Hrev_master Healthcare in Low-resource Settings 2024; volume 12:12054 Exploring the relationship between maternal parenting styles and stunt- ing prevention behaviors in children aged 3-5 years Arum Dwi Ningsih,1 Endang Yuswatiningsih,2 Dwi Prasetyaningati2 1Faculty of Health Sciences, Universitas Bina Sehat PPNI Mojokerto, Mojokerto; 2Faculty of Health Sciences, Institut Teknologi Sains dan Kesehatan Insan Cendekia Medika Jombang, Jombang, Indonesia Abstract Indonesia, as a developing country, continues to grapple with various nutritional challenges, with stunting among toddlers being a significant concern. According to Nutritional Status Monitoring data from the past three years, stunting has the highest prevalence compared to other issues such as undernutrition, underweight, and obesity. Stunting reflects inhibited growth owing to insufficient nutrient intake. This study aimed to analyze the relationship between parenting styles and behaviors aimed at preventing stunt- ing in children aged 3-5 years. Employing a correlational analysis with a cross-sectional research design, the study surveyed 128 respondents. Maternal parenting styles were assessed using ques- tionnaires with parameters for authoritarian, democratic, and per- missive approaches, while stunting prevention behaviors were evaluated using questionnaires covering cognitive, affective, and conative aspects. Analysis revealed that most respondents exhibit- ed a democratic parenting style (52 respondents, 41%), and most demonstrated good stunting prevention behaviors (58 respon- dents, 45%). The Spearman test yielded a p-value of 0.000, indi- cating a significant relationship. Therefore, enhancing parents’ understanding of proper parenting practices is crucial for prevent- ing stunting in children aged 3-5 years. Introduction Indonesia, as a developing country, continues to face various nutritional challenges.1 Among these, stunting in toddlers is a major issue.2 Stunting often goes unrecognized in communities where short stature is normalized and height checks are infre- quent, making it difficult to identify.3 Growth failure typically begins in utero and can persist until at least the age of two. If stunt- ing is not balanced with catch-up growth, it leads to decreased growth, increased risk of illness and death, and impediments to both motor and mental development.4 Several factors contribute to the incidence of stunting in children, including maternal factors such as poor nutritional status during pregnancy, short stature, and inadequate parenting, especially regarding feeding practices.5,6 The role of parents, particularly mothers, in caring for toddlers significantly impacts the nutritional intake received by the child.7 Therefore, mothers need to understand how to provide balanced nutrition to ensure their toddlers grow healthily and develop appropriately for their age.8 Maternal behavior in preventing stunting is crucial.9 Research by Fildzah et al. in 2020 showed that 46.3% of mothers had poor behavior in preventing stunting.10 This indicates that the eight pil- lars of stunting prevention behavior—ending open defecation, handwashing with soap, managing drinking water and household food, securing household waste, managing household liquid waste, monitoring pregnant women’s nutrition, feeding infants and children, and monitoring growth—are not being optimally implemented.6,11,12 According to Nutritional Status Monitoring data from the last three years, stunting has the highest prevalence among nutritional problems such as undernutrition, underweight, and obesity. Stunting is characterized by impaired growth due to prolonged inadequate nutritional intake. According to Kepmenkes Correspondence: Arum Dwi Ningsih, Faculty of Health Sciences, Universitas Bina Sehat PPNI Mojokerto, Mojokerto, Indonesia. E-mail: arumdn87@gmail.com Key words: children, malnutrition, mothers, parenting style, stunting. Contributions: AND, conceptualization, data curation, formal analysis, methodology, validation, visualization, writing – original draft, review and editing; EY, conceptualization, investigation, methodology, valida- tion, and writing – original draft, review and editing; DP, conceptualiza- tion, methodology, formal analysis, validation, and writing – original draft, review and editing. All the authors have read and approved the final version of the manuscript and agreed to be held accountable for all aspects of the work. Conflict of interest: the authors declare no potential conflict of interest. Ethics approval and consent to participate: this research has passed the ethical test with number 028/KEPK/ICME/II/2023 by the Nursing Research Ethics Commission of the Jombang Institute for Science Technology and Human Scholar Medika Health. Patient consent for publication: written informed consent was obtained for anonymized patient information to be published in this article. Funding: none. Availability of data and materials: all data generated or analyzed during this study are included in this published article. Acknowledgements: we would like to thank the Universitas Bina Sehat PPNI Mojokerto, Institut Teknologi Sains dan Kesehatan Insan Cendekia Medika Jombang, and the research respondents at the health center in the working area of Kediri Regency who have supported the implementation of this research. Also, we would like to acknowledge the contribution of mentoring program conducted by The Research Centre of Excellence in Advancing Community Health (REACH), Surabaya, Indonesia. Received: 8 November 2023. Accepted: 4 June 2024. Early access: 18 July 2024. This work is licensed under a Creative Commons Attribution 4.0 License (by-nc 4.0). ©Copyright: the Author(s), 2024 Licensee PAGEPress, Italy Healthcare in Low-resource Settings 2024; 12:12054 doi:10.4081/hls.2024.12054 Publisher's note: all claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organi- zations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher. [page 592] [Healthcare in Low-resource Settings 2024;12:12054] Non -co mmerc ial us e o nly 1995/MENKES/SK/XII/2010, stunting is defined as a z-score of less than -2 SD (stunted) and less than -3 SD (severely stunted).13,14 The World Health Organization (WHO) data indicates that Indonesia has the third highest prevalence of stunting in the South- East Asia Region (SEAR). From 2005-2017, the average preva- lence of stunting in Indonesian toddlers was 36.4%, with an increase from 27.5% in 2016 to 30.8% in 2018.13 Stunting affects children’s intelligence and health into adult- hood. Children suffering from stunting can experience physical and cognitive impairments, leading to reduced growth.15 If not addressed properly, stunting can lead to weak cognitive abilities, delayed psychomotor development, increased susceptibility to degenerative diseases in adulthood, and a long-term decline in human resource quality.16 Stunted children are strongly associated with poor educational achievement, shorter schooling duration, and lower income as adults. They are more likely to grow into adults who are less educated, poorer, less healthy, and more vulner- able to non-communicable diseases. Consequently, stunted chil- dren are predictors of a nation’s future human resource quality and productive capacity.17 Family factors are significant contributors to stunting in chil- dren. These include low parental education and income levels, poor parenting, inadequate diet, lack of exclusive breastfeeding, infections, and parents with short stature.18 Since late 2017, the Ministry of National Planning and Development/National Planning and Development Agency has implemented the “Integrated Intervention in Districts/Cities” to prevent stunting. This initiative includes broad multi-sector interventions covering food access, basic health services, clean water and sanitation access, and parenting patterns.19 The family’s role, especially that of the mother in implementing parenting and childcare practices, impacts children’s growth and development. Mother’s parenting involves behaviors such as providing breast milk or complementa- ry foods, teaching proper eating habits, providing nutritious foods, controlling food portions, preparing hygienic meals, and ensuring an appropriate diet. These behaviors ensure adequate nutritional intake for children’s growth and development.20 Parenting involves actions by caregivers (mother, father, grandmother, or others) to provide food, maintain health, offer emotional support, and fulfill other needs for children’s growth and development, including parental love and responsibility.21 The mother’s role is dominant in nurturing and educating children to grow and develop into quality individuals. Proper maternal behav- ior in breastfeeding, feeding, healthy eating, providing nutritious food, and controlling food portions enhances a child’s nutritional status.22 Parenting affects nutritional status because proper growth and nutrition enable children to develop better.13 Food plays a critical role in children’s development, with their nutritional needs differ- ing from adults. Proper feeding during the golden age periods is crucial for development. A mother’s parenting significantly influ- ences stunting incidence in toddlers since mothers regulate food intake. Mothers with good parenting practices tend to have tod- dlers with better nutritional status than those with less effective parenting.23 Research in Makassar shows a significant relationship between parenting and stunting in children aged 24-59 months.24 Effective parenting includes maternal attention/support in feeding practices, psychosocial stimulation, hygiene, environmental sani- tation, and health service utilization. Similarly, research in North Central Timor found a significant relationship between parenting history and stunting, with a 14.5 times higher risk of stunting in children with inadequate parenting compared to those with good parenting.25 Based on this context, this study aimed to determine the relationship between maternal parenting practices and stunting prevention behaviors in children aged 3-5 years at the Kediri Regency Health Center. Materials and Methods This study employed a correlational analysis with a cross-sec- tional research design. The population comprised all mothers with children aged 3-5 in the working area of the Kediri Regency Health Center. The sample consisted of 128 respondents, selected using a simple random sampling method. Researchers utilized a list of mothers with children aged 3-5. They selected 128 respondents randomly from a pool of 189 potential participants using a method similar to a lottery system. Data collection for parenting variables was conducted using questionnaires assessing authoritarian, democratic, and permissive parameters. This questionnaire was validated (p-value <0.05) and demonstrated high reliability with a Cronbach’s Alpha value of 0.968. For stunting prevention behavior, the questionnaire assessed cognitive, affective, and conative parameters with similar valida- tion (p<0.05) and reliability (Cronbach’s Alpha =0.962). The researcher developed the questionnaire based on established indi- cators/parameters. The parenting indicators corresponded to the permissive, democratic, and authoritarian categories, and the ques- tionnaire items were derived from these parenting styles. The study examined two variables: the independent variable, maternal parenting (categorized as permissive, democratic, and authoritarian), and the dependent variable, stunting prevention behavior (categorized as good, sufficient, and lacking). Stunting prevention behavior was evaluated using a Likert scale across 15 statements, with responses ranging from Always to Never. Scores were allocated from 1 to 4, and the total scores were converted into percentages, categorized as follows: high if the score fell between 76-100%, moderate if the score ranged from 56-75%, and low if the score was <56%. Data processing involved editing, coding, scoring, tabulating, and statistical analysis using Spearman’s correlation with an alpha level of 0.05. The Spearman Rank test was chosen due to the ordi- nal nature of the variables. Data analysis was performed using SPSS version 25. This research was approved by the Nursing Research Ethics Commission of the Institute of Science and Health Technology Insan Cendekia Medika Jombang, with ethical clear- ance number 028/KEPK/ICME/II/2023. Results Table 1 shows the frequency distribution of respondents based on the mother’s age. Most respondents are aged 26-30 years, with 43 people (34%). Most mothers have a high school education, accounting for 48 people (37%). Most mothers are housewives, with 58 people (45%). Regarding the sex of the respondents’ chil- dren, most respondents have sons, totaling 76 (59%). Most respon- dents have children aged 4 years, with 53 people (41%). Additionally, most mothers practiced a democratic parenting style, with 52 people (41%), and stunting prevention behavior was cate- gorized as good for 58 people (45%). Based on the statistical analysis results in Table 2, stunting pre- vention behavior is categorized as good among those with a dem- ocratic parenting style, with 33 people (63%). The analysis using the Spearman Correlation test yielded a p-value of 0.000, indicat- Transforming Healthcare in Low-Resource Settings: A Multidisciplinary Approach Towards Sustainable Solutions [Healthcare in Low-resource Settings 2024;12:12054] [page 593] Non -co mmerc ial us e o nly ing a significant relationship between stunting prevention behavior and maternal parenting style at the Health Center in Kediri Regency. Discussion The study results showed that most mothers (63%) practiced a democratic parenting style, with 33 respondents. This finding aligns with the research conducted by Nuraeni et al. (2022), which also found that most respondents (94.6%) used a democratic par- enting style20. Democratic parenting positively impacts normal nutritional status. This is because parents in democratic households set expectations and guidelines, particularly regarding food. They tend to explain the reasons behind these rules, ensuring that chil- dren understand and follow them during meals.26 Good parenting is democratic parenting. Parents who practice democratic parenting positively influence their children’s eating behavior. Eating behavior is a person’s response to food as a vital necessity of life. When a child’s eating behavior is good, their nutritional needs are met, leading to ideal growth and reducing the risk of stunting or other nutritional problems. Parents who use democratic parenting tend to encourage their children to be inde- pendent while providing boundaries and control.4 Democratic par- enting has a positive impact because parents recognize and nurture their child’s abilities. Children are given opportunities to be inde- pendent and not overly reliant on their parents. Parents are always open to their children’s opinions and desires, prioritizing rational thoughts and interests.27 In terms of providing nutrition, democrat- ic parents offer a food menu that meets children’s nutritional needs while allowing them the freedom to choose their food. These par- ents encourage their children to eat without issuing commands and provide ongoing support. Democratic parenting is considered the best and healthiest because parents control the types of food their children eat, manage their children’s weight, regulate their emo- tions during meals, and encourage children to regulate their own intake under parental supervision. Good communication is key in implementing democratic parenting. Parents typically praise their children for positive actions, teach them to be independent and responsible, and show love.28 The results revealed that most respondents exhibited good stunting prevention behavior, totaling 58 people (45%). Education is among the factors influencing parental behavior in stunting pre- vention, with 48 respondents (37%) having a high school educa- tion. Maternal education serves as a significant predictor of child stunting. Mothers with higher education levels possess enhanced cognitive abilities, are more receptive to information from various sources, and demonstrate greater adaptability in applying health knowledge to parenting. Improved literacy and numeracy skills acquired through education empower women to recognize dis- eases, seek appropriate treatment for their children, comprehend medical instructions, and administer treatment effectively. Moreover, increased years of schooling enhance women’s recep- tivity to modern medicine.29 Higher education is associated with greater knowledge, which translates to improved childcare prac- tices. A mother’s educational attainment correlates with her under- standing of healthcare, pregnancy, postpartum care, and child health and nutrition awareness.30 Another influential factor in the incidence of stunting is the mother’s age. Most respondents were within the 26-30 age range, comprising 43 individuals (34%). Mothers in the young adult cat- egory typically possess the physical and psychological maturity necessary for childcare. Children born to mothers in adulthood face a lower risk of stunting compared to those born to teenage or older mothers. Adult mothers are better equipped to absorb knowl- edge, exhibit greater maturity in their thought processes, and con- sequently, are more adept at implementing effective parenting practices. As a result, children of adult mothers are less susceptible to stunting than their counterparts born to teenage or older moth- ers.26 The employment status of mothers significantly influences the incidence of stunting. In this study, most mothers were house- wives, totaling 58 individuals (45%). Being a housewife provides mothers with more time to dedicate to their children’s growth and development around the clock. Consequently, mothers who do not Transforming Healthcare in Low-Resource Settings: A Multidisciplinary Approach Towards Sustainable Solutions Table 1. Frequency distribution of respondents. Characteristics of respondents Frequency Percentage (f) (%) Mother's age 21-25 years 28 22 26-30 years 43 34 31-35 years 36 28 36-40 years 21 16 Mother's education Elementary School 34 27 Junior High School 28 22 Senior High School 48 37 College 18 14 Mother's job Housewife 58 45 Private Staff 32 25 Farmer 38 30 Child's gender Male 52 41 Female 76 59 Child's age 3 years 34 27 4 years 53 41 5 years 41 32 Parenting style Democratic 52 41 Permissive 40 31 Authoritarian 36 28 Stunting prevention behavior High 58 45 Moderate 50 39 Low 20 16 Total 128 100 Table 2. Analysis of stunting prevention behavior and mother's parenting style. Stunting Preventive Behavior Parenting High Moderate Low Total Style f % f % f % f Democratic 33 63 19 37 0 0 52 Permissive 23 58 5 12 12 30 40 Authoritarian 2 6 26 72 8 22 36 Total 58 45 50 39 20 16 128 Spearman’s rho of p=0.000. [page 594] [Healthcare in Low-resource Settings 2024;12:12054] Non -co mmerc ial us e o nly work outside the home tend to be more attentive to their child’s development. This finding is consistent with prior research indicat- ing that working mothers may exhibit poorer parenting practices due to limited time spent with their children.31 In some low-income households, mothers may juggle earning a livelihood with house- hold responsibilities. This dual role reduces the time and attention available for childcare. As a result, the mother’s employment status directly impacts the parenting style employed with the child.32 Parenting encompasses methods of interaction, communica- tion, ethical application within the family, and the cultivation of discipline in children.33 Within the framework of democratic par- enting, parents afford children the autonomy to select foods they prefer, while still offering guidance and choices aligned with bal- anced nutrition. A mother’s adoption of a democratic parenting style with her young child often signifies nurturing and support, thereby positively influencing the child’s nutritional status. Maternal behaviors such as breastfeeding, providing healthy meals, offering nutritious foods, and controlling portions play piv- otal roles in enhancing children’s nutritional status.34 Indeed, a mother’s parenting style significantly influences various aspects of children’s growth and development, encompassing interactions, growth, and the inculcation of values and morals. Mother’s parenting practices significantly influence the inci- dence of stunting by encompassing how mothers utilize their knowledge and skills to ensure food processing meets nutritional requirements, implement a clean and healthy lifestyle, and monitor child health.36 The correlation between democratic parenting and stunting prevention behavior categorized as good underscores the emphasis of democratic parenting on granting children opportuni- ties for exploration within the framework of parental supervision and guidance. Parents continue to educate and guide children on the importance of balanced nutrition for optimal growth and devel- opment and adopting a clean and healthy lifestyle. Research indicates a correlation between democratic parenting and stunting prevention behavior categorized as good. This finding can inform government programs aimed at preventing or reducing stunting in Indonesia. One such program is the “Integrated Intervention in Districts/Cities” initiative by the Ministry of National Planning and Development, which includes the enhance- ment of specific program services related to the health sector, such as providing high-calorie, protein-rich, and micronutrient-dense supplementary feeding, and improving children’s health services.13 In this context, mothers play a crucial role in ensuring proper care for their children. They are responsible for ensuring adequate nutritional intake and regulating their children’s lifestyle within their environment. By adopting democratic parenting practices, mothers are expected to exhibit optimal stunting prevention behav- ior, thereby facilitating optimal growth and development in chil- dren according to their age. Conclusions The research findings reveal a significant relationship between maternal parenting and stunting prevention behavior among chil- dren aged 3-5 in the Kediri Regency, Indonesia. These results are poised to enhance respondents’ comprehension regarding the criti- cality of adopting appropriate parenting practices and implement- ing stunting prevention behaviors to mitigate stunting in children. Moreover, the study outcomes are anticipated to serve as funda- mental data for informing governmental policy deliberations aimed at reducing stunting rates in Indonesia. Future research endeavors should delve deeper into exploring additional factors influencing maternal behavior in stunting prevention. References 1. Mboi N, Syailendrawati R, Ostroff SM, et al. The state of health in Indonesia’s provinces, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Glob Heal 2022;10:e1632-45. 2. Mar’ah Has Ekam, Sabela A, Qona’ah A, et al. Maternal care- giving capabilities are associated with energy-protein adequa- cy of children with stunting in Central Java, Indonesia. Curr Res Nutr Food Sci 2024;12:13. 3. Izza N, Purnomo W, Mahmudah. Factors affecting the occur- rence of stunting in indonesia. Indian J Public Heal Res Dev 2019;10:1845-50. 4. Rahmadhita K. Permasalahan Stunting dan Pencegahannya. J Ilm Kesehat Sandi Husada 2020;11:225-9. 5. Komalasari K, Supriati E, Sanjaya R, Ifayanti H. Faktor-Faktor Penyebab Kejadian Stunting Pada Balita. Maj Kesehat Indones 2020;1:51-6. 6. Surani E, Susilowati E. The relationship between fulfilment of basic needs with the incidence of stunting in toddlers. J Ners 2020;15:26-30. 7. Krisnana I, Azizah R, Kusumaningrum T, Has EMM. Feeding patterns of children with stunting based on WHO (World Health Organization) determinant factors of behaviours approach. Indian J Public Heal Res Dev 2019;10:2756-61. 8. Kuswanti I, Khairani Azzahra S. Hubungan Pengetahuan Ibu Tentang Pemenuhan Gizi Seimbang Dengan Perilaku Pencegahan Stunting Pada Balita. J Kebidanan Indones 2022;13:15-22. 9. Has EMM, Krisnana I, Efendi F. Enhancing maternal caregiving capabilities model to prevent childhood stunting: a UNICEF-inspired model. SAGE Open Nurs 2024;10:2377960 8231226060. 10. Fildzah FK, Yamin A, Hendrawati S. Perilaku Ibu Dalam Pencegahan Stunting Pada BADUTA. J Keperawatan Muhammadiyah 2020;5:272-84. 11. Fadmi FR, Kuntoro, Otok BW, Melaniani S. Stunting incident prevention: a systematic literature review. J Public Health Africa 2023;14:2547. 12. Yunita FC, Yusuf A, Nihayati HE, Hilfida NH. Coping strate- gies used by families in Indonesia when caring for patients with mental disorders post-pasung, based on a case study approach. Gen Psychiatry 2020;33:e100035 13. Kurniawati R. Situasi Balita Pendek (Stunting) di Indonesia. 2018. Available from: https://online.flipbuilder.com/ vcbje/skgj/ 14. Flynn J, Alkaff FF, Sukmajaya WP, Salamah S. Comparison of WHO growth standard and national Indonesian growth refer- ence in determining prevalence and determinants of stunting and underweight in children under five: a cross-sectional study from Musi sub-district. F1000Research 2021;9:1-20. 15. Maulina R, Qomaruddin MB, Prasetyo B, et al. The effect of stunting on the cognitive development in children: a systematic review and meta-analysis. Stud Ethno-Medi 2023;17:19-27. 16. Dasman H. Empat dampak stunting bagi anak dan negara Indonesia Empat dampak stunting bagi anak dan negara Indonesia. 2019. Available from: http://repo.unand.ac. id/21312/1/Empat%20dampak%20stunting%20bagi%20anak Transforming Healthcare in Low-Resource Settings: A Multidisciplinary Approach Towards Sustainable Solutions [Healthcare in Low-resource Settings 2024;12:12054] [page 595] Non -co mmerc ial us e o nly %20dan%20negara%20Indonesia.pdf?hdjecjecbaimglng 17. Trihono, Atmarita, Tjandrarini DH, et al. Pendek (Stunting) Di Indonesia, Masalah Dan Solusinya. 2015. Available from: https://repository.badankebijakan.kemkes.go.id/id/eprint/3512 /1/Pendek%20(Stunting)%20di%20Indonesia.pdf 18. Rohmawati N, Antika RB. Risk factors stunting incidence in children aged 6-36 months in Jember Regency. Proceeding 3rd Int Nurs Conf 2017;4:128-36. 19. Sudikno, Irawan IR, Setyawati B, et al. Laporan Akhir Penelitian Status Gizi Balita Tahun 2019. 2019. Available from: http://perpustakaan.badankebijakan. kemkes.go.id/index.php?p=show_detail&id=38739 20. Banjarmasin M, Asuh P. Hubungan Pola Asuh Ibu dengan Kejadian Stunting Anak Usia 12-59 Bulan. J Ilmu Keperawatan Anak 2021;4:37-42. 21. Nabuasa CD, Juffrie M, Huriyati E. Riwayat pola asuh, pola makan, asupan zat gizi berhubungan dengan stunting pada anak 24–59 bulan di Biboki Utara, Timor Tengah Utara, Nusa Tenggara Timur. Indonesian J Nutr Diet 2016;1:151. 22. Picauly I, Toy SM. Analisis Determinan Dan Pengaruh Stunting Terhadap Prestasi Belajar Anak Sekolah Di Kupang Dan Sumba Timur, Ntt. J Gizi dan Pangan 2013;8:55. 23. Lailatul M, Ni’mah. C. Hubungan Tingkat Pendidikan, Tingkat Pengetahuan dan Pola Asuh Ibu dengan Wasting dan Stunting pada Balita Keluarga Miskin. Media Gizi Indones 2015;10:84- 90. 24. Rahmayana, Ibrahim IAI, Darmayati DS. Hubungan Pola Asuh Ibu Dengan Kejadian Stunting Anak Usia 24-59 Bulan Di Posyandu Asoka II Wilayah Pesisir Kelurahan Ba- rombong Kecamatan Tamalate Kota Makassar Tahun 2014. Public Heal Sci J 2014;6:424-36. 25. Nursalam. Metodologi Penelitian Ilmu Keperawatan: Pendekatan Praktis. Metodol Penelit Ilmu Keperawatan Pendekatan Prakt. Salemba Medika; Jakarta, Indonesia; 2017. 26. Gustina E, Sofiana L, Ayu SM, et al. Good parental feeding style reduces the risk of stunting among under-five children in Yogyakarta, Indonesia. Multidisc J Public Health Preventat Med 2020;8:120-5. 27. Nuraeni SP, Herliana L, Patimah S. Hubungan Pola Asuh Ibu terhadap Derajat Stunting pada Balita Usia 24-59 Bulan di Desan Tanjungsari. J Midwifery Inf 2022;3:53. 28. Nita S. The Relationship Between Parenting Patterns and Disease Patterns with the Incident of Stunting in Toddlers 6-36 Months at the Panyabungan Jae Community Health Center, Panyabungan District, Mandailing Regency, Christmas 2022. Benih : J Midwifery 2022;2:50-7. 29. Abuya BA, Ciera J, Kimani-Murage E. Effect of mother’s edu- cation on child’s nutritional status in the slums of Nairobi. BMC Pediatr 2012;12:80. 30. Sari M, Rahmi N. Faktor-Faktor yang Mempengaruhi Pola Asuh Orang Tua pada Anak Balita di Desa Batoh Kecamatan Lueng Bata Kota Banda Aceh. J Healthc Technol Med 2017;3:94. 31. Sastria Ahmad A, Azis A, Fadli. Analysis of risk factors for the incidence of stunting in toddlers. J Heal Sci Prev 2021;5:10-4. 32. Suharto A, Wildan M, Handayani TE. Development of stunting prevention behavior model based on health promotion model and social capital in the Magetan District. Heal Notions 2020;4:48-56. 33. Pebriani LV, Jatnika R, Haffas M. Relationship between par- enting style and parental feeding style in the locus stunting area in West Java. Proc 1st Paris Van Java Int Semin Heal Econ Soc Sci Humanit (PVJ-ISHESSH 2020) 2021;535:773-6. 34. Puspita S, Aryani HP. Pola Asuh Orang Tua terhadap Pertumbuhan Anak Balita. J Educ Res 2023;2:92-9. 35. Pertiwi MR, Lestari P, Ulfiana E. Relationship between parent- ing style and perceived information sources with stunting among children. Int J Nurs Heal Serv 2019;2:273. Transforming Healthcare in Low-Resource Settings: A Multidisciplinary Approach Towards Sustainable Solutions [page 596] [Healthcare in Low-resource Settings 2024;12:12054] Non -co mmerc ial us e o nly