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MALNUTRITION, PARENTING, POVERTY: CONSTRUCTION AND STUNTING PHENOMENA IN INDONESIA
WILLYA ACHMAD 1, NUNUNG NURWATI 2, MUHAMMAD FEDRYANSYAH 2, R. WIDYA SETIABUDI
SUMADINATA 3
1 Postgraduate Student Department Social Welfare Faculty of Social and Political Sciences, Universitas
Padjadjaran, Indonesia
2Department Social Welfare, Faculty of Social and Political Sciences, Universitas Padjadjaran, Indonesia
3 Departement International Relations, Faculty of Social and Political Sciences, Universitas Padjadjaran,
Indonesia
Email: 1 willya18001@mail.unpad.ac.id; 2 nunung.nurwati@unpad.ac.id; 3 m.fedryansyah@unpad.ac.id; 4
w.setiabudi@unpad.ac.id Orchid: https://orcid.org/0000-0002-6424-9396
Abstract
Stunting is a problem of malnutrition that causes a child's growth to not reach its potential. This article discusses the construction of stunting and the factors that influence it in Indonesia. The factors that become the subject of discussion include malnutrition, parenting and poverty. This study uses a descriptive qualitative approach by collecting data through a literature review. The findings of this study indicate that poor nutrition can result in a lack of intake of substances the body needs such as proteins, carbohydrates, fats and vitamins so that the growth of the body and brain is hampered, this poor nutrition itself is caused by improper parenting due to a lack of knowledge and skills old. Besides that, poverty is also a factor causing stunting because poverty causes families to live in unhealthy environments, such as poor sanitation and an unhygienic environment.
Keywords: Malnutrition, Parenting Style, Poverty, Incidence of stunting.
Table of Contents
1. INTRODUCTION
2. METHODS
3. RESULTS AND DISCUSSION
4. CONCLUSION
1. INTRODUCTION
According to data from the Central Statistics Agency (BPS) in 2020, the stunting rate in
Indonesia still reaches 27.67%. This figure shows that around 1 in 3 children in Indonesia is stunted. The rate of stunting in Indonesia is still far above the average rate of stunting in other Southeast Asian countries, such as Vietnam and the Philippines The high rate of stunting in Indonesia is an indicator of health and malnutrition problems which are still a serious concern in Indonesia. (Agustino & Widodo, 2022).
Stunting has a negative impact not only on children's physical development but also on their mental and emotional maturation, which in turn can have an adverse effect on a child's academic potential and future accomplishments (Daracantika et al, 2021). In addition, short stature has been linked to an increased risk of developing chronic conditions later in life, such as obesity, diabetes, and cardiovascular disease. A child's IQ, health, learning ability, productivity, and even future income can all be negatively impacted by stunting, as can a number of other aspects of their life, such as the ability to learn. Stunting can also lower a child's immune system, which can increase the likelihood that the youngster will get a disease later in life. As a result, childhood stunting is not only a problem associated with starvation in children, but also a difficult and multifaceted problem associated with health and development (Aridiyah et al, 2015).
The reasons for stunting can be broken down into a number of different categories. The way in which one raises their children is one of the established risk factors, along with dietary considerations. The problems of malnutrition and stunting can be made worse by factors such as poverty and a lack of access to health services. As a result, combating the issues of undernutrition and stunting needs to be carried out in an all-encompassing manner by means of a multidisciplinary strategy that incorporates the participation of a large number of relevant parties, such as the government, non-governmental organizations, and families (Kalsum & Jahari, 2015).
Previous studies have demonstrated that the social construction of stunting might have an effect on the measures that are made to combat it. Some people in Indonesia, for instance, believe that small and thin children are the result of inherited features or because they are active and play a lot, forgetting the significance of proper nourishment for the children's development in the process. Other individuals in Indonesia share this misconception. On the other hand, the ways in which parents raise their children are also an essential factor in the prevention and treatment of stunting. According to a number of studies, there is a correlation between children having a lower risk of stunting and parents who engage in nurturing behaviors such as exclusive breastfeeding, giving infants with nutritional meals, and providing adequate care. As a result, the part that parents and other family members play in addressing the issue of undernourishment and stunting in children is of the utmost significance (Mitra, 2015).
Apart from pattern and nutrition factors, poverty is also an important risk factor that influences the incidence of stunting in Indonesia. Poor families often have limited access to nutritious food and health services, increasing the risk of malnutrition and stunting among children. Therefore, stunting management programs in Indonesia must not only pay attention to nutritional factors and parenting styles, but also pay attention to poverty factors and provide access to nutritious food and adequate health services (Rosha et al, 2016).
In the Indonesian context, programs for handling malnutrition and stunting have been carried out by the government and non-governmental organizations through various programs, such as the Supplemental Food Program, the Family Hope Program, and the Program to Accelerate the Reduction of Stunting. The Supplemental Food Program, for example, aims to provide additional food for poor families, pregnant women and toddlers to meet their nutritional needs.
The Hope Family Program, on the other hand, provides social assistance to poor families to meet basic needs, including nutritional needs. In addition, the Stunting Reduction Acceleration Program launched in 2018 is also a strategic program to reduce stunting rates in Indonesia. This program includes several components, such as increasing access to and quality of health services, increasing community capacity in terms of health and nutrition, and improving access to clean water and sanitation (Ridua & Djurubassa, 2020).
Despite multiple efforts to address it through the aforementioned measures, the incidence of stunting in Indonesia remains high. The high rate of stunting in Indonesia demonstrates the urgent need for comprehensive and long-term control initiatives. It is believed that this research would provide a better knowledge of the constructions and factors that influence the occurrence of stunting in children in Indonesia, allowing efforts to combat malnutrition and stunting to be more effective (Archda & Tumangger, 2019).
We will perform an analysis of data obtained from various sources based on these descriptions in this study to understand the components and factors that influence the occurrence of stunting in children in Indonesia. We will investigate nutritional determinants, parenting styles, and poverty in relation to the phenomena of childhood stunting. The findings of this study are expected to provide a better knowledge of the problems of malnutrition and stunting in Indonesia, as well as policy recommendations to assist address these issues.
2. METHODS
In this study, the authors used a qualitative descriptive research type, which provides an overview of construction and the phenomenon of stunting in Indonesia seen from the factors of malnutrition, parenting and poverty. The type of research used is library research, namely data
collection or scientific writing aimed at research objects or library data collection (Moleong, 2014). Or a study conducted to solve a problem which is basically focused on critical and in-depth studies of relevant literature. The primary data sources used are books related to the stunting phenomenon and its influencing factors. Secondary data sources in this study are books, scientific articles, and sources from the internet. The descriptive method is a method used in researching a group of people, an object, a set of conditions, a system of thought, or a class of events in the present (Soendari, 2012). In this study, library research was done to acquire the data. Literature review is a research technique used to collect data and research sources from books, journals, magazines, and newspapers, among others. Collecting existing data, examining each result, and using the data sources as literature and references for understanding and analyzing research constitutes a literature review. This study uses content analysis as its method of analysis.
3. RESULTS AND DISCUSSION 1. Malnutrition on Construction and the phenomenon of stunting
Stunting is a chronic nutritional problem that occurs in children around the world. Stunting is a condition where a child has a height that is shorter than the height he should have at a certain age. This condition is caused by a lack of proper nutritional intake, especially during the first 1,000 days of life, namely during pregnancy up to 2 years of age. One of the main causes of stunting is malnutrition.
Intake of poor nutrition results in permanent damage that cannot be repaired in the future. If a mother experiences a lack of nutrition during pregnancy, the fetus will experience a reduction in the growth and development of body cells which will persist into adulthood. Research in India proves that children with malnutrition tend to be short adults and when they are adults have a tendency to give birth to small babies (Hidayat et al, 2019)
Malnutrition occurs when children do not get enough nutrition to support their physical and cognitive growth and development. Lack of nutritional intake such as protein, iron, vitamin A, and folic acid can inhibit the growth of children's height and weight, and hinder the development of the brain and central nervous system. This can result in children lacking concentration and memory, as well as lower intelligence compared to children who receive adequate nutrition. In the long term, stunting can affect the quality of life for children and adults. Stunting can increase the risk of infection, interfere with productivity and social life, and increase the risk of chronic diseases such as diabetes, obesity and cardiovascular disease.
According to the World Health Organization (2017), there are three causes of child malnutrition: direct causes, indirect causes, and basic causes. Insufficient dietary intake and infectious illnesses are the two direct causes of malnutrition. A lack of nutritional intake may result from a restricted diet or from the consumption of foods that are deficient in essential nutrients. While the illness damages various organ functions, they are unable to absorb nutrition effectively. Indirect causes of malnutrition include insufficient food, insufficient parenting and sanitation, and insufficient access to clean water and essential health services. The primary cause of malnutrition is due to economic, political, and social crises, such as natural disasters, which impact food availability, family parenting and health services, and sufficient sanitation, eventually affecting toddlers' nutritional status ( Martorell & Young, 2012).
Stunting also affects economic growth and human resource capabilities in a country. Because stunted children tend to have lower academic achievements, they have lower opportunities to get a good education. In the long term, this can hinder economic growth and reduce a country's ability to compete in global markets.
Efforts to prevent stunting must start from the gestation period up to 2 years of age, by providing adequate and appropriate nutrition. This includes exclusive breastfeeding for the first 6 months of life, appropriate complementary feeding at 6 months of age, and providing balanced and nutritious food to children at the age of 2 years and over.
In addition, providing balanced and nutritious food to children aged 2 years and over is also very important to prevent stunting. Children need sufficient intake of carbohydrates, proteins, fats,
vitamins and minerals in their daily diet. Providing balanced and nutritious food to children can help support optimal growth and development, and prevent stunting (Semba & Bloem, 2016).
In addition to providing balanced and nutritious food, it is also necessary to pay attention to environmental cleanliness and personal hygiene to prevent infections that can affect children's growth and development. In addition, proper stimulation in children is also very important to help cognitive and psychosocial development.
Overall, malnutrition can affect the phenomenon of stunting in children. To prevent stunting, efforts are needed to provide adequate and appropriate nutrition from the gestation period to the age of 2 years. By preventing stunting, it is hoped that children can achieve their potential for optimal physical and cognitive growth and development, and can contribute to the economic progress and development of a country (Wirjatmadi et al, 2017).
2. Parenting patterns of construction and the phenomenon of stunting
In addition to nutritional factors, wrong parenting can also cause stunting in children. Incorrect parenting includes a lack of attention and affection from parents or caregivers, lack of stimulation, and bad parenting behaviors such as giving excessive physical and verbal punishment.
Lack of attention and affection from parents or caregivers can cause children to experience chronic stress which can affect physical and cognitive growth and development. On the other hand, providing proper stimulation and sufficient affection can help the child's cognitive and psychosocial development. Bad parenting behavior such as giving excessive physical and verbal punishment can also have a negative impact on children's development. This can cause stress and anxiety which can affect the child's immune system and physical growth.
Parenting itself is a practice that is carried out by caregivers such as mothers, fathers, grandmothers, or other people in maintaining health, providing food, emotional support for children and providing stimulation that children need during the growth and development period. The provision and quality of food for infants is very dependent on the knowledge and education of the mother and the availability of these foodstuffs. Mother's awareness in fulfilling good nutrition in children has an important role in determining the quality of food.
According to Yudianti & Saeni (2016), that the better the mother's parenting style, the fewer children with stunting, while the worse the mother's parenting style, the more parents have stunted children. Good maternal parenting will influence how mothers practice, act or behave in caring for children. The intended mother's behavior is how the mother's behavior in providing nutritional intake, maintaining cleanliness or hygiene for children, maintaining sanitation for the child's environment and how the mother utilizes health facilities and infrastructure related to the needs of her child.
Proper nutrition must also be considered during the child's growth and development period, most mothers who provide improper nutrition to their children such as feeding their children plain rice with tempeh or rice and vegetable gravy alone are at risk of stunting. Meanwhile, mothers provide proper nutrition, such as providing foods that contain more protein, such as rice and eggs and fish as well as vegetables, to have non-stunting children (Ningtias & Solikhah, 2020)
The nurturing and caring role of the family, particularly the mother, can have an effect on the growth and development of children. Maternal parenting is the manner in which mothers care for or raise their children. In order for children's nutritional intake to be well-received, a mother's behavior includes providing breast milk or complementary foods, teaching proper eating procedures, providing food with high nutritional value, the ability to control the number of portions that must be consumed, preparing hygienic food, and correct eating patterns. However, it is also essential to ensure that the diet is diverse, so that children are pleased and enjoy a variety of good and nourishing foods. Compared to short toddlers with the same family socioeconomic status, toddlers with normal height or who are not stunted are more likely to have healthy parenting practices.
Unfavorable parenting factors can cause problems in child growth and development, this is due to mothers not understanding proper parenting methods, as well as economic conditions.
Overcoming this problem can be done several solutions such as providing education and health information related to appropriate parenting. The results of this study are also in accordance with Nurmalasari et al (2020) that parenting style has an influence on the incidence of stunting, this is because parents always accompany children and pay attention, especially in providing food intake that contains good nutrition for children, so it is hoped that children will have good nutritional status. good nutrition and preventing the risk of stunting, as well as the link with the mother's education level which can influence the mother's insight and knowledge about food sources and nutritional sources that should be consumed by children (Nurmalasari & Septiyani, 2019).
As it is known that the relationship between poor maternal parenting has a high risk of causing stunting in children. However, there is still stunting that occurs even though the mother has practiced good parenting. This may be caused by several other factors that can lead to stunting in children. One of them is the smoking behavior factor of parents, especially fathers, which can directly affect children's growth by exposing children to harmful chemicals that will inhibit growth and having indirect effects such as the lack of fulfillment of shopping needs related to reduced nutritional intake due to the cost of buying cigarettes ( Wiradnyani & Kusuma, 2019) in line with Nurmalasari's research in 2020 there is a relationship between family income and the incidence of stunting, low family income is five times more at risk of experiencing stunting than high income (Nurmalasari et al, 2020). In addition, there are still factors that need to be considered regarding stunting such as the nutritional status of the mother during pregnancy, the mother who has a short stature, the mother who during pregnancy experienced nutritional problems, anemia, a history of breastfeeding, the presence of infectious diseases that the child had experienced. So even though the mother's upbringing is good, these other factors can increase the occurrence of stunting.
3. Poverty to construction and the phenomenon of stunting
Poverty is a very complex global problem and is of concern to many countries around the world. Poverty affects many aspects of life, including health and nutrition. One of the health problems that often occurs in the poor is stunting. Stunting is a condition of failure to thrive in children as measured by a shorter height than the average child of their age. Stunting does not only affect a child's physical appearance, but can also affect their cognitive development and health in general. Stunting can also make children more susceptible to disease and infection (Zulfan & Kurniawan, 2019).
Poverty causes stunting because poor people often do not have adequate access to healthy and nutritious food, as well as clean water and adequate sanitation. Children born to poor families are also more vulnerable to malnutrition and malnutrition which can lead to stunting.
Poor environmental conditions such as inadequate sanitation, inadequate housing, and environmental pollution can also affect children's health and development and increase the risk of stunting. The poor often also do not have adequate access to health and education services that can help prevent stunting (Widiyastuti et al, 2017).
Efforts to overcome stunting in children born to poor families must be carried out with a holistic approach. To overcome stunting in poor families, there are several efforts that can be made, including:
1. Increasing access to nutritious food: Poor families often find it difficult to meet their daily nutritional requirements, so it is important to increase access to nutritious food. The government can provide food assistance programs or food subsidies for poor families.
2. Education on nutrition and healthy eating: Increasing knowledge and awareness about nutrition and healthy eating is very important. Educational programs can be carried out through social campaigns, health counseling, or training programs for young mothers.
3. Improved access to health services: Poor families often do not have access to adequate health services. Increasing access to health services, such as routine health checks, immunizations, and nutritional supplements, can help prevent stunting in children.
4. Exclusive breastfeeding: Mother's milk (ASI) is the best source of nutrition for infants and young children. Exclusive breastfeeding for the first 6 months of life can help prevent stunting in children.
5. Improved sanitation and environmental health: Poor sanitation and environmental health can lead to stunting in children. Therefore, it is important to increase access to adequate sanitation and raise awareness about environmental health.
All of these efforts can be carried out jointly by the government, social institutions, community organizations, as well as the families and individuals themselves. With the right efforts, stunting in poor families can be prevented and overcome. Poverty and stunting are two interrelated problems and require serious attention from the government, non-governmental organizations and society as a whole. With the right and integrated efforts, we can reduce stunting rates in children and help them grow and develop optimally.
4. CONCLUSION
Stunting occurs when a child is malnourished in the long term resulting in stunted growth of the body and brain. Stunting in Indonesia is closely related to poverty and lack of access to nutritious food. In addition, improper parenting also plays an important role in the occurrence of stunting. Improper parenting can occur due to a lack of knowledge and skills of parents in providing balanced and proper nutritional intake. Poverty causes families to live in an unhealthy environment, such as poor sanitation and an unhygienic environment which can exacerbate the problem of stunting in children. This article highlights that the role of government and society is very important in overcoming the problem of stunting. In overcoming the problem of stunting in Indonesia, efforts are needed that involve all sectors and aspects of life, both from the government, society and individuals. These efforts include providing better access to nutritious food, increasing parents' knowledge and skills in providing balanced nutrition, and improving environmental conditions that are healthy and hygienic. With these efforts, it is hoped that it can reduce and prevent stunting in children in Indonesia.
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