Heti Ira Ayue, Nurdiana Nurdiana, Viera Wardhani, Ani Budi Astuti, Heri Prayitno, Agung Dwi Laksono, Tonny Sundjaya
Background: Stunting is a global health challenge with high prevalence in Asia and Africa. Although many studies have discussed its determinants, fragmented evidence and regional differences still hinder the formulation of effective policies. Objective: This study aims to identify and map predictors of stunting in children under 5 years of age, focusing on socio-demographic, prenatal, natal, and postnatal factors, as well as distinguishing universal and contextual determinants across regions. Design and methods: This systematic review followed the PROSPERO protocol (CRD42025633321) and the PRISMA 2020 guidelines. Literature searches were conducted in databases (Scopus, Web of Science, PubMed, ProQuest, ScienceDirect, Taylor & Francis, and Emerald). Included articles were original English-language studies published between 2015 and 2024 that examined predictors of stunting in children aged 0–59 months. Methodological quality was assessed by two independent reviewers using the JBI Critical Appraisal Tools. Data were then extracted, narratively synthesized, and mapped according to UNICEF regional classifications. Results: Of the 5094 initial records, 92 studies met the inclusion criteria. Maternal education, socioeconomic status, sanitation, maternal age, maternal height, birth weight, and exclusive breastfeeding and complementary feeding practices emerged as the most consistent and universal predictors. Other factors were more contextual, depending on the region. Cross-regional analysis confirmed the existence of universal determinants as well as specific regional risk factors. Conclusion: Stunting is a multifactorial problem across life phases. Regional mapping enriches theoretical understanding and provides a scientific basis for context-based policies. These findings emphasize the need for multi-level interventions and cross-regional longitudinal research with uniform measurement standards. © The Author(s) 2025. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia; Departement of Midwifery, Politeknik Kesehatan Palangka Raya, Central Kalimantan, Indonesia; Department of Pharmacology, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia; Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia; Department of Statistics, Faculty of Mathematics and Natural Sciences, Universitas Brawijaya, Malang, Indonesia; Universitas Brawijaya, Malang, Indonesia; National Research and Innovation Agency Republic of Indonesia, Jakarta, Indonesia; Department of Epidemiology, Faculty of Public Health, Universitas Indonesia, Jakarta, Indonesia
