Geographic and Socioeconomic Disparity in Child Undernutrition across 514 Districts in Indonesia

Abstract

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.

District-Level Inequalities in Hypertension among Adults in Indonesia: A Cross-Sectional Analysis by Sex and Age Group

“…A reference to the provinces and regions is provided in Appendix A . In Indonesia, the western part is generally more developed (especially Java and Bali) than the eastern part (including Papua, Nusa Tenggara, and Maluku) [ 15 , 16 , 17 ]. In terms of urban and rural, we conducted the analyses using all districts, urban districts (i.e., cities) and rural districts (i.e., regencies).…”

“…By income level, we grouped district-level poverty rates into five quintiles, with quintile one being the poorest (or highest poverty rates) and quintile five being the wealthiest (or lowest poverty rates). By education level, we grouped the net enrollment ratios of senior secondary into five quintiles, with quintile 1 being the least educated and quintile 5 being the most educated [ 15 , 16 , 17 ].…”

Increasing mother’s knowledge through “Isi Piringku” education as an effort to prevent stunting among toddlers in Sungai Tuan Ulu Village, Banjar Regency

“…Secara global, diperkirakan sebanyak 149 juta anak balita stunting (Ayuningtyas et al, 2022). Stunting adalah kekurangan gizi kronis, di mana tinggi badan anak tidak sesuai dengan usianya dan menyebabkan kerusakan fisik dan kognitif yang signifikan (Onis & Branca, 2016).…”

Maternal and Child Health handbook and under-6 child overweight in greater Jakarta, Indonesia: a cross-sectional web-based survey

“…The reported associations between parents’ education level, [ 11 , 13 , 17 , 19 ] economic level [ 14 , 17 , 20 ] and child obesity have been inconsistent among previous studies. In previous studies in Indonesia, being a male child, having parents who are overweight, having a father with a university education, [ 13 , 14 ] being part of a family in the higher economic quintile, [ 14 , 17 ] being stunted, [ 18 , 20 ] being an urban resident, [ 13 , 16 , 17 ] having a low physical activity level, [ 17 ] consuming ultra-processed food, [ 13 ] and frequent intake of fried foods [ 19 ] have been identified as risk factors for child obesity. However, the way in which the MCH handbook relates to child nutrition in current conditions regarding the increasing prevalence of child overnutrition has not been investigated.…”