Determinants of Growth and Development in Stunted Children: Systematic Review and Meta-Analysis of Nutrition, Parenting, and Early Stimulation

<ns3:p> Stunting remains a major global public health problem that adversely affects children’s physical growth and developmental potential. Its multifactorial nature necessitates identifying key determinants influencing growth and development, particularly nutrition, parenting practices, and early childhood stimulation. This study aimed to systematically assess and quantify determinants of growth and developmental outcomes among stunted children, focusing on nutritional factors, parenting practices, and early childhood stimulation. A systematic review and meta-analysis were conducted following PRISMA guidelines. Articles published between 2015 and 2025 were retrieved from PubMed, Scopus, Web of Science, and Google Scholar. Of 1,876 records identified, 18 studies met the inclusion criteria. Data on nutrition, caregiving practices, stimulation interventions, and child growth and developmental outcomes were extracted. Random-effects models calculated pooled effect sizes. Early childhood stimulation was the most dominant determinant of improved developmental outcomes (pooled RR = 1.58; 95% CI: 1.31–1.90), followed by adequate nutrition (RR = 1.44; 95% CI: 1.21–1.71) and responsive parenting practices (RR = 1.36; 95% CI: 1.14–1.62), with moderate heterogeneity (I <ns3:sup>2</ns3:sup> = 45%). Early childhood stimulation plays a central role in improving growth and developmental outcomes in stunted children, highlighting the need for integrated interventions combining nutrition, responsive parenting, and structured stimulation. </ns3:p>