Background: Stunting remains a significant global health issue, particularly in low- and middle-income countries (LMICs). Globally, around 22% of children under five are affected, with high rates persisting in South and Southeast Asia. This review examines government-led programs in high-performing LMICs (Nepal, Bangladesh, and Vietnam) to identify key strategies and opportunities for effective intervention. Methods: A literature search was conducted on PubMed using keywords and Medical Subject Heading terms, including “stunting”, “child undernutrition”, “malnutrition” and the names of the three specified countries. Articles were evaluated for relevance based on their focus on stunting prevalence, risk factors, and interventions in these countries, without restrictions on publication date or language. Results: Stunting prevalence among children under five has significantly declined in Nepal, Bangladesh, and Vietnam over the past two decades, reflecting the impact of sustained nutrition and health interventions. Nepal reduced stunting from 55.8% in 2000 to 26.7% in 2022, Bangladesh from 54.7% to 26.4%, and Vietnam from 41.5% to 19.3%. Successful strategies included multisectoral approaches integrating nutrition-specific and nutrition-sensitive interventions, enhanced policy frameworks, and strong governance. Despite progress, challenges remain, such as high wasting prevalence in Nepal and disparities among marginalized communities in Vietnam, emphasizing the need for targeted, context-specific interventions. Conclusions: Effective stunting reduction requires multisectoral strategies addressing underlying, intermediate, and immediate determinants. Insights from Nepal, Bangladesh, and Vietnam highlight the importance of sustained government commitment, robust policies, and coordinated interventions. Adapting these successful strategies to local contexts can support stunting prevention and management, promoting healthier and more resilient communities.

Background The complementary feeding period of 6-24 months of age is one of the most crucial moments in child growth, in which most of the decline in length-for-age Z-score (LAZ) occurs. The Minimum Acceptable Diet (MAD) and Infant and Child Feeding Index (ICFI) are indicators to assess complementary feeding practices in the children with potential for stunting. Objective To assess and compare the usefulness of MAD and ICFI scores as indicators of inadequate feeding practice on stunting in children aged 6-23 months. Methods This case-control study was conducted in South and West Wewewa subdisctricts of Southwest Sumba, East Nusa Tenggara, Indonesia, from February to August 2019. Participants were children aged 6-23 months who had received complementary feeding for a minimum duration of one month. Children with LAZ <-2 were allocated into the case group (stunted) and those with LAZ>-2 into the control group. Both MAD and ICFI scores were assessed in both groups. ICFI was categorized as low, average, and high. The association between complementary feeding practice which depicted by the MAD and ICFI scores and stunting was measured using logistic regression. Results Of 322 participants, 161 children were allocated into each group. Multivariate analysis revealed that those in low and average ICFI tertile had higher odds of stunting [(OR 2.85; 95%CI 1.35 to 6.00; P<0.01) and (OR 1.95; 95%CI 1.09 to 3.46; P<0.05), respectively]. No association was found between MAD and stunting. Conclusion Inadequate complementary feeding practice is found to increase the risk of stunting among children aged 6-23 months. Compared to MAD, ICFI is a better indicator in demonstrating an association between complementary feeding practice and stunting.

Hospital malnutrition increase morbidity and mortality rate of hospitalized children, regardless of underlying diseases. This study evaluated the risk of malnutrition using STRONGkids screening tool in hospitalized children in government hospitals. An observational study was done in seven government hospitals in Bali, Indonesia. The STRONGkids score of consecutively hospitalized children was calculated and compared with the nutritional status, age, gender, and underlying diseases. Chi-Square and Logistic Regression test were done with considered significant if P value < 0.05. Total 129 children included this study. Fifty-six percent males, mean age 4.1<3.4 years, 20.3% had an underlying chronically diseases, 6.2% had severe malnutrition, and 25.6% had moderate malnutrition. Based on STRONGkids, 12.4% children were at high risk and 87.6% at moderate risk without at low risk for malnutrition. High risk for malnutrition was associated with chronically diseases (p= 0.020), severe and moderate malnutrition (p = 0.001 and p = 0.012, respectively). It can be concluded that the STRONGkids can be recommended in identify the risk of malnutrition in hospitalized children. Children with high or moderate risk for malnutrition need nutritional support such as high energy density oral supplementation.

Introduction: Hospital-acquired malnutrition is one aspect of childhood malnutrition that healthcare professionals might not recognize. The prevalence of hospital-acquired malnutrition globally and in developing countries is still high varies between 6.1%-40.9%. Various factors contributed to the frequency of hospital-acquired malnutrition, including the nutritional status at the onset of the disease. Material and Methods: The prospective cohort study was conducted on the patients in Pediatric Ward at Sanglah General Hospital, Denpasar Bali period July 2020 and January 2021. We Include children aged one month to 18 years old. Samples were taken by consecutive sampling. Hospital-acquired malnutrition was marked by more than 2% loss of weight from the measurement during admission. Univariate analysis was performed using the chi-square test. Nutritional status presented as Prevalence Ratio (PR) and 95% Confidence Interval (95% CI). The result is considered as significant if p<0.05. Results: 208 subjects were included and analyzed in this study. Malnutrition incidence was 15.4%. The risk factors significantly associated with hospital-acquired malnutrition were an underlying disease, length of stay, admission nutritional status. Malnutrition, length of stay and underlying condition were the independent risk factors for hospital-acquired malnutrition with PR 7.528 (95% CI, 2.528-21.033; p=0.001), PR 9.061 (95% CI, 2.925-28.066; p=0.001) and PR 2.638 (95% CI, 1.0325-6.724; p=0.042). Conclusion: The incidence of hospital acquired malnutrition in Sanglah Hospital was 15.4%. Children with malnutrition, prolonged hospitalization length, and underlying disease are associated with hospital-acquired malnutrition.

Bali Medical Journal is a peer-reviewed quarterly journal published by Sanglah General Hospital in collaboration to Indonesian Physician Forum and Indonesian College of Surgeon, Bali-Indonesia.

Latar belakang. Gizi buruk pada anak bawah lima tahun (balita) masih menjadi beban di negara berkembang. Anak balita gizi buruk perlu menjalani pemeriksaan lengkap secara klinis dan laboratoris untuk mengidentifikasi ada tidaknya tanda bahaya atau komplikasinya. Tujuan. Untuk mengetahui prevalens gangguan serum elektrolit anak balita dengan gizi buruk dan karakteristiknya.Metode. Penetilian retrospektif dengan rancangan cross-sectional menggunakan data rekam medis pasien. Kriteria gizi buruk adalah berat menurut panjang atau tinggi badan < -3 SD menurut standar WHO. Hubungan antara variabel diuji dengan uji chi-square.Hasil. Jumlah pasien yang memenuhi kriteria adalah 94 pasien, terdiri dari 56 laki (59,6%) dan 38 perempuan (40,4%), 22,3% usia dibawah 6 bulan dan 77,7% usia 6 bulan keatas. Prevalensi hiponatremia, hipokalemia, hipokalsemia dan hipokloridemia masing-masing 64,9%, 26,6%, 52,1% dan 60,6%. Gangguan elektrolit kalium signifikans lebih tinggi pada usia dibawah 6 bulan (p=0,011), sedangkan gangguan elektrolit kalsium signifikans lebih tinggi pada usia 6-59 bulan (p=042).Kesimpulan. Anak balita dengan gizi buruk mayoritas mengalami hiponatremia dan hipokalsemia. Gangguan kalium signifikans lebih tinggi pada anak gizi buruk usia dibawah 6 bulan, sedangkan gangguan kalsium signifikans lebih tinggi pada usia 6-59 bulan.