The Association between Household Food Security with Stunting

Incidence in Children Aged 6-23 Months in Sukaluyu and

Srikamulyan Village Karawang Regency

Alfi Fairuz Asna

, Praudya Denisa Ramadhanty

, Tri Marta Fadhilah

Public Health Faculty, Universitas Diponegoro, Semarang, Indonesia

Nutrition Program, STIKES Mitra Keluarga, Bekasi, Indonesia

Keywords: Household Food Security, Stunting, Children Aged 6-23 months.

Abstract: Stunting is the impact of malnutrition in a long period of time which ultimately causes linear growth

retardation in children under two years old. A number of the causes of stunting is that access and affordability

to food are still low. This study aims to determine the relationship between household food security and

stunting in children aged 6-23 months in Sukaluyu and Srikamulyan Village, Karawang Regency. This study

used an observational study with a cross-sectional design. The sample of this research were 144 children aged

6-23 months. Data were analyzed by using univariate and bivariate. Statistic test in bivariate analysis used

spearman correlation. Bivariate analysis showed that food security of the household had no correlation with

stunting incidence children aged 6-23 months (p = 0.457). There was no significant correlation between

household food security and stunting incidence in children aged 6-23 months in Sukaluyu and Srikamulyan

Village, Karawang Regency.

1 INTRODUCTION

Stunting is the impact of malnutrition, occurring over

a long period of time which ultimately causes linear

growth retardation (Schmidt, 2014). One of the

assessments of nutritional status based on the WHO

classification is to use indicators of PB/U (body

length according to age) or TB/U (height according to

age). TB/U indicator with cut-off point z-score in the

short category of -3SD to ≤-2 SD and very short, it is

<-3 SD. This indicate of chronic nutritional problems

as a result of long-lasting conditions that result in

children becoming short. Based on basic health

research data (Balitbangkes, 2013) the prevalence of

stunting in Indonesia nationally in 2007 (36.8%) and

2010 (35.6%) and an increase again in 2013 (37.2%).

Basic health research data shows that there was a

decline in stunting in 2018 to 30.8%. According to the

results of Riskesdas (2013), the prevalence of

stunting in West Java is 30-40%. According to the

National Team for the Acceleration of Poverty

Reduction (TNP2K) the prevalence of stunting in

2013 in the Karawang area was 34.87%. Factors

related to the incidence of stunting such as low

maternal education, low maternal knowledge, so that

the parenting pattern of mothers to infants and

toddlers becomes less precise. In addition, low family

economic factors can lead to low family nutritional

adequacy, especially infants and toddlers (Beal,

Tumilowicz, Sutrisna, Izwardy, & Neufeld, 2018)

Household food security is one of the factors for

fulfilling the nutrition of family members. The

emergence of various malnutrition problems is

caused by not achieving nutritional security as a result

of unfulfilled household food security. The novelty

element of this research is that the researcher collects

data on the stunting locus area set by the government.

This study aims to analyze the relationship between

food security and the incidence of stunting in children

aged 6-23 in Sukaluyu and Srikamulyan Villages,

Karawang Regency

2 METHODS

This study used a cross-sectional design. The study

population was all children aged 6-23 months in

Sukaluyu Village and Srikamulyan Village,

Karawang Regency. The sample size of the study was

144 children 6-23 months, consisting of 48 children

Asna, A., Ramadhanty, P. and Fadhilah, T.

The Association between Household Food Security with Stunting Incidence in Children Aged 6-23 Months in Sukaluyu and Srikamulyan Village Karawang Regency.

DOI: 10.5220/0010758300003235

In Proceedings of the 3rd International Conference on Social Determinants of Health (ICSDH 2021), pages 43-47

ISBN: 978-989-758-542-5

who were stunted and 96 were not stunted. The

sample was selected by simple random sampling

technique. The dependent variable in this study was

stunting, while the independent variable was

household food security.

Data collected by interview using a questionnaire

includes data on the characteristics of children under

two such as age and gender, and data on family

characteristics such as education of the head of the

household, education of housewives, age of head of

household, number of family members, occupation of

head of household, income of head of household.

Data on maternal nutritional knowledge, and

nutritional intake were also taken.

The Household Food Insecurity Access Scale

questionnaire used to measure household food

security which consists of 9 questions is also taken.

Each question in the questionnaire was given a score

of 1. Categorization of family food security, namely

food security was given a score of 0-1, slightly food

insecure 2-7, moderate food insecurity 8-14. Stunting

and non-stunting children were assessed using the

PB/U index and anthropometric measurements of

body length were carried out using a length board

with an accuracy of 0.1 cm. The statistical analysis

used the Spearman test to analyze the correlation

between household food security and stunting.

The research has obtained approval from the

research ethics commission of the University of

Muhammadiyah Prof. DR. HAMKA (KEPK-

UHAMKA) Jakarta with number 03/18/.12/034.

Meanwhile, consent to participate in the study from

children 6-23 months was obtained through informed

consent signed by the mother or family.

3 RESULTS

Characteristic data taken include the age and gender

of children, family characteristics data such as

education of the head of the household, education of

housewives, age of the head of the household, number

of family members, occupation of the head of the

household, income of the head of the household,

knowledge of maternal nutrition, and nutrient intake.

The most education of the head of household was

middle education (46.5%) and the most housewives’

education is low education (52.8%). The age of the

head of household is mostly at the age of 31-49 years

(61.8%), the greatest number of family members is

the small households (66%), and the work of the head

of household is mostly on employees. The income of

head of household in the high category that was

86.1%. Mother's nutritional knowledge on the

question of the definition of nutrition who answered

correctly was 53.5%, the definition of nutritious food

who answered correctly was 86.1%, and the source of

carbohydrates who answered correctly was 74.3%.

Most of the respondents (52.5%) were male, and aged

0-12 months (55.6%).

Table 1: Socio-economic characteristics of the family and

the characteristics of the respondents

Characteristics

Jumlah

n %

Head of household education

No school

Low education

Middle education

higher education

3,5

45,1

46,5

4,9

Housewife education

No school

Low education

Middle education

higher education

4,2

52,8

34,7

8,3

Age of head of household

16-18 years old

19-30 years old

31-49 years old

50-64

ears ol

7,0

35,4

61,8

2,1

Number of Family Members

Small household <4 people

Medium household 5-6 people

Large household >7 people

32,6

1,4

Head of household job

Not Working

Employee

entrepreneur

Farmer/fisherman/labor

Others

2,8

41,7

31,9

18,8

4,9

Head of household income

Low

High

124

13,9

86,1

Child gender

Man

Girl

52,5

47,9

Child's age

0-12 months

12-24 months

55,6

44,6

Based on the table 2, it shows that the highest

prevalence is in the slightly food insecure category,

which is 45.8%. The results of the analysis of the

nutritional status of PB/U (stunting) show that there

are 33.3% of children aged 6-23 months who are

stunted.

ICSDH 2021 - International Conference on Social Determinants of Health

Table 2: Distribution of respondents by food security and stunting

Category

Total P-value

Stunting Normal

n % n % n %

0,457

Severe food insecurity 2 33,3 4 66,6 6 100

Moderate food insecurity 10 50 10 50 20 100

Slightly food insecurity 19 28,7 47 71,2 66 100

Food secure 17 32,6 35 67,3 52 100

Based on Table 3, it shows that the highest low energy

intake, low fat intake, and low carbohydrate intake

were in households slightly food insecure (30.5%,

34,7%, and 31,2%). The highest low protein intake is

in households’ food secure 27%.

The results of the Spearman correlation test show

a p-value of 0.457 which means that there is no

significant relationship between household food

security and stunting (p>0.05). The data above shows

that households with severe food insecurity and

experiencing stunting are 33.3%, households with

moderate food insecurity and experiencing stunting

are 50%, households are slightly food insecurity and

experience stunting 28.7%, and households are food

insecure and experienced stunting 32.6%.

4 DISCUSSION

4.1 Respondent Characteristics

This study took data on family characteristics, namely

parental education, age of the head of the household,

The Association between Household Food Security with Stunting Incidence in Children Aged 6-23 Months in Sukaluyu and Srikamulyan

Village Karawang Regency

occupation of the head of the household, monthly

income, household size, knowledge of maternal

nutrition. The results of the analysis of household

social characteristics show that the highest education

level for the head of household is SMA/SMK at

46.5%, the mother's education is SMA/SMK 34.7%.

The work of the head of household is mostly

owned by the respondents, namely employees by

41.7%. This is in line with the research of Utami and

Sisca (2015) in Bogor, West Java, most heads of

households have an employee job of 46.2% (Utami &

KP, 2015). According to Baliwati et al. (2015) that

the economic status of a household is determined by

the type of work (Baliwati, Briawan, & Melani,

2015). Heads of poor households who live in urban

areas are more likely to have status as laborers/

employees/ employees/ others. In addition, the heads

of poor households in rural areas tend to work in the

agricultural sector (Sugiyarto, Mulyo, & Seleky,

2015).

The variable age of the head of the household is at

most 30-49 years old at

61.8%. Most of the age of the

head of the household belongs to the middle age

group. The characteristics of the monthly income of

the head of the household are seen from the Poverty

Line. In Karawang Regency the average respondent

is included in the non-poor household with a high-

income category of 86.1%. According to Rachman

and Supriyati (2005), the income level in rural areas

is much lower than the income level in urban areas

(Rachman & Supriyati, 2005). When a household is

in the poor category, it will be constrained in meeting

food needs because of limited income which leads to

hunger and food insecurity (Damayanti, 2018).

Income affects food security (Shisanya &

Mafongoya, 2016); (Herawati, Ginting, Asngari,

Susanto, & Puspotawati, 2011); (Mohammadi, et al.,

2011); (Shoae, Omidvar, & ghazi-tabatabaie, 2007).

The characteristic of household size is mostly owned

by respondents, namely 3-4 people in one family by

66%. This is in line with Ashari's research (2017),

most households fall into the small household

category of 82.4%. This is in line with what (Olaniyi

A., 2014) stated that household size is related to

household income. High-income households tend to

have small household sizes and vice versa (Olaniyi

A., 2014). The characteristics of the nutritional

knowledge of mothers who answered correctly were

mostly on the question of the definition of nutritious

food, namely 86.1%. According to

Yuliana et al.

(2013) knowledge of nutrition of housewives has a

positive effect on household food security (Yuliana,

Zakaria, & Adawiyah, 2013).

4.2 The Relationship between Food

Security and Stunting Incidents in

0-23 Months Children

The results of the data show that households with

severe food insecurity have 33.3% stunting children,

while food insecure households have 32.6% stunting

children. Based on statistical tests, there is no

significant relationship between household food

security and the incidence of stunting as shown by the

results of the Spearman correlation test (p>0.05). The

results of the study (Saaka et al. 2014) a study

conducted in Northern Ghana stated that there was no

relationship between the nutritional status index

(stunting) and household food security. This study

also states that household food security is not a

sensitive indicator for children under 2 years of age

(Saaka, 2014). Emiyas and Mengistie's research

(2017) reveals that there is no relationship between

food security and stunting, because malnourished

children are children whose nutritional status is poor

as a result of inadequate care and poor child health,

not only in terms of food. Emiyas and Mengistie's

research findings (2017) point to the fact that food

security is a necessary but not sufficient condition to

ensure good nutritional status (Mulu & Mengistie,

2017).

According to research (Spiro et al. 2010) in

Kailali Nepal stated that there is no significant

relationship between food security and the incidence

of stunting, because not only food access affects

stunting but also family socioeconomic welfare, low

birth weight, infectious diseases and diarrhea,

hygiene and sanitation, mother's education, mother's

knowledge about optimal nutrition

, non-exclusive

breastfeeding parenting, incomplete immunization

status (Osei, et al., 2010).

5 CONCLUSION

Based on the results of the research and discussion in

the previous chapter, the researcher can conclude that

there is no significant relationship between household

food security and stunting. The prevalence of stunting

under two children was mostly found in food insecure

households, namely 33.3%, while stunting children

under five in food insecure households was 32.6%

The

prevalence of stunting under children aged 0-24

months in Sukaluyu and Srikamulyan Villages,

Karawang Regency is 33.3%.

ICSDH 2021 - International Conference on Social Determinants of Health

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The Association between Household Food Security with Stunting Incidence in Children Aged 6-23 Months in Sukaluyu and Srikamulyan

Village Karawang Regency