Spatial Distribution and Spatial Determinants of Stunting Among Under-Five Children in West Sumatra Province

Authors

  • Aztika Ramadanti Master's Program in Public Health, Universitas Andalas, Padang, West Sumatra Author
  • Defriman Djafri Master's Program in Public Health, Universitas Andalas, Padang, West Sumatra Author
  • Yudi Pradipta Master's Program in Public Health, Universitas Andalas, Padang, West Sumatra Author

DOI:

https://doi.org/10.22437/jkmj.v10i2.57612

Keywords:

Bivariate LISA, Ecological Study, Global Moran’s I, Spatial Autocorrelation, Stunting

Abstract

Stunting remains a major public health challenge because of its long-term impacts on growth, cognitive development, productivity, and future health. Marked differences in stunting prevalence across districts and municipalities in West Sumatra suggest spatial heterogeneity that cannot be adequately explained using conventional ecological approaches. This study aimed to examine the spatial distribution, spatial autocorrelation and spatial association between stunting among children under five and its ecological determinants in West Sumatra Province in 2024. An ecological study was conducted using secondary data from the West Sumatra Provincial Health Office and the Central Bureau of Statistics, covering all 19 districts and municipalities. Spatial patterns were analyzed using Global Moran's I and Bivariate Local Indicators of Spatial Association (LISA). The findings showed that stunting prevalence was predominantly moderate across the province. Global Moran's I indicated significant negative spatial autocorrelation (Moran's I = −0.245; p < 0.05), reflecting a dispersed spatial pattern. Bivariate LISA identified limited significant local associations, with clusters mainly classified as Low-Low and High-Low. These results suggest that stunting is influenced more by local contextual conditions than by geographic clustering, highlighting the need for geographically targeted and context-specific interventions to strengthen stunting prevention and control.

References

1. Nurdin A, Masrul M, Gusnedi G, Umar HB, Purnakarya I, Syafrawati S, et al. Prevalence and determinants of stunting risk factors among children under five years old: an analysis of the Indonesian secondary database. 2023. https://doi.org/10.21203/rs.3.rs-3019263/v1

2. Anjani DM, Nurhayati S, Immawati I. Implementation of Health Education to Improve Mothers' Knowledge of Stunting Among Children Under Five in the Working Area of the Banjarsari Inpatient Community Health Center, North Metro. (Penerapan pendidikan kesehatan terhadap pengetahuan ibu tentang stunting pada balita di Wilayah Kerja UPTD Puskesmas Rawat Inap Banjarsari Metro Utara). Jurnal Cendikia Muda 2024;4(1):62–9. https://jurnal.akperdharmawacana.ac.id/index.php/JWC/article/view/564

3. UNICEF / WHO / World Bank Group Joint Child Malnutrition Estimates. Levels and Trends in Child Malnutrition. 2023. https://www.who.int/publications/i/item/9789240073791

4. Kementerian Kesehatan RI. Indonesia Nutritional Status Survey 2024. (Survei Status Gizi Indonesia 2024). 2025.

https://kesprimkom.kemkes.go.id/assets/uploads/contents/others/SSGI_DALAM_ANGKA_LAUNCHING_250526_signed.pdf

5. Dinas Kesehatan Provinsi Sumatera Barat. West Sumatra Provincial Health Office Annual Report 2024. (Laporan Dinas Kesehatan Provinsi Sumatera Barat Tahun 2024). 2025.

6. Wardana W, Munibah K, Baliwati YF. Spatial Distribution Patterns of Stunting in South Lampung Regency Using a Spatial Autocorrelation Approach. (Pola sebaran spasial stunting di Kabupaten Lampung Selatan dengan pendekatan autokorelasi spasial). Journal of Regional and Rural Development Planning (Jurnal Perencanaan Pembangunan Wilayah dan Perdesaan) 2023;7(1):68–78. https://journal.ipb.ac.id/index.php/p2wd/article/view/39797

7. Setiyawati ME, Ardhiyanti LP, Hamid EN, Muliarta NAT, Raihanah YJ. Studi literatur: keadaan dan penanganan stunting di Indonesia. IKRA-ITH HUMANIORA: Jurnal Sosial Dan Humaniora 2024;8(2):179–86. https://doi.org/10.37817/ikraith-humaniora.v8i2.3113

8. Lespitawaty L, Rusmilawaty, Megawati, Yuniarti. Association Between Maternal Chronic Energy Deficiency (CED) During Pregnancy and Stunting at Bantuil Community Health Center. (Hubungan Ibu Hamil Kurang Energi Kronik (KEK) dengan Kejadian Stunting di Puskesmas Bantuil). Medic Nutricia 2025;20. https://cibangsa.com/index.php/medicnutriciajournal/article/view/6252

9. Fadillah NA, Delima AAA, Rahmadhani R, Haruna N, Manda I. Analysis of Risk Factors for Stunting Among Children Aged 6-23 Months at Pekkae Community Health Center, Tanete Rilau District, Barru Regency, 2020. (Analisis Faktor Risiko Kejadian Stunting pada Balita Usia 6 Bulan–23 Bulan di Puskesmas Pekkae Kecamatan Tanete Rilau Kabupaten Barru Tahun 2020). Al-Iqra Medical Journal: Jurnal Berkala Ilmiah Kedokteran 2022;5(2):88–100. https://doi.org/10.26618/aimj.v5i2.7937

10. Septiana E. Association of Access to Improved Sanitation and Improved Drinking Water as Sensitive Interventions with the Reduction of Stunting in the Working Area of Susunan Baru Community Health Center, Bandar Lampung. (Hubungan Akses Sanitasi Layak dan Akses Air Minum Layak Dalam Intervensi Sensitif Dengan Penurunan Kejadian Stunting di Wilayah Kerja Puskesmas Susunan Baru Kota Bandar Lampung). Jurnal Ilmu Kesehatan Masyarakat Indonesia (JIKMI) 2024;5(2). https://jurnal.umitra.ac.id/index.php/jikmi/article/view/1756/1532

11. Sonya D. Geographical Distribution of Stunting Cases in Tanah Datar Regency. Jurnal Kesehatan Cendekia Jenius. 2025.

https://jurnal.kesehatan.cendikiajenius-ind.id/index.php/jenius/article/view/331/179

12. Eryando T, Sipahutar T, et al. Spatial analysis of stunting determinants in 514 Indonesian districts/cities: Implications for intervention and setting of priority. 2022. Geospat Health. 2022 May 17;17(1). https://pubmed.ncbi.nlm.nih.gov/35579253/

13. Riznawati A, Yudhistira D, Rahmaniati M, Sipahutar T, Eryando T. Spatial Autocorrelation of Stunting Prevalence in West Java in 2021. (Autokorelasi spasial prevalensi stunting di Jawa Barat tahun 2021). Jurnal Biostatistik, Kependudukan, Dan Informatika Kesehatan 2023;3(1):2. https://doi.org/10.7454/bikfokes.v3i1.1035

14. Pradipta Y, Djafri D, Putri ASE, Ilmaskal R. Distribution of coronavirus disease (Covid-19) in west Sumatra Province with local indicator of spatial association (LISA) cluster map. Contagion: Scientific Periodical Journal of Public Health and Coastal Health 2023;5(1):141–53. https://jurnal.uinsu.ac.id/index.php/contagion/article/view/14959

15. Warin T. Spatial Autocorrelation. 2025. https://warin.ca/geospatial/11-spatial-autocorrelation.html

16. Suratri MAL, Putro G, Rachmat B, Nurhayati, Ristrini, Pracoyo NE, et al. Risk Factors for Stunting among Children under Five Years in the Province of East Nusa Tenggara (NTT), Indonesia. Int J Environ Res Public Health 2023;20(2). https://pubmed.ncbi.nlm.nih.gov/36674391/

17. Kuse KA, Debeko DD. Spatial distribution and determinants of stunting, wasting and underweight in children under-five in Ethiopia. BMC Public Health. 2023;23(1):641. https://doi.org/10.1186/s12889-023-15488-z

18. Mufida AA, Fahmi MA. Spatial Distribution of Stunting Cases in Lamongan Regency, 2023. (Pemetaan Kasus Stunting di Kabupaten Lamongan Tahun 2023). Ficco Public Health Journal 2024;1(02):42–8. https://doi.org/10.5281/zenodo.14561145

19. Fajri RN, Pertiwi TS, Nurmalasari M. Prevalence of Stunting in Sumedang Regency Using Local Indicators of Spatial Association (LISA). (Prevalensi Stunting di Kabupaten Sumedang Menggunakan LISA (Local Indicator of Spatial Association). Journal of Syntax Literate 2025;10(1). https://jurnal.syntaxliterate.co.id/index.php/syntax-literate/article/view/17361/11161

20. Hermawan A, Raras Anasi, Winarto AT, Sudikno. Factors Affecting Stunting in Indonesia in 2021: A Geographically Weighted Regression (GWR) Approach. Penel Gizi Makan 2023;2023(1):31–44. https://pgm.persagi.org/pgm/article/view/770

21. Agustina W, Fathurrahman. Maternal Chronic Energy Deficiency During Pregnancy, Low Birth Weight, and Non-Exclusive Breastfeeding as Risk Factors for Stunting. (Ibu Hamil KEK, Berat Bayi Lahir Rendah, dan Tidak ASI Eksluif sebagai Faktor Risiko Terjadinya Stunting). 2022;3(1). https://doi.org/10.31004/jkt.v3i1.4015

22. World Health Organization. Low Birth Weight. 2024. https://www.who.int/data/nutrition/nlis/info/low-birth-weight

23. Nuha R, Murni D. Analysis of Stunting Cases Across Districts/Cities in West Sumatra Province Using the Spatial Autoregressive (SAR) Method. (Analisis Kasus Stunting Kabupaten/Kota di Provinsi Sumatera Barat dengan Menggunakan Metode Spatial Autoregressive (SAR)). Journal of Mathematics UNP 2025;10(4):81–7. https://doi.org/10.24036/trqq6a30

24. Pane NK, Almadany UH, Sujoko E. Maternal Nutritional Status During Pregnancy as a Predictor of Stunting Among Children Aged 24-59 Months in South Padang Sidimpuan District. (Status Gizi Ibu Hamil sebagai Prediktor Kejadian Stunting pada Anak Usia 24–59 Bulan di Kecamatan Padangsidimpuan Selatan). PubHealth Jurnal Kesehatan Masyarakat 2025;4(1):46–53. https://doi.org/10.56211/pubhealth.v4i1.1026

25. Wahyuni NW, Makful MR. Spatial Analysis of Pneumonia Cases in Mainland West Sumatra Province in 2022. (Analisis Spasial Kasus Pneumonia di Provinsi Sumatera Barat (Daratan) Tahun 2022). Media Publikasi Promosi Kesehatan Indonesia (MPPKI) 2024;7(4):985–90. https://doi.org/10.56338/mppki.v7i4.4783

26. Aprilia D, Tono SFN. Effect of Basic Immunization Status on Stunting and Developmental Disorders Among Children Under Five. (Pengaruh status imunisasi dasar terhadap kejadian stunting dan gangguan perkembangan balita). Jurnal Kebidanan 2023;12(1):66–74. https://doi.org/10.47560/keb.v12i1.496

27. Wulandari Y, Provinsi Banten B, Kemenkes Banten P. Stunting Under Food Insecurity, Poor Sanitation, and Inadequate Drinking Water Conditions Among Families in Banten Province (Analysis of SSGI 2021 Data) 2023. (Stunting pada Kondisi Rawan Pangan, Sanitasi, dan Kelayakan Sumber Air Minum pada Keluarga di Provinsi Banten (Analisis Data SSGI 2021)). 2023.

https://jurnal.poltekkesbanten.ac.id/index.php/Medikes/article/view/524

28. Kuewa Y, Herawati H, Sattu M, Otoluwa AS, Lalusu EY, Dwicahya B. The Relationship Between Environmental Sanitation and The Incidence of Stunting in Toddlers in Jayabakti Village in 2021. Jurnal Kesmas Untika Luwuk 2021;12(2):470332. https://www.neliti.com/publications/470332/hubungan-sanitasi-lingkungan-dengan-kejadian-stunting-pada-balita-di-desa-jayaba

29. Paramasatya A, Wulandari RA. Korelasi akses sanitasi dan akses air minum dengan kejadian stunting pada balita di wilayah Kabupaten Serang tahun 2022. Jambura Journal of Health Science and Research 2023;5(2):695–706. https://ejurnal.ung.ac.id/index.php/jjhsr/article/view/19145

30. Bujawati E, Alam S, Amansyah M, Adnan Y, FW J, Putri P, et al. Determinants of Stunting in Maros Regency. (Determinan Kejadian Stunting di Kabupaten Maros). Jurnal Kesmas Jambi 2023;7(1):22–30. https://online-journal.unja.ac.id/jkmj/article/view/23392

31. Tanjung R, Lestrina D, Sinaga J, Andrianti S. Analysis of Spatial Distribution Patterns, Environmental Sanitation, and Stunting Incidence. (Analisis Pola Sebaran, Sanitasi Lingkungan dengan Kejadian Stunting). 2024;16. https://repository.poltekkes-medan.ac.id/id/eprint/1888/

32. Putri, Anandia Aliyani, Rahajeng, Anggi. Analysis of the Effects of Population Density and Socioeconomic Factors on Stunting in Java Island. (Analisis Pengaruh Kepadatan Penduduk dan Faktor Sosial Ekonomi terhadap Stunting di Pulau Jawa). 2025. https://etd.repository.ugm.ac.id/penelitian/detail/259411

33. Rinjani EZV. Risk Factors for Stunting Among Children Under Five: An Ecological Study in West Sumatra Province. (Faktor Risiko Stunting pada Balita: Studi Ekologi di Provinsi Sumatera Barat). IPB University: Scientific Repository 2024. https://repository.ipb.ac.id/handle/123456789/158902

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Published

2026-07-31

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