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

Thu, 21 May 2026 21:53:24 +0700

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

Sat, 23 May 2026 00:00:00 +0700

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.

Berita Kedokteran Masyarakat

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

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