SOCIOECONOMIC AND DEMOGRAPHIC FACTORS ASSOCIATED WITH GROWTH MONITORING RECORD COMPLETENESS IN THE INDONESIAN MATERNAL AND CHILD HEALTH HANDBOOK: EVIDENCE FROM THE 2023 INDONESIAN HEALTH SURVEY

Abstract

The Maternal and Child Health (MCH) Handbook is the only home-based health record in Indonesia that contains the child growth monitoring chart. Complete growth records allow health workers and families to follow a child's growth trajectory over time. This study aimed to examine the socioeconomic and demographic factors associated with the completeness of growth monitoring records in the MCH Handbook among children aged 0–59 months in Indonesia. This cross-sectional study used published aggregated tabulations from the 2023 Indonesian Health Survey (SKI) report. We reconstructed category-specific counts by multiplying the weighted number of children in each category by the reported proportion, yielding an estimated weighted total of 55,145 children. Socioeconomic variables included household head occupation, household economic status, household head education, and place of residence; child age was analysed as a demographic variable. Bivariate analyses were performed using the chi-square test and crude odds ratios (COR) with 95% confidence intervals (CI); these analyses could not account for the complex survey design. Overall, 61.2% of children had complete growth records. In bivariate analyses, record completeness was associated with household head occupation (p=0.034), economic status (p<0.001), place of residence (p<0.001), and child age (p=0.002), but not with household head education (p=0.685). Completeness was higher in rural than in urban areas (COR 1.13; 95% CI 1.10–1.18), and lower in the rich than in the poor group (COR 0.93; 95% CI 0.89–0.98) and among children aged 36–59 months than among infants (COR 0.92; 95% CI 0.88–0.97). However, the absolute differences between groups were small (at most 3.2 percentage points). Nearly four in ten children did not have complete growth records, indicating that incomplete recording is common across all socioeconomic and demographic groups. Because the associations were unadjusted and derived from aggregated data, they should be interpreted cautiously and confirmed using individual-level survey data with design-based multivariable analysis.