Media Publikasi Promosi Kesehatan Indonesia (MPPKI)

Smoking, Obesity, Hypertension, and Lifestyle are Associated with Coronary Heart Disease: A Cross-Sectional Study in Central Sulawesi, Indonesia

Mon, 15 Dec 2025 00:00:00 +0700

Introduction: Cardiovascular disease is the leading cause of death globally, with 17.9 million deaths in 2019, of which 85% were caused by stroke and coronary heart disease (CHD). In Indonesia, CHD accounts for 26.4% of all deaths; therefore, controlling risk factors is a priority. This study aimed to analyze the relationship between modifiable risk factors (smoking, obesity, hypertension, and lifestyle) and the incidence of CHD.

Methods: This analytical study used a cross-sectional design with accidental sampling and was conducted at the Heart Polyclinic of the Undata Hospital, Central Sulawesi, in August 2025. A total of 112 respondents aged ?35 years who sought treatment were included in this study. Data were collected through direct measurements (blood pressure, height, and weight) and questionnaires assessing smoking habits, lifestyle, and medical histories. Ethical approval was obtained from the Health Research Ethics Committee of Poltekkes Kemenkes Palu. Data analysis included univariate, chi-squared (95% CI), and logistic regression tests.

Results: Among 112 respondents, 56 (50%) were diagnosed with CHD. There was a significant association between CHD and smoking (p < 0.001), obesity (p = 0.004), hypertension (p = 0.001), and lifestyle habits (p = 0.031). Logistic regression analysis identified smoking as the strongest predictor of CHD (odds ratio [OR] = 16.626; p = 0.009).

Conclusion: Smoking, obesity, hypertension, and lifestyle were significant risk factors for CHD, with smoking emerging as the main determinant. Preventive strategies should prioritize smoking cessation, weight control, hypertension management, and promotion of healthy lifestyles.

The Role of Parental Pressure in Relation to Academic Stress and Adolescent Mental Health in Urban Indonesia

Mon, 15 Dec 2025 00:00:00 +0700

Introduction: This study analyses the impact of parental pressure on academic stress among adolescents in urban Indonesia, emphasizing adolescent mental health as a critical health promotion issue. With increasing evidence of mental health challenges among school-aged youth worldwide, our objective was to investigate how parental expectations and restrictions contribute to academic stress, addressing a gap in the literature on school-based health promotion in Southeast Asia.

Methods: We conducted a quantitative cross-sectional survey in leading public high schools in urban Indonesia during the 2024 academic year. A total of 100 students were enrolled through purposive sampling, and data were collected via validated scales that measured parental pressure and academic stress. Ethical approval was obtained from the institutional ethics committee, and all participants provided informed consent before data collection.

Results: The primary outcome of the study was the relationship between parental pressure and academic stress. Regression analysis revealed a significant positive correlation between the two variables (R² = 0.566; p < 0.001), indicating that parental pressure had a strong and significant influence on academic stress among adolescents. Additionally, parental restrictions on nonacademic activities were associated with increased stress levels, highlighting the complex nature of parental influence on adolescent well-being.

Conclusion: Our study enhances the understanding of adolescent mental health by identifying parental pressure as a key determinant of academic stress. This research emphasizes the need for school-based health promotion strategies that involve parental engagement to foster supportive learning environments. Future studies should investigate culturally tailored interventions to reduce academic stress and improve adolescent well-being, ultimately advancing knowledge in the field of international health promotion.

Lean Strategy for Optimizing Response Time in Hospital Code Blue Activation: A Two-Cycle Action Research in Central Java, Indonesia

Habib Laksmana Prima, Merita Arini — Mon, 15 Dec 2025 00:00:00 +0700

ntroduction: Inefficiencies or delays in Code Blue activation for cardiac arrest patients contribute significantly to increased mortality. Rapid response time is closely associated with better prognosis. However, no previous study has systematically addressed the problem of Code Blue activation delay using a structured approach in hospital settings. This study aimed to formulate and implement improvement strategies to minimize waste and accelerate Code Blue activation.

Methods: This research employed an action research design and adopted a two-cycle action research design to validate the application of Lean Management in optimizing Code Blue activation at a private Type D hospital in Banyumas, Central Java, Indonesia. A total of 11 consecutive Code Blue cases were observed in each cycle — 11 cases before (Cycle 1) and 11 cases after intervention (Cycle 2). Each cycle consisted of four stages: diagnosis, planning, action, and evaluation, guided by Value Stream Mapping (VSM) to identify and eliminate waste. Quantitative data (lead time, waiting time, cycle time, and Value-Added Ratio) were analyzed using Mann–Whitney tests, while qualitative insights were obtained from in depth interview and focus group discussions with 20 healthcare professionals.

Results: The top three critical wastes identified in the baseline assessment were waiting (20.7%), defects (20.4%), and transportation (17%). Thus, waiting was concluded to be the most critical waste in the Code Blue activation process. Initially, the activation process had four phases: initial assessment by inpatient nurse, assessment by ward doctor, system activation, and arrival of the secondary team. After interventions, it was streamlined to three phases by removing the ward doctor’s assessment. Post-intervention, response time dropped by 92.2 % (from 122.1 to 9.5 minutes, p < 0.001), waiting time decreased by 91.3 % (from 50.7 to 4.4 minutes, p < 0.001), and the Value-Added Ratio (VAR) increased from 7 % to 39 % (p < 0.001).

Conclusion: The implementation of Lean Management significantly reduces response time in Code Blue activation. Sustaining these improvements requires ongoing commitment and a multidimensional approach, including training, system evaluation, and strengthening a supportive work culture.

Empowerment of Health Cadres in the Early Detection of High-Risk Pregnancies: The Role of Motivation, Competence, and Social Support

Mon, 15 Dec 2025 00:00:00 +0700

Introduction: Community health cadres serve as vital front-line actors in improving maternal health outcomes, particularly in the early identification of high-risk pregnancies. Operating as motivators, facilitators, and educators, their performance is influenced by internal attributes such as knowledge, skills, competence, and motivation, alongside external elements including social support. However, limited evidence exists on how these factors interact to influence their effectiveness. This study aimed to develop a structural model to analyze the relationships between these internal and external factors and their impact on cadre performance in early risk detection.

Methods: A cross-sectional study with a correlational approach was conducted from January to May 2025. A total of 330 active health cadres from 37 community health centers in Kediri Regency, Indonesia, were selected using proportional random sampling. Data were collected through a structured questionnaire and analyzed using Partial Least Squares Structural Equation Modeling (PLS-SEM) to explore both direct and mediated effects among variables.

Results: Knowledge (? = 0.044, p = 0.004), skills (? = 0.329, p < 0.001), and social support (? = 0.639, p < 0.001) significantly enhanced competence. Competence, in turn, strengthened motivation (? = 0.546, p < 0.001), which had the strongest direct effect on performance (? = 0.319, p = 0.043). Social support and skills indirectly improved performance through competence and motivation. The final model demonstrated good fit (SRMR = 0.046; NFI = 0.91; RMS_theta = 0.08) and explained 68% of the variance in cadre performance (R² = 0.68).

Conclusion: Competence and motivation act as key mediators linking individual capacities and social support to performance. Strengthening these aspects through structured training and continuous social reinforcement is essential to enhance early detection of high-risk pregnancies and improve maternal health outcomes.

Effect of Location-Based Health Messages on Tourist Knowledge of Travel Disease Risks in Bantimurung National Park, Indonesia

Harpiana Rahman, Zulkhair Burhan, Septiyanti Septiyanti — Mon, 15 Dec 2025 00:00:00 +0700

Introduction: Bantimurung National Park faces health risks such as dengue fever transmission due to its location in an endemic area and the potential for zoonotic transmission through frequent tourist interactions with Macaca maura. The lack of health promotion media related to disease prevention in tourism exacerbates these health risks. This study aims to analyze tourists' knowledge after receiving health messages via location-based advertising, specifically examining whether perceived susceptibility, perceived severity, perceived benefits, and perceived barriers that influence the effectiveness of digital health promotion in high-risk ecotourism environments.

Methods: The study used a quantitative approach with a survey method, involving 92 tourist respondents who accessed health information through LBA messages while in the Bantimurung tourist area. The LBA system delivered tailored health messages via mobile devices using geofencing technology within the park area. Data were analyzed using descriptive and inferential statistical tests to measure changes in knowledge levels before and after receiving the information.

Results: The results show a significant increase in tourists' knowledge after receiving location-based health messages. Before the intervention, only 23.9% of tourists fully understood disease types, transmission modes, and prevention methods. This figure rose to 67.7% post-intervention, while those with no understanding dropped from 1.1% to 1.0%, and partial understanding decreased from 75.0% to 31.3%.

Conclusion: This study concluded that location-based health messages significantly improved tourists' understanding of disease risks and addressed the gap in health promotion in Bantimurung National Park. This research is essential for international health studies, particularly in strengthening health promotion within global health security through the tourism cluster.

Effect of BTCLS Training on Emergency Department Clinicians' Competencies in Cardiac Arrest Management: A Single-Group Pretest–Posttest Study at Pongtiku General Hospital

Anshar Rante, Djusmadi Rasyid, Hardianto Dg Salimung, Warda M — Mon, 15 Dec 2025 00:00:00 +0700

ntroduction: Cardiac arrest refers to a critical condition in which the heart abruptly ceases to pump blood effectively, leading to an interruption of blood flow throughout the body. This disruption prevents vital organs, including the brain and heart, from receiving the necessary oxygen and nutrients. Without immediate intervention, cardiac arrest can result in fatality or irreversible brain damage within minutes. The Emergency Department is pivotal in managing cardiac arrest cases. As the first line of healthcare response, it is imperative for medical personnel to engage in ongoing training and education to enhance the quality of emergency care, particularly in scenarios involving cardiac arrest

Methods: This study employed a single-group pretest-posttest design involving 24 clinicians from the emergency department of Rumah Sakit Umum (RSU) Pongtiku. Data collection utilized validated instruments, including a 25-item multiple-choice knowledge assessment (Cronbach’s ? = 0.87) and a 10-item psychomotor skill checklist (inter-rater reliability = 0.89). The normality of the data was assessed using the Shapiro-Wilk test. Given that the data did not follow a normal distribution, the Wilcoxon signed-rank test was used for analysis.

Results: The results of the analysis using the Wilcoxon Signed Rank Test indicate that all respondents experienced an increase in knowledge scores after being given the educational intervention, with a value of Z = -4.288 and a significance value (Asymp. Sig. 2-tailed) of 0.000 (p < 0.05). This shows that there is a significant difference between pretest and posttest knowledge scores. Therefore, the educational intervention provided is effective in increasing respondents' knowledge.Based on the results of the Wilcoxon Signed-Rank Test analysis, a Z value of -4.046 was obtained, with a significance value (Asymp. Sig. 2-tailed) of 0.000 (p < 0.05). This result indicates that there is a significant difference in skill scores before and after the educational intervention. A total of 21 respondents experienced an increase in their skills, while 3 respondents maintained the same score. Therefore, the educational intervention provided was effective in improving the skills of the respondents.

Conclusion: BTCLS training for emergency department nurses significantly increases knowledge scores and standardized skills in the short term. These results support the sustainability of the program and highlight the need for curriculum improvement. Further research is necessary to evaluate retention and its impact on clinical indicators.

Health Promotion Perspectives on Self-Efficacy and Psychosocial Determinants of Sustainable Sanitation Behavior in Rural Indonesia

Mon, 15 Dec 2025 00:00:00 +0700

Introduction: Open defecation remains a major public health challenge in rural and dryland regions, where infrastructural constraints and psychosocial barriers intersect. This study analyzed the associations between self-efficacy, community perceptions, and basic sanitation infrastructure and sanitation behavior in East Baumata Village, Kupang Regency.

Method: An analytic, community-based cross-sectional survey was conducted with n = 128 randomly sampled household heads, using theory-informed structured questionnaires and observational checklists to capture psychosocial and infrastructural determinants. Data were analyzed using descriptive statistics, ?² tests, and multivariable logistic regression reporting adjusted odds ratios (aOR) and p-values.

Result: Most respondents demonstrated favorable knowledge and attitudes; self-efficacy was strongly associated with consistent latrine use (aOR ? 16.2, p < 0.001). Community perceptions and latrine distance were significant in bivariate analyses (p = 0.0153 and p = 0.001, respectively) but were not significant after adjustment (p > 0.05), suggesting their associations may be accounted for by self-efficacy (no formal mediation was tested). Water availability was not associated with the outcome (p = 0.985) when minimum access was present. These findings align with behavioral models emphasizing perceived control, self-regulation, and normative influences in health promotion.

Conclusion:Policy and program design should prioritize self-efficacy–building interventions (e.g., peer modeling, guided practice) and norm-focused community engagement, alongside proximity-sensitive infrastructure investments, to enhance sustainability. This research contributes to refining the implementation of Indonesia’s Community-Based Total Sanitation program and offers insights for global strategies aimed at achieving SDG 6.2.

An Integrated Risk Analysis Approach in Military Hospitals: Implications for Public Health Preparedness and Resilience

Mon, 15 Dec 2025 00:00:00 +0700

Introduction: Military hospitals perform a dual function by providing healthcare services for soldiers and their families while also supporting public health needs during crises. This dual role generates complex hazards spanning biological, chemical, physical, and psychological dimensions, thereby requiring a comprehensive risk analysis framework. The objective of this study is to develop an integrated risk analysis approach comprising risk assessment, risk management, and risk communicationto strengthen occupational safety in military hospitals, with broader relevance for public health and global health security.

Methods: A mixed methods design was applied. Data were collected through direct observation and in-depth interviews with healthcare personnel, complemented by a structured survey using standardized questionnaires. Qualitative analysis was conducted using NVivo 12 and quantitative analysis using SEM PLS-4. The study involved 100 respondents comprising medical personnel, health workers, and staff at Rumah Sakit Pusat Pertahanan Negara (RSPPN) and Pusat Kesehatan TNI, selected through random sampling.

Results: Qualitative findings derived from NVivo 12 analysis revealed a multidimensional hazard spectrum characterized by weak cross sectoral coordination, limited personnel capacity, and insufficient integration among risk analysis components. Quantitative analysis using SEM PLS-4 further confirmed that Integrated Risk Analysis has a positive and statistically significant effect on Public Health Preparedness and Community Resilience (T-statistic = 11.046 > 1.96; p-value < 0.05); and F-square (0.18- efect moderat).

Conclusion: This study concludes that Integrated Risk Analysis exerts a significant influence on public health preparedness and community resilience in military hospitals. The findings underscore the necessity of strengthening management, integration, and cross sectoral communication. Nonetheless, the contextual limitations regarding research setting and sample size suggest the need for future studies with broader scope and institutional diversity to reinforce the generalizability of the findings.

Glove Puppet as a Distraction Method: Reducing Hospitalization Response in Preschool Children During Injections

Faridah Faridah, Diyah Arini, Iis Fatimawatai, Ainin Ulifah — Mon, 15 Dec 2025 00:00:00 +0700

Introduction: Hospitalization and medical procedures such as injections are common causes of anxiety and behavioral distress in preschool children. Non-pharmacological, atraumatic care such as distraction technique is an imperative to reverse such reactions. This study aimed to analyse the effectiveness of glove puppets as a distraction method in reducing hospitalization-related behavioural responses in preschool children undergoing injection procedures.

Methods: This quasi-experimental pretest–post-test non-equivalent control group study was conducted among 32 preschool children aged 3–6 years hospitalized at Dr. Ramelan Naval Hospital, Surabaya, Indonesia. Participants were assigned to an intervention group (n = 16) and a control group (n = 16). Behavioural responses were assessed using a validated observational checklist before and after the injection procedure. Glove puppet distraction therapy was administered to the intervention group prior to the injection procedure. Data were analysed using the McNemar test to evaluate categorical changes and the Wilcoxon test to compare pre–post scores.

Results: Before the intervention, 87.5% of children in the intervention group and 75% in the control group exhibited high levels of behavioural distress. After the intervention, the proportion of high distress in the intervention group decreased significantly to 25%, while no meaningful change occurred in the control group (81.3%). A significant reduction in distress was observed in the intervention group (p < 0.001; Cohen’s d = 1.56).

Conclusion: Glove puppet distraction is a simple, cost-effective, and developmentally appropriate strategy that significantly reduces hospitalization-related behavioural distress among preschool children.

Associations Between Community Health Worker Capacity and Stunting Reduction Efforts in South Central Timor, Indonesia

Mon, 15 Dec 2025 00:00:00 +0700

Introduction: Malnutrition, particularly childhood stunting, remains a critical issue in Indonesia, including the South-Central Timor (SCT) District, East Nusa Tenggara Province. Stunting affects 149.2 million children under five years globally. In the SCT District (2025), stunting prevalence reached 41%. Climatic conditions, food insecurity, and cultural factors contribute to this problem. Prevention efforts involve national strategies, including behavioral change communication campaigns, with Community Health Workers (CHWs) playing crucial roles due to their community credibility and responsiveness. CHW participation is voluntary without continuous commitment obligations. CHW activity and roles in stunting reduction acceleration are paramount, necessitating the investigation of influencing factors. This study aims to identify the factors associated with the roles of Community Health Workers (CHWs) in accelerating stunting reduction in the SCT District in 2025.

Methods: This quantitative cross-sectional study included 124 CHWs from 10 community health centers in the SCT District. The study was conducted from January to May 2025. Separate questionnaires measured each variable (CHW role, knowledge, and skills). Ethical approval was obtained from the Kupang Health Polytechnic Research Ethics Committee.

Results: Bivariate analysis revealed that knowledge level, education, training history, work duration (all p<0.001), and CHW skills (p=0.002) were significantly associated with CHW roles. The final model showed training history increased CHW role effectiveness by 45.3 times (OR=45.354; 95% CI=1.634-1258.56), CHW skills by 44.3 times (OR=44.393; 95% CI=2.721-724.36), and work duration by 16.9 times (OR=16.934; 95% CI=1.280-224.02).

Conclusion: Training, skill level, and work duration were associated with higher CHW role performance, supporting improved stunting prevention efforts. This study provides a new understanding of the importance of enhancing CHW knowledge and skills through structured/routine training programs. Further research comparing CHW capacity in low versus high stunting areas is important for understanding CHW capacity management program improvements.

The Influence of Husbands’ Knowledge, Attitudes, and Support on Wives’ Antenatal Care Visits

Nurfatimah Nurfatimah, Kadar Ramadhan, Lisda Widianti Longgupa, Nur Aziza Labolo — Mon, 15 Dec 2025 00:00:00 +0700

Introduction: Antenatal Care (ANC) coverage reflects access to healthcare during pregnancy. Husbands play a crucial role in encouraging ANC attendance through their knowledge, attitude, and support. This study aimed to analyze the relationship between husbands’ knowledge, attitudes, and support and the frequency of their wives’ ANC visits in Wakai Village, Indonesia.

Methods: This analytical cross-sectional study included 40 husbands whose wives were pregnant in the second or third trimester or had delivered within the past month. Total sampling was performed. Data on husbands’ sociodemographic characteristics, knowledge, attitudes, and support toward ANC were collected using structured interviewer-administered questionnaires, while the frequency of ANC visits was verified using the Maternal and Child Health Handbook (KIA). Data were analyzed using the chi-square test and multivariable logistic regression using STATA 15.1.

Results: Overall, 47.5% of wives had completed four or more ANC visits. Husbands with good knowledge and positive attitudes tended to have wives with more frequent ANC visits; however, these associations were not statistically significant in the multivariate analysis. In contrast, husbands’ support showed a strong and significant association with ANC utilization. Wives whose husbands provided support were 4.9 times more likely to complete at least four ANC visits than those whose husbands did not provide support (AOR = 4.9; 95% CI: 1.0–35.0; p < 0.05).

Conclusion: Husbands’ support was the strongest determinant of regular ANC attendance among pregnant women in this rural setting, whereas knowledge and attitudes alone were not consistently associated with visit frequency. Interventions to improve maternal health in similar contexts should prioritize strengthening husbands’ practical support along with educational efforts.

Systematic Review: Impact of Air, Leachate, and Soil Contamination on Health Problems in Landfill Workers and Local Residents

Mon, 15 Dec 2025 00:00:00 +0700

Introduction: The rising global production of municipal solid waste (MSW) poses significant ecological challenges. In developing countries, inadequate landfill management results in the uncontrolled release of hazardous gases and leachate, posing significant risks to human health. This systematic review investigated the association between environmental factors at these landfills and adverse human health outcomes.

Methods: This review was conducted in accordance with the PRISMA guidelines. A comprehensive search was rapidly conducted across ScienceDirect, Scopus, PubMed, and EBSCOhost for articles published between 2020 and 2025. PECO criteria screening was conducted independently by two reviewers, resulting in the selection of 25 articles for critical synthesis.

Results: Hazardous landfill pollutants—including heavy metals, volatile organic compounds (VOCs), and particulate matter—are rapidly escalating severe health issues. Residents and landfill workers face acute respiratory and cardiovascular disorders, heightened cancer risk, reproductive issues, and neurological impairments. Leachate contamination of soil and groundwater compounds these urgent systemic risks.

Conclusion:The ongoing failure to manage landfills effectively, particularly in developing countries, has triggered a pressing environmental and public health crisis. Immediate action to improve waste management and enforce stricter environmental policies is critical for preventing further harm.

Determinants of Stunting in Children Under Five

Mon, 15 Dec 2025 00:00:00 +0700

Introduction: Stunting in children under five years old remains a major global health concern, affecting approximately 22.3% of children worldwide. It contributes to impairments in physical and cognitive development, reduced academic performance, lower economic productivity, and increased susceptibility to non-communicable diseases. This study aims to synthesize comprehensive evidence regarding the determinants associated with stunting in children under five.

Methods: A systematic review and meta-analysis were conducted using data from 22 eligible studies retrieved from international databases (Scopus, PubMed, ScienceDirect, and Springer). Heterogeneity was assessed using the I² statistic, and a random-effects model was applied to estimate the odds ratio (OR) and 95% confidence interval (CI). Publication bias was evaluated using funnel plot visualization and Egger’s test.

Results: Meta-analysis findings demonstrate that several determinants significantly increase the risk of stunting, including low maternal education (OR = 1.63; 95% CI: 1.11–2.41; I² = 84.64%), low paternal education (OR = 1.66; 95% CI: 1.05-2.61; I² = 55.64%), maternal occupation (OR = 1.59; 95% CI: 1.09-2.32; I² = 71.16%), low household income (OR = 1.83; 95% CI: 1.30-2.58; I² = 73.72%), and households with two or more young children (OR = 2.34; 95% CI: 1.65-3.30; I² = 23.89%). Additional factors such as inadequate antenatal care (OR = 1.62; 95% CI: 1.07-2.47; I² = 41.71%), non-exclusive breastfeeding (OR = 1.21; 95% CI: 1.60-3.03; I² = 80.25%), incomplete immunization (OR = 2.77; 95% CI: 1.48-5.19; I² = 63.58%), low birth weight (OR = 2.72; 95% CI: 1.61-4.66; I² = 65.71%), and a history of infectious diseases (OR = 1.96; 95% CI: 1.36-2.82; I² = 64.06%) were also strongly associated with stunting. No substantial publication bias was indicated by Egger’s test (p > 0.05).

Conclusion:Stunting is influenced by a combination of sociodemographic factors and maternal-child health services, such as parental education, household income, and exclusive breastfeeding. Reducing the prevalence of stunting requires integrated policies that encompass education, health, and family economic empowerment.

Impact of Community-Based Nutrition Interventions on Children with Undernutrition Aged 6-23 Months: A Systematic Literature Review

Mon, 15 Dec 2025 00:00:00 +0700

Introduction: Providing optimal nutritional interventions during critical ages can save children from the risk of malnutrition and long-term health effects such as growth disorders, cognitive disorders, illness, and death. Although the WHO has issued guidelines for community-based nutritional interventions, their implementation varies across regions. To explore the impact of community-based nutrition interventions on children with undernutrition aged 6–23 months.

Methods: This study used the reporting guidelines from the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), which have been registered with PROSPERO with registration number CRD420251008033. The search strategy employed the Population-Intervention-Comparisons-Outcomes (PICO) framework. The search was conducted using databases from Scopus, PubMed, and ProQuest. Risk of bias assessment used the critical appraisal tool from the Joanna Briggs Institute (JBI).

Results: 13 articles were reviewed in this systematic review, consisting of 9 RCTs and four quasi-experimental studies. Community-based nutrition interventions identified in the literature review included nutrition education for parents or caregivers of children with malnutrition, such as stunting, wasting, underweight, or anemia, aged 6–23 months. Other interventions included behavior change communication, complementary feeding practices, or food supplementation, as well as integrated community health programs and cash transfer and economic-support models.

Conclusion: Community-based nutrition interventions, particularly nutrition education, can significantly improve mothers' knowledge and behavior in managing malnutrition. However, interventions will have a greater impact when combined with other interventions, such as behavior change communication, food supplementation, cash transfers, and integrated programs across various sectors. These findings can serve as a basis for policy formulation and implementing malnutrition prevention programs targeting vulnerable groups through targeted and sustainable community-based nutrition interventions.