Risk Factors Associated with Stunting among Children Under Five in Timor-Leste

Background: Undernutrition, including stunting, is the cause of almost 45% of all deaths among children under the age of five. It not only affects child growth but also has a longterm negative influence on cognitive and physical abilities. Timor-Leste has the highest prevalence of child stunting in Southeast Asia. Therefore, this study aimed to identify the prevalence of stunting and factors associated with it. Methods: This was a cross-sectional study conducted using the Demographic and Health Survey of 2016 for Timor-Leste. The prevalence of stunting among children under five years of age was examined, and bivariable and multivariable logistic regression analysis was conducted to identify the factors associated with stunting. Results: Among 4,581 children under five years of age, growth in nearly 40% was stunted. The majority of the mothers with stunted children were of age 20-30 years with about 33% having their first baby at <= 19 years of age. Compared to women of <145 cm of height, those of >= 145 cm height had lower likelihood of having a stunted child (OR: 0.62, 95% CI: [0.48-0.80], p < 0.001). It was also interesting to note that the risk of stunting was lower among female children than male children [OR: 0.75, 95% CI: (0.64-0.88), p < 0.001] in our adjusted model. Similarly, other factors such as wealth index, postnatal care visits, currently breastfeeding, age of the child, and size of the child at birth were also associated with stunting. Conclusion: The present findings indicate that child stunting in Timor-Leste is mainly associated with maternal and child sociodemographic status. Hence, it is crucial to identify the quality of services provided by health facilities, the involvement of health workers and volunteers, and the intention of mothers to use the health services in Timor-Leste.