Socio-economic, Environmental, and Maternal Determinants of Stunting in Children Under Five Years of Age: A Systematic Review

Abstract

Background: Stunting remains a serious chronic nutritional problem in Indonesia, with prevalence declining from 21.5% (2023) to 19.8% (2024) (Kemenkes RI, 2025), yet disparities across economic groups and regions remain wide. Objective: To synthesize evidence from the past five years (2021–2026) on socioeconomic, environmental, and maternal determinants of stunting among Indonesian children under five. Methods: A systematic literature review was conducted following the PRISMA framework, searching Scopus, PubMed, ScienceDirect, DOAJ, Google Scholar, and Sinta/Garuda. Included articles were limited to primary studies indexed in Sinta 1–4 or Scopus Q1-Q3, published 2021–2026, focusing on Indonesia; systematic and scoping reviews were excluded. Twenty-nine articles met the criteria and were synthesized narratively and in tabular form. Results: Socioeconomic determinants (maternal education, poverty, maternal employment) increased stunting risk by 1.2–2.2 times. Environmental determinants (inadequate hygiene, unimproved water sources) increased risk by 1.2–1.4 times. Maternal determinants, particularly chronic energy deficiency (CED) in pregnant women (AOR 1.63) and low birth weight history (3.3 times risk), were the strongest predictors, while exclusive breastfeeding was protective. Conclusion: Childhood stunting in Indonesia results from a complex interaction of three determinant domains, requiring integrated nutrition-specific and nutrition-sensitive interventions targeted at the poorest households and regions with the highest disparities.