Prevalence and determinants of childhood stunting in Indonesia: updated evidence from the national health survey

Abstract

Introduction: Stunting remains a major public health problem in Indonesia, affecting child growth, development, and future health. Many previous studies used older datasets or examined limited determinants; updated national evidence is needed. Theory: Guided by the UNICEF Conceptual Framework, stunting was examined as the result of child, maternal, and health service determinants. Method: A cross-sectional study used nationally representative data from the 2023 Indonesia Health Survey (SKI). Children aged 0–59 months were included. Stunting was defined as height-for-age z-score < −2 SD using World Health Organization standards. Descriptive analyses, chi-square tests, and hierarchical multivariable logistic regression were performed using three sequential models. Results are presented as adjusted odds ratios (AORs) with 95% confidence intervals (CIs). Results: Among 84,178 children, 21.4% were stunted. Lower odds of stunting were observed in children aged 0–11 months. Higher odds were found among boys, children with low birth weight, those without newborn examination within 6–48 hours after birth, and those not fully immunized. Maternal factors associated with higher odds included no formal education, first pregnancy before age 20 years, four or more pregnancies, and lack of antenatal care. Tetanus toxoid injection during pregnancy was associated with slightly lower odds. Child-related factors contributed most to model fit. Discussion: Stunting remains a substantial challenge in Indonesia and is shaped by child, maternal, and health service determinants. Priority actions include preventing low birth weight, strengthening antenatal and postnatal care, improving maternal education and reproductive health, and expanding vaccination coverage.