Association Between Household Structure and Concurrent Stunting and Overweight Among Young Children in Indonesia: Evidence from A National Health Survey

Abstract

Objectives To examine the association of household type and household composition with concurrent stunting and overweight in young children in Indonesia. Methods A secondary data analysis of children aged 2–5 years (n = 45,050) in a nationally representative cross-sectional survey (Indonesian Basic Health Research/RISKESDAS 2013). We utilized household member information to construct the household structure which was analyzed as household type (nuclear, extended, and grandfamilies), number of parents, household size, number of working adults, number of dependent adults and number of dependent children. We defined concurrent stunting and overweight as height-for-age Z-score +2 based on WHO Child Growth Standards. Multivariate logistic regression was performed separately for urban and rural to assess the relationship between household structure variables and concurrent stunting and overweight. The analyses were weighted to reflect national estimates and were adjusted for confounding variables. Results The prevalence of concurrent stunting and overweight was higher in children from the nuclear household (5.8%) than those living in extended household (4.5%) or grandfamilies (4.9%). In rural areas, children from extended households had lower odds of concurrent stunting and overweight compared to those from nuclear households (OR: 0.76; 95% CI: 0.61–0.95). In urban areas, when compared to small-sized households (2–4 people), the odds of concurrent stunting and overweight in children decreased to 0.71 (95% CI: 0.55–0.90), 0.67 (95% CI: 0.47–0.97), and 0.65 (95% CI: 0.38–1.10), respectively for households with five, six, and seven or more people. We also found that when compared to households with three or more working adults, the odds of concurrent stunting and overweight in children increased to 1.66 (95% CI: 1.09–2.54) and 1.91 (95% CI: 1.22–2.99), respectively for households with two and one working adult. However, such association was not observed in rural settings. Conclusions The extent to which household structures were associated with concurrent stunting and overweight in children differed between urban and rural. These findings highlight the need to consider different strategies addressing double burden of malnutrition for children living in urban and rural areas. Funding Sources None.