Determinants of stunting and prevention strategies in remote villages of West Aceh, Indonesia: A case–control study

This study examined determinants of stunting among children aged 24-59 months in remote rural areas of West Aceh, Indonesia, and proposed context-specific prevention strategies. A case-control study was conducted in the Kaway XVI sub-district between March and June 2022, involving 33 stunted and 33 non-stunted children selected from the same communities. Data were collected through maternal interviews, anthropometric measurements, and health records, assessing nutritional care practices, household sanitation, food availability, infectious disease history, maternal knowledge, and breastfeeding practices. Multivariate logistic regression showed that inadequate household sanitation (aOR = 26.41), poor nutritional care practices (aOR = 17.43), limited household food availability (aOR = 8.96), and frequent infectious diseases (aOR = 8.45) were independently associated with stunting. These findings demonstrate the relative strength of caregiving, environmental, and food access determinants in a highly resource-limited setting. A multilevel prevention model guided by the MATCH framework is proposed to inform integrated, community-based stunting prevention strategies in remote rural areas.