Stunting Interventions in Developing Countries: Literature Review

Stunting (dwarfism) is a condition in which a toddler is shorter than their own age. This condition is defined as having a body length or height that is greater than the - 2 SD median of WHO child development criteria. Childhood stunting can have an effect on growth and development. Growth is not ideal, and developmental hurdles arise from birth, resulting in low educational achievement later in life. To reduce the risk of stunting, it is essential to identify and implement appropriate and optimal action as soon as possible in order to avoid or minimize lasting negative effects on children's growth and development. It aims at determining the way in which stunt interventions take place in a few developing countries. The research plan utilized may be a Writing Survey utilizing the Prisma strategy, which depicts the comes about of hindering intercessions in creating countries. Fifteen articles met the incorporation criteria. Most come about of the article talks about education intervention and multi-micronutrients. In Indonesia, four articles show results with a significant impact on the p-value. and;0.05, 3 articles had no effect in Cambodia, 2 articles showed significant results in India, and 3 influential articles in Ethiopia with p-value and;0.05, impact had a p-value of <0.05.


Introduction
Toddlers with stunting are shorter than average.This condition is defined as body length or height more than -2 SD median of WHO child growth criteria.Chronic nutritional problems like stunted toddlers are caused by socioeconomic situations, The high prevalence of stunting in Indonesia in 2021, 24.4%, is expected to decrease to 14% according to the RPJMN in 2024.Therefore, there is a need for a summary in the form of a literature review of nutritional interventions given to stunted children with the same conditions in developing countries that can be applied in Indonesia.

Research Methods
This research uses a literature review research design with the Prisma method.Search for published articles using Google Scholar, Scopus, and Pubmed.Subsequent articles

Results And Discussions
After screening and fulfilling the inclusion requirements, 15 articles were reviewed.

Conclusion
The intervention that has an influence on stunting is education combined with the provision of micronutrient supplementation.Education is provided through home visits.
In Cambodia, intervention in the form of community-based growth promotion was not very influential.In India, routine home visits for 12 months provide 5 developmental games to stimulate child stimulation, counseling sessions are carried out by providing flip charts, visual materials, and cooking demonstrations.In Ethiopia, home visits with participatory discussions, communication on MP-ASI behavior change with family members for 9 months, education and provision of supplementation.

Compliance with ethical standards
Journal Homepage : https://jurnal.agdosi.com/index.php/IJHS/indexVolume 1 | Number 3 | September 2023 | e-ISSN: 2987-0836 DOI:https://doi.org/10.59585/ijhs409 International Journal of Health Sciencesis licensed under aCreative Commons Attribution 4.0 International License maternal nutrition during pregnancy, baby pain, and lack of nutrient intake.Future stunted toddlers will struggle to develop physically and cognitively..(Stratanas, 2019) Nutritional interventions to prevent stunting focus on the first 1000 days (1000 HPK), including interventions for pregnant women, lactating mothers and children aged 0-23 months.Integrated stunting reduction interventions can be in the form of specific nutritional interventions and sensitive nutritional interventions.(Berawi,2021) Childhood stunting can have an effect on growth and development.Growth is not ideal, and developmental hurdles arise from birth, resulting in low educational achievement later in life.If there are obstacles to cognitive and motor development, it can have an impact on reducing the ability to absorb lessons at school age which will affect productivity as an adult.(Berawi,2021) Reducing stunting requires finding appropriate and best early, measures should be made to prevent long-term effects that hurt children's growth and development.Two kinds of actions can help lower stunting: those that are specific and those that are sensitive.The results of (Kustiani & Misa, 2018) research in Indonesia stated that there were significant changes (p<0.05) in mothers' knowledge, attitudes, and practices in providing complementary foods after being given nutritional education.The results of (Sharma et al., 2020) research in India stated that the effectiveness of nutritional education interventions through health services for complementary foods for breastfed babies, there was an increase in weight and body length in the intervention group.The results of (Lai et al., 2022) According to studies done in Cambodia on the effects of nutrition and sanitation interventions on the growth of children in rural Cambodia, the group that got the nutrition intervention was more likely to follow the rules than the group that got the sanitation intervention.The results of (Hess et al., 2015) study in Ethiopia stated that there was a 25% reduction in the effects on motor, language, and personalsocial development were significantly positive, and the rate of stunting at 18 months dropped from 39% to 29%.(Andrew et al., 2020) research results in India.The home visit care program is effective in improving the development of children with disabilities.410 International Journal of Health Sciencesis licensed under aCreative Commons Attribution 4.0 International License will be analyzed according to the inclusion criteria (Original research articles (full text), RCT (Randomized Control Trial), Experiments, and stunting toddlers) and exclusion (Adolescent, adult subjects and journal types not open access/full text, only abstracts and title).This literature review uses published articles from 2012-2021 which can be accessed in full text from both Indonesian language journals and English language journals.Health Sciencesis licensed under aCreative Commons Attribution 4.0 International License women's education and standing in their households and communities improves nutrition and food security, especially child nutrition.(WorldHealth Organization, 2018)    Conflict causes food insecurity and malnutrition.The Borana, Garre, Guji, and Konso of Ethiopia are frequently involved in bloody wars with one another.Despite their local nature, these wars have had national and even regional implications, involving communities and their allies elsewhere in Ethiopia and even over the border in Kenya.415 International Journal of Health Sciencesis licensed under aCreative Commons Attribution 4.0 International License According to(World Health Organization, 2018), appropriate nutritional intervention for babies born with stunting is giving exclusive breast milk for up to 6 months, giving MP-ASI according to balanced nutrition guidelines from 6 months and giving breast milk for up to 2 years.This has the potential to improve child health and nutrition among hardto-reach populations with skilled/trained implementing staff, it is hoped that the intervention will be more effective.The results of a literature review of the most influential intervention, namely the educational intervention carried out by (Teshome et al., 2020), stated that nutritional education delivered by health extension workers through home visits was successful in increasing children's consumption of nuts and their nutritional status.Nutrition education given to mothers for 9 months.(Dewi & Aminah, 2016) research results stated that nutritional education interventions three times per week at posyandu could increase the knowledge and feeding practice scores of stunted mothers of toddlers using food models.

Table 4 .
1 shows the results of the characteristics of research articles based on the category of the year of publication, type of intervention, and research design.Research articles were published from 2012-2021.The most published articles in 2020 were mostly types of educational interventions.In Africa and Asia, more than one in three women have anemia and roughly a quarter of children under five are stunted.Lack of sufficient, nutritious, and safe food is not the main cause of malnutrition.It is also caused by a variety of issues connected to poor access to health care, education, water, sanitation, and cleanliness.Poor women can face additional challenges to resources and services.The research is clear that enhancing 412 International Journal of Health Sciencesis licensed under aCreative Commons Attribution 4.0 International License International Journal of Health Sciences (IJHS) Journal Homepage : https://jurnal.agdosi.com/index.php/IJHS/indexVolume 1 | Number 3 | September 2023 | e-ISSN: 2987-0836 DOI:https://doi.org/10.59585/ijhs413 International Journal of Health Sciencesis licensed under aCreative Commons Attribution 4.0 International License (MNP)contains 15 micronutrients, including 10 mg of iron.Vit.A 400RE, Vit.D 5g, Vit.E 5mg, Vit C 30 mg, VIT B1 and B2 0.5 mg, B3 6mg, B6 0.5 mg, B12 0.9 mg, B9 150 g, zinc 4 .1 mg, copper 0.56 mg, selnium 17 g, iodine 90 g 414 International Journal of Health Sciencesis licensed under aCreative Commons Attribution 4.0 International License