Bridging the knowledge divide: a national cross-sectional analysis of urban-rural disparities in the stunting knowledge index among mothers/caregivers in Indonesia.

BACKGROUND: Indonesia continues to encounter a significant public health crisis due to stunting. Maternal knowledge is the key driver of nutritional practices and outcomes. This study aimed to develop a maternal/caregiver stunting knowledge index (SKI), analyze disparities in urban-rural knowledge, and identify the key determinant factors driving these disparities. METHODS: This cross-sectional study analyzed data points from the 2024 Indonesian Nutritional Status Survey, involving 294,538 mothers and caregivers. Data regarding stunting knowledge, sociodemographic, maternal, and caregiver characteristics, child characteristics, area of residence, and variables related to maternal health knowledge and utilization were collected via interviews conducted with mothers. Height-for-Age Z-score (HAZ) was calculated using age and height measurements. Knowledge level was measured using a constructed SKI categorized as low, moderate, or high. Chi-square tests and multivariate logistic regression were used to identify the predictors of low SKI and risk(s) for stunting. RESULTS: The prevalence of low SKI scores was significantly higher in rural areas, and maternal education was the strongest determinant of low SKI scores in both regions. In rural areas, limited access to formal health information (e.g., lack of a Maternal and Child Health book) was a major predictor. Low SKI was associated with higher odds for stunting risk (urban: adjusted odds ratio [aOR], 1.617; rural: aOR, 1.576), whereas high awareness of the long-term impacts of stunting provided a significant protective effect. CONCLUSION: Urban-rural knowledge disparities were concentrated among caregivers with lower education and limited health service utilization. Interventions should be tailored regionally, targeting caregivers with low education levels and emphasizing the long-term consequences of stunting to promote preventive behaviors.