Analysis of Factors Associated with Stunting in Toddlers: A Mixed Methods Study in Banten, Indonesia

Stunting remains a major public health issue in Indonesia, particularly in regions like Pandeglang Regency, where prevalence rates are high. Understanding the contributing factors is essential for targeted interventions.

This study aimed to analyze factors associated with stunting among toddlers using a mixed-methods approach.

A cross-sectional mixed-methods study was conducted in two health centers in Banten Province from December 2021 to January 2022. Quantitative data were collected using a structured questionnaire and analyzed using chi-square tests (p <0.05). Qualitative data were gathered through in-depth interviews and focus group discussions with mothers of stunted toddlers and were analyzed thematically. Participants were selected through purposive sampling. Purposive sampling was used to select participants who met specific criteria relevant to the study objectives, ensuring the inclusion of both mothers of stunted toddlers (for qualitative analysis) and non-stunted toddlers (for quantitative analysis).

Qualitative research showed good parenting patterns of exclusive breastfeeding and health care. The pattern of providing complementary food, food preparation, and storage, and parenting practices for basic health practices still needs improvement. In quantitative research, it was found that maternal knowledge (p<0.001), exclusive breastfeeding (p<0.001), history of supplementary food (p=0.006), health workers' support (p=0.002), and socio-economic status (p<0.001) were associated with stunting. Pregnancy history (p=0.419) and history of infectious disease (p=0.419) were not associated with stunting.

There is a relationship between maternal knowledge, history of exclusive breastfeeding, history of supplementary feeding, support from health workers, and socio-economic status with the prevalence of stunting. However, the pattern of exclusive breastfeeding and seeking health services in the working areas of Bangkonol Health Center and Kaduhejo Health Center, Pandeglang Regency, is not good enough and needs to be improved. Health workers need to educate mothers with toddlers about patterns of providing complementary feeding, food preparation, and storage, and basic health practices to prevent stunting.