Effectiveness of Maranti Stimulation in Improving Growth and Development Among Stunted Toddlers: A Quasi-Experimental Study
Abstract
Introduction: Stunting remains a major public health concern in Indonesia, particularly during the first 1,000 days of life, and reflects the cumulative effects of nutritional deficits, infection, and suboptimal caregiving within broader social and environmental conditions. This study draws on current national and global evidence to frame stunting as a developmental and ecological problem that requires integrated, family-centred interventions. This study aimed to assess the effectiveness of Maranti stimulation (massage therapy for stunting), in enhancing growth and development among stunted children.
Methods: This quasi-experimental study utilized a non-equivalent control group design and was conducted from August to November 2024 at two public health centers in Bantul, Yogyakarta, Indonesia. Participants were divided into two groups: the intervention group (n=23), which received weekly Maranti massage sessions over six weeks, and the control group (n=25), which was provided with educational booklets on child growth and developmental stimulation. Growth measurements were collected using anthropometric tools, and developmental outcomes were assessed using the BSID-III instrument. Data normality was assessed prior to analysis. Normally distributed variables were analyzed using independent t-tests, while non-normally distributed variables were analyzed using the Mann–Whitney U test in Stata.
Results: The findings revealed significant improvements in growth and development post-intervention in both groups, with more pronounced effects in the intervention group. Notably, Maranti therapy significantly increased body weight (p=0.016) and height (p=0.001). Language (p=0.025) and motor skills (p=0.045) also improved significantly. Cognitive development, however, did not show a statistically significant change (p=0.635). Effect size analysis indicated medium to strong effects for weight and height (Cohen’s d = 0.724 and 1.041), and moderate effects for language and motor development (Cohen’s d = 0.580 and 0.595).
Conclusion: Maranti stimulation demonstrates promise as an effective complementary strategy to improve physical growth and developmental outcomes in stunted children, though further research is needed regarding cognitive impacts. These findings suggest that culturally embedded tactile stimulation can serve as a feasible complementary approach for growth-promotion programs. The intervention holds potential for integration into community-based stunting-reduction strategies, particularly in settings where traditional practices remain influential.
References
Van Beekum M, Berger J, Van Geystelen J, Hondru G, Som SV, Theary C, et al. The associations between stunting and wasting at 12 months of age and developmental milestones delays in a cohort of Cambodian children. Sci Rep [Internet]. 2022;12(1):17859. Available from: https://doi.org/10.1038/s41598-022-22861-2
Raj E, Urbano BC, Heffernan C, Halder J, Webster JP. Systematic review to evaluate a potential association between helminth infection and physical stunting in children. Parasit Vectors [Internet]. 2022;1–19. Available from: https://doi.org/10.1186/s13071-022-05235-5
Siswati T, Susilo J, Kusnanto H, Waris L. Risk Factors of Mild and Severe Stunting Children in Rural and Urban Areas in Indonesia. Iran J Public Health [Internet]. 2022 Jan 4;51(1 SE-Letter to the Editor). Available from: https://doi.org/10.18502/ijph.v51i1.8316
Akhmadi A, Sunartini S, Haryanti F, Madyaningrum E, Sitaresmi MN. Effect of care for child development training on cadres’ knowledge, attitude, and efficacy in Yogyakarta, Indonesia. Belitung Nurs J [Internet]. 2021 Aug 27;7(4 SE-Original Research Article):311–9. Available from: https://doi.org/10.33546/bnj.1521
Uwiringiyimana V, Ocké MC, Amer S, Veldkamp A. Data on child complementary feeding practices, nutrient intake and stunting in Musanze District, Rwanda. Data Br [Internet]. 2018;21:334–42. Available from: https://doi.org/10.1016/j.dib.2018.09.084
Walker SP, Chang SM, Wright A, Osmond C, Grantham-McGregor SM. Early Childhood Stunting Is Associated with Lower Developmental Levels in the Subsequent Generation of Children. J Nutr [Internet]. 2015 Apr 1;145(4):823–8. Available from: https://doi.org/10.3945/jn.114.200261
Adane B, Id T, Gezie LD, Alamneh TS. Pooled prevalence of stunting and associated factors among children aged 6 – 59 months in Sub-Saharan Africa countries : A Bayesian multilevel approach. PLoS One [Internet]. 2022;1–19. Available from: http://doi.org/10.1371/journal.pone.0275889
Beal T, Tumilowicz A, Sutrisna A, Izwardy D, Neufeld LM. A review of child stunting determinants in Indonesia. Matern Child Nutr. 2018;(March):1–10. Available from: https://doi.org/10.1111/mcn.12617
Dwi A, Yadika N, Berawi KN, Nasution SH. Pengaruh Stunting terhadap Perkembangan Kognitif dan Prestasi Belajar. Med J Lampung Univ [Internet]. 2019;(September):273–82. Available from: https://juke.kedokteran.unila.ac.id/index.php/majority/article/view/2483/2439
Perkins JM, Kim R, Krishna A, McGovern M, Aguayo VM, Subramanian S V. Understanding the association between stunting and child development in low- and middle-income countries: Next steps for research and intervention. Soc Sci Med [Internet]. 2017;193:101–9. Available from: https://doi.org/https://doi.org/10.1016/j.socscimed.2017.09.039
Kia AA, Goodarzi S, Asadi H, Khosravi A, Rezapour A. A Decomposition Analysis of Inequality in Malnutrition among under Five Children in Iran: Findings from Multiple Indicator Demographic and Health Survey, 2010. Iran J Public Health [Internet]. 2019 Apr 17;48(4 SE-Original Article(s)). Available from: https://doi.org/10.18502/ijph.v48i4.1009
Radjamuda N, Khofiyah N. Penyebab Stunting di Asia. J Kesehat [Internet]. 2022;1:8–20. Available from: https://doi.org/https://doi.org/10.35730/jk.v13i1.535
Bamisaye OB, Adepoju OT. Association between stunting and obesity among underfive children in urban and rural areas of Oyo State, Nigeria. Malays J Nutr. 2018;24(1):25–34.
Haniarti H, Sabriani S, Nurlinda N, Fitriani Umar. Socio-Cultural Influences on Stunting Children Aged 24-59 Months: A Cross-Sectional Study in the Bugis Community of Indonesia. Media Publ Promosi Kesehat Indones [Internet]. 2025 Aug 20;8(8 SE-Article):818–30. Available from: https://doi.org/10.56338/mppki.v8i8.7946
Khofiyah N. Edukasi Berpengaruh terhadap Pemberian Stimulasi Perkembangan Anak Usia 12-24 Bulan oleh Ibu di Posyandu Desa Tambakrejo Kabupaten Puworejo. J Ners dan Kebidanan (Journal Ners Midwifery); Vol 7, No 2 (2020)DO - 1026699/jnk.v7i2ART.p231-238 [Internet]. 2020 Aug 5; Available from: http://doi.org/10.26699/jnk.v7i2.ART.p231–238
Prastiwi I, Alindawati R. Analyzing The Effect Of Increasing Growth And Motoric Development Of Infants Aged 6-11 Months Who Are At Risk Of Stunting With Baby Spa Treatment. J KEBIDANAN KESTRA [Internet]. 2022 Oct 31;5(1 SE-Articles):90–102. Available from: https://doi.org/10.35451/jkk.v5i1.1344
Campbell M, Jacobs L. The effect of parent-administered infant massage on the developmental outcomes of premature infants. South African J Occup Ther [Internet]. 2021;51:36–43. Available from: http://dx.doi.org/10.17159/2310-3833/2021/vol51n1a6
Perrie ML. The Effect of Parent Administered Infant Massage on the Developmental Milestones of Premature Infants. University of the Witwatersrand, Faculty of Health Sciences; 2019.
Sutarmi S, Astuti Y, Siswanto S, Kunarti E, Susilowati D. Effectiveness of Healthy Massage on Growth and Development among Stunting Babies. Malaysian J Med Heal Sci [Internet]. 2022;18. Available from: https://medic.upm.edu.my/upload/dokumen/202202231717325_0935.pdf
Field T. Pediatric Massage Therapy Research: A Narrative Review. Children. 2019;6(78):1–12. Available from: https://doi.org/10.3390/children6060078
Lestari KP, Nurbadlina FR, Wagiyo, Jauhar M. The effectiveness of baby massage in increasing infant ’ s body weight. J Public health Res. 2021;10:1–5. Available from: https://doi.org/ 10.4081/jphr.2021.2332
Mathisen TF, Sundgot-Borgen J, Bulik CM, Bratland-Sanda S. The neurostructural and neurocognitive effects of physical activity: A potential benefit to promote eating disorder recovery. Int J Eat Disord [Internet]. 2021 Oct 1;54(10):1766–70. Available from: https://doi.org/10.1002/eat.23582
Rokhanawati D, Salimo H, Andayani TR, Hakimi M. The Effect of Parenting Peer Education Interventions for Young Mothers on the Growth and Development of Children under Five. Children [Internet]. 2023;10(2):1–15. Available from: https://doi.org/10.3390/children10020338
Nugroho MR, Sasongko RN, Kristiawan M. Faktor-faktor yang Mempengaruhi Kejadian Stunting pada Anak Usia Dini di Indonesia. J Obs J Pendidik Anak Usia Dini [Internet]. 2021;5. Available from: https://doi.org/10.31004/obsesi.v5i2.1169
Khofiyah N. Hubungan antara status gizi dan pola asuh gizi dengan perkembangan anak usia 6-24 bulan. J Ris Kebidanan Indones [Internet]. 2019;3(1):37–48. Available from: https://doi.org/10.32536/jrki.v3i1.53
Taqwin T, Linda L, Kusika SY, Ramadhan K, Radhiah S, Bohari B. The Effectiveness of Baby Massage in Stunting Prevention: Study Based on Body Length Gain in Infants aged 0–3 Months. Open Access Maced J Med Sci [Internet]. 2022 Apr 27;10(E SE-Public Health Education and Training):1184–9. Available from: https://doi.org/10.3889/oamjms.2022.8906
Lismayanti D, Adiyanti ID. STIMULASI ORANG TUA DENGAN PERKEMBANGAN ANAK USIA TODDLER (1-3 TAHUN) DI DUSUN 02 RANGGON KABUPATEN KARAWANG 2023. 2024;4(2):1271–82. Available from: https://www.bajangjournal.com/index.php/JIRK/article/view/8402
Veftisia V, Pranoto HH. Hubungan Persepsi Ibu tentang Stimulasi Perkembangan dengan Stimulasi Perkembangan Anak. Indones J Midwifery [Internet]. 2020 Mar 29;3(1 SE-Articles). Available from: https://jurnal.unw.ac.id/index.php/ijm/article/view/344
Azizah SN, Saleh S, Sulistyaningrum E. The Effect of Working Mother Status on Children ’ s Education Attainment : Evidence from Longitudinal Data. 2022;1–22. Available from: https://doi.org/10.35473/ijm.v3i1.344
Jumain, Talindong A, Wahyu, AB S, Pelima R V, Parmi, et al. Factors in the Incidence of Stunting in Children Under Five: Literature Review. Media Publ Promosi Kesehat Indones [Internet]. 2024 Jul 2;7(7 SE-Review Article):1780–7. Available from: https://doi.org/10.56338/mppki.v7i7.5350
Cassiano RGM, Gaspardo CM, Linhares MBM. PREMATURITY, NEONATAL HEALTH STATUS, AND LATER CHILD BEHAVIORAL/EMOTIONAL PROBLEMS: A SYSTEMATIC REVIEW. Infant Ment Heal J Infancy Early Child [Internet]. 2016 May 1;37(3):274–88. Available from: https://doi.org/10.1002/imhj.21563
Ramadia A, Sundari W, Permanasari I, Amidos J. PENGETAHUAN ORANGTUA TENTANG STIMULASI PERKEMBANGAN ANAK BERHUBUNGAN DENGAN TAHAP TUMBUH KEMBANG ANAK USIA TODLER. Psychiatry Nurs J (Jurnal Keperawatan Jiwa) [Internet]. 2021 Jan 15;9:1–10. Available from: https://doi.org/10.26714/jkj.9.1.2021.1-10
Sukamti S, Junengsih J, Aticeh A, Sriwenda D. Baby Massage is Useful in Stunting Prevention. Women, Midwives and Midwifery [Internet]. 2024 Feb 29;4(1 SE-):1–7. Available from: https://doi.org/10.36749/wmm.4.1.1-7.2024
Haryanti F, Hartini S, Akhmadi, Andarwati F, Risnawati H, Pratiwi AN, et al. Maternal knowledge on nutritional-focused nurturing care and associated factors among women with stunted children aged 6-23 months in Yogyakarta, Indonesia: A cross-sectional study. Belitung Nurs J [Internet]. 2024 Aug 28;10(4 SE-Original Research Article):472–80. Available from: https://doi.org/10.33546/bnj.3481
Rakhmawati W, Mediani H, Dhamayanti M, Maryati I, Setiawan A, Hendrawati S, et al. Potential of Massage Therapy for Improved Growth and Development Among Infants Under 9 Months: A Systematic Scoping Review of Intervention Type, Technique, and Outcome. J Multidiscip Healthc [Internet]. 2024 Aug 12;17:3931–43. Available from: https://doi.org/10.2147/JMDH.S475731
YUSNIARITA Y, PUSPITA Y, SARI WPEKA. PENGARUH STIMULASI TAKTIL KINESTATIK TERHADAP PERTUMBUHAN DAN PERKEMBANGAN BAYI RIWAYAT BERAT BADAN LAHIR RENDAH. J Midwifery [Internet]. 2021 Dec 10;9(2 SE-Articles). Available from: https://doi.org/10.37676/jm.v9i2.1825
Diego MA, Field T, Hernandez-Reif M. Vagal Activity, Gastric Motility, and Weight Gain in Massaged Preterm Neonates. J Pediatr [Internet]. 2005;147(1):50–5. Available from: https://doi.org/10.1016/j.jpeds.2005.02.023
Niemi A-K. Review of Randomized Controlled Trials of Massage in Preterm Infants. Vol. 4, Children. 2017. p. 21. Available form: https://doi.org/10.3390/children4040021
Chen S-C, Lin S-L, Wang M, Cheung DS-T, Liang J-G, Cheng Z-Y, et al. Pediatric massage therapy in infants and children under 5 years: An umbrella review of systematic reviews. Heliyon [Internet]. 2024 Aug 30;10(16). Available from: https://doi.org/10.1016/j.heliyon.2024.e35993
Sudarmi, Sukrama IDM, Sutirtayasa IWP, Weta IW, Irianto. Influence of baby massage stimulation on the improvement of nutritional status, IGF-1, and cortisol level on undernourished infant. Bali Med J. 2020;9(1 PP-Denpasar):36–40. Available from: https://doi.org/10.15562/bmj.v9i1.1688
Priyadarshi M. Effect of whole-body massage on growth and neurodevelopment in term healthy newborns : A systematic review. 2022;12. Available from: https://doi.org/10.7189/jogh.12.12005
Pastari M, Syokumawena. The Effect of Baby Massage on Language Development Disorder ( Speech Delay ). 2017;11238–47. Available from: https://www.bircu-journal.com/index.php/birci/article/view/4941
Siregar DN, Laoli NK, Pasaribu DA, Silangit NN. The Effectiveness of Oromotor Massage Stimulation on the Development of Language and Speech Skills in Babies Aged 12-18 Months. Indones J Glob Heal Res [Internet]. 2024; Available from: https://doi.org/10.37287/ijghr.v6i4.3253
Budiarti E, Rahmani E, Yusnita E, Sumiati C, Yunaini Y. Pengaruh Penerapan Oral Motor Untuk Anak Speech Delay Usia 2-4 Tahun. J Pendidik Indones [Internet]. 2022 Oct 20;3(10 SE-Articles):953–60. Available from: https://doi.org/10.59141/japendi.v3i10.1417
Sideropoulos V, Draper A, Munoz-Chereau B, Ang L, Dockrell JE. Childhood stunting and cognitive development: a meta-analysis. J Glob Health. 2025 Sep;15:4257. Available from: https://doi.org/10.7189/jogh.15.04257
Grantham-McGregor SM, Powell CA, Walker SP, Himes JH. Nutritional supplementation, psychosocial stimulation, and mental development of stunted children: the Jamaican Study. Lancet [Internet]. 1991;338(8758):1–5. Available from: https://doi.org/10.1016/0140-6736(91)90001-6
Walker SP, Chang SM, Powell CA, Grantham-McGregor SM. Effects of early childhood psychosocial stimulation and nutritional supplementation on cognition and education in growth-stunted Jamaican children: prospective cohort study. Lancet [Internet]. 2005 Nov 19;366(9499):1804–7. Available from: https://doi.org/10.1016/S0140-6736(05)67574-5
Jeong J, Franchett EE, Ramos de Oliveira C V, Rehmani K, Yousafzai AK. Parenting interventions to promote early child development in the first three years of life: A global systematic review and meta-analysis. PLOS Med [Internet]. 2021 May 10;18(5):e1003602. Available from: https://doi.org/10.1371/journal.pmed.1003602
Sharma P, Budhathoki CB, Maharjan RK, Singh JK. Nutritional status and psychosocial stimulation associated with cognitive development in preschool children: A cross-sectional study at Western Terai, Nepal. PLoS One [Internet]. 2023 Mar 13;18(3):e0280032. Available from: https://doi.org/10.1371/journal.pone.0280032
Azwar A, Setiawan A, Rahmadiyah DC. Psychosocial Stimulation Interventions to Optimise The Developmental Growth Process of Stunted Toodlers in The First 1000 Days of Life: A Systematic Review. Golden Age J Ilm Tumbuh Kembang Anak Usia Dini [Internet]. 2024 Mar 31;9(1 SE-Articles):105–18. Available from: https://doi.org/10.14421/jga.2024.91-10
Qibtiah M, Mariyani M. Differences In The Effect Of Baby Massage And Baby Spa On The Growth And Motoric Development Of Infants Aged 3-6 Months At Pmb Cakung Kelurahan, Jakarta Timur. Int J Med Heal [Internet]. 2023;2(1):79–90. Available from: https://doi.org/10.55606/ijmh.v2i1.1092
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