Journal of Preventive Medicine and Public Health

Original Articles

Association Between Basic Immunization Status and Stunting in Toddlers Aged 12-59 Months in Indonesia: Eka Desi Purwanti, Siti Masitoh, Sudarto Ronoatmodjo; J Prev Med Public Health. 2025;58(3):298-306. Published online January 30, 2025; DOI: https://doi.org/10.3961/jpmph.24.230

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Objectives
Immunization has been identified as a specific nutrition-related intervention to address the direct causes of stunting. This study examines the association between basic immunization status and stunting among toddlers in Indonesia.
Methods
We conducted a cross-sectional analysis using data from the 2021 Study of Indonesia’s Nutritional Status. A total of 70 267 toddlers, aged 12 months to 59 months, were examined. Cox regression was employed to calculate adjusted prevalence ratios (aPRs) with their 95% confidence intervals (CIs).
Results
The prevalence of stunting among children aged 12 months to 59 months in Indonesia was 23.1%, while 74.9% of children under 5 years old had complete basic immunization status. Multivariable analysis revealed a statistically significant association between basic immunization status and the incidence of stunting. Relative to toddlers with complete basic immunization, those with incomplete (partial) immunization were at a 1.18 times higher risk of stunting (aPR, 1.18; 95% CI, 1.15 to 1.22). Furthermore, toddlers who had not been immunized at all faced an even greater stunting risk (aPR, 1.27; 95% CI, 1.17 to 1.37). This association persisted after adjusting for variables such as maternal education, economic status, and the child’s birth weight.
Conclusions
Basic immunization status influences the incidence of stunting in toddlers aged 12 months to 59 months. Thus, parents must ensure that their children’s immunizations are completed according to the recommended schedule. Additionally, it is crucial to increase parental awareness regarding health service utilization, disease prevention, and the nutritional needs of toddlers.

Summary

Key Message
Stunting remains a major public health concern in Indonesia. Immunization is recognized as a specific nutrition-related intervention to address its direct causes. Using data from 70,267 toddlers aged 12–59 months, this study found that children with partial or no basic immunization had significantly higher risks of stunting (aPR 1.18 and 1.27, respectively) compared to fully immunized peers. Given the high stunting prevalence (23.1%) and suboptimal immunization coverage (74.9%), the findings underscore the need to strengthen immunization programs and enhance parental awareness of health service utilization, disease prevention, and the nutritional needs of young children.

Citations

Citations to this article as recorded by

Mapping and Forecasting District-Level Stunting Dynamics in Indonesia Toward SDG Target 2.2: A Hybrid Bayesian-Machine Learning Spatiotemporal Analysis
I Gede Nyoman Mindra Jaya, Bertho Tantular, Sinta Septi Pangastuti, Kiki Amelia, Cece Mulyadi, Farah Kristiani
Sustainability.2026; 18(12): 5959. CrossRef

Common Mental Disorders and Associated Factors During Pregnancy and the Postpartum Period in Indonesia: An Analysis of Data From the 2018 Basic Health Research: Arum Ariasih, Besral , Meiwita Budiharsana, Sudarto Ronoatmodjo; J Prev Med Public Health. 2024;57(4):388-398. Published online June 19, 2024; DOI: https://doi.org/10.3961/jpmph.24.082

21,125 View
776 Download
5 Web of Science
10 Crossref

Abstract Summary PDF

Objectives
A substantial proportion of women experience mental health challenges during pregnancy or the postpartum period. Common mental disorders (CMDs), including depression, anxiety, and obsessive-compulsive disorder, are prevalent. Identifying causes and associated risk factors is imperative for early intervention and the prevention of mental health issues.
Methods
This study utilized data from the 2018 Basic Health Research, which was conducted nationwide in Indonesia, using a crosssectional approach. We focused on women aged 13-49 years who were currently or previously married, and had experienced pregnancy, including 8889 pregnant women and 77 012 women who had delivered between January 1, 2013 and August 31, 2018. The Self-Reporting Questionnaire-20 was employed to assess CMDs. Multivariate logistic regression was performed.
Results
The prevalence of CMDs in pregnant women was 12.6%, while postpartum mothers exhibited a prevalence of 10.1%. Poor health status displayed the strongest impact on CMDs during both pregnancy (adjusted odds ratio [aOR], 12.23; 95% confidence interval [CI], 9.01 to 16.60) and the postpartum period (aOR, 16.72; 95% CI, 14.85 to 18.82). Additional significant factors for both group include young maternal age, lack of education, unemployment, history of hypertension, and smoking status. Among pregnant women, CMDs was also associated with first-trimester pregnancy, previous pregnancy complications, and small upper arm circumference. For postpartum mothers, significant factors include living in rural areas, history of abortion, unwanted pregnancy, pregnancy complications, lack of antenatal care, spontaneous delivery, postpartum complications and contraceptive use.
Conclusions
CMDs can impact in pregnant and postpartum women. Early diagnosis and management must be seamlessly integrated into primary healthcare practices.

Summary

Key Message
A significant proportion of women experience common mental disorders (CMDs) during pregnancy (12.6%) and postpartum (10.1%) in Indonesia. Poor health status is the strongest predictor of CMDs in both periods. Other significant factors include young maternal age, lack of education, unemployment, hypertension history, and smoking. Additional pregnancy-specific factors are first-trimester pregnancy, previous complications, and small upper arm circumference. In contrast, postpartum factors include rural living, abortion history, unwanted pregnancy, pregnancy complications, lack of antenatal care, spontaneous delivery, postpartum complications, and contraceptive use. Integrating early diagnosis and management of CMDs into primary healthcare is essential.

Citations

Citations to this article as recorded by

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British Journal of Nutrition.2026; 135(6): 653. CrossRef
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Nur'aini Inayah, Eufrasia Kartika Hanindraputri
Asian Journal of Psychiatry.2026; 122: 105057. CrossRef
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E3S Web of Conferences.2025; 609: 04002. CrossRef
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