Community Nursing Care in Meeting Nutritional Needs of Food-Insecure Families with Stunted Toddlers in Rural Areas of Indonesia

Document Type : original article

Authors

1 Department of Community, Family & Geriatric Nursing, Faculty of Nursing, Universitas Jember, Jember, Indonesia.

2 Department of Psychiatric Nursing, Faculty of Nursing, Universitas Jember, Jember, Indonesia.

3 Department of Pediatric Nursing, Faculty of Nursing, Universitas Jember, Jember, Indonesia.

10.22038/jpp.2025.91241.5598

Abstract

Background: Families in rural areas face a high risk of having stunted toddlers, often exacerbated by household food insecurity (HFI), which prevents adequate nutritional intake. This study aims to identify the fundamental principles of community nursing care to address food insecurity for family nutritional fulfillment and tackle specific and sensitive stunting issues in toddlers.
Methods: This two-year mixed-methods study will involve families with stunted toddlers in rural Indonesia. In the first year, qualitative exploration (in-depth interviews and focused group discussions (FGD)) to identify precipitating, supporting, and reinforcing factors of stunting, HFI, and household food resilience. Quantitative analysis will identify HFI (using the Food Insecurity Experience Scale (FIES-9)), dietary diversity (FAO 2013 24/48-hour and 7-day recall), and stunting parameters (length/height, weight via WHO Anthro plus Z-score). The findings the first year will guide the development of community nursing care principles. The second year will involve testing these principles through a quasi-experimental trial, integrating health promotion and family assessment theories through family-based, Posyandu, and Puskesmas interventions for growth monitoring. Data will be analyzed using paired t-test and independent t-tests.
Results: The research aim to establish basic principles of community nursing care for addressing HFI, dietary diversity, and improving family nutrition in stunted toddlers in rural areas, supported by health promotion and family assessment theories.
Conclusions: This study seeks to define specific and sensitive community nursing care principles for addressing HFI and ensuring nutritional fulfillment in stunted toddlers in rural settings, guided by health promotion and family assessment theory.

Keywords

References

  1. Statistik BP. Prevalensi Penduduk Dengan Kerawanan Pangan Sedang Atau Berat, Berdasarkan pada Skala Pengalaman Kerawanan Pangan [Internet]. 2021
  2. Saint Ville A, Po JY, Sen A, Bui A, Melgar-Quiñonez H. Food security and the Food Insecurity Experience Scale (FIES): ensuring progress by 2030. Food security. 2019 Jun 15;11(3):483-91.
  3. Sheikomar OB, Dean W, Ghattas H, Sahyoun NR. Validity of the Food Insecurity Experience Scale (FIES) for use in League of Arab States (LAS) and characteristics of food insecure individuals by the Human Development Index (HDI). Current developments in nutrition. 2021 Apr 1;5(4):nzab017.
  4. Balistreri KS. Family structure and child food insecurity: Evidence from the current population survey. Social indicators research. 2018 Aug;138(3):1171-85.
  5. Leung CW, Stewart AL, Portela-Parra ET, Adler NE, Laraia BA, Epel ES. Understanding the psychological distress of food insecurity: a qualitative study of children’s experiences and related coping strategies. Journal of the Academy of Nutrition and Dietetics. 2020 Mar 1;120(3):395-403.
  6. Gallegos D, Eivers A, Sondergeld P, Pattinson C. Food insecurity and child development: a state-of-the-art review. International Journal of Environmental Research and public health. 2021 Aug 26;18(17):8990.
  7. Mahmudiono T, Nindya TS, Andrias DR, Megatsari H, Rosenkranz RR. Household food insecurity as a predictor of stunted children and overweight/obese mothers (SCOWT) in urban Indonesia. Nutrients. 2018 Apr 26;10(5):535.
  8. Razzaq HA, Majeed MF, Ali H. Effects of Socioeconomic Status and Food Insecurity on Stunting among Children aged 06-59 Months. Pakistan Social Sciences Review. 2022 Jun 30;6(2):986-95.
  9. Ravikumar D, Spyreli E, Woodside J, McKinley M, Kelly C. Parental perceptions of the food environment and their influence on food decisions among low-income families: a rapid review of qualitative evidence. BMC public health. 2022 Jan 5;22(1):9.
  10. Shinsugi C, Matsumura M, Karama M, Tanaka J, Changoma M, et al. Factors associated with stunting among children according to the level of food insecurity in the household: a cross-sectional study in a rural community of Southeastern Kenya. BMC public health. 2015 Apr 30;15(1):441.
  11. BPS. Profil Kemiskinan di Indonesia Maret 2023. https://www.bps.go.id/id/pressrelease/2023/07/17/2016/profil-kemiskinan-di-indonesia-maret-2023.html
  12. Kemenkes RI. Hasil survei status gizi Indonesia (SSGI) 2022.
  13. Susanto T, Rasni H, Susumaningrum LA. Prevalence of malnutrition and stunting among under-five children: A cross-sectional study family of quality of life in agricultural areas of Indonesia. Mediterranean Journal of Nutrition and Metabolism. 2021 Jun 3;14(2):147-61.
  14. Susanto, T., Yunanto, Ra., Rasni, H., Susumaningrum, La. Maternal and Child Health Status Related to Nutritional Status and Development of Children During the Lactation Period: A Cross-Sectional Study Among Mothers With Children Aged 0–6 Months in Agricultural Areas of Indonesia. Malaysian Journal of Public Health Medicine; 2021; Aug 21 (2), 61-74.
  15. Wariin S, Susanto T, Rahmawati I. Functions of Agrarian Families in the Prevention of Stunting: A Literature Review. Jurnal Keperawatan Komprehensif (Comprehensive Nursing Journal). 2024 Jan 30;10(1).
  16. Deviantony F, Susanto T. Gender role analysis in achieving farmer household food security in Jember District. AcTion: Aceh Nutrition Journal. 2024 Mar 15;9(1):120-8.
  17. Susanto T, Yunanto RA, Rasny H, Susumaningrum LA, Nur KR. Promoting Children Growth and Development: A community‐based cluster randomized controlled trial in rural areas of Indonesia. Public Health Nursing. 2019 Jul;36(4):514-24.
  18. Ainy FN, Susanto T, Susumaningrum LA. The relationship between environmental sanitation of family and stunting among underfive children: A cross-sectional study in the public health center of Jember, Indonesia.
  19. Solichah Z. Kolaborasi dan sinergi turunkan angka stunting di Jember. ANTARA. 2023 Feb. https://jatim.antaranews.com/berita/681129/kolaborasi-dan-sinergi-turunkan-angka-stunting-di-jember
  20. Susanto T, Sulistyorini L, Yudisianto A. Local-food-based complementary feeding for the nutritional status of children ages 6–36 months in rural areas of Indonesia. Korean Journal of Pediatrics. 2017 Oct 20;60(10):320.
  21. Hariani H, Rahmatiah R. A Method of Stunting Reduction Intervention Based on Community and Local Culture. Urban Health. 2021 Dec 7;3(1).
  22. Haque MA, Choudhury N, Wahid BZ, Ahmed ST, Farzana FD, Ali M, et al. A predictive modelling approach to illustrate factors correlating with stunting among children aged 12–23 months: a cluster randomised pre-post study. BMJ open. 2023 Apr 1;13(4):e067961.
  23. Nope HA. Behavior of People Affected by Stunting and Their Prevention in Meler Village and Compang Dalo Village, Ruteng District, Manggarai Regency. International Journal of Environmental, Sustainability, and Social Science. 2023 Mar 31;4(2):345-55.
Journal of Pediatric Perspectives
Volume 13, Issue 11
November 2025
Pages 19751-19767

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