P-ISSN: 2808-0467

E-ISSN: 2808-5051

Homepage: https://iss.internationaljournallabs.com/index.php/iss

1895

DETERMINANT FACTORS OF CHILD DEVELOPMENT IN VARIOUS

ECOSYSTEM ZONES IN PAPUA

Stefanus P. Manongga, Serlie Litik

Faculty of Public Health, Universitas Nusa Cendana, Kupang, East Nusa Tenggara, Indonesia

boymanon[email protected]

[email protected]na.ac.id

PAPER INFO ABSTRACT

Received:

December 2022

Revised:

February 2023

Approved:

February 2023

Background: The negative impact of malnutrition is generally associated

with impaired motor development, behavioural and cognitive development

which results in decreased learning achievement and social skills.

Aim: The purpose of this study was to examine the situation of child

development and to assess the role of various factors related to the

development of children under five years of age in various ecosystem zones

in Papua Province.

Method: The research was carried out in four districts in Papua representing

three ecosystem zones, namely the mainland coast, the middle plains and the

mountains. Data was collected through structured interviews, observations

and field measurements. Analysis of the differences in variables between

ecosystem zones used the smallest significant difference test and the Kruskal

Wallis test. Meanwhile, the analysis of the impact of malnutrition on

children's development used Structural Equation Modelling-Regression with

a partial least square approach using the SmartPLS version 3.2.9 application.

Findings: The prevalence of Papuan children suffering from developmental

delays reached 77.7%, especially in language development, fine motor

adaptive, and personal social. An increase in the degree of malnutrition in the

form of stunting suppresses the development of children to be low, while an

increase in the degree of sickness in children has the potential to worsen the

degree of malnutrition by suppressing the nutritional intake of children to be

low.

KEYWORDS

child development, fine motor, gross motor, language, social personal

Commons Attribution-ShareAlike 4.0 International License (CC BY-SA 4.0)

INTRODUCTION

The healthy development of children is very important so that their physical and mental

potential can develop as a whole. Child development is the best global indicator of physical

well-being for children. The consequences of poor child development are very severe and far-

reaching mortality, morbidity, and impaired cognitive development. Even in adult life, this

results in short or stunted body size, low work capacity and reproductive performance, and a

high incidence of chronic disease risk. Thus, early childhood development is the basis for the

formation of children's behaviour and health. Childhood is arguably the most vulnerable period

in human life. Children are very dependent on others to meet their basic needs and this makes

them very vulnerable (Bagattini, 2019). Early childhood development forms the basis of adult

health and well-being (Lu et al., 2016).

Many factors are associated with child development. Parental factors are very important,

such as knowledge and parenting. Mother's knowledge is the level of mother's understanding

of the child's growth and development. Mother's knowledge is very important for children who

Determinant Factors of Child Development in Various Ecosystem Zones in Papua

1896 Interdisciplinary Social Studies, 2(5), Feb 2023

are undergoing a period of growth because if the mother understands the child's growth and

development, the child's growth and development will be optimal (Gamette et al., 2021).

Another factor that also hinders the development of children is nutritional factors. Severe

malnutrition can cause children to suffer from persistent short stature, secondary immune

deficiency, and permanent damage to the brain and central nervous system (Mwene-Batu et al.,

2020; Hadisuyitno & Riyadi, 2021). This situation has implications for the development of

children to be hampered and the quality of life of children to be low. For this reason, early

identification and prompt treatment can help prevent long-term developmental deficits.

Several previous studies have shown that both stunting and underweight are the highest in

developing countries (Kramer & Allen, 2015). In Indonesia, according to the results of

Riskesdas 2018, it was revealed that the prevalence of nutritional status based on the BB/U

index in children aged 0-23 months was 3.9% suffering from malnutrition and 13.8%

malnutrition. The prevalence of nutritional status based on the TB/U index in children aged 0-

23 months, it was revealed that 19.3% were born short and 11.5% were born very short

(Kemenkes RI, 2019). Meanwhile in Papua province, 2018 regional health research data shows

the prevalence of stunting in children reaches 33.1%, while the Indonesian Nutrition Status

Study (SSGI) 2021 reaches 29.5%. Stunting conditions are widespread in most districts -Cities

in Papua, where the highest prevalence of stunting according to the 2019 SSGI is Dogiyai

Regency (65.99) and the lowest is Sarmi Regency (27.36) (Kemenkes RI, 2021). Likewise,

Papua has the lowest Human Development Index (HDI) in Indonesia, which is at 60.62

(Kemenkes RI, 2021). This situation is found in about two thirds of all districts in Papua that

have an HDI in the low – very low category. However, research on the nutritional and health

situation of Papuan children is still very limited.

Several researchers have conducted research related to Papuan public health. Pudjohartono

et al. (2019) surveyed the nutritional status of children under five in Asmat, after the

extraordinary event of malnutrition. Their findings show that the high incidence of stunting in

Asmat is influenced by the habits of the people who still sell their catch and garden to buy less

nutritious food. Ramadhani (2019) investigated the risk of parenting and eating patterns on the

incidence of stunting in children aged 6-24 months in Papuan and non-Papuan ethnic groups at

the Keerom Health Center. Their findings show that parenting, energy intake and protein intake

are risk factors for stunting in Papuans and non-Papuans. Wulandari et al. (2022) analyzed the

most appropriate maternal characteristics for stunting prevention policies. Their findings show

that mothers with low education and unmarried have an important role in stunting prevention.

Based on the discussion above, it can be concluded that the problem of child development

in Papua is very complex and requires more in-depth research. This study aims to find a

structural model of the development of Papuan children in various ecosystem zones in Papua

Province. This research was carried out in four districts representing three ecosystem zones,

namely the mainland coastal zone (Merauke and Sarmi districts), the middle plains zone

(Nabire District) and the mountainous zone (Jayawijaya District).

Child development disorders have a close relationship with the ecological characteristics

of the region (Matariya et al., 2016). Each ecosystem zone in Papua has its own characteristics

that can differ from other ecosystem zones, which in turn has a potential influence on the

growth and development of children. This is because ecosystem services have an influence on

food security and malnutrition (Richardson, 2010), as well as underpin human well-being and

Determinant Factors of Child Development in Various Ecosystem Zones in Papua

1897 Interdisciplinary Social Studies, 2(5), Feb 2023

activities and future economic and social development (Butler & Oluoch-Kosura, 2006; Yin et

al., 2021).

METHOD

The design of this study was cross sectional to obtain information about family

characteristics, nutritional status and development of children under age five, with quantitative

approach. This study examined the dynamics of the correlation of various latent variables or

constructs formed in the household investment model for child development. Each latent

construct had several variables to be observed. The latent constructs in question were the

physical environment (A), social environment (B), maternal parenting (D), environmental

sanitation (E), disease control efforts (F), nutritional intake (G), poor nutrition (H), history of

disease (I), and child development (J). Figure 1 shows a structural model of Papuan child

development.

Figure 1. Structural Model of Papuan Child Development

This research was carried out in three ecosystem zones in Papua Province, namely the

mainland coastal zone (< 100 m asl), the middle plain zone (>100 - < 1000 m asl) and the

mountainous zone (>1000 m asl). The selection of research sites was carried out based on a

multistage sampling procedure using stratification and cluster techniques. The sample size for

the lowland strata was 724 households, the medium plain 381 households and the highland 373

households, so that the total sample size was 1481 households.

Primary data collection used questionnaires, observations and measurements. To measure

the latent constructs of the physical environment, 34 indicators were used in nominal and

ordinal scales, 45 indicators for the social environment in nominal and ordinal scales, maternal

parenting 5 indicators in ordinal scales, 11 indicators for environmental sanitation in nominal

and ordinal scales, 35 indicators in disease control efforts nominal and ordinal scales,

nutritional intake 4 indicators in ratio and ordinal scales, malnutrition 4 indicators, sickness 3

indicators in ordinal scales, and child development 4 indicators in nominal scales. In addition,

Determinant Factors of Child Development in Various Ecosystem Zones in Papua

1898 Interdisciplinary Social Studies, 2(5), Feb 2023

in-depth interviews were also conducted with community leaders at the research sites.

Furthermore, secondary data collection was obtained from various related agencies and reports

on existing research results.

Child development is intended as an increase in the structure and function of the body in

the ability of gross motion, fine motion, speech, and language as well as socialization and

independence. Child development is measured using a child development screening test

according to Denver (Denver Developmental Screening Test II/DDST II), which is a screening

method for child developmental disorders with the classification as normal, abnormal,

questionable, and untestable. Assessment of child development covers 4 main domains:

1) Social Personal, namely aspects related to the ability to be independent, socialize, and

interact with the environment;

2) Fine motor movements, namely aspects related to the child's ability to observe

something, perform movements that involve certain body parts and are carried out by

small muscles, but require careful coordination;

3) Language, namely the ability to respond to sounds, follow commands, and speak

spontaneously; and

4) Gross motor movements, namely aspects related to body movements and postures.

Data analysis used multivariate analysis, in the form of testing the measurement model

and structural model. Meanwhile, for testing the model using Structural Equation Modelling-

Regression (SEM) with a partial least squares (PLS) approach using SmartPLS version 3.2.9.

In addition, the Kruskal Wallis test was also used to see the differences in certain variables

between ecosystem zones.

RESULTS AND DISCUSSION

Child Development Situation

Table 1. Kruskal Wallis Test Results: Prevalence Distribution of Papuan Toddlers by

Child Development Level and Ecosystem Zone

Ecosystem Zone

Child Development (%)

Kruskal Wallis Test

Suspected

Delay

Normal

Mean

Rank

p. Sign

The mainland coastal

zone

75.8

24.2

727.41

100.411 (p<0.010)

The middle plain zone

65.1

34.9

643.73

The mountainous zone

94.3

5.7

867.97

Papua

77.7

22.3

Source: Processed from Primary Data

Table 1 shows the results of measuring the development of Papuan children using DDST

II. The prevalence of children with suspected developmental delay was 77.7% and normal was

22.3%. This shows that more than three quarters of the Papuan child population experience

developmental delays according to age. The mountainous zone has the highest prevalence of

children with suspected delays (94.3%) or only 5.7% of the child population experiencing

Determinant Factors of Child Development in Various Ecosystem Zones in Papua

1899 Interdisciplinary Social Studies, 2(5), Feb 2023

normal development. This is followed by the mainland coastal zone with a suspected

developmental delay of 75.8% and the middle plain zone of 65.1%.

Table 2. Kruskal Wallis Test Results: Distribution of Prevalence of Papuan Toddler by

Domain and Level of Child Development and Ecosystem Zone

Domain and Child

Development Level

Ecosystem Zone

Papua

The

Mainland

Coastal

The Middle

Plain

The

Mountainous

Social Personal

Delayed

38.8

18.6

48.9

36.1

Normal

61.2

81.4

51.1

63.9

Kruskal Wallis:

Test

Mean

Rank

721.43

870.51

646.26

Sign.

78.910 (P<0.010)

Fine Motor Adaptive

Delayed

43.7

29.4

62.2

44.6

Normal

58.3

70.8

37.8

55.4

Kruskal Wallis

Test:

Mean

Rank

747.91

853.82

611.19

Sign.

82.002 (P<0.010)

Language

Delayed

48.5

36.7

71.6

51.2

Normal

51.5

63.3

28.4

48.8

Kruskal Wallis

Test:

Mean

Rank

761.41

848.40

590.14

Sign.

95.697 (P<0.010)

Gross Motor

Delayed

17.0

6.3

27.8

16.9

Normal

83.0

93.7

72.2

83.1

Kruskal Wallis

Test:

Mean

Rank

740.72

819.85

660.36

Sign.

61.826 (P<0.010)

Source: Processed from Primary Data

Table 2 shows the tracing results for the domains of child developmental delays. For social

personal development, 36.1% of children experience delays. The Kruskal Wallis test showed

that there was a significant difference (P<0.010) in terms of the level of social personal

development according to the ecosystem zone in Papua. The highest percentage of suspected

Determinant Factors of Child Development in Various Ecosystem Zones in Papua

1900 Interdisciplinary Social Studies, 2(5), Feb 2023

delays was in children living in the mountainous zone, followed by the mainland coastal zone

and the midland zone. This indicates that children living in mountainous zones have a greater

risk of experiencing delays in personal and social development than children in other zones.

For adaptive motor development, it was found that the prevalence of Papuan children who

experienced fine motor adaptive delay reached 44.6%. The Kruskal Wallis test showed that

there was a significant difference (P<0.010) in terms of the level of adaptive motor

development according to ecosystem zones in Papua. The highest percentage of children with

normal adaptive motor development levels are in the intermediate zone, followed by the

mainland coastal zone and the mountainous zone. This indicates that children living in the

mountainous zones have a greater risk of developing adaptive motor development delays than

children in other zones.

For language development, it was found that Papuan children suffer from language

development delays reaching 51.2%. The highest prevalence of language delay was found in

children living in the mountainous zone, which was 71.6%, followed by the mainland coastal

zone at 48.5% and the middle plain zone at 36.7%. The Kruskal Wallis test confirmed that

there was a significant difference (P<0.010) in the level of language development of children

under five according to the ecosystem zone in Papua. It indicates that children living in

mountainous zones have a greater risk of experiencing language development delays than

children in other zones.

For gross motor development, it was found that Papuan children who suffer from delayed

gross motor development are relatively few, namely 16.9%. In other words, there are as many

as 83.1% of Papuan toddlers who have normal gross motor development. The highest gross

motor delay is found in children who live in the mountainous zone, followed by the mainland

coastal zone and the middle plain zone. The Kruskal Wallis test showed that there was a

significant difference (P<0.010) between zones.

Structural Model of Child Development

The measurement of child development is multidimensional. The multidimensional

measurement aims to deepen and broaden understanding of child welfare and inform neglected

areas (Gabel & Zhang, 2017). Several interrelated domains, including motor development,

cognition, social and emotional. Child development is influenced by many factors such as

genetics, child characteristics, biological conditions of the child), closely related environment

(e.g. level of stimulation at home, quality of mother-child interaction) and far related

environment (Ego parental education, culture, place of residence and education) etc). In this

study the hypothesis was formulated that "the physical environment, social environment,

maternal parenting, poor nutrition and a history of sickness have a direct or indirect effect on

child development."