Multilevel Analysis on The Contextual Effects of Posyandu Activity on The Occurrence of Stunting among children Aged 6-24 Months in Purworejo, Central Java, Indonesia

Atika Rakhmahayu1),Yulia Lanti Retno Dewi2), Bhisma Murti1)


1)Masters Program in Public Health, Universitas Sebelas Maret

2)Faculty of Medicine, Universitas Sebelas Maret



Background:Linear growth failure serves as a marker of multiple pathological disorders asso­ciated with increased morbidity and mortality, loss of physical growth potential, reduced neu­rodevelopmental and cognitive function and an elevated risk of chronic disease in adulthood. Growth faltering often begins in utero and continues for at least the first 2-years of post-natal life. This study aimed to examine contextual effects of posyandu activity on the occurrence of stun­ting among children aged 6-24 months in Purworejo, Central Java, Indonesia using mul­ti­level analysis.

Subjects and Method: A case control study was conducted in Purworejo, Central Java, from October to November 2018. A sample of 200 children aged 6-24 months from 25 integrated com­munity heath posts (posyandu) was selected by simple random sam­pling.The dependent vari­able was stunting. The independent variables were maternal mid-upper arm circumference (MUAC) at pregnancy, maternal education, paternal education, family income, food allocation, birth weight, exclusive breast­feeding, and complementary feeding. Data on child height was mea­­sured by microtoise. The other data were measured by questionnaire. The data were ana­ly­zed by a multilevel logistic regression.

Results: The risk of stunting decreased with maternal MUAC at pregnancy≥23.5 cm(b=-1.62; 95% CI=-2.93 to -0.30; p=0.016), maternal education ≥senior high school (b=-1.78; 95% CI=-3.01 to -0.55; p=0.005), paternal education ≥senior high school (b=-2.17; 95% CI=-3.66 to -0.68; p=0.004), highfamily income (b=-2.04; 95% CI=-3.40 to -0.68; p=0.003), food allo­cation (b=-2.29; 95% CI=-3.67 to -0.91; p=0.001), birth weight ≥2,500 g (b=-1.34; 95% CI= -2.67 to -0.04; p=0.043), exclusive breastfeeding (b=-2.21; 95% CI=-3.70 to -0.72; p=0.004), and appropriate complementary feeding (b=-1.70; 95% CI=-3.02 to -0.37; p=0.012). Posyandu had contextual effect on stunting in children aged 6-24 months with ICC=18.4%.

Conclusion:The risk of stunting decreases with maternal MUAC at pregnancy≥23.5 cm, ma­ternal education ≥senior high school, paternal education ≥senior high school, highfamily in­come, food allocation, birth weight ≥2,500 g, exclusive breastfeeding, and appropriate com­plementary feeding. Posyandu has contextual effect on stunting in children aged 6-24 months.

Keywords: stunting, children aged 6-24 months, multilevel analysis

CorrespondenceAtika Rakhmahayu. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36 A, Surakarta57126, Central Java, Indonesia. Email: tikarakhmaha­ 083124386960.


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