Analisis Kecenderungan Common Mental Disorders pada Ibu yang Diukur Menggunakan SRQ-20 dengan Kejadian Stunting pada Balita di Asia-Afrika: Systematic Review-Meta Analysis

ESTER BELLANDINA TAMENO, Dr. dr. Emy Huriyati, M.Kes ; Bayu Satria Wiratama, S.Ked., MPH., PhD., FRSPH

2026 | Tesis | S2 Ilmu Kesehatan Masyarakat

Latar Belakang: Stunting tetap menjadi isu kesehatan masyarakat yang penting di Asia-Afrika, dengan penyebab yang melibatkan faktor biologis, lingkungan, serta kondisi psikologis ibu, termasuk Common Mental Disorders (CMD). Kondisi ini berkaitan dengan kualitas pengasuhan dan praktik pemberian makan anak, sehingga berkontribusi terhadap peningkatan risiko stunting. Namun, studi sebelumnya masih menunjukkan variasi hasil penelitian dan belum memberikan kesimpulan yang konsisten, termasuk terkait pengukuran CMD yang menggunakan SRQ-20.

Tujuan: Melakukan systematic review dan meta analisis terkait hubungan kecenderungan CMD ibu yang diukur menggunakan SRQ-20 dengan kejadian stunting pada balita di negara Asia-Afrika.

Metode: Systematic review dan meta-analysis ini mengikuti pedoman PRISMA 2020 dan kriteria PEO. Pencarian artikel dilakukan di PubMed, Scopus, ScienceDirect dan Google Scholar untuk publikasi tahun 2000-2025. Data yang diekstraksi meliputi karakteristik studi, cut-off SRQ-20, ukuran efek hubungan CMD stunting, serta penilaian kualitas menggunakan alat Joanna Briggs Institute (JBI). Analisis dijelaskan secara naratif dilanjutkan meta analisis, uji heterogenitas, uji bias publikasi, analisis moderator, serta penilaian certainty of evidence dengan pendekatan GRADE.

Hasil: Sebanyak 14 artikel memenuhi kriteria inklusi. Sebagian besar studi menggunakan desain cross-sectional, yaitu 10 studi (71,43%), dan mayoritas penelitian dilakukan di wilayah Asia, yaitu 9 studi (64,28%). Cut-off SRQ-20 yang dilaporkan dalam studi yang diikutsertakan meliputi 6, 7, dan 8, dengan cut-off 8 sebagai ambang yang paling banyak digunakan, yaitu pada 5 studi. Meta-analisis menggunakan model random effects menunjukkan bahwa CMD ibu berhubungan signifikan dengan peningkatan risiko stunting pada anak di Asia-Afrika (OR 1,33; 95% CI 1,08-1,65), dengan heterogenitas tinggi (I² = 86,6%). Analisis moderator menunjukkan bahwa variasi estimasi efek dijelaskan oleh desain studi dan kualitas studi. Uji bias publikasi tidak menunjukkan indikasi adanya bias publikasi. Penilaian JBI menunjukkan kualitas studi kuat hingga sangat kuat. Namun, certainty of evidence tergolong sangat rendah.

Kesimpulan: CMD pada ibu berhubungan dengan peningkatan risiko kejadian stunting pada anak di Asia-Afrika. Tingginya heterogenitas antar studi dapat dijelaskan oleh variasi desain studi dan kualitas studi.

Background: Stunting remains a major public health concern in Asia and Africa, with determinants involving biological, environmental, and maternal psychological factors, including common mental disorders (CMD). Maternal CMD may affect the quality of caregiving and child feeding practices, thereby contributing to an increased risk of stunting. However, previous studies have reported variable findings and have not provided consistent conclusions, particularly among studies that assessed CMD using the Self-Reporting Questionnaire-20 (SRQ-20).

Objective: This systematic review and meta-analysis aimed to examine the association between maternal CMD, measured using the SRQ-20, and stunting among children under five in Asia and Africa. 

Methods: This systematic review and meta-analysis followed PRISMA 2020 guidelines and PEO criteria. Articles were searched in PubMed, Scopus, ScienceDirect, and Google Scholar (published 2000-2025). Extracted data included study characteristics, SRQ-20 cut-off values, effect estimates of the CMD stunting association, and study quality assessed using the Joanna Briggs Institute (JBI) tool. Data were synthesized narratively and quantitatively using meta-analysis, heterogeneity tests, publication bias assessment, moderator analysis, and certainty of evidence evaluation using the GRADE approach. 

Results: A total of 14 articles met the inclusion criteria. Most studies employed a cross-sectional design, accounting for 10 studies (71.43%), and the majority were conducted in Asia, representing 9 studies (64.28%). The SRQ-20 cut-off values reported across the included studies were 6, 7, and 8, with cut-off 8 being the most frequently used threshold, reported in 5 studies. The random-effects meta-analysis showed that maternal CMD was significantly associated with an increased risk of stunting among children in Asia and Africa (OR 1.33; 95% CI 1.08-1.65), with high heterogeneity (I² = 86.6%). Moderator analysis indicated that variation in effect estimates was partly explained by study design and study quality. The publication bias assessment showed no indication of publication bias. The JBI assessment indicated strong to very strong study quality. However, the overall certainty of evidence based on GRADE was very low.

Conclusion: Maternal CMD are associated with an increased risk of child stunting in Asia and Africa, with heterogeneity largely explained by differences in study design and study quality.

Kata Kunci : systematic review, meta-analysis, stunting, common mental disorders, SRQ-20, Asia, Afrika