Household, Maternal, and Child Determinants of Stunting in a Rural Island Community: A Study from Haruku, Maluku Province, Indonesia

Background: Stunting remains a major health challenge in Indonesia’s small-island communities, where geographic isolation and food insecurity elevate risks, yet empirical evidence remains limited. Objective: This study examined household-, maternal-, and child-level factors associated with stunting among children under 5 in the Haruku-Sameth Community Health Centre catchment area in the Central Maluku District. Methods: Data were derived from a cross-sectional household survey conducted in July 2025. Using a total sampling approach, data were collected from 248 biological mother-child pairs across five villages. Assessments included structured interviews via CommCare, anthropometric measurements, and hemoglobin testing. Multivariable logistic regression was employed to identify factors independently associated with stunting. Results: The overall stunting prevalence was 22.0% (95% CI: 17.0-27.0%). At the household level, stunting was associated with food insecurity (aOR=7.54; 95% CI: 1.59-35.79; p=0.011) and having more than two children under five (aOR=2.90; 95% CI: 1.26-6.66; p=0.012). Maternal factors included limited stunting knowledge (aOR=4.87; 95% CI: 1.85-12.79; p=0.001, maternal anemia (aOR=2.95; 95% CI: 1.35-6.43; p=0.006), and short stature (aOR=2.41; 95% CI: 1.07-5.40; p=0.033). Child-level factors included age ≥24 months (aOR=6.07; 95% CI: 1.79-20.72; p=0.004), unknown birth weight aOR=3.98; 95% CI: 1.44-10.99; p=0.008), and unknown birth length (aOR=4.03; 95% CI: 1.25-12.99; p=0.019). Conclusion: Stunting on Haruku Island was associated with multiple maternal, child, and household vulnerabilities within a geographically constrained setting. These findings may inform adaptation of national health and nutrition programs to the needs of remote archipelagic communities.