Determinants Factors of Stunting among Children Under Five in Timor-Leste: Evidence from Ermera, Viqueque, and Oe-Cusse
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Abstract
Stunting remains a serious public health problem in Timor-Leste, particularly among children under five years of age. This study aimed to analyze factors associated with stunting among children under five in the Ermera, Viqueque, and Oe-Cusse districts in 2025. This research used an analytic observational design with a cross-sectional approach. The study involved 421 children under five selected using multistage cluster sampling and systematic random sampling. Data were collected through structured interviews with mothers or caregivers using questionnaires and anthropometric measurements. Stunting status was determined based on height-for-age (HAZ) with a Z-score < −2 SD according to WHO standards. The dependent variable was stunting, while independent variables included infectious diseases, family income, maternal knowledge, culture, and exclusive breastfeeding. Data were analyzed using univariate and multivariate analyses with binary logistic regression at a significance level of p < 0.05.
The results indicated that the prevalence of stunting among children under five years of age was 49.9%. Multivariate logistic regression analysis revealed that infectious diseases (p = 0.019; OR = 6.642), family income (p < 0.001; OR = 34.224), maternal knowledge (p = 0.001; OR = 19.796), culture (p = 0.018; OR = 6.269), and exclusive breastfeeding (p = 0.008; OR = 8.986) were significantly associated with stunting. Among these variables, family income was identified as the most dominant factor influencing stunting.
In conclusion, stunting among children under five in the study areas is influenced by socioeconomic, health, behavioral, and cultural factors. Therefore, multisectoral interventions focusing on improving family economic conditions, maternal nutrition knowledge, infectious disease prevention, and promotion of exclusive breastfeeding are essential to reduce the prevalence of stunting in Timor-Leste.