Effect of the family medicine approach in reducing stunting among toddlers

Main Article Content

Retno Asti Werdhani
Vican Sefiany Koloi
Julietta Tantri
Abiyyu Ghiyats Mahardika
Lydia Rosalina Widjaja
Michelle Michelle
Tiffany Tiffany

Abstract

Background
One health indicator assessed for achieving the Sustainable Development Goals (SDGs) is the nutritional status of toddlers. Stunting, indicating chronic malnutrition in children, remains a pressing concern globally, especially in low‑ and middle‑income countries. Stunting is still prevalent in Jakarta as the capital city of Indonesia. The study's objective was to evaluate the implementation of the family medicine approach on stunting in toddlers in Koja Sub-District, North Jakarta.


Methods
A pre- and post-test design study was conducted involving 40 toddlers who were diagnosed with stunting. Outcome variables were body weight, height, and stunting while the independent variable was the family medicine approach (home visits, family education, and monitoring for 3 months). The Friedman test was used to determine the difference in height and weight after 3 months of the family medicine approach.


Results
After 3 months of the family medicine approach, consisting of holistic history taking, performing a thorough physical examination, educating parents about toddlers' nutritional issues, and conducting routine monthly home visits, the toddlers’ body weight increased by 0.68 kg and their height increased by 1.37 cm (p<0.001). The total number of cases of stunting after the family medicine approach decreased by 30% (12/40) from 40 to 28.


Conclusions
There is a decrease in the number of stunting cases after the family medicine approach, but further research is needed. The study findings will help to improve policy measures focusing on the family medicine approach to reduce childhood stunting.

Article Details

Section

Original Articles

How to Cite

Effect of the family medicine approach in reducing stunting among toddlers. (2025). Universa Medicina, 44(1), 50-56. https://doi.org/10.18051/UnivMed.2025.v44.50-56

References

Grosso G, Mateo A, Rangelov N, Buzeti T, Birt C. Nutrition in the context of the Sustainable Development Goals. Eur J Public Health 2020;30 (Supplt_1):i19–23. doi: 10.1093/eurpub/ckaa034.

De Sanctis V, Soliman A, Alaaraj N, et al. Early and long-term consequences of nutritional stunting: from childhood to adulthood. Acta Biomed 2021;92:e2021168. doi: 10.23750/abm. v92i1.11346.

World Health Organization. Stunting in a nutshell. Geneva: World Health Organization;2015.

Wright CM, Macpherson J, Bland R, Ashorn P, Zaman S, Ho FK. Wasting and stunting in infants and young children as risk factors for subsequent stunting or mortality: longitudinal analysis of data from Malawi, South Africa, and Pakistan. J Nutr 2021;151:2022–8. doi: 10.1093/jn/nxab054.

World Health Organization. Malnutrition. Geneva: World Health Organization; 2023.

Kementerian Kesehatan Republik Indonesia. Buku saku pencegahan dan tata laksana gizi buruk pada balita di layanan rawat jalan bagi tenaga kesehatan. [Pocket book on prevention and management of poor nutrition in underfives in ambulatory health care services for medical personnel]. Jakarta: Kementerian Kesehatan Republik Indonesia;2020. Indonesian.

Saunders J, Smith T. Malnutrition: causes and consequences. Clinical Medicine 2010;10:624–7. doi: 10.7861/clinmedicine.10-6-624.

Lelijveld N, Kerac M. A holistic approach to malnutrition follow-up care. J Public Health Emerg 2017;1:44. doi: 10.21037/jphe.2017.03.11.

White F. Application of disease etiology and natural history to prevention in primary health care: a discourse. Med Princ Pract 2020;29:501-13. doi: 10.1159/000508718.

Rifki NN. Diagnosis holistic: pendekatan biopsikososial dalam praktik kedokteran. Edisi Ketiga. [Holistic diagnosis: biopsychosocial approach in medical practice. 3rd ed.]. Jakarta: Departemen Ilmu Kedokteran FK UI, 2017. Indonesian.

Puskesmas Kecamatan Koja. Status gizi balita Puskesmas Kecamatan Koja. [Nutritional status of underfives at Koja Sub-District Public Health Center]. Jakarta; 2023. Indonesian.

Insani NF, Mayasari D, Zahra SD. [Holistic management in 2-year-old underfives with nutritional problems through the family medicine approach]. J Penelitian Perawat Profesional 2023;5:579–90. Indonesian. DOI: https://doi.org/10.37287/jppp.v5i2.1466.

Hardani M, Zuraida R. [Management of poor nutrition and stunting in 14 month-old underfives by the family medicine approach]. Medula 2019 ;9 :565-75. Indonesian.

Yasin Z, Nawawi A, Sofiyana AA, Febriyanti E. Handling nutrition in stunted children through education and family education in Madura, Indonesia. Health Dynamics 2024;1:15–21. DOI: https://doi.org/10.33846/hd10104.

Bhutta ZA, Berkley JA, Bandsma RHJ, Kerac M, Trehan I, Briend A. Severe childhood malnutrition. Nat Rev Dis Primers 2017;3:17067. doi: 10.1038/ nrdp.2017.67.

Barker M, Dombrowski SU, Colbourn T, et al. Intervention strategies to improve nutrition and health behaviours before conception. Lancet 2018;391:1853–64. doi: 10.1016/S0140-6736(18)30313-1.

Pearson O, Schwartzkopff K, Dawson A, et al. Aboriginal community controlled health organisations address health equity through action on the social determinants of health of Aboriginal and Torres Strait Islander peoples in Australia. BMC Public Health 2020;20:1859. doi: 10.1186/ s12889-020-09943-4.

Setyawan FEB, Lestari R. Holistic-comprehensive approaches to improve nutritional status of children under five years. J Public Health Res 2021;10:2183. doi: 10.4081/jphr.2021.2183.

Smith JD, Fu E, Kobayashi MA. Prevention and management of childhood obesity and its psychological and health comorbidities. Annu Rev Clin Psychol 2020;16:351–78. doi: 10.1146/ annurev-linpsy-100219-060201.

Bueno NB, Lisboa CB, Clemente AG, Antunes RT, Sawaya AL, Florêncio TT. Effectiveness of a stunting recovery program for children treated in a specialized center. Pediatr Res 2018;83:851–7. doi: 10.1038/pr.2017.321.

Kementerian Kesehatan RI. Posyandu dan puskesmas garda depan pengendalian stunting. [Integrated service posts and public health centers as vanguards of stunting control]. Jakarta: Kementerian Kesehatan RI; 2021. Indonesian.