STUNTING PHENOMENON DURING THE COVID-19 PANDEMIC

Coronavirus disease 2019 (COVID-19) is an infectious disease caused by the newly

discovered coronavirus. This new disease was unknown before the outbreak in Wuhan, China, in
December 2019. COVID-19 has now become a pandemic affecting many countries globally
(World Health Organization, 2020a). Coronavirus disease 2019 (COVID-19) is a disease caused
by a new strain of coronavirus. 'CO' is taken from corona, 'VI' virus, and 'D' disease. Previously,
this disease was called the '2019 novel coronavirus' or '2019-nCoV.' The COVID-19 virus is a
new virus related to the same family of viruses as a severe acute respiratory syndrome (SARS)
and several types of common cold viruses (UNICEF, 2020). The international health
organization, namely the World Health Organization, states that coronaviruses can infect the
respiratory tract in humans. The virus has the scientific name COVID-19. COVID-19 can have
effects ranging from the mild flu to a very serious equivalent or even more severe than MERS-
CoV and SARS-CoV (Kirigia & Muthuri, 2020 at Nasution, et al, 2020).
Coronavirus disease 19 (COVID-19) has spread to more than 122 countries, including
Indonesia. To deal with this problem, the government has taken measures of substantive policies
(prevention), with a focus on policies for economic growth. The COVID-19 pandemic threatens
not only public health but also social conditions and economic growth, especially the economy
of the underprivileged which is supported by daily income is affected. This depresses the
economic condition of the community (Wulandari & Suparti, 2022).
Apart from dealing with the COVID-19 pandemic, malnutrition in children (stunting,
wasting, and overweight) is still a global health problem, including in Indonesia. The incidence
of stunting has become a global focus and the COVID-19 pandemic has had various impacts.
Currently, the Indonesian government is also still resolving the stunting problem which is feared
to get worse due to COVID-19. The COVID-19 pandemic makes it possible for the number of
stunting children (chronic malnutrition) in Indonesia to increase (Wulandari & Suparti, 2022).
The existence of a policy limiting social activities in Indonesia has resulted in changes in
economic patterns that affect access to consumption, nutrition services, and routine health
services that affect the nutritional status of children, including stunting (Efrizal, 2020)
Stunting is an indicator of nutritional status at the same height/age with or less than minus
two standard deviations (-2 SD) below the average standard or a child's body condition that is
shorter compared to other children of the same age, this is an indicator chronic malnutrition that
occurs from the fetus to birth and will be seen when the child is 2 years old (UNICEF, 2013).
Stunting is caused by multidimensional factors, namely family income, poor nutritional
fulfillment, and lack of mother's knowledge about maternal health and nutrition (Rohmawati and
Antika, 2017). Stunting is a condition in children under five years of age whose height is
disproportionate to their age (WHO). Stunting is a condition of failure to thrive in toddlers due to
repeated infections and chronic malnutrition, especially in the period of the first 1,000 days of
birth (TNP2K, 2017). A child is classified as stunted if his height is below minus 2 (two)
standard deviations for the height of a child of his age.
Before the pandemic occurred, stunting was still a big problem in Indonesia with the
problem of failing to develop physically and brain (Ministry of Health RI, 2019). Indonesia is a
South-East Asian country with the sixth highest prevalence after Bhutan, Timor Leste, Maldives,
Bangladesh, and India, which is 36.4% (WHO, 2020). Even though there has been a decline from
2013 to 2019 (Teja, 2019). More than 37% of children under five experienced stunting in 2013
or around 8.4 million children. Of the 24 provinces, 15 provinces have a stunting prevalence of
more than 40%, where the largest cases are in West Nusa Tenggara, around 40% (BAPPENAS
and UNICEF, 2017). There is a significant difference in the number of stunted children in
Indonesia before and after the pandemic. According to the 2019 Indonesian Toddler Nutrition
Status Survey (Kemenkes RI, 2021), the prevalence of stunting in Indonesia is 27.7%. This
means that one in every four children under the age of five in Indonesia (more than eight million
children) is stunted. Even though it was before the Covid-19 pandemic, this figure was still very
high when compared to the WHO threshold of 20%. When the Covid-19 pandemic begins in
2020 and 2021, the prevalence of stunting in Indonesia has increased compared to 2019.
According to the results of the Ministry of Health's Indonesian Nutrition Status Study
(Kemenkes RI, 2021), the prevalence of stunted toddlers in Indonesia will be 26.92% in 2021, up
from 24.4% in 2020. As a result, nearly a quarter of all toddlers in the country were stunted last
year.

The results of the 2019 Indonesian Toddler Nutrition Status Survey (Survei Status Gizi
Balita Indonesia) stated that the prevalence rate of stunting under-fives in 2013 was around
37.2%, and in 2018 it had decreased by 6.4% (Ministry of Coordinating Republic of Indonesia,
2020). UNICEF predicts that there will be an increase in the number of stunted children
considering that many households in Indonesia have lost their economic income. The results of
the 2019 Indonesian Toddler Nutrition Status Survey (SSGBI) show that the prevalence of
stunting has reached 27.67 percent. This means that for every ten children, 3 of them are stunted.
This figure is also still above the World Health Organization (WHO), which is 20 percent.
One of the reasons for the increase in the number of stunting during the pandemic was
that the food supply chain was disrupted due to the loss of people's income due to COVID-19.
Zemrani et al. (2021) stated that the COVID-19 pandemic had a real impact on children such as
poor diet, mental health, social isolation, screen addiction, and lack of education and health care,
especially vulnerable groups. The crisis has public health implications that affect a child's
lifetime, including stunting.
In line with the statement of Akseer et al. (2020) that COVID-19 has put pressure on
health and the global economy, including the health of mothers and children. even though there
is an increased focus on maternal and child nutrition, malnutrition rates tend to experience an
increasing impact from the co-19 pandemic, namely poverty and lack of intervention and access
to services to nutritious food.
Several factors that influence the incidence of stunting in toddlers in Indonesia consist of
direct causes which include nutritional intake and health status. While indirect causes include
economic factors, food security, social environment, health environment, and residential
environment (Bappenas, 2018; IFPRI, 2016). Family economic status is the family's ability to
meet the financial needs of all family members. Food security is measured from the economic
aspect based on food expenditure and is measured from the nutritional aspect based on the
fulfillment of sufficient food consumption in energy units (Wulandari & Suparti, 2022).
In Indonesia, the number of stunted children has soared because the government is
struggling hard to stem the impact of the COVID-19 pandemic on health problems. UNICEF
(2020) states that currently, Indonesia is facing a high level of malnutrition more than 7 million
children under five are stunted. This is because many families have lost household income so
they are unable to buy healthy and nutritious food for their children. In line with the statement
from UNICEF (2020a) found evidence that the COVID-19 pandemic caused Indonesian people
to have difficulty obtaining income and were not covered by social protection programs. The
sudden loss of work also pushed millions of children into poverty so that nutritional status,
education, and child protection are worse. The COVID-19 pandemic has indirectly increased the
occurrence of cases of impaired growth and development of children including stunting due to
nutritional disorders, mental health and decreased coverage of basic immunizations, and delays
in detecting child development (Chamidah, 2020).
Wulandari & Suparti (2022) in their research stated that during the COVID-19 pandemic,
family economic status and family food security status affected the incidence of stunting.
Toddlers will experience stunting if the family's economic status is low and food security is low.
So those toddlers don't experience stunting, it is necessary to have assistance from various parties
to help families with low economic status. So that families with low economic status can still
fulfill the family's food needs and can provide nutritious food for toddlers. Based on the results
of the study, the incidence of stunting under five years old was found in families with low
economic status and low family food security, it was also found in families with low maternal
education and mothers who did not work. Therefore, it is necessary to empower mothers who do
not work to do farming techniques by utilizing the land around the house. This program can not
only maintain family food security, but it can also increase the family's economic income.
Counseling on nutrition for toddlers also needs to be done considering that many mothers have
low education. According to the data presented above, the Covid-19 pandemic has had an impact
on the prevalence rate of stunting in Indonesia. This is consistent with Safitri et al (2021), which
found that the number of children with the highest risk of stunting in toddlers during the Covid-
19 Pandemic during the 2021 Gunung Kaler Tangerang Health Center Work Area has an Odd
Ratio value of 4.87 times. This is because the Covid-19 pandemic has had an impact on child
poverty, learning, nutrition, care, and security. Herlinah et al (2022) shared the same viewpoint,
stating that four variables were risk factors for stunting during the COVID-19 pandemic, namely
the child's age, income, knowledge, and mother's upbringing. When viewed through the lens of
family income characteristics, the origin of the economic crisis is one of the root causes of the
impact of infant growth and various other nutritional problems. The majority of children under
the age of five who have growth disorders come from low-income families.

REFERENCE
World Health Organization. 2020. Coronavirus disease (COVID-19). Found at
https://www.who.int/indonesia/news/novel-coronavirus/qa/qa-for-public, accessed on
December 17, 2022.
United Nations Children’s Fund. 2020. Frequently Asked Questions about coronavirus disease
(COVID-19). Found at https://www.unicef.org/indonesia/coronavirus/FAQ, accessed on
December 17, 2022.
Nasution, D. A. D., Erlina, & Muda. I. 2020. Dampak Pandemi COVID-19 Terhadap
Perekonomian Indonesia. Jurnal Benefita 5(2) Juli 2020 (212-224). Found at
http://ejournal.lldikti10.id/index.php/benefita/article/view/5313, accessed on December
17, 2022.

Islami, N.W. & Khouroh, U. 2021. Analisis Faktor-Faktor yang mempengaruhi balita stunting
dan tantangan pencegahannya pada masa pandemic. KARTA RAHARDJA 3(2) (2021);
6-19. Found at https://ejurnal.malangkab.go.id/index.php/kr/article/view/49/29, accessed
on December 18, 2022.
Sulistyawati, F. & Widarini, N.P. 2022. Kejadian Stunting Masa Pandemi COVID-19. Medika
Respati: Jurnal Ilmiah Kesehatan Vol. 17 No. 1 Februari 2022; 37 – 46. Found at
https://medika.respati.ac.id/index.php/Medika/article/download/587/pdf, accessed on
December 18, 2022.
Wulandari, S. & Suparti, S. 2022. Analysis of Stunting Phenomenon in Sragen Regency During
the COVID-19 Pandemic from Economic Perspective. Media Kesehatan Masyarakat
Indonesia Volume 18 Issue 1. Found at
https://journal.unhas.ac.id/index.php/mkmi/article/view/18341, accessed on December
14, 2022.
Saputra, H.I. et al. 2021. Faktor Risiko Penyebab Terjadinya Stunting Di Masa Pandemi
COVID-19. Jurnal Kesehatan Masyarakat Indonesia, Volume 2, No. 3. Found at
http://jurnal.iakmi.id/index.php/IJKMI, accessed on December 14, 2022.
Efrizal, E. 2020. Berdampakkah Pandemi Covid-19 Terhadap Stunting di Bangka Belitung?
Jurnal Kebijakan Kesehatan Indonesia; JKKI, Volume 09, No. 03. Found at
https://journal.ugm.ac.id/jkki/article/view/58695, accessed on December 18, 2022.