Explaining the fall of socioeconomic inequality in childhood stunting in Indonesia

Abstract

In spite of the enormous economic progress and development witnessed in Indonesia in the last few decades, still more than 30% of Indonesian children under the age of five suffer from stunting, or low height for age. This concern is exacerbated by the fact that stunting remains more concentrated among the poorer households, leading to further intergenerational transmission of poverty and ill health. We examine recent trends in the evolution of the prevalence of childhood stunting and severe stunting, its socioeconomic inequality and the factors that appear to have contributed to these developments. Using the two most recent waves of the Indonesia Family Life Survey (IFLS), we study the changes in the prevalence of (severe) stunting between 2007 and 2014 for children aged 0–59 months and their socioeconomic-inequality using the Erreygers Concentration Index (EI) and its regression-based decomposition. We find a significant drop in the rate of severe stunting but not in stunting, as well as a significant reduction in the degree of absolute inequality of stunting. A decomposition analysis shows that household wealth, maternal education, institutional delivery, and availability of adequate sanitation contribute most to socioeconomic inequality in under-five stunting. Further analysis of the change in inequality over time indicates that the reduction in the association of wealth with stunting and a substantial improvement of health care access of the poor (as proxied by immunizations and institutional deliveries) play the most important role in narrowing the stunting gap between richer and poorer kids. General economic growth, poverty reduction, and implementation of pro-poor health and social programs during the studied period such as the expansion of health insurance coverage for the poor (Jamkesmas) and Conditional Cash Transfer program ( Program Keluarga Harapan, PKH ) are some plausible explanations of the observed result.

Social Determinants and Access to Water-Sanitation-Hygiene as Dominant Risk Factors of Stunting among Under-five Children in Rural Area of East Indonesia

“…Over one-third (30.8%) under-five children were stunted in 2018 [1]. This prevalence is even higher among poor households and who is living in rural areas in Indonesia [6][7][8][9].…”

Hubungan Faktor Air dan Sanitasi dengan Kejadian Stunting pada Balita di Indonesia

“…Sebagian besar bukti hasil penelitian di Indonesia menunjukkan bahwa faktor air mencakup sumber air minum unimproved, pengolahan air minum dapat meningkatkan kejadian stunting pada balita (Badriyah & Syafiq, 2017;Fikru & Doorslaer, 2019;Hasanah & Susanti., 2018;Irianti S, et al, 2019;Otsuka et al, 2019;Siswati, 2019;Torlesse. et al, 2016;Hasan & Kadarusman., 2018;Nasrul, 2018;Zairinayati & Purnama, 2019).…”

“…Sebagian besar hasil temuan di wilayah Pedesaan Indonesia terkait sanitasi penggunaan fasilitas jamban mulai dari kepemilikan jamban, jenis jamban, jamban tidak menggunakan septik tangki , kebersihan jamban, perilaku Open defecation dan pembuangan tinja balita tidak pada jamban berhubungan dengan peningkatan stunting pada balita di Indonesia (Ahmadi et al, 2020;Badriyah & Syafiq, 2017;Choirunnisa et al, 2020;Dwipayanti et al, 2020;Fikru & Doorslaer, 2019;Hasanah & Susanti., 2018;;Hafid., et al, 2017;Hasan & Kadarusman., 2018;Herawati et al, 2020;Nasrul, 2018;Otsuka et al, 2019;Rahayu et al, 2017;Lobo et al, 2020;Siswati, 2018;Torlesse. et al, 2016;Wiyono et al, 2019;cahyono et al, 2016;Rahayu dan Darmawan, 2019;Zairinayati & Purnama, 2019) .…”

Penerapan Teknologi Deteksi Dini Stunting Sebagai Upaya Peningkatan Status Gizi Anak Di Kelurahan Siwalankerto Kecamatan Wonocolo Surabaya

“…Stunting (kerdil) adalah dimana keadaan balita mempunyi tinggi badan yang kurang bila dibandingkan dengan teman seumurnya. Kondisi ini dapat dinilai melalui pegukuran tinggi badan yang lebih minus dua standar deviasi median standar pertumbuhan normal pada anak (Rizal & van Doorslaer, 2019). Stunting berdampak pada meningkatnya kematian pada anak, mempengaruhi kognitif dan motorik, menurunkan kinerja di sekolah, meningkatkan kejadian obesitas serta penyakit tidak menular ( Black RE, et al 2013(Nefy et al, 2019).…”