Risk Factors of Stunting Among Toddlers in the Working Area of Kandeman Community Health Center, Batang Regency

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Pekalongan– Exclusive Breastfeeding and Poor Sanitation Identified as Major Stunting Risks in Batang. The latest research by Wika Indriyani, Ardiana Priharwanti, Jaya Maulana, and Choiroel Anwar from the Public Health Study Program, Pekalongan University, published in the International Journal of Education and Life Sciences (IJELS) Vol. 4 No. 2 (February 2026).

The latest research by Wika Indriyani, Ardiana Priharwanti, Jaya Maulana, and Choiroel Anwar from the Public Health Study Program, Pekalongan University, identified four main risk factors for stunting in toddlers in the Kandeman Community Health Center working area.

The study results indicate that not receiving exclusive breastfeeding, improper complementary feeding practices, incomplete immunization, and poor environmental sanitation significantly increase the risk of stunting.

Batang Among the Highest Stunting Areas in Central Java

Nationally, Indonesia’s stunting prevalence stood at 21.6 percent in 2022—lower than the previous year but still above the World Health Organization (WHO) threshold of 20 percent and far from the national development target of 14 percent by 2024.

At the regional level, Batang Regency recorded fluctuating figures over recent years. Although prevalence declined to 13.56 percent in 2022, SSGI data still place Batang among the ten highest districts in Central Java. In January 2025, Kandeman Community Health Center reported 525 stunted toddlers—the second highest number after Bawang Health Center, which recorded 543 cases.

This situation prompted researchers to examine risk factors at the primary healthcare level.

Case-Control Study of 88 Toddlers

The study applied an analytical observational approach with a case-control design involving 88 respondents:

44 stunted toddlers (cases)
44 non-stunted toddlers (controls)

The independent variables analyzed included:

Exclusive breastfeeding
Appropriateness of complementary feeding (MP-ASI)
Basic immunization status
Environmental sanitation conditions

Data were analyzed using Chi-Square tests with a 5 percent significance level.

Non-Exclusive Breastfeeding Increases Risk Sevenfold

According to Table 1 (page 144), 68.2 percent of stunted toddlers did not receive exclusive breastfeeding.

Statistical results show:

p-value = 0.000
Odds Ratio (OR) = 7.286
95% Confidence Interval = 2.822–18.810

This means toddlers who were not exclusively breastfed were 7.2 times more likely to experience stunting compared to those who received exclusive breastfeeding.

Exclusive breastfeeding during the first six months provides optimal nutrition and immune protection during the critical First 1,000 Days of Life.

Inappropriate Complementary Feeding Raises Risk 3.4 Times

Table 2 (page 145) indicates that 63.6 percent of stunted toddlers received inappropriate complementary feeding.

Statistical findings:

p-value = 0.006
OR = 3.383
95% CI = 1.410–8.117

Toddlers who received complementary feeding too early, too late, or with insufficient nutritional quality were 3.4 times more likely to develop stunting.

WHO recommends initiating complementary feeding at six months with adequate nutritional quality and quantity to support linear growth.

Incomplete Immunization and Poor Sanitation Also Significant

Table 3 (page 145) shows that 61.4 percent of stunted children had incomplete basic immunization.

p-value = 0.000
OR ≈ 3.383

Children with incomplete immunization were more than three times as likely to experience stunting due to higher susceptibility to infectious diseases.

Meanwhile, Table 4 (page 146) highlights the impact of sanitation:

68.2 percent of stunted toddlers lived in households with poor sanitation
p-value = 0.000
OR = 7.286

Poor sanitation increases exposure to pathogens, leading to recurrent gastrointestinal infections and Environmental Enteric Dysfunction (EED), which impairs nutrient absorption.

Stunting Is a Multifactorial Condition

The study reinforces that stunting is not solely a nutritional issue. It is influenced by the interaction between:

Feeding practices
Preventive health services
Environmental hygiene

Children exposed to multiple risk factors face cumulative disadvantages during critical growth periods.

Recommendations for Integrated Intervention

The researchers recommend:

Strengthening education programs on exclusive breastfeeding and appropriate complementary feeding through maternal classes and community health posts.
Ensuring full immunization coverage through routine and catch-up programs.
Improving access to clean water and sanitation facilities.
Providing targeted assistance for high-risk households.

Nutritional interventions alone are insufficient without parallel improvements in sanitation and preventive healthcare.

Conclusion

Exclusive breastfeeding, appropriate complementary feeding, complete immunization, and good sanitation are protective factors against stunting.

Conversely, toddlers without exclusive breastfeeding and those living in poor sanitation environments face the highest risk.

An integrated First 1,000 Days of Life approach remains essential for reducing stunting at the primary healthcare level.

Author Profiles

Wika IndriyaniUniversitas Pekalongan
Ardiana PriharwantiUniversitas Pekalongan
Jaya MaulanaUniversitas Pekalongan
Choiroel AnwarUniversitas Pekalongan

Research Source

Indriyani, W., Priharwanti, A., Maulana, J., & Anwar, C. (2026). Risk Factors of Stunting Among Toddlers in the Working Area of Kandeman Community Health Center, Batang Regency. International Journal of Education and Life Sciences (IJELS), Vol. 4 No. 2, 139–150.

DOI: https://doi.org/10.59890/ijels.v4i2.273

URL: https://ntlmultitechpublisher.my.id/index.php/ijels