Evidence map›Paper›PMID 41142017›Full record

ArticleFood science & nutrition2025

Effectiveness of a Tiered Referral System and Early Nutritional Intervention to Prevent and Recover Stunting in Under-Five Indonesian Children.

Damayanti Rusli Sjarif, Klara Yuliarti, Lanny Christine Gultom, Cut Nurul Hafifah, I Gusti Lanang Sidiartha, Meta Herdiana Hanindita, Neti Nurani, Aidah Juliaty, Ali Alhadar, Anik Puryatni and 14 more

Abstract read
In one paragraph

Article in Food science & nutrition, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

24 authors.

Damayanti Rusli SjarifDepartment of Child Health, Faculty of Medicine Universitas Indonesia/Dr Cipto Mangunkusumo Hospital Jakarta Indonesia.
Klara YuliartiDepartment of Child Health, Faculty of Medicine Universitas Indonesia/Dr Cipto Mangunkusumo Hospital Jakarta Indonesia.
Lanny Christine GultomDepartment of Child Health Fatmawati General Hospital Jakarta Indonesia.
Cut Nurul HafifahDepartment of Child Health, Faculty of Medicine Universitas Indonesia/Dr Cipto Mangunkusumo Hospital Jakarta Indonesia.
I Gusti Lanang SidiarthaDepartment of Child Health, Faculty of Medicine Universitas Udayana/Sanglah Hospital Denpasar Indonesia.
Meta Herdiana HaninditaDepartment of Child Health, Faculty of Medicine Universitas Airlangga/Dr Soetomo Hospital Surabaya Indonesia.
Neti NuraniDepartment of Child Health, Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada/Dr Sardjito Hospital Yogyakarta Indonesia.
Aidah JuliatyDepartment of Pediatrics, Faculty of Medicine Hasanuddin University/Dr Wahidin Sudirohusodo Hospital Makassar Indonesia.
Ali AlhadarDepartment of Child Health Hermina Jatinegara Hospital Jakarta Indonesia.
Anik PuryatniDepartment of Pediatrics, Faculty of Medicine Universitas Brawijaya/Saiful Anwar Hospital Malang Indonesia.
Arief BudiartoDepartment of Pediatrics, Faculty of Medicine Lambung Mangkurat University/Ulin Banjarmasin Hospital Banjarmasin Indonesia.
Endy Paryanto PrawirohartonoDepartment of Child Health, Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada/Dr Sardjito Hospital Yogyakarta Indonesia.
Irma Sri HidayatiDepartment of Child Health, Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada/Dr Sardjito Hospital Yogyakarta Indonesia.
Julius AnzarDepartment of Pediatrics, Faculty of Medicine Universitas Sriwijaya/Dr Mohammad Hoesin General Hospital Palembang Indonesia.
Moretta DamayantiDepartment of Pediatrics, Faculty of Medicine Universitas Sriwijaya/Dr Mohammad Hoesin General Hospital Palembang Indonesia.
Nur Aisiyah WidjajaDepartment of Child Health, Faculty of Medicine Universitas Airlangga/Dr Soetomo Hospital Surabaya Indonesia.
Nice Rachmawati MasnadiDepartment of Pediatrics, Faculty of Medicine Universitas Andalas Padang Indonesia.
Rina PratiwiDepartment of Pediatrics, Faculty of Medicine Universitas Diponegoro/Dr Kariadi Hospital Semarang Indonesia.
Rini AndrianiDepartment of Pediatrics Medical Faculty of Tanjungpura University/Kharitas Bhakti Hospital Pontianak West Kalimantan Indonesia.
Ronald RompiesDepartment of Child Health, Faculty of Medicine Universitas Indonesia/Dr Cipto Mangunkusumo Hospital Jakarta Indonesia.
Novitria DwinandaDepartment of Pediatrics National Women and Children Health Center RSAB Harapan Kita Jakarta Indonesia.
Winra PratitaDepartment of Pediatrics, Faculty of Medicine Universitas Sumatera Utara Medan Indonesia.
William Jayadi IskandarDepartment of Child Health, Faculty of Medicine Universitas Indonesia/Dr Cipto Mangunkusumo Hospital Jakarta Indonesia.
Jessy HardjoDepartment of Child Health, Faculty of Medicine Universitas Indonesia/Dr Cipto Mangunkusumo Hospital Jakarta Indonesia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Stunting remains a major global malnutrition problem in children. A protocol for stunting prevention and management in Indonesia is needed to achieve the WHO's stunting reduction target by 40% in 2025. This study aimed to evaluate the effectiveness of a tiered referral system across different healthcare levels and the importance of animal proteins and food for special medical purposes (FSMP) in preventing and managing stunting in Indonesia. This one-group pre-post experimental study involved children under 5 years old from 14 regencies in Indonesia. All subjects initially received education about breastfeeding and animal proteins. Eligible subjects were then given daily animal protein (milk and/or egg) supplementation. Subjects with weight faltering, underweight, or wasting were referred and given nutritional intervention for 2 weeks. If treatments failed to normalize undernutrition, subjects were referred to regional hospitals. Those confirmed as stunted or with low birth weight were directly referred for treatment and FSMP as indicated. A total of 1841 subjects received egg and/or milk supplementation. In 6 months, animal protein supplementation prevented weight faltering in 1320/1841 subjects (71.7%; 95% CI 69.6%-73.8%). Red flags management successfully prevented stunting in 536/709 subjects (75.6%; 95% CI 72.4%-78.8%) in 2 weeks. FSMP prescription for catch-up growth in regional hospitals led to stunting recovery in 166/381 subjects (43.6%; 95% CI 38.6%-48.5%) in ±14 weeks. A tiered referral system with well-defined treatment guidelines is crucial to address stunting in Indonesia. Timely referral and FSMP prescription for catch-up growth can effectively treat stunting. Animal proteins and education are keys to preventing stunting in children.

Indexed as

catch‐up growth interventiondietary animal proteinsFSMPpatient educationstunting

Identifiers

PMID41142017
PMCPMC12547623

What Socratic holds

Textmetadata
LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.