Hubungan Tingkat Pengetahuan Ibu, Pola Pemberian Makanan, Sanitasi Lingkungan, dan Kemiskinan Terhadap Kejadian Stunting Pada Balita Usia 0–59 Bulan di Puskesmas Paceda Kota Bitung

Abstract

Abstrak Stunting merupakan masalah gizi kronis yang ditandai dengan tinggi badan anak di bawah standar berdasarkan indikator tinggi badan menurut umur (TB/U). Penelitian ini bertujuan untuk menganalisis hubungan tingkat pengetahuan ibu, pola pemberian makanan, sanitasi lingkungan, dan kemiskinan terhadap kejadian stunting pada balita usia 0–59 bulan di Puskesmas Paceda Kota Bitung. Desain penelitian menggunakan pendekatan kuantitatif cross-sectional dengan 328 responden yang dipilih melalui teknik proportional random sampling dari total populasi 1.809 ibu yang memiliki balita usia 0–59 bulan. Data dikumpulkan melalui kuesioner terstruktur, lembar observasi, dan pengukuran antropometri. Analisis dilakukan secara univariat, bivariat, dan multivariat menggunakan regresi logistik. Hasil penelitian menunjukkan bahwa 46,6% balita mengalami stunting. Analisis bivariat menunjukkan sanitasi lingkungan yang buruk (p=0,000; POR=4,998; CI 95%: 3,101–8,056) dan kemiskinan (p=0,000; POR=2,781; CI 95%: 1,777–4,354) berhubungan signifikan dengan kejadian stunting. Analisis multivariat mengidentifikasi sanitasi lingkungan (POR=4,326; CI 95%: 2,654–7,051) dan kemiskinan (POR=2,133; CI 95%: 1,321–3,446) sebagai faktor dominan. Tingkat pengetahuan ibu dan pola pemberian makanan tidak terbukti signifikan secara statistik pada analisis bivariat. Disimpulkan bahwa sanitasi lingkungan dan kemiskinan merupakan faktor risiko utama stunting. Intervensi terintegrasi meliputi perbaikan sanitasi, peningkatan edukasi gizi ibu, dan program pengentasan kemiskinan diperlukan untuk menurunkan prevalensi stunting di wilayah tersebut. Kata Kunci: stunting, balita, sanitasi lingkungan, kemiskinan, pengetahuan ibu Abstract Stunting is a chronic nutritional problem characterized by a child's height falling below the standard for height-for-age (HFA). This study aimed to analyze the relationship between maternal knowledge level, feeding practices, environmental sanitation, and poverty with the incidence of stunting among children aged 0–59 months at Puskesmas Paceda, Bitung City. A quantitative cross-sectional design was employed with 328 respondents selected through proportional random sampling from a total population of 1,809 mothers with children aged 0–59 months. Data were collected via structured questionnaires, observation checklists, and anthropometric measurements. Univariate, bivariate, and multivariate logistic regression analyses were performed. Results showed that 46.6% of children experienced stunting. Bivariate analysis revealed that poor environmental sanitation (p=0.000; POR=4.998; 95% CI: 3.101–8.056) and poverty (p=0.000; POR=2.781; 95% CI: 1.777–4.354) were significantly associated with stunting. Multivariate analysis identified environmental sanitation (POR=4.326; 95% CI: 2.654–7.051) and poverty (POR=2.133; 95% CI: 1.321–3.446) as the dominant risk factors. Maternal knowledge level and feeding practices were not statistically significant in bivariate analysis. It is concluded that environmental sanitation and poverty are the primary risk factors for stunting. Integrated interventions including sanitation improvement, maternal nutrition education, and poverty alleviation programs are needed to reduce stunting prevalence in this region. Keywords: stunting, under-five children, environmental sanitation, poverty, maternal knowledge