-56.8) |
Neither working | 32 | 37.5 (21.1-57.4) | 25.0 (11.7-45.7) | 37.5 (23.1-54.6) | 21.9 (11.4-38.0) |
Household wealth Index
| |||||
Poorest | 867 | 32.9 (27.6-38.7) | 17.4 (13.4-22.4)** | 43.1 (39.0-44.0)** | 21.1 (17.4-25.4)** |
Middle | 867 | 28.2 (24.3-32.5) | 13.9 (11.0-17.6) | 37.4 (33.9-40.9) | 18.9 (16.3-21.9) |
Least Poor | 434 | 23.4 (18.1-29.7) | 8.3 (5.1-13.4) | 30.9 (26.4-35.8) | 11.8 (8.7-15.7) |
Household member
| |||||
≤5 members | 1359 | 31.3 (27.6-35.4) | 14.8 (11.6-18.7) | 39.3 (36.2-42.5) | 18.5 (15.7-21.7) |
6-12 members | 809 | 24.9 (21-29.4) | 12.9 (10.1-16.4) | 36.8 (33.0-40.8) | 18.1 (15.2-21.3) |
Number of family Meals per day
| |||||
2 Times | 675 | 24.9 (20.5-29.8) | 13.1 (9.9-17.1) | 36.3 (32.2-40.6) | 17.6 (14.3-21.6) |
>2 Times | 1493 | 30.8 (27.0-34.8) | 14.5 (11.5-18.2) | 39.3 (36.22-42.5) | 18.7 (16-21.8) |
Child level factors
| |||||
Child's age in category
| |||||
0-5 | 266 | 12.8 (9.1-17.7)*** | 7.9 (5.6-11.0)*** | 12.8 (9.1-17.7)*** | 7.9 (5.6-11.0)*** |
6-11 | 365 | 24.1 (19.3-29.7) | 10.1 (5.6-11.0)*** | 24.1 (19.3-29.7) | 10.1 (6.6-15.2) |
12-17 | 318 | 33.9 (28.6-39.7) | 15.7 (5.6-11.0)*** | 33.9 (28.6-39.7) | 15.7 (11.7-20.8) |
18-23 | 234 | 48.3 (40.3-56.3) | 25.2 (5.6-11.0)*** | 48.3 (40.3-56.3) | 25.2 (18.8-32.9) |
24-29 | 238 | 48.7 (42.2-55.4) | 26.5 (20.4-33.6) | ||
30-35 | 169 | 51.5 (42.9-60.0) | 23.1 (16.8-30.8) | ||
36-41 | 215 | 52.6 (45.9-59.1) | 25.6 (20.5-31.5) | ||
42-47 | 147 | 47.6 (37.7-57.7) | 19.7 (13-28.8) | ||
48-53 | 135 | 49.6 (39.9-59.4) | 23.7 (16.8-32.3) | ||
54-59 | 81 | 44.4 (34.6-54.8) | 16.1 (8.7-27.6) | ||
Gender
| |||||
Male | 1115 | 32.2 (28.0-36.7)* | 16.7 (13.2-21.1)** | 41.4 (37.9-44.8)* | 20.5 (17.4-24.1)** |
Female | 1053 | 25.6 (21.6-30.1) | 11.3 (8.9-14.3) | 35.2 (31.8-38.8) | 16.1 (13.7-18.7) |
Antenatal visit (n = 2110)
| |||||
No | 91 | 39.6 (27.2-53.4) | 16.7 (7.6-32.7) | 44.0 (35.1-53.2) | 23.1 (15.4-33.1) |
Yes | 2019 | 28.4 (25.4-31.5) | 16.7 (11.5-16.6) | 38.2 (35.6-40.9) | 18.2 (15.9-20.8) |
Overall
| 29.0 (26.0-32.2) | 16.7 (11.7-17.0) | 38.4 (35.9-41.0) | 18.4 (16.1-20.9) |
Multivariate Analyses
Characteristic | Stunted children 0-23 Months | Stunted children 0-59 Months | ||
---|---|---|---|---|
Unadjusted OR (95% CI) | Adjusted OR (AOR) (95% CI) | Unadjusted OR (95% CI) | AOR (95% CI) | |
Region
| ||||
Rural | 1.00 | 1.00 | ||
Urban | 1.13 (0.77-1.65) | 1.33 (1.03-1.71) | ||
District
| ||||
Ternate | 1.00 | 1.00 | ||
Tidore | 0.53 (0.24-1.17) | 0.60 (0.38-0.94) | ||
Central Halmahera | 1.06 (0.66-1.72) | 1.31 (0.91-1.88) | ||
East Halmahera | 1.31 (0.76-2.24) | 1.29 (0.81-2.06) | ||
West Halmahera | 0.69 (0.38-1.28) | 1.08 (0.78-1.50) | ||
North Halmahera | 1.01 (0.62-1.64) | 1.24 (0.84-1.83) | ||
South Halmahera | 0.73 (0.46-1.16) | 1.10 (0.82-1.45) | ||
Sula-Isles | 0.84 (0.50-1.41) | 0.91 (0.66-1.26) | ||
Household factors Father's education
| ||||
Completed Elementary School (aged 7-12) | 1.00 | 1.00 | ||
Completed Middle School (aged 13-15) | 0.84 (0.59-1.21) | 0.90 (0.71-1.14) | ||
Completed High School (aged 16-18) | 0.76 (0.55-1.05) | 0.70 (0.57-0.91) | ||
Mother's Education
| ||||
Completed Elementary School (aged 7-12) | 1.00 | 1.00 | ||
Completed Middle School (aged 13-15) | 0.95 (0.69-1.31) | 0.85 (0.66-1.09) | ||
Completed High School (aged 16-18) | 0.73 (0.55-0.97) | 0.64 (0.50-0.83) | ||
Parental Education
| ||||
Both with high education | 1.00 | 1.00 | ||
Father with high education | 1.41 (0.78-2.54) | 1.37 (0.92-2.04) | ||
Mother with high education | 1.17 (0.83-1.64) | 1.38 (1.09-1.73) | ||
Neither with high education | 1.31 (0.96-1.80) | 1.43 (1.11-1.84) | ||
Provided with nutritional information during pregnancy
| ||||
No | 1.00 | 1.00 | ||
Yes | 0.78 (0.56-1.07) | 0.77 (0.57-1.03) | ||
Father's occupation
| ||||
Any Labour | 1.00 | 1.00 | ||
Fisher man | 0.93 (0.66-1.32) | 0.83 (0.65-1.06) | ||
No work | 1.35 (0.65-2.80) | 1.23 (0.77-1.96) | ||
Government private officer | 0.92 (0.62-1.38) | 0.77 (0.60-0.99) | ||
Mother's occupation
| ||||
Any Labour | 1.00 | 1.00 | ||
Fisherwoman | 1.03 (0.58-1.83) | 0.96 (0.65-1.42) | ||
No work | 0.93 (0.69-1.25) | 0.93 (0.75-1.17) | ||
Government private officer | 0.96 (0.49-1.92) | 0.89 (0.55-1.46) | ||
Parental employment
| ||||
Both working | 1.00 | 1.00 | ||
Father only working | 0.92 (0.70-1.21) | 0.97 (0.79-1.18) | ||
Mother only working | 1.18 (0.39-3.59) | 1.83 (0.97-3.47) | ||
Neither working | 1.41 (0.62-3.20) | 0.95 (0.47-1.92) | ||
Household wealth Index
| ||||
Poorest | 1.00 | 1.00 | 1.00 | |
Middle | 0.80 (0.58-1.10) | 0.87 (0.65-1.16) | 0.78 (0.63-0.98) | |
Least Poor | 0.62 (0.41-0.94) | 0.50 (0.33-0.75) | 0.62 (0.45-0.85) | |
Household member
| ||||
≤5 members | 1.00 | 1.00 | ||
6-12 members | 0.73 (0.56-0.95) | 0.90 (0.73-1.11) | ||
Family Meals per day
| ||||
2 Times | 1.00 | 1.00 | 1.00 | |
>2 Times | 0.74 (0.54-1.02) | 0.70 (0.50-0.99) | 0.88 (0.70-1.11) | |
Child level factors
| ||||
Child's age (months)
| 1.10 (1.07-1.14) | 1.11 (1.08-1.14) | 1.03 (1.02-1.04) | 1.03 (1.02-1.04) |
Gender
| ||||
Male | 1.00 | 1.00 | 1.00 | 1.00 |
Female | 0.73 (0.54-0.97) | 0.67 (0.50-0.89) | 0.77 (0.63-0.95) | 0.74 (0.59-0.93) |
Antenatal visit
| ||||
No | 1.00 | 1.00 | ||
Yes | 0.89 (0.60-1.32) | 0.77 (0.57-1.03) |
Characteristic | Severely stunted children 0-23 Months | Severely stunted children 0-59 Months | ||
---|---|---|---|---|
Unadjusted OR (95% CI) | Adjusted OR (95% CI) | Unadjusted OR (95% CI) | Adjusted OR (95% CI) | |
Region
| ||||
Rural | 1.00 | 1.00 | ||
Urban | 1.04 (0.64-1.70) | 1.33 (1.03-1.71) | ||
District
| ||||
Ternate | 1.00 | 1.00 | ||
Tidore | 0.88 (0.29-2.68) | 0.60 (0.38-0.94) | ||
Central Halmahera | 1.10 (0.64-1.92) | 1.31 (0.91-1.88) | ||
East Halmahera | 1.70 (0.81-3.56) | 1.29 (0.81-2.06) | ||
West Halmahera | 0.40 (0.18-0.92) | 1.08 (0.78-1.50) | ||
North Halmahera | 0.93 (0.51-1.68) | 1.24 (0.84-1.83) | ||
South Halmahera | 0.85 (0.46-1.57) | 1.10 (0.82-1.45) | ||
Sula-Isles | 0.72 (0.37-1.40) | 0.91 (0.66-1.26) | ||
Household factors Father's education
| ||||
Completed Elementary School (aged 7-12) | 1.00 | 1.00 | ||
Completed Middle School (aged 13-15) | 0.78 (0.48-1.26) | 0.89 (0.64-1.24) | ||
Completed High School (aged 16-18) | 0.75 (0.51-1.10) | 0.68 (0.50-0.91) | ||
Mother's education
| ||||
Completed Elementary School (aged 7-12) | 1.00 | 1.00 | ||
Completed Middle School (aged 13-15) | 0.65 (0.41-1.05) | 0.70 (0.51-0.98) | ||
Completed High School (aged 16-18) | 0.63 (0.43-0.92) | 0.66 (0.49-0.88) | ||
Parental education
| ||||
Both with high education | 1.00 | 1.00 | ||
Father with high education | 1.07 (0.44-2.63) | 1.37 (0.92-2.04) | ||
Mother with high education | 1.51 (0.97-2.35) | 1.38 (1.09-1.73) | ||
Neither with high education | 1.62 (1.09-2.41) | 1.43 (1.11-1.84) | ||
Provided with nutritional information during pregnancy
| ||||
No | 1.00 | 1.00 | ||
Yes | 0.78 (0.56-1.07) | 0.77 (0.57-1.03) | ||
Father's occupation
| ||||
Any Labour | 1.00 | 1.00 | 1.00 | |
Fisherman | 0.80 (0.49-1.32) | 0.92 (0.70-1.19) | 1.13 (0.85-1.52) | |
No work | 1.45 (0.63-3.34) | 1.65 (0.92-2.94) | 2.04 (1.17-3.53) | |
Government private officer | 0.68 (0.42-1.10) | 0.63 (0.45-0.89) | 0.79 (0.55-1.14) | |
Mother's occupation
| ||||
Any Labour | 1.00 | 1.00 | ||
Fisherwoman | 1.33 (0.62-2.88) | 1.31 (0.78-2.22) | ||
No work | 0.93 (0.63-1.39) | 0.98 (0.75-1.28) | ||
Government private officer | 1.01 (0.51-2.01) | 0.83 (0.49-1.40) | ||
Parental employment
| ||||
Both working | 1.00 | 1.00 | ||
Father only working | 0.87 (0.60-1.26) | 0.97 (0.79-1.18) | ||
Mother only working | 0.88 (0.16-4.74) | 1.83 (0.97-3.47) | ||
Neither working | 1.90 (0.72-5.01) | 0.95 (0.47-1.92) | ||
Household wealth Index
| ||||
Poorest | 1.00 | 1.00 | 1.00 | 1.00 |
Middle | 0.77 (0.51-1.15) | 0.78 (0.52-1.18) | 0.87 (0.65-1.16) | 0.89 (0.66-1.20) |
Least Poor | 0.43 (0.24 -0.79) | 0.42 (0.23-0.79) | 0.50 (0.33-0.75) | 0.52 (0.33-0.82) |
Household member
| ||||
≤5 members | 1.00 | 1.00 | ||
6-12 members | 0.86 (0.59-1.24) | 0.90 (0.73-1.11) | ||
Family Meals per day
| ||||
2 Times | 1.00 | 1.00 | ||
>2 Times | 0.89 (0.60-1.32) | 0.93 (0.69-1.26) | ||
Child level factors
| ||||
Child's age (months)
| 1.08 (1.05-1.12) | 1.08 (1.05-1.12) | 1.03 (1.02-1.04) | 1.02 (1.01-1.03) |
Gender
| ||||
Male | 1.00 | 1.00 | 1.00 | 1.00 |
Female | 0.63 (0.45-0.89) | 0.58 (0.42-0.81) | 0.77 (0.63-0.95) | 0.72 (0.58-0.90) |
Antenatal visit
| ||||
No | 1.00 | 1.00 | ||
Yes | 0.89 (0.60-1.32) | 0.77 (0.57-1.03) |