Background: Globally, in 2020, 45 million children were estimated to be wasted, and 149 million children under five years of age were estimated to be stunted. Undernutrition makes children in particular much more vulnerable to disease and death. Our study aims to examine geographic and socioeconomic disparities in child undernutrition across 514 districts in Indonesia. Methods: Employing both geospatial and quantitative analyses (descriptive statistics and Ordinary Least Squares regressions), we analyzed the disparities in the prevalence of underweight, severe underweight, wasting, severe wasting, stunting, and severe stunting among districts. Child undernutrition data were from Indonesia Basic Health Survey (Riskesdas) 2018, which included a sample of 93,620 children under five years. Socioeconomic data were from the World Bank. Results: We found a relatively large geographic and socioeconomic disparity in child undernutrition in Indonesia. By region, districts in the Papua region (including Maluku and Nusa Tenggara) had a significantly higher prevalence of underweight and wasting than those in the Java region (including Bali). Districts in Papua had 44%, 121%, 38%, and 57% higher prevalence of underweight, severe underweight, wasting, and severe wasting, respectively. Similarly, the poorest districts had a significantly higher prevalence of underweight, wasting, and stunting than the wealthiest districts. The poorest districts had 30%, 83%, 16%, 21%, and 74% higher prevalence of underweight, severe underweight, wasting, stunting, and severe stunting, respectively. These results were similar among rural districts. Conclusion: There is a significant disparity in child undernutrition across districts in Indonesia. The government needs to prioritize the reduction of child undernutrition, especially in rural areas, districts outside of Java and Bali, and the poorest and least educated areas.

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Background Accessing immediate health care during pregnancy is key to preventing and treating pregnancy-related complications, which are the leading cause of maternal morbidity and mortality. As the largest archipelago country in the world, Indonesia faces the challenges of disparity in access to healthcare services across geographical regions and socioeconomic groups. Objective This study aims to assess the relationship between perceived barriers to accessing health care and the risk of pregnancy-related complications among women of reproductive age in Indonesia. Methods Data from a nationally representative sample of 15,021 last births within 5 years preceding the 2017 Indonesia Demographic and Health Survey were analyzed to examine barriers in accessing health care and the risk of having complications during pregnancy. The statistical model of logistic regression was used to investigate the effect of barriers on the risk of pregnancy complications, and results were presented as odds ratios (ORs) with 95% confidence intervals (CIs). Results The majority of women in Sumatra and Maluku–Papua regions encountered physical, cultural, and financial barriers to accessing health care. The results indicate significantly higher odds of having complications in mothers who had distance barriers (OR: 1.46, 95% CI: 1.20–1.77), relative to mothers who reported no barriers, after adjusting for women’s characteristics. Conclusion The findings suggest that it is necessary to tackle specific physical barriers by providing more developed health-care systems in rural and geographically isolated areas, to bring health services closer to home.

ABSTRACT The implementation of government policies in stunting prevention has been carried out from the central level to the village level. The Ministry of Home Affairs annually establishes stunting locus villages in 34 provinces. At the stunting locus village, sensitive and specific interventions were carried out. Many factors influence the prevalence of stunting. This study aims to determine the determinants of stunting in locus and non-locus villages in 13 stunting locus districts in Indonesia. This study was a quantitative study with a cross-sectional design. The study was conducted in 13 districts of stunting locus. Each district was chosen one sub-district which was then selected one locus of stunting village and one village of non locus. In each village 90 children were selected. Data analysis was carried out univariate, bivariate, and multivariate with logistic regression test to see the relationship between independent and dependent variables after being controlled by several variables. The results showed that 20 percent lower chance of stunting in locus villages than non locus villages. Toddlers who are breastfed for more than 24 months have a 1.7 times risk of becoming stunted. Toddlers who do not do early initiation of breastfeeding have a 1.5 times risk of becoming stunted compared to toddlers who do early initiation of breastfeeding. High maternal education can prevent stunting 2 times compared to mothers with low education. The selection of stunting locus villages affects the prevalence of stunting. In addition, several determinant factors influence the incidence of stunting, namely the sex of the child, the duration of breastfeeding more than 24 months, the child's age,  early initiation of breastfeeding, growth monitoring, the mother's age and the mother's education.   ABSTRAK Implementasi kebijakan pemerintah dalam pencegahan stunting telah dilaksanakan mulai dari tingkat pusat sampai tingkat desa. Kementerian Dalam Negeri setiap tahun menetapkan desa lokus stunting di 34 provinsi. Pada desa lokus stunting dilakukan intervensi sensitif dan spesifik. Banyak faktor yang mempengaruhi prevalensi stunting. Studi ini bertujuan untuk mengetahui faktor determinan kejadian stunting pada desa lokus dan non lokus di 13 kabupaten lokus stunting di Indonesia. Studi ini merupakan studi kuantitatif dengan desain potong lintang. Penelitian dilakukan di 13 Kabupaten lokus stunting, setiap kabupaten dipilih satu kecamatan yang kemudian dipilih satu desa lokus stunting dan satu desa non lokus. Pada setiap desa dipilih 90 balita. Analisis data dilakukan secara univariat, bivariat, dan multivariat dengan uji regresi logistik untuk melihat hubungan variabel bebas dan terikat setelah dikontrol oleh beberapa variabel. Hasil penelitian memperlihatkan bahwa peluang terjadinya stunting 20 persen lebih rendah di desa lokus dibanding desa non lokus. Balita yang mendapatkan ASI lebih dari 24 bulan berisiko 1,7 kali menjadi stunting. Balita yang tidak melakukan inisiasi menyusui dini (IMD) berisiko 1,5 kali menjadi stunting dibandingkan dengan balita yang melakukan IMD. Pendidikan ibu yang tinggi dapat mencegah kejadian stunting 2 kali dibandingkan ibu berpendidikan rendah. Pemilihan desa lokus stunting memengaruhi kejadian stunting. Selain itu, terdapat beberapa faktor determinan yang memengaruhi kejadian stunting yaitu jenis kelamin anak, durasi menyusui ASi lebih dari 24 bulan, usia anak, IMD, pemantauan pertumbuhuan, umur ibu dan pendidikan ibu. [Penel Gizi Makan 2021, 44(2):79-92]

Anemia in Indonesia is high. One of two pregnant women suffers from anemia as highest prevalence (85%) was among pregnant women aged 15-24. Maternal anemia are at risk of maternal death and giving birth to premature infant with low birth weight. Among age group 15-24 years, 32% is anemic (both men-women). The prevalence of anemia among women higher than men. The Ministry of Health has determined the consumption of iron tablet as nutrition program among adolescents, but only 8% of female teenagers who received iron tablet. Among adolescents who didn't consume iron tablets, 26% thought that it is unnecessary. The study aims to provide information about the knowledge profile of female adolescents on anemia, and disparity among them in Indonesia. We used the 2012 and 2017 IDHS which was held in all provinces. We analyzed unmarried women aged 15-24 (weighted) descriptively to identify knowledge about anemia from knowledge adolescent reproductive health section. Disparity analysis based on the results of difference percentage of knowledge of anemia according to age group, residence, education level and region. Most female adolescents (77% and 82%) have had heard of anemia. Adolescents who lived in urban areas and aged group 20-24 had higher percentage of having knowledge, and its percentage increased along with the increasing of education. High disparity of knowledge was found by educational background. Highest knowledge of terminology of anemia is blood deficit (69% and 73%). Knowledge of how someone become anemic ranged between 1% and 39%, while more 20% didn't know. Among female adolescent, 94% knew how to treat anemia, as 18% to 63% treated anemia by consuming iron and pills to increase blood. This study indicates that knowledge of female adolescent about anemia still a challenge to reduce prevalence of anemia in Indonesia. Low education as the sub group who need intervention.