DOI: https://doi.org/10.14710/jpki.21.2.146%20-%20155

An Analysis of Reproductive Health Risks, Health Worker Role, and Family Prosperity as a Determinant of Stunting Prevention

*Fikitri Marya Sari orcid scopus  -  Faculty of Health Sciences, Universitas Dehasen Bengkulu, Indonesia
Yusran Fauzi scopus  -  Faculty of Health Sciences, Universitas Dehasen Bengkulu, Indonesia
Wulandari Wulandari scopus  -  Faculty of Health Sciences, Universitas Dehasen Bengkulu, Indonesia
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Abstract

Background: Stunting is a complex public health issue, influenced by various biological aspects, medical services, and socioeconomic conditions. In Lebong Regency, the prevalence of stunting showed variability, with a recent increase that requires a thorough investigation of its determinants. Reproductive risks in couples of childbearing age (PUS) related to the 4T criteria (too young, too old, too close pregnancy interval, and too many children), the role of health workers, and family prosperity are thought to correlate with stunting prevention.

Method: This study employed a quantitative analytical design with a cross-sectional approach, utilizing secondary data from the National Population and Family Planning Board (BKKBN) in 2024. A total of 20,327 families in Lebong Regency became the study population. Following validation and data cleaning stages, 17,922 families were selected as samples using purposive sampling based on the criteria of adequate data completeness. The analyzed variables included reproductive risks of PUS 4T, the role of health workers, family prosperity, and stunting prevention Data analysis included univariate analysis, bivariate analysis using the chi-square test, and multivariate analysis through multiple logistic regression to determine the most influential factors.

Result: The investigation revealed that factors including reproductive risk of PUS 4T, health workers’ involvement, and family prosperity conditions significantly correlated with stunting prevention efforts (p<0.001). Multivariate analysis identified reproductive risk of PUS 4T as the most dominant predictive indicator (OR=2.109; 95% CI: 1.958–2.273). Therefore, this study emphasized the need to strengthen reproductive health programs, increase the effectiveness of the role of health workers, and improve family prosperity through an integrated approach.

Keywords: Reproductive risk, Health worker, Prosperity, Stunting


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Keywords: Reproductive risk, Health worker, Prosperity, Stunting

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Section: Research Article
Language : EN
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  1. Sari FM, Wulandari W, Sofais DAR, Novega N, Ramlis R, Fauzi Y, et al. Determinants of stunting in children under five. Media Publikasi Promosi Kesehatan Indonesia. 2026;9(1):165–78
  2. World Health Organization, World Bank, UNICEF. Level and trend in child malnutrition. Geneva: World Health Organization;2023
  3. ati D, Laksono AD, Khairunnisa M, Purwoko S, Wulandari Muis E, Nursafingi A, et al. Education role in stunting under two years among poor communities in Indonesia. J Promosi Kesehat Indones [Internet]. 2024 [cited 2026 Jun 25];20(1):30–6
  4. Global Nutrition Report. 2022 Global Nutrition Report [Internet]. Bristol: Development Initiatives; 2022
  5. N. Analisis faktor determinan stunting di Desa Pesa Kecamatan Wawo Kabupaten Bima. J Manaj Kesehat Indones. 2020;8(2):120–6
  6. Lestari E, Siregar A, Hidayat AK, Yusuf AA. Stunting and its association with education and cognitive outcomes in adulthood: a longitudinal study in Indonesia. PLoS One. 2024;19(5):e0295380
  7. de Hoop T, Molotsky A, Walcott R, Gaitán-Rossi P, Hernández-Cordero S, Laar A, et al. The role of nutrition-sensitive interventions in improving nutritional outcomes: findings from a systematic review and meta-analysis. Int J Equity Health. 2025;24(1):325
  8. World Health Organization. Interventions for improving complementary feeding practices. Geneva: World Health Organization; 2024
  9. Zaleha S, Idris H. Implementation of stunting program in Indonesia: a narrative review. J Adm Kesehat Indones. 2022;10(1):143–51
  10. Sari K, Sartika RAD. The effect of the physical factors of parents and children on stunting at birth among newborns in Indonesia. J Prev Med Public Health. 2021;54(5):309-16
  11. de Onis M, Branca F. Childhood stunting: a global perspective. Matern Child Nutr. 2016;12(Suppl 1):12–26
  12. Aini Q, Mufarika M, Aini N. Correlation between pregnancy anemia and nutritional status of pregnant women to the case of toddlers 2-5 years old with stunting. J Sci Res Educ Technol (JSRET). 2022;1(2):162–74
  13. Azarine S, Meinarisa, Sari PI. Hubungan pengetahuan, peran petugas kesehatan, dan dukungan keluarga terhadap perilaku pencegahan stunting pada ibu hamil di wilayah kerja Puskesmas Pondok Meja Jambi Tahun 2023. J Ilm Ners Indones. 2023;4(1):116–23
  14. Sari FM, Fauzi Y. Pengelolaan sumber daya manusia bidang kesehatan. Bantul: CV. Mitra Edukasi Negeri; 2025
  15. Siswati T, Iskandar S, Pramestuti N, Raharjo J, Rubaya AK, Wiratama BS. Impact of an integrative nutrition package through home visit on maternal and children outcome: finding from locus stunting in Yogyakarta, Indonesia. Nutrients. 2022;14(16):3448
  16. Elisaria E, Mrema J, Bogale T, Segafredo G, Festo C. Effectiveness of integrated nutrition interventions on childhood stunting: a quasi-experimental evaluation design. BMC Nutr. 2021;7(1):17
  17. Shofiyulloh AF, Wasil M. Determinan kesehatan, perlindungan sosial dan akses sanitasi dalam menurunkan prevalensi stunting di Indonesia. JDEP (Jurnal Dinamika Ekonomi Pembangunan). 2024;7(2):69–79
  18. Putri SM, Rokhaidah R. Indikator sosial ekonomi dan ketahanan pangan keluarga dengan kejadian stunting pada balita. J Keperawatan Widya Gantari Indones. 2023;7(1):68-78
  19. Rezaeizadeh G, Mansournia MA, Keshtkar A, Farahani Z, Zarepour F, Sharafkhah M, et al. Maternal education and its influence on child growth and nutritional status during the first two years of life: a systematic review and meta-analysis. EClinicalMedicine. 2024;71:102574
  20. Chakraborty R, Armijos RX, Beidelman ET, Rosenberg M, Weigel MM. Household food and water insecurity and its association with diarrhoea, respiratory illness, and stunting in Ecuadorian children under 5 years. Matern Child Nutr. 2024;20(4):e13689
  21. Alivia F, Sabri R, Banowo AS. The relationship between household food security and stunting incidence in toddlers. Indones J Glob Health Res. 2024;6(S5):491–500
  22. Azriani D, Masita, Qinthara NS, Yulita IN, Agustian D, Zuhairini Y, et al. Risk factors associated with stunting incidence in under five children in Southeast Asia: a scoping review. J Health Popul Nutr. 2024;43(1):174
  23. United Nations Children's Fund. UNICEF conceptual framework on nutrition. New York: UNICEF; 2021
  24. Fauzi Y, Sari FM. Determinan keluarga berisiko stunting di daerah pesisir Kecamatan Nasal Kabupaten Kaur. J Sains Kesehat. 2025;32(1):56-66
  25. Pan American Health Organization, World Health Organization. Global child malnutrition estimates dashboard. Washington, D.C.: PAHO/WHO; 2023
  26. ilmu kesehatan. Bantul: CV. Mitra Edukasi Negeri; 2025
  27. Essilfie G, Kofinti RE, Asmah EE. Reducing stunting and underweight through mother’s birth spacing: evidence from Ghana. BMC Pregnancy Childbirth. 2024;24(1):624
  28. Tamirat KS, Tesema GA, Tessema ZT. Determinants of maternal high-risk fertility behaviors and its correlation with child stunting and anemia in the East Africa region: A pooled analysis of nine East African countries. PLoS One. 2021;16(6):e0253736
  29. Torlesse H, Benedict RK, Craig HC, Stoltzfus RJ. The quality of maternal nutrition and infant feeding counselling during antenatal care in South Asia. Matern Child Nutr. 2021;17(3):e13153
  30. Bridge R, Lin TK. Evidence on the impact of community health workers in the prevention, identification, and management of undernutrition amongst children under the age of five in conflict-affected or fragile settings: a systematic literature review. Confl Health. 2024;18(1):16
  31. Alristina AD, Laili RD, Nagy É, Feith HJ. The importance of socioeconomic factors associated with maternal nutrition knowledge and undernutrition among children under five. Nutrients. 2025;17(21):3355
  32. Vongsakit S, Ohara K, Fujita Y, Takada A, Kouda K. Household wealth index is associated with stunting among children under 5: a cross-sectional analysis of the Lao social indicator survey II. J Physiol Anthropol. 2025;44(1):20-34
  33. Astuti Y, Paek SC, Meemon N, Marohabutr T. Analysis of traditional feeding practices and stunting among children aged 6 to 59 months in Karanganyar District, Central Java Province, Indonesia. BMC Pediatr. 2024;24(1):29
  34. Nafisah KD, Christiana I. Maternal characteristics associated with stunting incidence: a cross-sectional study. Women Midwives Midwifery. 2025;5(2):48–59
  35. Feyissa TR, Chojenta C, Hassen TA, Beyene T, Khan MN, Bagade T, et al. Short birth/pregnancy interval and its association with adverse maternal outcomes in Asia Pacific Region: A systematic review and meta-analysis. Midwifery. 2025;144:104342
  36. Lathifah N, Kusumawati L, Palimbo A, Jannah F. The correlations between the determinants of women’s health during pregnancy to the incidence of stunting. Health Sci Int J. 2024;2(1):12–23
  37. Darma IGAS, Wibowo IPA, Setiawan KH, Pasek MS. Maternal factors associated with stunting in children under five in Asia: a systematic review. JIMKI (Jurnal Ilmiah Mahasiswa Kedokteran Indonesia). 2026;12(3):836-55
  38. Teddyansyah, Ariani M, Fetriyah UH, Latifah F. Riwayat hipertensi dan paritas ibu dengan kejadian stunting pada balita. Surya Medika: Jurnal Ilmiah Ilmu Keperawatan dan Ilmu Kesehatan Masyarakat. 2025;20(2):102–9
  39. Garina LA, Dewi MK, Trusda SAD, Purbaningsih W, Muflihah H, Tursina A, et al. Maternal, child, and household risk factors for children with stunting. Open Public Health J. 2024;17(1):e18749445321448
  40. Dharminto D, Agushybana F, Nuridzin DZ, Sevtiani I, Winarni S, Fitri IA. Revealing the social and reproductive health dimensions associated with stunting among children 6-23 months in urban areas of Indonesia. J Health Educ. 2025;10(1):30-41
  41. Maravilla JC, Betts K, Adair L, Alati R. Stunting of children under two from repeated pregnancy among young mothers. Sci Rep. 2020;10(1):14265
  42. Atamou L, Rahmadiyah DC, Hassan H, Setiawan A. Analysis of the determinants of stunting among children aged below five years in stunting locus villages in Indonesia. Healthcare (Basel). 2023;11(6):810
  43. Das M, Jana A, Muhammad T. Understanding the associations between maternal high-risk fertility behaviour and child nutrition levels in India: evidence from the national family health survey 2015–2016. Sci Rep. 2022;12(1):17742-56
  44. Syabania R, Yuniar PA, Fahmi I. Faktor-faktor prenatal yang mempengaruhi stunting pada anak usia 0-2 tahun di wilayah Asia Tenggara: literature review. J Nutr Coll. 2022;11(3):188–96
  45. Sukmawati S, Hermayanti Y, Fadlyana E, Maulana I, Mediani HS. Health cadres’ experiences in detecting and preventing childhood stunting in Indonesia: a qualitative study. BMC Public Health. 2025;25(1):2987-96
  46. Widiasih R, Sunjaya DK, Rahayuwati L, Rusyidi B, Ermiati, Sari CWM, et al. Evaluating the knowledge, roles, and skills of health cadres in stunting prevention: a mixed-method study in Indonesia. Belitung Nurs J. 2025;11(3):330–9
  47. Pranata MAE, Sadiq F, Wang JY, Yeh YL. Effectiveness of interventions utilizing community health worker model on reducing stunting in low- and middle-income countries: a systematic review. Iran J Public Health. 2025;54(11):2442–55
  48. Galasca SA, Fadhilah I. Peran penyuluhan kesehatan dalam pencegahan stunting pada anak usia dini menggunakan pendekatan berbasis komunitas. J Human Educ (JAHE). 2024;4(5):753–8
  49. Safrudin B, Setia Purdani KS, Zalukhu I, Reinita D, Kurniawan N, Anastasya K, et al. Efektivitas pemberdayaan masyarakat terhadap pencegahan stunting pada balita: literature review. J Kesehat Ilm Indones (Indonesian Health Scientific Journal). 2025;10(2):234-45
  50. Nadifa SA, Sutarto S, Kusumaningtyas I. A literature review: the benefits of home visit interventions by health workers in preventing stunting. Med Profession J Lampung. 2024;14(8):1627–34
  51. Yani DI, Rahayuwati L, Sari CWM, Komariah M, Fauziah SR. Family household characteristics and stunting: an update scoping review. Nutrients. 2023;15(1):233
  52. Harahap H, Syam A, Palutturi S, Syafar M, Hadi AJ, Ahmad H, et al. Stunting and family socio-cultural determinant factors: a systematic review. Pharmacogn J. 2024;16(2):268–75
  53. Rafi’i A, Sari AS, Ririnsahawaitun. The relationship between maternal characteristics and socioeconomic factors and the incidence of stunting among children under five in Palembik Village. Omni Nurs J. 2025;2(2):30–9

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