Berita Kedokteran Masyarakat

A multilevel analysis of the double burden of malnutrition among under-five children within the same household in Indonesia

Agnes Boenardy — 2026-05-21

Purpose: Indonesia faces a persistent double burden of malnutrition (DBM), in which undernutrition and overnutrition coexist within populations. Although national stunting rates have declined, other nutritional challenges persist across provinces, with moderate-to-high rates indicating a complex nutritional transition. This study aims to identify individual, household, and contextual factors influencing the DBM among children in the same household and to provide evidence-based recommendations for region-specific, sustainable interventions.

Methods: Using cross-sectional data from the Indonesian Nutrition Status Survey (SSGI) 2024, we analyzed 0-59-month-old children using multilevel logistic regression. Progressive models examined individual, household, and contextual (district or provincial) determinants of DBM, defined as the coexistence of undernutrition and overnutrition within households.

Results: The prevalence of household-level DBM was 0.08%. In adjusted models, residing in Java–Bali was associated with significantly lower odds of DBM (OR = 0.39; 95% CI: 0.27–0.57). Children without birth certificates had significantly higher odds of experiencing DBM (OR=1.70; 95% CI: 1.48–1.95). Exclusive breastfeeding was associated with lower odds of DBM (OR = 0.54; 95% CI: 0.48–0.61). Households having more than one child under five showed substantially higher odds of DBM (OR = 3.30; 95% CI: 2.93–3.71), and district-level DBM remained a strong contextual predictor (OR = 2.01; 95% CI: 1.66–2.45). At the contextual level, the district-level DBM index remained strong contextual predictor.

Conclusion: Household-level DBM among children in Indonesia exists but remains rare, yet it signals emerging intra-household nutritional inequalities and complexity. Key determinants include household structure, exclusive breastfeeding, birth certificate ownership, region disparities, and district-level contextual factors. These findings highlight the need for integrated, multilevel interventions that address both undernutrition and overnutrition, particularly in vulnerable households and underserved areas.

Work-related quality of life and its predictors among mining industry workers: a cross-sectional study

Galuh Saraesti Ardhianingrum — 2026-05-23

Purpose: This study aimed to examine the associations between Work-Related Quality of Life (WRQoL) domains and overall Quality of Work Life (QoWL) among mining employees and to assess the relative contribution of each domain to QoWL.

Methods: A cross-sectional study was conducted among 187 Dump Truck (DT) operators in a coal mining site in East Kalimantan, Indonesia. Data were collected using the standardized WRQoL instrument. QoWL was analyzed as a continuous variable. Bivariate analysis was performed using Pearson correlation, and multivariate analysis was conducted using multiple linear regression to examine the associations between WRQoL domains and QoWL.

Results: Five WRQoL domains, consisting of general well–being, home–work interface, job and career satisfaction, control at work, and working conditions, were significantly associated with overall QoWL (all p < 0.001). Stress at work was not significantly associated with QoWL (p = 0.345). In the multivariate model (R² = 0.727), all five domains remained significantly associated with QoWL, with control at work (β = 4.085), job and career satisfaction (β = 3.917), and home–work interface (β = 3.848) demonstrating the strongest relative contributions.

Conclusion: QoWL among mining employees is shaped by both structural and psychosocial factors, with work–life balance, autonomy, and career satisfaction playing key roles. These findings highlight the importance of organizational strategies that enhance working conditions, support work–life integration, and promote career development to improve workforce well–being in high-risk industries.

Distribution of maternal and child characteristics based on stunting status among children under five years in a primary health care setting

Nursindia A Sugoro — 2026-05-22

Purpose: Stunting remains a major public health concern in Indonesia, particularly among children under five, as it is linked to impaired growth and developmental outcomes. This study aimed to describe the distribution of maternal and child characteristics according to stunting status in a primary health care setting.

Methods: A cross-sectional study was conducted among children under 5 years of age (0–59 months) using systematic random sampling (n = 110). Data were collected through structured interviews with mothers and supplemented by health center records. Stunting status was determined using height-for-age z-scores from the 2020 Primary Health Care Center report, in accordance with standard child growth monitoring practices. A bivariate analysis using the chi-square test was conducted to examine crude associations between maternal and child characteristics and stunting.

Results: Stunting was more common among children whose mothers had lower nutritional knowledge, lower educational attainment, and shorter maternal height. A higher proportion of stunting was also observed among children with a history of infectious diseases and those with limited access to health services. Maternal nutritional knowledge, maternal education, maternal height, history of infectious diseases, and access to health services were statistically associated with stunting (p < 0.05), while household income was not (p = 0.094).

Conclusion: Several maternal and child characteristics were statistically associated with stunting at the bivariate level. These findings highlight the importance of strengthening maternal education, nutrition counseling, infection prevention, and access to primary health care services. However, the results should be interpreted cautiously as they reflect crude associations rather than independent effects.

Determinants and contextual barriers of childhood stunting in rural Indonesia: a mixed-methods study in Sengonwetan Village

Fadhilah Apriliandri — 2026-05-26

Purpose: Stunting continues to pose a significant child health burden in Indonesia, particularly in rural settings where healthcare access, maternal education, and dietary quality remain limited. Addressing these community-level determinants is crucial to accelerating progress in reducing stunting. This study aimed to identify the determinants and explore contextual barriers of childhood stunting among children under five in Sengonwetan Village, Grobogan Regency, Indonesia.

Methods: A mixed-methods cross-sectional study was conducted in March 2025 involving 120 children aged 6–59 months selected through stratified random sampling. Anthropometric measurements followed World Health Organization standards. Household food security, dietary diversity, and maternal characteristics were assessed using structured questionnaires, while qualitative interviews explored contextual barriers. Quantitative data were analyzed using logistic regression, and qualitative data were analyzed thematically.

Results: Stunting prevalence was 21.7%. Children of mothers with lower education had higher odds of being stunted (AOR 2.10; 95% CI 1.05–4.20). Household food insecurity (AOR 1.80; 95% CI 1.02–3.22) and low dietary diversity (AOR 1.95; 95% CI 1.10–3.48) were also associated with increased odds of stunting. Recurrent diarrheal episodes emerged as the strongest determinant (AOR 3.20; 95% CI 1.30–7.85). Qualitative findings highlighted limited dietary diversity, economic constraints, and inadequate sanitation as key contextual barriers.

Conclusion: Childhood stunting in this rural setting is influenced by both measurable determinants and contextual barriers, particularly maternal education, household food security, dietary diversity, and recurrent infections. Integrated, community-based interventions that address both behavioral and structural factors are essential to accelerate reductions in stunting.

Identifying critical behavioral gaps in standard precautions among healthcare workers: a CSPS-based study at an academic hospital in Yogyakarta

Marselinus Edwin Widyanto Daniwijaya — 2026-05-30

Purpose: Compliance with standard precautions is essential to mitigate healthcare-associated infections (HAIs) and occupational hazards. However, behavioral gaps often persist despite institutional policies. This study aimed to evaluate compliance with standard precautions among healthcare workers at Universitas Gadjah Mada (UGM) Academic Hospital.

Methods: This cross-sectional study was conducted in 2024 among 120 healthcare workers across the outpatient, inpatient, and emergency units at UGM Academic Hospital in Yogyakarta. Participants were selected according to predefined inclusion and exclusion criteria. Adherence was assessed using the 20-item Compliance with Standard Precautions Scale (CSPS), with responses recorded on a 4-point Likert scale (ranging from never to always). Data were analyzed using descriptive statistics and the Kruskal-Wallis test to assess the significance of demographic factors.

Results: The mean compliance score was 80.458, and 66.67% of participants were categorized as having "Moderate" compliance. Critical deficits were identified in needle recapping (Item 4; score 67/120) and ocular protection (Item 13; score 67/120). Work duration had no significant effect (p > 0.05), whereas educational background significantly influenced compliance (p < 0.05), with Diploma IV and Bachelor-graduated staff outperforming those with advanced specialist or doctoral degrees. Compliance levels were consistent across all workplace units, with no statistically significant differences (p > 0.05).

Conclusion: Selective compliance remains a challenge in clinical settings. Institutional interventions should move beyond theoretical training to prioritize targeted behavioral reinforcement for staff at all educational levels.