Spatial Analysis of Nutritional Status in Children Under Five in East Java, Indonesia: Identifying Priority Intervention Areas Using 2018-2023 Provincial Data

Introduction: Reducing global stunting rates is a critical focus of the Sustainable Development Goals (SDGs), particularly under the objectives of zero hunger, good health and well-being. Indonesia has set a target to reduce the prevalence of stunting to 14%. However, as of 2023, the national prevalence remains at 21.5%, with East Java, a densely populated region, reporting a rate of 19.2%. This study aimed to identify risk factors for nutritional problems among infants and toddlers in East Java to guide region-specific interventions and serve as a global model for addressing stunting and nutritional issues. Methods: Data was collected from provincial health registries and analysed for trends and associations using STATA18 and spatial distribution using QGIS3.34. Factors examined included community participation, ferrous supplementation during pregnancy, newborn birth weight, exclusive breastfeeding rates, vitamin A supplementation, and child nutritional status monitoring Results: While the prevalence of underweight, stunted, and wasted children showed a decreasing trend, critical factors such as ferrous supplementation in pregnant women, exclusive breastfeeding rates, and vitamin A supplementation also exhibited declines. Early and exclusive breastfeeding and vitamin A supplementation were significantly associated with underweight status. Discussion: Improvements in child nutritional status coexist with persistent challenges, including suboptimal breastfeeding practices, declining vitamin A supplementation, and pandemic-related healthcare disruptions, necessitating reinforced health systems and targeted interventions to attain national and SDGs targets. Conclusion: Strengthening nutritional and health services in high-burden areas could improve outcomes in East Java and offer a replicable framework for addressing stunting and malnutrition globally.