Caregivers’ Stunting Knowledge Score, Breastfeeding and Complementary Food Introduction Practices, and Posyandu Use: An Analysis of the 2024 Indonesian Nutritional Status Survey

Stunting-prevention policy in Indonesia relies heavily on educating caregivers, assuming that knowledge translates into practice, yet this assumption has rarely been tested at national scale. This study asked whether caregivers’ stunting knowledge is associated with breastfeeding, the timing of non-breast-milk foods or liquids, and growth monitoring at community health posts (posyandu), and how large the knowledge–practice gap is. We conducted a cross-sectional secondary analysis of the 2024 Indonesian Nutritional Status Survey covering 300,143 children under five in 273,959 households and 33,687 census blocks. Knowledge was scored from 15 positively worded statements on a 0–100 scale. Prevalence ratios were estimated with survey-weighted modified Poisson regression, and census-block fixed-effects models separated household-level associations from interviewer and local-context effects. The mean score was 65.0; household characteristics explained only 3.1% of its variance, whereas 52.2% lay between census blocks. Compared with the lowest quartile, children of caregivers in the highest quartile were more likely to be exclusively breastfed (prevalence ratio 1.17), not given other foods or liquids before six months (1.13), and weighed at least eight times in the previous year (1.11). Even so, 28–34% of children in the highest quartile did not receive these practices, and 23.6% of infants were cared for by someone who agreed that exclusive breastfeeding prevents stunting but were not exclusively breastfed. Within census blocks, 69–133% of the associations persisted. The study contributes national evidence that knowledge is a consistent but weak correlate of practice and that survey-based knowledge scores partly reflect the interview context. Stunting programmes should therefore target practical breastfeeding support and service access, and national surveys should strengthen their knowledge instruments.