Abstract

Stunting remains the largest public health challenge among macro-nutrition problems in Indonesia, affecting almost a quarter of children under five in 2023. The prevalence is considered high according to the World Health Organization standard. This study analyzed 15 aggregated provincial variables from the 2023 Indonesian Health Survey using Structural Equation Modeling (SEM), focusing on determinants of stunting among children under two to identify primary intervention levers. Findings indicated that intervention urgency should focus on the first 1,000 days, particularly the steep increase in stunting prevalence observed in the 12–24-month age range. While the highest prevalence is in Eastern provinces (e.g., Central Papua, 39.4%), 51% of children with stunting were concentrated in five densely populated provinces (e.g., West and Central Java). The SEM consistently identified underweight (standardized coefficient: 0.69) and wasting (standardized coefficient: 0.57) as the strongest positive determinants of provincial stunting prevalence. Controlling acute malnutrition is essential; a 1% decrease in wasting is projected to reduce stunting prevalence by 1.2%. Furthermore, increasing coverage of key interventions, such as complete basic immunization and appropriate complementary feeding, is negatively associated with stunting, providing critical operational targets.

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