Effectiveness of Education and Supplementary Feeding Interventions in Stunting Prevention: A Systematic Review

Ernawati Ernawati; Gita Indri Puspitawanti; Qorinah Estiningtyas Sakilah Adnani; Hadi Susiarno

doi:10.55681/jige.v7i1.5053

Authors

Ernawati Magister of Midwifery, Faculty of Medicine, Padjadjaran University, Bandung, Indonesia
Gita Indri Puspitawanti Magister of Midwifery, Faculty of Medicine, Padjadjaran University, Bandung, Indonesia
Qorinah Estiningtyas Sakilah Adnani Department of Public Health, Faculty of Medicine, Padjadjaran University, Bandung, Indonesia
Hadi Susiarno Department of Obstetrics and Gynecology, Faculty of Medicine, Padjadjaran University, Bandung, Indonesia

DOI:

https://doi.org/10.55681/jige.v7i1.5053

Keywords:

Education, Supplementary Feeding, Stunting, Stunting Prevention

Abstract

This coverage review aims to identify the effectiveness of educational interventions and supplementary feeding as preventive measures against stunting among children aged 6 to 59 months in various countries. The methodology applied in this study follows the PRISMA guidelines to ensure a systematic and transparent review process. A comprehensive literature search was conducted through relevant electronic databases, including Google Scholar, PubMed, and ScienceDirect, focusing on articles published between 2020 and 2024. Only studies written in English and examining supplementary feeding practices for children within the specified age range were included. From the total number of articles initially identified, 11 studies met all eligibility criteria and were analyzed in depth. The findings indicate that educational interventions for parents and the provision of diverse supplementary foods such as milk-based products, eggs, lipid-based supplements, and locally sourced nutrient-dense foods play a significant role in improving weight and height outcomes in young children. These foods, which are rich in protein, vitamins, minerals, and other essential micronutrients, contribute substantially to supporting growth and preventing nutritional deficiencies. Furthermore, the results highlight that appropriate feeding practices by caregivers, particularly mothers, are crucial for the successful prevention of stunting. Overall, this review concludes that proper supplementary feeding strategies, combined with strengthened parental education on nutrition, can effectively promote optimal growth and development in children under five. Continuous efforts to improve community awareness, enhance feeding practices, and ensure accessibility of nutritious supplementary foods are essential strategies to reduce stunting prevalence globally

Downloads

Download data is not yet available.

References

Aisyah Bella, N., Risca Fauzia, F., & Lailatul Mahfida, S. (2024). Parental Feeding Styles Related to the Stunting in Sleman, Indonesia. J. Gizi Pangan, 19(2), 314–321.

Akombi, A. h. (2017). stunting and severe among childern under 5 years in nigeria: a multi level analysis. B MC Pediatric, 1-16. https://doi.org/10.1186/s12887-016-0770-z

Apriluana G, F. S. (2018). Analisis Faktor-faktor terhadap Kejadian Stunting pada Balita (0-59 Bulan) di Negara Berkembang dan Asia Tenggara. Meida Penelitian dan Pengembangan Kesehatan, 28 (4), 247-256. https://doi.org/10.22435/mpk.v28i4.472

Ara, G., Sanin, K. I., Khanam, M., Sarker, M. S. A., Tofail, F., Nahar, B., Chowdhury, I. A., Boitchi, A. B., Gibson, S., Afsana, K., Askari, S., & Ahmed, T. (2022). A comprehensive intervention package improves the linear growth of children under 2-years-old in rural Bangladesh: a community-based cluster randomized controlled trial. Scientific Reports, 12(1). https://doi.org/10.1038/s41598-022-26269-w

Ararsa, G. G., Getachew, M. T., Diddana, T. Z., & Alemayehu, F. R. (2023). Prevalence of undernutrition and associated factors among children aged 6-23 months: A cross-sectional analysis from South-East Ethiopia. Journal of Nutritional Science, 12. https://doi.org/10.1017/jns.2023.109

Ashraf, K., Huda, T. M., Ikram, J., Ariff, S., Sajid, M., Khan, G. N., Umer, M., Ahmed, I., Dibley, M. J., & Soofi, S. B. (2024). The Effectiveness of Nutritional Interventions Implemented through Lady Health Workers on the Reduction of Stunting in Children under 5 in Pakistan: The Difference-in-Difference Analysis. Nutrients, 16(13). https://doi.org/10.3390/nu16132149

Bierut, T., Duckworth, L., Grabowsky, M., Ordiz, M. I., Laury, M. L., Callaghan-Gillespie, M., Maleta, K., & Manary, M. J. (2021). The effect of bovine colostrum/egg supplementation compared with corn/soy flour in young Malawian children: A randomized, controlled clinical trial. American Journal of Clinical Nutrition, 113(2), 420–427. https://doi.org/10.1093/ajcn/nqaa325

Capra, M. E., Decarolis, N. M., Monopoli, D., Laudisio, S. R., Giudice, A., Stanyevic, B., Esposito, S., & Biasucci, G. (2024). Complementary Feeding: Tradition, Innovation and Pitfalls. In Nutrients (Vol. 16, Issue 5). Multidisciplinary Digital Publishing Institute (MDPI). https://doi.org/10.3390/nu16050737

Chiwila, M. K., Krebs, N. F., Manasyan, A., Chomba, E., Mwenechanya, M., Mazariegos, M., Sami, N., Pasha, O., Tshefu, A., Lokangaka, A., Goldenberg, R. L., Bose, C. L., Koso-Thomas, M., Goco, N., Do, B. T., McClure, E. M., Hambidge, K. M., Westcott, J. E., & Carlo, W. A. (2024). Junk food use and neurodevelopmental and growth outcomes in infants in low-resource settings. Frontiers in Public Health, 12. https://doi.org/10.3389/fpubh.2024.1308685

Costa, A., & Oliveira, A. (2023). Parental Feeding Practices and Children’s Eating Behaviours: An Overview of Their Complex Relationship. In Healthcare (Switzerland) (Vol. 11, Issue 3). MDPI. https://doi.org/10.3390/healthcare11030400

Dinkes Jabar. (2023). Laporan Penyelenggaraan percepatan penurunan stunting provinsi jawa barat semester II - Tahun 2023. Jawa Barat: Dinkes Jabar

Effendy, D. S., Prangthip, P., Soonthornworasiri, N., Winichagoon, P., & Kwanbunjan, K. (2020). Nutrition education in Southeast Sulawesi Province, Indonesia: A cluster randomized controlled study. Maternal and Child Nutrition, 16(4). https://doi.org/10.1111/mcn.13030

Kemenkes RI. (2013). Riset Kesehatan Dasar 2013. Jakarta: Kemenkes RI.

Kemenkes RI. (2018). Survei Kesehatan Indonesia (SKI). Jakarta: Badan kebijakan pembangunan kesehatan.

Kemenkes RI. (2023). Petunjuk Teknis Pemberian Makanan Tambahan (PMT) berbahan Pangan Lokal Untuk Balita dan Ibu Hamil. 1-105

Kemenkes. (2022). Survei Status Gizi Indonesia. Jakarta: Kemenkes.

Khan, G. N., Kureishy, S., Ariff, S., Rizvi, A., Sajid, M., Garzon, C., Khan, A. A., De Pee, S., Soofi, S. B., & Bhutta, Z. A. (2020). Effect of lipid-based nutrient supplement-medium quantity on reduction of stunting in children 6-23 months of age in Sindh, Pakistan: A cluster randomized controlled trial. PLoS ONE, 15(8 August). https://doi.org/10.1371/journal.pone.0237210

Kusunawati, R. S. (2015). Model of stunting risk factor control among children under three years old. Kesmas: National public health journal, 205-212. https://doi.org/10.21109/kesmas.v9i3.572

Margaritha Sustanti, Kalsum, U., & Siregar, N. (2023). The Effect of Giving PMT Combination of Mung Bean Porridge and Boiled Eggs on Changes in Weight and Height of Stunting Toddlers at the Barong Tongkok Health Center. Formosa Journal of Science and Technology, 2(2),655–670.https://doi.org/10.55927/fjst.v2i2.2641

Masilela, L. N., & Modjadji, P. (2023). Child Nutrition Outcomes and Maternal Nutrition-Related Knowledge in Rural Localities of Mbombela, South Africa. Children, 10(8).https://doi.org/10.3390/children10081294

Modjadji, P., & Mashishi, J. (2020). Persistent malnutrition and associated factors among children under five years attending primary health care facilities in Limpopo Province, South Africa. International Journal of Environmental Research and Public Health, 17(20), 1–15. https://doi.org/10.3390/ijerph17207580

Mutumba, R., Pesu, H., Mbabazi, J., Greibe, E., Nexo, E., Olsen, M. F., Briend, A., Mølgaard, C., Michaelsen, K. F., Ritz, C., Filteau, S., Mupere, E., Friis, H., & Grenov, B. (2024). Effect of lipid-based nutrient supplements on micronutrient status and hemoglobin among children with stunting: secondary analysis of a randomized controlled trial in Uganda. American Journal of Clinical Nutrition, 119(3), 829–837. https://doi.org/10.1016/j.ajcnut.2024.01.018

Nyamasege, C. K., Kimani-Murage, E. W., Wanjohi, M., Kaindi, D. W. M., & Wagatsuma, Y. (2021). Effect of maternal nutritional education and counseling on children’s stunting prevalence in urban informal settlements in Nairobi, Kenya. Public Health Nutrition, 24(12), 3740–3752. https://doi.org/10.1017/S1368980020001962

Pibriyanti, K., Ariefianto, A. T., Santoso, L. M., Hanifa At-Tamami, R., Harahap, K., Rahmawati, N. F., Findiyani, M. A., Khoirunnisaa, S., Ayudani, T., Luthfiya, L., Nurohmi, S., Studi, P., Gizi, I., Kesehatan, I., & Bringin, P. (2024). Pemberian Makanan Tambahan (PMT) Modifikasi pada Balita Gizi Kurang dan Peningkatan Pengetahuan Ibu. BERNAS: Jurnal Pengabdian Kepada Masyarakat, 5(1), 678–689. https://doi.org/10.31949/jb.v5i1.7956

Piniliw, M. B., Africa, L. S., & Agne, J. P. (2021). Factors Associated with Stunting among 24–35-Month-Old Kalinga Indigenous Children in Pinukpuk, Kalinga, Philippines: A Case-Control Study. Jurnal Gizi Dan Pangan, 16(2), 81–90. https://doi.org/10.25182/jgp.2021.16.2.81-90

Ririn N D, Kalsum, U., & Siregar, N. (2023). The Effect of Giving Jagaq Porridge on Body Weight and Height of Stunted Toddlers Aged 12-24 Months in the Work Area of the Depar Health Center. Formosa Journal of Science and Technology, 2(2), 525–544.https://doi.org/10.55927/fjst.v2i2.2799

Septy Nurfahilah, Y. H. (2023). Pengaruh Stunting Terhadap perkembangan kognitif dan prestasi belajar. jurnal akselerasi merdeka belajar dalam pengabdian orientasi masyarakat, 1. https://doi.org/10.32672/ampoen.v1i2.585

Siswati, T., Iskandar, S., Pramestuti, N., Raharjo, J., Rubaya, A. K., & Wiratama, B. S. (2022). Impact of an Integrative Nutrition Package through Home Visit on Maternal and Children Outcome: Finding from Locus Stunting in Yogyakarta, Indonesia. Nutrients, 14(16). https://doi.org/10.3390/nu14163448

Sulistyawati Anton, S., Bukhari, A., Juliaty Baso, A. A., & Ayu Erika, K. (2022). Effect of Rebon Shrimp-Based Supplementary Feeding on Height of Stunted Children. Journal of International Conference Proceedings, 5(24), 236–241. https://doi.org/10.32535/ijcp.v5i1.1461

Suratri, M. A. L., Putro, G., Rachmat, B., Nurhayati, Ristrini, Pracoyo, N. E., Yulianto, A., Suryatma, A., Samsudin, M., & Raharni. (2023). Risk Factors for Stunting among Children under Five Years in the Province of East Nusa Tenggara (NTT), Indonesia. International Journal of Environmental Research and Public Health, 20(2). https://doi.org/10.3390/ijerph20021640

Tadele, T. T., Gebremedhin, C. C., Markos, M. U., & Fitsum, E. L. (2022). Stunting and associated factors among 6–23 month old children in drought vulnerable kebeles of Demba Gofa district, southern Ethiopia. BMC Nutrition, 8(1). https://doi.org/10.1186/s40795-022-00501-2

Taneja, S., Upadhyay, R. P., Chowdhury, R., Kurpad, A. V., Bhardwaj, H., Kumar, T., Dwarkanath, P., Bose, B., Devi, S., Kumar, G., Kaur, B., Bahl, R., & Bhandari, N. (2022). Impact of supplementation with milk-cereal mix during 6-12 months of age on growth at 12 months: a 3-arm randomized controlled trial in Delhi, India. American Journal of Clinical Nutrition, 115(1), 83–93. https://doi.org/10.1093/ajcn/nqab304

Tello, B., Rivadeneira, M. F., Moncayo, A. L., Buitrón, J., Astudillo, F., Estrella, A., & Torres, A. L. (2022). Breastfeeding, feeding practices and stunting in indigenous Ecuadorians under 2 years of age. International Breastfeeding Journal, 17(1). https://doi.org/10.1186/s13006-022-00461-0

Teshome, G. B., Whiting, S. J., Green, T. J., Mulualem, D., & Henry, C. J. (2020). Scaled-up nutrition education on pulse-cereal complementary food practice in Ethiopia: A cluster-randomized trial. BMC Public Health, 20(1). https://doi.org/10.1186/s12889-020-09262-8

Tri Rini Puji Lestari. (2023). Stunting di Indonesia: akar masalah dan solusinya. Info Singkat: Bidang Kesejahteraan Rakyat, 21-26.

UNICEF. (2023). Levels and trends in Chilid Malnutrition. Joint Child Malnutrition Estimates 2023 edition. https://www.who.int/publications/i/item/9789240073791 [Accessed 2th April 2025].

Victora, C. G., Christian, P., Vidaletti, L. P., Gatica-Domínguez, G., Menon, P., & Black, R. E. (2021). Revisiting maternal and child undernutrition in low-income and middle-income countries: variable progress towards an unfinished agenda. In The Lancet (Vol. 397, Issue 10282, pp. 1388–1399). Elsevier B.V. https://doi.org/10.1016/S0140-6736(21)00394-9

Wang, C. C., Abdul Jalal, M. I., Song, Z. L., Teo, Y. P., Tan, C. A., Heng, K. V., Low, M. S. Y., Anuar Zaini, A., & Lum, L. C. S. (2022). A Randomized Pilot Trial of Micronutrient Supplementation for Under-5 Children in an Urban Low-Cost Flat Community in Malaysia: A Framework for Community-Based https://doi.org/10.3390/ijerph192113878

Wasihun, Y., Addissie, G., Yigezu, M., & Kebede, N. (2024). Early initiation of complementary feeding practice and its associated factors among children aged 6 to 24 months in Northeast Ethiopia. Journal of Health, Population and Nutrition, 43(1). https://doi.org/10.1186/s41043-024-00554

WHO. (2017). Childhood Stunting: Challenges and Opportunities. WHO, Geneva. https://www.who.int/publications/i/item/WHO-NMH-NHD-GRS-14.1 [Accessed 2th April 2025].

WHO. (2022). Joint child malnutrition estimates. https://www.who.int/teams/nutrition-and-food-safety/monitoring-nutritional-status-and-food-safety-and-events/joint-child-malnutrition-estimates [Accessed 3th April 2025].