Background: Stunting among toddlers is highly prevalent in Indonesia. As a chronic malnutrition problem, stunting is closely related to internal (maternal health) and external factors such as feeding practices, illness and socio-economics of the community. The purpose of this study was to analyze the relationship between low birth weight (LBW), child feeding practices and neonatal illness with stunting among Indonesian toddlers. Methods: For this study, we took data from the 2010 Indonesian National Basic Health Survey (RISKESDAS). Totally 3024 children aged of 12-23 months included in this analysis. Stunting was measured using standardized body length and was defined based on criteria from WHO AnthroII.PC2007. Data analysis was done through bivariate and multivariate logistic regressions.
Results:The results showed that the prevalence of stunting among Indonesian toddlers (12 23 months) was 40.4%. Early initiation of breast-feeding and exclusive breast feeding was experienced by 42.7% and 19.7% of the babies. More than half of the babies were given pre-lacteal feeds, while early complementary feeding was given to 68.5% of the subjects. Multivariate analysis showed infants born with LBW were 1.74 times more likely to be stunted (95% CI 1.38-2.19) than those born with normal weight. Boys were 1.27 times (95% CI 1.10-1.48) more likely to be stunted than girls. Infants with a history of neonatal illness, they were 1.23 times (95% CI 0.99-1.50) more susceptible to stunting. Being poor was another indirect variable that significantly associated with stunting (OR = 1.3, 95% CI 1.12-1.51). Conclusion: LBW, gender (boys), history of neonatal illness and poverty are factors related to stunting among children aged 12-23 months in Indonesia, with LBW being the major determinant of stunting.
Background
Maternal Mortality Ratio (MMR) in Indonesia is still high, 305, compared to 240 deaths per 100,000 in South East Asian Region. The use of Traditional Birth Attendance (TBA) as a cascade for maternal health and delivery, suspected to be the pocket of the MMR problem. The study aimed to assess the influence of traditional practices on maternal health services in Indonesia.
Methods
We used two data sets of national surveys for this secondary data analysis. The samples included 14,798 mothers whose final delivery was between January 2005 and August 2010. The dependent variables were utilization of maternal healthcare, including receiving antenatal care (ANC≥4), attended by skilled birth attendance (SBA), and having a facility-based delivery (FBD). The independent variables were the use of traditional practices, type of family structure, and TBA density. We run a Multivariate logistic regression for the analysis by controlling all the covariates.
Results
Traditional practices and high TBA density have significantly inhibited the mother’s access to maternal health services. Mothers who completed antenatal care were 15.6% lost the cascade of facility-based delivery. The higher the TBA population, the lower cascade of the use of Maternal Health Services irrespective of the economic quintile. Mothers in villages with a high TBA density had significantly lower odds (AOR = 0.30; CI = 0.24–0.38; p<0.01) than mothers in towns with low TBA density. Moreover, mothers who lived in an extended family had positively significantly higher odds (AOR = 1.33, CI = 1.17–1.52; p<0.01) of using maternal health services.
Discussion
Not all mothers who have received proper antenatal delivered the baby in health care facilities or preferred a traditional birth attendance instead. Traditional practices influenced the ideal utilization of maternal health care. Maternal health care utilization can be improved by community empowerment through the maternal health policy to easier mothers get delivery in a health care facility.
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