Socioeconomic and Environmental Determinants of Community Stunting Prevention Behaviors: A Systematic Literature Review

Abstract

Stunting represents a critical public health challenge in developing countries, affecting over a quarter of children globally and resulting from complex interactions between socioeconomic, environmental, and behavioral factors that require comprehensive understanding for effective intervention strategies. This study aimed to identify, analyze, and synthesize the determinants of stunting prevention behaviors in developing countries through systematic literature review to provide evidence-based recommendations for targeted intervention strategies. A systematic literature review following PRISMA 2020 guidelines was conducted using PubMed, Scopus, Science Direct, and Google Scholar databases. Search terms included "stunting," "malnutrition," "determinant factors," "prevention," "community behavior," and "developing countries." Inclusion criteria encompassed articles published 2019-2024 focusing on children aged 0-59 months in developing countries. Quality assessment utilized Newcastle-Ottawa Scale and Cochrane Risk of Bias Tool, resulting in 20 high-quality studies from 309 initially identified articles. Maternal education emerged as the most consistent determinant, with low educational levels significantly correlated with suboptimal parenting practices. Economic status demonstrated complex relationships where poverty limited nutritious food access and affected family resource allocation priorities. Health promotion models proved effective for behavioral change, with self-efficacy and social support as significant factors. Environmental and sanitation factors played crucial roles through infection prevention and optimal nutrient absorption mechanisms. Multisectoral collaborative approaches emerged as most effective strategies requiring stakeholder trust and integrated coordination mechanisms. Comprehensive stunting prevention requires holistic intervention programs integrating maternal education, economic empowerment, and improved healthcare access. Strategic recommendations include participatory health education approaches, community-involved sanitation infrastructure development, and multisectoral collaboration models with neutral coordination platforms and shared performance indicators for sustainable program implementation.