Prevalence and Determinants of Stunting among Female Adolescents in Priority Areas of Bali: A Cross-Sectional Study in the Year 2022

Objective: This study aims to determine the prevalence and factors associated with the occurrence of stunting in female adolescents in the Bangli Regency, Bali Province, Indonesia. Methods: This cross-sectional study was conducted from May to July 2022 in senior and vocational high schools in Bangli Regency, Bali Province, Indonesia. Adolescent girls aged 15-18 years not experiencing any illness at the time of enrolment were included. Stunting was defined using the WHO's 2007 standards (Height-for-Age z-score <-2SD). Dietary habits were evaluated using the Dietary Diversity Score (DDS), with a score of less than 5 indicating low dietary diversity. Chronic Energy Deficiency (CED) was determined by mid upper arm circumference, with a threshold of <23 cm indicating CED. Sociodemographic factors, dietary habits, and knowledge and attitudes regarding stunting were also assessed. Results: Of total 560 females, the mean age was 16.32 ±0.854 years. Stunting was observed in 66 (11.8%) adolescents. The risk of stunting was approximately 2.55 times significantly higher among adolescents with negative attitude towards stunting prevention (cOR 2.55, 95% CI 1.48 to 4.38, p-value <0.001), 2 times significantly higher among adolescents with low DDS (cOR 1.87, 95% CI 1.10 to 3.22, p-value 0.021) and experienced CED (cOR 1.76, 95% CI 1.01 to 3.04, p-value 0.042). Conclusion: This study identified a stunting prevalence of 11.8% among female adolescents in the Bangli Regency, Bali Province, Indonesia. The findings indicate that a negative attitude towards stunting prevention, poor diet, and continuous energy imbalance are significant risk factors associated with stunting.