Community-Level Determinants of Child Growth
The present study uses a socioecological-economic approach to identify community-level factors that influence the physical growth of young children. A multidisciplinary team of investigators collaborated to study the different prevalence rates of low growth among children living in 24 communities located in a tea plantation near Bandung, West Java, Indonesia. Measurements of weight and length were taken for 415 children between the ages of 6 and 18 months. Low growth prevalence rates were determined by calculating the number of children in each community who fell below two anthropometric cutoffs. Epidemiological and ethnographic methods were used to measure community infrastructure and services related to child growth. The principal finding is that a probit model using community-level variables successfully predicted the prevalence rates of low growth across communities. Quality community vaccination programs, child care services, environmental sanitation and latrines are associated with better child growth. The quantitative and qualitative evidence strongly suggests that community-level goods and services contribute substantially to health in early childhood.