Peer Review : Tax ratio was the most dominant social predictor associated with stunting and severe stunting of children in Indonesia: Multilevel analysis

International Health and Nutrition Symposium

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Introduction: In Indonesia and other developing countries, stunting was still a seriouse public health problem. Tax revenue was an effort to encourage regional economic growth, equity of income distribution, and development including the health sector. Objective: to analyze multilevel risk factors stunting and severe stunting of children. Method: ecological study were using Indonesia Base Health Reseacrh (Riskesdas-2013), central bureau of statistic (2012), KPK (2010), and Susenas (2012). Independent variable were divide into three catagories; ie. biologic (birth weight, newborn lenght, gender, parental height), structural (parental education, occupation, residence setting, SES) and social factors (GDP, gini ratio, HDI, DGI, GEI P1, P2, tax ratio). The dependent variable were stunting and severe stunting. Samples were all under-fives children in Riskesdas 2013, including 33 provinces with criteria 24-59 months, singleton, >37 gestational age, have no chronic disease. Missing data and HAZ>-6SD were excluded. A total of 3,812 children were selected in this study. Data were analyzed by general mix model using stata 13 Results: Prevelence of severe stunting was 43.15%, while the average of tax ratio was 2.88±1.13. Risk factors associated with severe stunting at the individual level were LBW (AOR 1.38, CI95%:1.01-1.88); father occupation (unemployement and non formal sectors: AOR 1.45 CI95%:0.91-2.30 and AOR: 1.18 CI95%: 1.00-1.38 rspectively); and at the provincial level was tax ratio (AOR 0.88 CI95%: 0.82-0.95) Conclusion: LBW, unemployment father or non formal sector employee were more likely to be severe stunting. Every 0.12% increasing of tax ratio will reduce 1% of severe stunting. Keywords: stunting, severe stunting, tax ratio, multilevel analysis.