Effectiveness of an integrated nutrition and developmental stimulation program on growth, dietary intake, and motor development among stunted toddlers in coastal Kendari

Background: An integrated approach combining nutritional improvement and developmental stimulation may improve multiple domains of child health, particularly in coastal communities facing nutritional challenges. Objective: This study evaluated the effectiveness of an Integrated Nutrition and Developmental Stimulation Program on growth, dietary intake, and motor development among stunted children aged 24–59 months. Methods: A quasi-experimental non-randomized controlled trial with a pretest–posttest control group design included 80 stunted children, with 40 assigned to the intervention group and 40 to the control group. The intervention group received a 12-week program comprising nutritional counseling, feeding support, and age-appropriate developmental stimulation, while the control group received routine health services. Continuous outcomes were analyzed using ANCOVA adjusted for baseline values and predefined covariates. Motor development was assessed using the KPSP and analyzed as a categorical outcome using modified Poisson regression with robust variance. Results: The intervention produced greater improvements in body weight (adjusted mean difference [AMD], 0.47 kg; 95% CI, 0.09–0.85; p = 0.016), height (AMD, 1.18 cm; 95% CI, 0.39–1.97; p = 0.004), and HAZ (AMD, 0.23 SD; 95% CI, 0.06–0.40; p = 0.009). Significant improvements were also observed in energy intake (AMD, 158.6 kcal/day; 95% CI, 102.4–214.8; p < 0.001), protein intake (AMD, 6.81 g/day; 95% CI, 4.12–9.50; p < 0.001), and dietary diversity (AMD, 1.37 points; 95% CI, 0.98–1.76; p < 0.001). Appropriate motor development increased from 42.5% to 80.0% in the intervention group and from 45.0% to 57.5% in the control group. The adjusted categorical analysis showed a significant intervention effect. Conclusion: The integrated program was associated with greater improvements in growth, dietary intake, and motor developmental status than routine care and may strengthen community-based interventions for stunted children in coastal settings.