Effect of parental formal education on risk of child stunting in Indonesia and Bangladesh: a cross-sectional study

Background: Child stunting is associated with poor child development and increased mortality. Our aim was to determine the effect of length of maternal and paternal education on stunting in children under the age of 5 years. Methods: Data for indicators of child growth and of parental education and socioeconomic status were gathered from 590 570 families in Indonesia and 395 122 families in Bangladesh as part of major nutritional surveillance programmes. Findings: The prevalence of stunting in families in Indonesia was 33·2%, while that in Bangladesh was 50·7%. In Indonesia, greater maternal formal education led to a decrease of between 4·4% and 5% in the odds of child stunting (odds ratio per year 0·950, 95% CI 0·946-0·954 in rural settings; 0·956, 0·950-0·961 in urban settings); greater paternal formal education led to a decrease of 3% in the odds of child stunting (0·970, 0·967-0·974). In Bangladesh, greater maternal formal education led to a 4·6% decrease in the odds of child stunting (0·954, 0·951-0·957), while greater paternal formal education led to a decrease of between 2·9% and 5·4% in the odds of child stunting (0·971, 0·969-0·974 in rural settings; 0·946, 0·941-0·951 in urban settings). In Indonesia, high levels of maternal and paternal education were both associated with protective caregiving behaviours, including vitamin A capsule receipt, complete childhood immunisations, better sanitation, and use of iodised salt (all p<0·0001). Interpretation: Both maternal and paternal education are strong determinants of child stunting in families in Indonesia and Bangladesh.