Contextual Risk Factors of Stunting and Severe Stunting among Indonesian Children Under 2 Years: Based on Cross-sectional Data from Basic Health Research.

Background: Stunting is the most common form of chronic malnutrition in children that continues to be a public health concern in Indonesia. Local capacity at district, subdistrict, and village levels is still insufficient and remains a major constraint that needs to be addressed.

Objectives: This study aimed to assess factors related to stunting and severe stunting among children aged under 2 years at the individual, household, and district levels.

Materials and methods: The integrated 2018 Indonesian Basic Health Research and National Socioeconomic Survey were analyzed utilizing multilevel multinomial logistic regression analysis to examine the role of the individual, household, and district levels with stunting and severe stunting among children aged under 2 years. The magnitude of the role of the individual/household level and district level in the prevalence of stunting and severe stunting can be seen from the Interclass Correlation Coefficient (ICC) value.

Results: At the district level, food insecurity status is the main predictor of increased odds of severe stunting. ICC individuals and households for stunting 83. 6% severe stunting 25.4%, ICC at the district stunting 16.4%, and severe stunting 74.7%. This indicates that the district level has a greater contribution to the prevalence of severe stunting and the individual/household level contributes more to the prevalence of stunting.

Conclusions: This study's findings have resulted in the influence of district contextual factors on severe stunting and an effect of the individual household factors on stunting indicating that multilevel interventions are the key to preventing and reducing stunting and severe stunting.