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Stunting is a chronic nutritional problem that remains a major public health challenge in Indonesia, including in Ngombakan Village, Polokarto District, Sukoharjo Regency. Moringa leaves (Moringa oleifera Lam.) are known as a superfood plant with nutritional content far exceeding conventional food ingredients, including protein, vitamin A, calcium, potassium, iron, and vitamin C, making them highly potential as a functional food for stunting prevention. This community service activity aims to improve the knowledge of mothers at the Posyandu of Ngombakan Village about stunting and the benefits of moringa leaves, while also introducing the innovation of moringa leaf pudding as a nutritious supplementary food for toddlers. The activity was carried out from August 13 to September 6, 2024 through 6 meetings at the posyandu using lecture methods, leaflet distribution, and pudding-making demonstrations. The results showed a significant increase in mothers' knowledge about stunting and the nutritional content of moringa leaves, as well as positive enthusiasm from participants in accepting moringa leaf pudding as an affordable and nutritious supplementary food alternative for toddlers.

Background: Low immunization coverage and exclusive breastfeeding coverage are problems in various regions. This program is caused by a lack of maternal knowledge and family support. This problem increases the risk of infection, growth disorders, and impacts the health status of infants. Therefore, the IMASI MOVEMENT (Immunization and Exclusive Breastfeeding Movement) is needed to increase community knowledge and participation regarding infant and toddler health. Method: The methods used include interactive counseling, demonstrations of breastfeeding techniques according to the pink book (KIA), distribution of leaflets, and evaluation through pre-tests and post-tests. Evaluation was carried out on aspects of structure, process, results, and impact of the activity. Results: The results of the activity showed an increase in participants' knowledge scores by ?50–60% after education. Participant attendance reached ?85% of the target, and there was an increase in participation in integrated health post activities compared to the previous month. Discussion: The increase in knowledge scores in the post-test results compared to the pre-test indicates that the educational intervention is effective in increasing mothers' understanding of the benefits of exclusive breastfeeding and the importance of immunization. These findings indicate that community-based health education is an effective strategy to improve maternal health literacy and has the potential to increase the coverage of exclusive breastfeeding and complete basic immunization. Conclusion: This program has proven effective in increasing awareness and health behavior of mothers and toddlers as an effort to prevent stunting and infectious diseases.

Stunting masih menjadi salah satu permasalahan kesehatan masyarakat di Indonesia. Rendahnya pengetahuan ibu mengenai pencegahan stunting merupakan salah satu faktor yang berkontribusi terhadap tingginya angka kejadian stunting. Penggunaan media flipbook sebagai media promosi kesehatan diharapkan mampu meningkatkan pengetahuan ibu secara efektif. Mengetahui pengaruh promosi kesehatan menggunakan media flipbook terhadap pengetahuan pencegahan stunting pada ibu balita di Puskesmas Kragan II. Penelitian ini menggunakan desain pra-eksperimental dengan pendekatan one group pretest-posttest design. Populasi penelitian berjumlah 1.126 ibu balita yang terdaftar di wilayah kerja Puskesmas Kragan II dan diperoleh sampel sebanyak 295 responden menggunakan teknik cluster random sampling. Pengumpulan data dilakukan menggunakan kuesioner sebelum dan sesudah pemberian promosi kesehatan menggunakan media flipbook. Analisis data menggunakan uji Wilcoxon Signed Rank Test dengan tingkat signifikansi 0,05. Sebelum intervensi, sebagian besar responden memiliki tingkat pengetahuan kategori kurang sebanyak 182 responden (61,7%). Setelah diberikan promosi kesehatan menggunakan media flipbook, mayoritas responden memiliki tingkat pengetahuan kategori baik sebanyak 257 responden (87,1%). Hasil uji Wilcoxon menunjukkan nilai p = 0,000 (p < 0,05), yang berarti terdapat pengaruh signifikan promosi kesehatan menggunakan media flipbook terhadap pengetahuan pencegahan stunting pada ibu balita. Promosi kesehatan menggunakan media flipbook terbukti efektif dalam meningkatkan pengetahuan ibu balita mengenai pencegahan stunting di wilayah kerja Puskesmas Kragan II.

Ibu memiliki peran yang sangat penting dalam pencegahan stunting sejak masa prakonsepsi, kehamilan, hingga anak berusia dua tahun. Pengetahuan ibu mengenai gizi, stunting, dan praktik kesehatan anak menjadi dasar dalam menentukan pola asuh yang tepat . Penelitian ini bertujuan Untuk mengetahui Hubungan Persepsi Dengan pengetahuan ibu Dalam Pencegahan Stunting Pada Balita Di Puskesmas Mojolangu Kota Malang. Penelitian ini menggunakan desain analitik korelasional Populasi penelitian adalah seluruh ibu yang memiliki balita usia 0–59 bulan yang berkunjung ke Poli KIA Puskesmas Mojolangu sebanyak 50 orang. Teknik pengambilan sampel menggunakan total sampling .Analisis data dilakukan secara univariat untuk menggambarkan karakteristik responden dan distribusi variabel penelitian, serta analisis bivariat menggunakan uji Chi-Square dengan tingkat kepercayaan 95% (? = 0,05). Berdasarkan hasil penelitian  menunjukkan nilai p-value = 0,000 (< 0,05), sehingga H? ditolak dan H? diterima yaitu terdapat adanya  hubungan yang signifikan antara persepsi ibu dan pengetahuan tentang pencegahan stunting pada balita. Nilai koefisien korelasi sebesar (r=0,817). semakin positif persepsi ibu mengenai stunting maka semakin baik pula pengetahuannya tentang pencegahan stunting

Background: Stunting remains one of the public health problems that requires early prevention through health education and growth monitoring in children under five years old. Lack of parental knowledge regarding balanced nutrition, child feeding practices, hygiene, and routine physical examination can increase the risk of growth disorders in toddlers. Purpose: Physical examination in toddlers is important to identify early signs of growth and developmental problems, including body weight, height or length, nutritional status, and general physical condition. Method: This community service activity was conducted face-to-face using health education, discussion, and direct physical examination methods. The stages of activity included preparation, delivery of educational materials about stunting, physical examination of toddlers, recording the results, and providing simple counseling to parents. Results: The activity showed that mothers were enthusiastic in participating in counseling and toddler physical examination. Before the education was given, several mothers still had limited understanding about the causes, impacts, and prevention of stunting. After the activity, mothers began to understand the importance of balanced nutrition, routine weighing, height measurement, immunization, hygiene, and regular visits to posyandu or health facilities. Conclusion: Education about stunting and physical examination of toddlers can increase parental awareness regarding early prevention of growth disorders. This activity is useful in encouraging families to monitor toddler growth regularly and implement healthy childcare practices.

Masa balita merupakan periode emas (golden period) yang menentukan pertumbuhan dan perkembangan anak. Salah satu upaya stimulasi yang dapat dilakukan untuk mendukung tumbuh kembang, meningkatkan kualitas tidur, nafsu makan, serta membantu peningkatan berat badan balita adalah pemberian pijat bayi/balita sehat. Asuhan kebidanan komunitas berperan penting dalam meningkatkan pengetahuan dan keterampilan keluarga dalam memberikan stimulasi yang tepat kepada balita. Mendeskripsikan pelaksanaan asuhan kebidanan komunitas pada keluarga Tn. T, khususnya An. R usia 2 tahun, melalui pemberian pijat bayi/balita sehat sebagai upaya meningkatkan pertumbuhan dan perkembangan balita. Artikel ini menggunakan metode studi kasus deskriptif dengan pendekatan manajemen kebidanan yang meliputi pengkajian, identifikasi masalah, penetapan diagnosis, perencanaan, implementasi, evaluasi, dan tindak lanjut. Pengumpulan data dilakukan melalui wawancara, observasi, pemeriksaan fisik, serta dokumentasi selama pelaksanaan praktik kebidanan komunitas di Desa Batunyala. Hasil asuhan menunjukkan bahwa pemberian edukasi dan praktik pijat bayi/balita sehat dapat meningkatkan pengetahuan keluarga mengenai manfaat pijat balita serta kemampuan keluarga dalam melakukan stimulasi secara mandiri. Balita tampak lebih rileks, tidur lebih nyenyak, dan orang tua memahami pentingnya stimulasi rutin sebagai bagian dari upaya mendukung pertumbuhan, perkembangan, serta pencegahan gangguan gizi dan stunting. Asuhan kebidanan komunitas melalui pemberian pijat bayi/balita sehat merupakan intervensi komplementer yang efektif untuk meningkatkan pengetahuan keluarga dan mendukung optimalisasi tumbuh kembang balita. Keterlibatan aktif keluarga dalam melakukan pijat secara rutin di rumah menjadi salah satu strategi promotif dan preventif yang dapat meningkatkan kualitas kesehatan balita.

Pertumbuhan anak usia 24–59 bulan merupakan periode penting yang dipengaruhi oleh kecukupan asupan zat gizi, salah satunya protein. Kekurangan protein dalam jangka panjang dapat menyebabkan gangguan pertumbuhan linier berupa stunting yang berdampak terhadap kualitas tumbuh kembang anak. Penelitian ini bertujuan untuk mengetahui hubungan asupan protein dengan status pertumbuhan anak usia 24–59 bulan. Penelitian ini menggunakan desain observasional analitik dengan pendekatan cross sectional yang dilakukan di wilayah kerja Puskesmas Bambu Kabupaten Mamuju. Sampel penelitian berjumlah 30 anak usia 24–59 bulan yang dipilih menggunakan teknik purposive sampling. Data asupan protein diperoleh melalui food record, sedangkan status pertumbuhan diukur menggunakan indikator antropometri berat badan menurut umur (BB/U), tinggi badan menurut umur (TB/U), dan berat badan menurut tinggi badan (BB/TB). Analisis data menggunakan uji Spearman’s Rho dan Fisher’s Exact dengan tingkat kemaknaan ?=0,05. Hasil penelitian menunjukkan bahwa 70% anak mengalami stunting berdasarkan indikator TB/U, terdiri dari kategori stunted sebesar 50% dan severely stunted sebesar 20%. Terdapat hubungan antara asupan protein dengan BB/U (p=0,05; r=0,593) dan TB/U (p=0,000; r=0,601), sedangkan tidak terdapat hubungan antara asupan protein dengan BB/TB (p=1,000; r=0,023). Kesimpulan penelitian ini adalah asupan protein berhubungan dengan status pertumbuhan anak terutama pada indikator TB/U. Pemenuhan protein yang cukup dan berkualitas, terutama protein hewani, perlu menjadi perhatian dalam upaya mendukung pertumbuhan dan mencegah gangguan pertumbuhan pada balita

Child marriage remains a significant issue negatively impacting the health and quality of the younger generation, particularly through the increased risk of stunting in children. This article discusses the results of an educational outreach titled “Marriage Is Not Just About Legality: Legal Education on Marriage Dispensation and Its Implications for Stunting Prevention Among Students,” conducted at SMA Negeri 3 Parepare. The outreach aimed to raise students’ awareness about the relationship between minimum marriage age, marriage dispensation, and the health impacts on children, especially the risk of stunting. The methods employed included deconstruction, brainstorming, material delivery, reconstruction, and evaluation through pre-test and post-test assessments. Results demonstrated a significant improvement in students’ understanding from both medical and legal perspectives. The discussion focused on analyzing the contradictory legal norms regarding minimum marriage age and marriage dispensation, which frequently lead to implementation challenges. This outreach underscores the importance of integrating legal education and reproductive health as a preventive strategy to reduce child marriage and prevent stunting. Consequently, the program contributes to shaping a healthy, legally aware younger generation capable of making mature and responsible marriage decisions.

Stunting is a multifactorial public health problem influenced by various risk factors that may emerge during the prenatal period. Early identification of stunting risk during pregnancy is important to support preventive interventions. This study aimed to develop a stunting risk prediction model based on maternal prenatal factors using the Random Forest algorithm. Secondary data from 172 pregnant women, consisting of 83 stunting cases and 89 non-stunting cases, were analyzed. The predictor variables included maternal age during pregnancy, height, hemoglobin level, mid-upper arm circumference (MUAC), smoking history, hypertension, asthma, and diabetes mellitus. The research stages consisted of data preprocessing, model training using Stratified 5-Fold Cross Validation, performance evaluation, external testing, and feature importance analysis. Internal evaluation results showed an accuracy of 60%, precision of 60.6%, recall of 57.3%, F1-score of 58.9%, and AUC of 0.6688. External testing yielded an accuracy of 70% and an AUC of 0.6167. Feature importance analysis identified maternal age during pregnancy as the most influential variable in the prediction process. The findings indicate that maternal prenatal factors have potential for early stunting risk identification, although the predictive performance remains moderate. This approach may serve as a foundation for developing early screening tools to support targeted interventions among high-risk pregnancies.

Stunting dan malaria masih menjadi masalah kesehatan masyarakat yang banyak ditemukan pada wilayah endemis, termasuk Kabupaten Nabire, Papua. Kondisi lingkungan tempat tinggal yang kurang memadai diduga berkontribusi terhadap meningkatnya risiko infeksi malaria dan gangguan pertumbuhan pada anak. Penelitian ini bertujuan untuk menganalisis hubungan faktor lingkungan rumah dengan kejadian stunting pada balita yang memiliki riwayat malaria di wilayah kerja Puskesmas Kimi. Penelitian menggunakan desain observasional analitik dengan pendekatan case-control. Kelompok kasus terdiri atas balita stunting yang memiliki riwayat malaria dalam satu tahun terakhir, sedangkan kelompok kontrol merupakan balita dengan status gizi normal dan tanpa riwayat malaria. Data dikumpulkan melalui wawancara, observasi kondisi lingkungan rumah, serta penelusuran data kesehatan. Analisis statistik dilakukan menggunakan uji Chi-square dengan tingkat kemaknaan 95%. Hasil penelitian menunjukkan bahwa beberapa karakteristik lingkungan fisik rumah berhubungan secara signifikan dengan kejadian stunting pada balita yang memiliki riwayat malaria (p<0,05). Faktor yang terbukti berasosiasi meliputi tipe bangunan rumah, jenis lantai, penggunaan kawat kasa pada ventilasi, kondisi lingkungan di dalam rumah, serta kondisi lingkungan sekitar rumah yang mendukung perkembangbiakan nyamuk. Temuan ini menunjukkan bahwa kualitas lingkungan tempat tinggal memiliki peran penting dalam meningkatkan paparan terhadap malaria yang selanjutnya dapat memengaruhi status kesehatan dan pertumbuhan anak. Dapat disimpulkan bahwa lingkungan rumah yang tidak memenuhi standar kesehatan berpotensi meningkatkan risiko stunting melalui peningkatan kejadian malaria dan penyakit infeksi lainnya. Oleh karena itu, upaya penanggulangan stunting di daerah endemis malaria perlu diintegrasikan dengan perbaikan kualitas perumahan, peningkatan sanitasi lingkungan, pengendalian vektor, serta edukasi kesehatan masyarakat secara berkelanjutan.

Program Kuliah Kerja Nyata (KKN) mahasiswa Universitas 17 Agustus 1945 Semarang dilaksanakan di Kelurahan Purwosari, Kecamatan Mijen, Kota Semarang pada tanggal 3 Januari hingga 1 Februari 2026. Program ini bertujuan mengatasi permasalahan masyarakat di bidang kesehatan, literasi, keselamatan lingkungan, dan kesejahteraan sosial melalui pendekatan partisipatif yang terintegrasi. Program yang dilaksanakan meliputi pembuatan Taman TOGA, pembagian buku bacaan bergambar ke sekolah dasar, pemasangan kaca cembung di titik blind spot, penyuluhan pencegahan stunting disertai pembagian makanan bergizi, kerja bakti, serta pendampingan Posyandu, PKK, dan PAUD. Hasil program menunjukkan manfaat nyata: taman TOGA fungsional terbangun di halaman kantor kelurahan, 180 buku tersalurkan ke SDN Purwosari 1 dan 2, 3 kaca cembung terpasang di titik rawan kecelakaan, dan 25 paket makanan bergizi terdistribusi kepada anak PAUD. Program-program ini berhasil meningkatkan kesadaran dan kapasitas masyarakat di bidang kesehatan, pendidikan, dan keselamatan lingkungan.

The government policy known as the Free Nutritional Meal Program (MBG) aims to improve public nutrition and reduce stunting rates in Indonesia. The purpose of this study is to examine the MBG Program from a political perspective, particularly considering political dynamics, legal risks, and fiscal issues. This research was conducted through literature review, reviewing various journals and academic sources. The results indicate that the MBG not only has social impacts but also influences political interests, poses risks to legal enforcement, and disrupts the sustainability of the state budget. Therefore, for the program to be successful and sustainable, strong regulations and oversight are required. Furthermore, this populist program is often utilized as an instrument for power legitimacy, demanding compromises between the executive and legislative branches during its budget approval process. Without a detailed legal framework, the policy's implementation is highly vulnerable to overlapping institutional authority and potential misappropriation of funds. Ultimately, technology-based monitoring strategies and accountable governance are the main keys to maintaining the stability of the State Budget (APBN).

This study aims to analyze the paradox of stunting in Yemen, particularly the disconnect between humanitarian response priorities and children's actual nutritional needs amid the ongoing conflict. Stunting, a form of chronic malnutrition, is a significant public health issue in Yemen, exacerbated by the conflict's disruption of food, healthcare, and sanitation systems. Despite the clear evidence of rising stunting rates, international humanitarian interventions tend to focus on addressing acute crises, such as extreme hunger, while neglecting long-term nutritional needs. Using a qualitative literature review approach, the research synthesizes data from archival documents, reports, and secondary sources to explore the structural causes of stunting and the challenges faced by humanitarian actors in Yemen. The findings reveal that the protracted conflict, economic collapse, and humanitarian blockades have worsened food insecurity and malnutrition. Moreover, the humanitarian response often prioritizes short-term survival over long-term prevention of stunting, resulting in a lack of integrated, multisectoral interventions. The study emphasizes the need for a paradigm shift in humanitarian policies to incorporate long-term development strategies and integrate stunting prevention. This research contributes to the academic understanding of the humanitarian-development nexus and offers recommendations for more holistic interventions.

This Community Service (PKM) activity aims to improve the performance of Posyandu cadres in stunting prevention efforts in Kepudibener Village, Turi District, Lamongan Regency. The main problems faced by the community include low health literacy, suboptimal utilization of Posyandu, and limited capacity of cadres in providing health education. The implementation method uses a participatory and educational approach through the stages of observation, cadre training, health education, mentoring, and program evaluation. The results of the activity show an increase in the knowledge and skills of Posyandu cadres in monitoring child growth and development and nutrition education, increased community participation in Posyandu activities, and an increase in understanding of mothers of toddlers regarding stunting prevention. This program is also able to strengthen the role of cadres as agents of change in raising community awareness of the importance of family health. Thus, improving the performance of Posyandu cadres has proven effective in supporting community-based stunting prevention efforts. Sustainability of the program through ongoing training and mentoring is essential to maintain the positive impacts that have been achieved.

Stunting is a national health problem that has not been resolved to date. Training on the use of local coastal food is still rare and the use of yards through planting moringa is also still lacking in coastal areas. The purpose of this community service is to prevent stunting by training to toddler families about the benefits and innovations of local coastal food and planting moringa trees in the Soropia coastal area. The implementation method uses lectures and demonstrations of making fish and moringa chips. Community service has been carried out in Bajoe Village on 35 mothers with toddlers, using booklets and leaflets. The results of the implementation of the activity are knowledge and the media score obtained before health education is 8 and after 10, with a good knowledge achievement of 100%. The results of the training on making moringa chips, there was an increase in skills before was 10 and after training obtained a score of 12, the achievement of skills after being given training was 91.4%. The results of the Wilcoxon sign rank test obtained a p value of 0.000. The conclusion of community service is that there is an increase in the knowledge and skills of mothers who have toddlers in utilizing local coastal food and the availability of moringa trees in the yards of their homes and the Bajoe Village Hall, Soropia Subdistrict.

Stunting remains a major public health challenge in Indonesia, requiring systematic early detection and community-based interventions. This community service activity aimed to implement early stunting detection through parental health education and anthropometric measurements of children under five at Posyandu Pasir Putih, Kelurahan Baurung, Kecamatan Banggae Timur, Kabupaten Majene, West Sulawesi. A participatory approach was used, combining interactive health education sessions with standardized anthropometric screening (weight, height/length, mid-upper arm circumference, and head circumference) for 35 toddlers aged 0–59 months. Parental knowledge was assessed using pre-test and post-test questionnaires administered to 38 parents. Results showed a significant increase in parental knowledge, from a mean pre-test score of 52.4 (poor category) to 81.6 (good category) on post-test. Anthropometric assessment revealed that 13 out of 35 toddlers (37.1%) were identified as stunted (25.7% stunted; 11.4% severely stunted). All identified cases were referred to the local health center (Puskesmas) for specific nutritional interventions including supplementary feeding and intensive nutrition counseling. These findings indicate that integrated anthropometric screening combined with targeted parental education is an effective strategy for early stunting identification at the community level. Posyandu plays a crucial role as a platform for translating anthropometric data into meaningful risk communication and promoting sustained community engagement in child growth monitoring

Stunting remains a persistent nutritional challenge that threatens human capital development in Indonesia. This study examines the effects of exclusive breastfeeding, female education, sanitation, access to safe drinking water, inadequate food consumption, and poverty on stunting prevalence across 34 provinces in Indonesia during 2017–2024. The study employs a random-effects Panel EGLS estimator with Panel Corrected Standard Errors (PCSE) to address heteroskedasticity and cross-sectional dependence in provincial panel data. The findings reveal that exclusive breastfeeding, female education, and adequate sanitation significantly reduce stunting prevalence, while poverty significantly increases it. Interestingly, inadequate food consumption is negatively associated with stunting prevalence, potentially reflecting the contribution of government nutritional assistance and social protection programs. In contrast, access to safe drinking water does not show a statistically significant effect. Among the explanatory variables, female education is strongly associated with reductions in stunting. These findings highlight the importance of strengthening women’s education, improving sanitation quality, and expanding poverty-alleviation and nutrition-sensitive interventions to accelerate reductions in stunting and support the achievement of Sustainable Development Goal 2 in Indonesia.

Stunting remains a significant nutritional issue because it can impact a child's long-term growth and development. A history of low birth weight (LBW) is suspected to play a role, reflecting the condition of fetal growth during pregnancy. This study aimed to determine the relationship between a history of LBW and the incidence of stunting in children aged 2–5 years at the Bandarharjo Community Health Center in Semarang in 2025. This study used an analytical design with a case-control approach. The study sample consisted of 203 toddlers selected using consecutive sampling. Data were obtained from the KIA book and height measurements based on WHO standards. Analysis was performed using the Chi-Square test and Odds Ratio (OR) calculation. The proportion of LBW was 10.8% and stunting was 31.0%. There was a significant relationship between a history of LBW and the incidence of stunting (p = 0.012). Toddlers with a history of LBW had approximately a threefold greater risk of experiencing stunting compared to toddlers born with normal weight (OR = 3.059). There is a relationship between a history of low LBW and the incidence of stunting in toddlers aged 2-5 years at the Bandarharjo Community Health Center, Semarang in 2025.

Abstract. Stunting remains a major public health issue in Indonesia, necessitating health promotion and prevention efforts through health education. The purpose of this study was to assess the effectiveness of leaflets in health promotion to prevent stunting in mothers with toddlers. The method used was a literature review with the PRISMA approach, by searching for articles in the Google Scholar, Garuda, PubMed, and Neliti databases using the keywords "stunting," "leaflet," "health promotion," and "health education." Of the 55 articles found, 16 met the inclusion criteria for analysis. The results of the analysis showed that the use of leaflets can improve mothers' understanding and attitudes regarding stunting prevention, including knowledge about balanced nutrition, exclusive breastfeeding, complementary feeding, and the First 1000 Days of Life (HPK). Leaflets were considered practical, easy to understand, and can be used repeatedly as a means of public health education. The conclusion of this study states that leaflets are effective for use in health promotion as a measure to prevent stunting in community nursing practice.

Abstract. Stunting remains a major public health issue in Indonesia, necessitating health promotion and prevention efforts through health education. The purpose of this study was to assess the effectiveness of leaflets in health promotion to prevent stunting in mothers with toddlers. The method used was a literature review with the PRISMA approach, by searching for articles in the Google Scholar, Garuda, PubMed, and Neliti databases using the keywords "stunting," "leaflet," "health promotion," and "health education." Of the 55 articles found, 16 met the inclusion criteria for analysis. The results of the analysis showed that the use of leaflets can improve mothers' understanding and attitudes regarding stunting prevention, including knowledge about balanced nutrition, exclusive breastfeeding, complementary feeding, and the First 1000 Days of Life (HPK). Leaflets were considered practical, easy to understand, and can be used repeatedly as a means of public health education. The conclusion of this study states that leaflets are effective for use in health promotion as a measure to prevent stunting in community nursing practice.