Faktor Risiko Koeksistensi Stunting, Anemia, dan Kekurangan Vitamin A (KVA) pada Balita di Indonesia

Abstract

Balita rentan mengalami malnutrisi, termasuk stunting, anemia, dan kekurangan vitamin A (KVA), yang dapat terjadi secara bersamaan (koeksistensi) dan memperburuk kondisi kesehatan anak. Penelitian ini bertujuan menganalisis faktor risiko koeksistensi stunting, anemia, dan KVA pada balita di Indonesia menggunakan data Survei Kesehatan Indonesia (SKI) 2023 terhadap 628 balita usia 0–59 bulan dari 34 provinsi. Hasil menunjukkan prevalensi stunting sebesar 26,2%, anemia 16,1%, KVA 9,1%, koeksistensi stunting-anemia 4,4%, stunting-KVA 2,7%, anemia-KVA 2,9%, dan kombinasi ketiganya 0,3%. Faktor yang meningkatkan risiko koeksistensi stunting-anemia meliputi panjang badan lahir pendek (OR=3,700; 95%CI=1,750–7,823; p=0,001), ibu bekerja (OR=2,111; 95%CI=1,028–4,333; p=0,042), riwayat diare (OR=3,463; 95%CI=1,054–12,592; p=0,041), dan status BB/U tidak normal (OR=5,168; 95%CI=2,458–10,868; p<0,001). Riwayat ISPA meningkatkan risiko koeksistensi anemia-KVA (OR=1,517; 95%CI=1,288–2,995; p=0,049), sedangkan penerimaan bantuan sosial menurunkan risiko koeksistensi anemia-KVA (OR=0,371; 95%CI=0,187–0,734; p=0,004). Selain itu, pendidikan ibu yang rendah (OR=11,647; 95%CI=1,137–119,329; p=0,039) dan kunjungan antenatal care (ANC) kurang dari enam kali selama kehamilan (OR=13,558; 95%CI=1,465–125,460; p=0,022) meningkatkan risiko koeksistensi stunting, anemia, dan KVA. Temuan ini menunjukkan pentingnya penguatan intervensi gizi, peningkatan kualitas layanan ANC, suplementasi zat besi dan vitamin A, edukasi gizi keluarga, serta penguatan pendidikan dan perlindungan sosial untuk mencegah koeksistensi malnutrisi pada balita.

Kata kunci: anemia, kekurangan vitamin A (KVA), koeksistensi, stunting.

Children under five years of age are vulnerable to malnutrition, including stunting, anemia, and vitamin A deficiency (VAD), which may occur simultaneously (coexistence) and worsen child health outcomes. This study aimed to analyze the risk factors associated with the coexistence of stunting, anemia, and VAD among children under five years of age in Indonesia using data from the 2023 Indonesian Health Survey (Survei Kesehatan Indonesia/SKI), involving 628 children aged 0–59 months from 34 provinces. The results showed that the prevalence of stunting, anemia, and VAD was 26.2%, 16.1%, and 9.1%, respectively. The prevalence of stunting–anemia coexistence was 4.4%, stunting–VAD coexistence was 2.7%, anemia–VAD coexistence was 2.9%, and the coexistence of all three conditions was 0.3%. Factors associated with an increased risk of stunting–anemia coexistence included short birth length (OR=3.700; 95% CI=1.750–7.823; =0.001), maternal employment (OR=2.111; 95% CI=1.028–4.333; p=0.042), a history of diarrhea (OR=3.463; 95% CI=1.054–12.592; p=0.041), and abnormal weight-for-age status (OR=5.168; 95% CI=2.458–10.868; p<0.001). A history of acute respiratory infection (ARI) increased the risk of anemia–VAD coexistence (OR=1.517; 95% CI=1.288–2.995; p=0.049), whereas receipt of government social assistance reduced the risk of anemia–VAD coexistence (OR=0.371; 95% CI=0.187–0.734; p=0.004). Furthermore, low maternal education (OR=11.647; 95% CI=1.137–119.329; p=0.039) and fewer than six antenatal care (ANC) visits during pregnancy (OR=13.558; 95% CI=1.465–125.460; p=0.022) were associated with a higher risk of coexistence of stunting, anemia, and VAD. These findings highlight the importance of strengthening nutritional interventions, improving the quality of ANC services, providing iron and vitamin A supplementation, promoting family based nutrition education, and enhancing educational opportunities and social protection programs to prevent the coexistence of malnutrition in children under five years of age.

Keywords: anemia, coexistence, stunting, vitamin A deficiency (VAD).