Background Childhood stunting remains the most challenging consequence of undernutrition because it is associated with suboptimal brain development and the subsequent increased risk of metabolic diseases and decreased earnings in adult life. The Sambas District in Indonesia has a high prevalence of stunting (28.4%), followed by underweight (25.5.%) and wasting (14.4%) among children, as well chronic energy deficiency (27%) and anemia (62%) among pregnant women. The present study sought to determine significant factors in childhood stunting with a focus on maternal and child nutrition and prenatal and postnatal determinants. Methods This prospective, repeat, cross-sectional study investigated factors associated with stunting among 559 infants age 0–11 months in Sambas District, Indonesia. Anthropometric measurements were performed by trained enumerators. Data from a 2016 survey of pregnant women and a 2017 survey on mothers and their children were used for postnatal data collection to quantify the prevalence of stunting at age 0–11 months. Using 20 potential predictors of stunting categorized by household characteristics, maternal characteristics, antenatal care services, and child characteristics, logistic regression analysis was conducted to assess the adjusted association between stunting and these factors. Results Of 559 children analyzed, 20.8% were stunted. In the model with low birth weight (LBW) as predictor for stunting, the odds of stunting increased significantly among children who weighed <2.500 g at birth; children who had diarrhea in the past 2 weeks and children who had incomplete basic immunization coverage as infants age 9–11 months. In model without LBW, the odds of stunting increased significantly among children who had preterm at birth, short maternal stature and children who had incomplete basic immunization coverage for 9–11 months infants. Conclusions Postnatal factors—preterm birth, low birth weight, diarrhea and complete basic immunization coverage—were associated with infant stunting in Sambas District, Indonesia. The prenatal factors such as short maternal stature were significant in the multivariate model. Policy makers, especially in the government, should recommend measures focused on those prenatal and postnatal factors to prevent stunting in children and to avoid the sequelae of childhood stunting in adult life.

Salah satu bentuk medikalisasi kelahiran adalah angka persalinan sectio caesarea yang tinggi. Hasil beberapa studi menunjukkan bahwa dokter ahli kebidanan dan kandungan merupakan faktor penting yang menentukan persalinan yang dijalani responden. Penelitian ini bertujuan menilai perandokter ahli kebidanan dan kandungan dalam mengambil keputusan untuk melakukan sectio caesarea dibandingkan persalinan normal dengan mengontrol variabel sosiodemografi dan faktor risiko ibu. Penelitian dilakukandengan metode cross sectional menggunakan data Survei Demografi dan Kesehatan Indonesia (SDKI) DKI Jakarta. Populasi penelitian adalah wanita pernah kawin usia 15 – 44 tahun yang memiliki riwayat melahirkan 5 tahun terakhir sebelum survei dilakukan. Hasil penelitian menunjukkanpemilihan petugas pelayanan antenatal berhubungan dengan persalinan sectio caesarea, tetapi hubungan ini tidak berdiri sendiri, terkait dengan pengaruh status ekonomi rumah tangga. Dari penelitian ini disimpulkan bahwa terdapat hubungan yang signifikan antara responden yang memilihdokter ahli kebidanan dan kandungan sebagai petugas pelayanan antenatal dengan persalinan sectio caesarea yang juga dipengaruhi oleh status sosial ekonomi rumah tangga responden. Selain status sosial ekonomi, variabel yang berhubungan dengan persalinan sectio caesarea adalah usiaibu, paritas ibu, pendidikan ibu, riwayat komplikasi kehamilan, dan riwayat perdarahan.Kata kunci: Sectio caesarea, dokter ahli kebidanan dan kandungan, sosiodemografi, faktor risiko ibuAbstractOne of the birth medicalization form is the high number of sectio caesarea deliveries. Result of some studies shows that obstetrician is a factor which can determine the preference type of delivery. The purpose of this study is to assess the role of the obstectrician in order to make decision making inpreference sectio caesarea delivery than vaginal delivery after controlled with sociodemographic factors and maternal risk factor. The study was a cross sectional study using a quantitative approach. This study using secondary data which obtained from Indonesia Demographic and Health Survey 2007 with subset of the research is DKI Jakarta region. Population of this study was married women with age between 15 – 44 years old who has delivery history in term of 5 years before the survey. The study shows significant correlation between prenatal care workers with sectio caesarea delivery but this correlation also has an interaction with household economic status variables. There is significant correlation between respondent whose prenatal care with obstectrician with sectio caesarea delivery. This correlation also related with household economic status. Others variables related to sectio caesarea delivery beside social economic status are maternalage, parity, maternal education, complication during pregnancy history, and bleeding history.Keywords: Sectio caesarea, obstetrician, sociodemographic, maternal risk factor