Parenting Self-Efficacy and Grit among Mothers with Stunting Children in Indonesia

Introduction

One of the issues addressed by the Sustainable Development Goals (SDGs) includes reducing the rates of stunted growth among children. Globally in 2016, 22.9% or 154.8 million children under 5 years of age suffered from childhood stunting, defined by a low height-for-age (World Health Organization, 2018). Stunting is a failure to grow and develop that children experience due to the accumulation of poor nutrition, recurrent infections, and lack of psychosocial stimulation. Stunting in early life, usually occurring in the first thousand days after birth, impacts the child's future growth, including low cognitive function, learning achievement, wages, and productivity. Children who experience stunting due to deficiencies in iodine and iron may suffer irreversible brain damage, which can hinder their ability to reach their full developmental potential. As a result, they may have a shorter adult height and a greater susceptibility to chronic diseases later in life. Additionally, these children often have lower levels of education. The Global Nutrition Targets 2025, endorsed by the Sixty-fifth World Health Assembly in 2012, aimed for a 40% reduction in stunting among children under five years old (World Health Organization, 2018). The high prevalence of stunting in Indonesia continues to be an urgent issue that needs to be resolved (Saputri & Tumangger, 2019). Furthermore, the 2021 Indonesian nutritional status study (SSGI) highlights that Central Java is seventh globally in the prevalence of reported stunting cases. Banyumas Regency aims to reduce the prevalence of stunting by 14% by 2024 (Badan Pusat Statistik Provinsi Jawa Tengah [Statistics of Jawa Tengah Province], 2021).

Poor parenting practices are one of the factors correlated with  a hightened rates of stunting (Satriawan, 2018). These maladaptive parental patterns include a lack of knowledge about consuming nutritious food before and during pregnancy, exclusive breastfeeding, breast milk substitutes, and cognitive stimulation of children; it is even known that the two are interconnected (Rajagukguk, 2022). Moreover, good parenting also includes the family's ability to provide attention and support for children. On the basis of this good parenting children are better able to meet physical, mental, and social needs while they grow (Bella et al., 2020). Parents of stunted children realize the difficulties. They have to become more concerned about their children’s nutritional and developmental growth. Some factors such as health problems, the family’s role, and environmental factors can explain the varying impacts on the psychological well-being of parents. Many problems may arise as a consequence of child stunting. Hence, parenting is essential to support the potential and future success of the child.

The role of parents, especially mothers, is irreplaceable in improving the child's optimal growth. It takes self-confidence in mothers to support the process of ameliorating the effects of stunting among the children in their care (Rakhmawati, 2015). Parenting self-efficacy (PSE) which refers to self-confidence in parenting is derived from the concept of self-efficacy. Bandura defines self-efficacy as an individual's subjective belief in their ability to carry out the actions required to complete a specific task, a new task, or face sources of stress (Benedetto & Ingrassia, 2018). PSE refers to parents' estimates of their competence in parenting (P. K. Coleman & Karraker, 2000). It can also be interpreted as parents' perceptions of their ability to positively influence their children's behavior, development and actually promote children's health (Albanese et al., 2019). Parental self-efficacy beliefs assess how parents perceive their ability to perform the varied tasks associated with this highly demanding role. Parental self-efficacy beliefs significantly predict positive parenting practices and mediate the effects of factors such as maternal depression, child temperament, social support, and poverty (P. Coleman & Karraker, 1998). Parental self-efficacy (PSE) is parents' belief in their ability to influence their child in a healthy and success-promoting manner, which is pivotal in promoting healthy functioning for parents and their children (Albanese et al., 2019).

Previous research found that higher PSE was associated with more effective parenting practices, increased parenting skills, and an authoritative parenting style. Furthermore, it was found that PSE had an impact on levels of parenting satisfaction, reduced symptoms of depression/stress, increased mental health, optimism, and life satisfaction (Albanese et al., 2019; Benedetto & Ingrassia, 2018; P. Coleman & Karraker, 2000). Higher parenting self-efficacy was associated with greater parenting satisfaction among mothers of school-aged children, particularly among those whose children are less emotional and more sociable (P. Coleman & Karraker, 2000). Parents’ self-efficacy positively influences child’s behavior and development. Also, parents with a strong belief in parenting their own children play important role in challenging parenting practices, such as parenting children with stunting or special needs  (Pranindita & Ayriza, 2019).

Self-efficacy is a protective factor in cognitive processes that help individuals face challenges and sources of stress (Cherewick et al., 2023). The presence and degree of self-efficacy impacts decision-making, capacity for hard work, perseverance, and the ability to achieve goals. Even in childcare, PSE can encourage a mother's perseverance in efforts to improve her child's condition through various efforts. Perseverance in a person's efforts and hard work to achieve long-term goals is often referred to as grit. Grit is characterized by consistent interest and perseverance toward achieving long-term goals (Duckworth et al., 2007; Duckworth & Eskreis-Winkler, 2015). Grit is also defined as a strength a person may possesses to maintain the motivation to achieve a target (Eskreis-Winkler et al., 2014). Meanwhile, Sturman and Zappala-Piemme define grit as  the capacity for completing a task by facing and overcoming various obstacles (Sturman & Zappala-Piemme, 2017). This term is similar to resilience. Both concepts address an individual's ability to endure challenging situations and reflect personality traits essential for maintaining well-being. Resilience is defined as a person's adaptive capacity to survive, recover, and regroup the resources needed to cope with pressure and negative experiences. On the other hand, grit refers to a long-term commitment to effort and is characterized by a sense of purpose (Stoffel & Cain, 2018). While grit emphasizes dedication and long-term goals, resilience is primarily concerned with an individual's ability to bounce back from negative or stressful experiences, which are typically temporary. Importantly, resilience does not include the elements of commitment or purpose found in grit. Thus, resilience can be viewed as an inherent quality that supports the broader concept of grit (Wahidah & Royanto, 2019).

Individuals who have grit will try to achieve their goals with great effort. Even though he feels disappointed and bored, he will face any obstacles and not just give up (Maddi, 2012). Sometimes, individuals must be reminded of their failures, which will make them strong and motivated. This motivation will make individuals continue to correct mistakes that have caused them to fail in achieving something (Dimenichi & Richmond, 2015). For instance, mothers who are gritty tend not to give up easily while caring for their stunted children. They will remain motivated to improve the situation, foster self-confidence, adapt and come accept to their child while demonstrating positive behavior in parenting practices in the knowledge that their involvement will have an impact on the betterment of their children (Pranindita & Ayriza, 2019). Furthermore, parents with grit, will look for information related to stunting and its treatment, follow guidance from the local government, visit health facilities, follow immunization guidelines, provide nutritious food at home, nurture children's attachment needs, and so on.

A preliminary survey of two mothers with stunted children showed that mothers who have hope and belief that their parenting skills have a positive impact on their children's future condition. Moreover, these mothers look for various reference sources and practical suggestions for improving children's nutrition and adopting more effective parenting patterns. Accordingly, these mothers believed their children would change for the better through optimistic efforts in parenting. The presence of PSE in mothers whose children are stunted is believed to develop the mother's grit in caring for her child.

This research aims to test whether Parental Self-Efficacy is a predictor of grit among mothers who have stunted children. It will be carried out using a quantitative approach that includes measure and in-depth interviews to obtain an overview of the phenomena and correlate the two variables studied. By connecting the concepts of Parental Self-Efficacy and grit, this research seeks to add to the scientific knowledge in psychology with broader field coverage. For practitioners, it can also enrich their perspective in providing interventions or policies for mothers with stunted children.

Parental Self-Efficacy is frequently associated with mental health, resilience, and well-being among parents (Hadi et al., 2020; Pranindita & Ayriza, 2019; Rafiee & Chehreii, 2016). Grit is commonly linked to academic success and work performance (Eskreis-Winkler et al., 2014; Lee, 2017; Sari & Royanto, 2019; Septania & Ishar, 2018; Sturman & Zappala-Piemme, 2017; Tentama et al., 2020).. Stunting is often viewed solely as a nutritional and physical health problem for mothers. However, parenting practices more broadly significantly influences a child's growth and development. For example, a mother's caregiving, affection, attachment-building behavior, food choices, and efforts to maintain the child's health, all play crucial roles in contributing to children’s wellbeing. In previous studies, scholars have demonstrated that PSE significantly enhances the resilience of parents with special needs children (Pranindita & Ayriza, 2019). Considering the conceptual similarities between resilience and grit, both are anticipated to be influenced by PSE; however, the specific relationship between PSE and grit warrants thorough exploration and this research deepens our knowledge in this a novel area of study.

Methods

Participants

Samples for this research include mothers with stunted children presiding in Banyumas Regency, Central Java, Indonesia. Participant sampling was conducted in collaboration with parties who monitor and evaluate stunted children, namely the Population Control, Family Planning, Women's Empowerment, and Child Protection Service (DPPKBP3A) of Banyumas Regency and Posyandu, who operate integrated health service posts at the stunting locus of Banyumas Regency. Sampling was taken using convenience sampling techniques based on recommendations from related parties and mothers who had a voluntary willingness to participate in this study. Demographic information and informed consent were requested from participants. Participation in the study was voluntary and subjects completed consent forms before fulfilling the demographic information and scales.

The government has established integrated health service posts, known as Posyandu, to address maternal health issues. It is one of the types of UKBM (Community-Based Health Efforts) that is organized and executed by the community to implement health development initiatives. Its intention is to empower the community, provide access to essential health services, and support a rapid reduction in maternal and infant mortality rates. Working within this integrated health service, members of the community, referred to as cadres, volunteer to organize and manage Posyandu events, and more broadly contribute their time, abilities, and demonstrate an ongoing willingness to contribute to the aims of the UKBM. Health professionals support these cadres by offering services such as pregnancy tests and vaccination injections, which the cadres are not qualified to perform on their own (Hayuningtyas et al., 2019; UNICEF, 2020). This governmental program reflects the ongoing and necessary effort to support a comprehensive and coordinated approach to enhance the quality of maternal health services through the optimization of a range of programs and policies, as well as the coordination of the cross-sectoral contributions of various stakeholders including the UKBM.

Researchers contacted local Posyandu cadres to request further recommendations for participants who fit the criteria after DPPKBP3A provided recommendations for stunting loci in Banyumas Regency. They verified the participants in-person and distributed the prepared scale after gathering information on the candidates who qualified for participation. A total of 40 people completed the informed consent and research scale voluntarily. Although, three participants' provided incomplete data, the remaining 37 were included in the analysis. As a research data, the minimum sample size is 30 to be statistically sound. Samples larger than 30 increase precision (Gravetter & Wallnau, 2011). Following the completion of the scale, five participants willingly shared their experiences and feelings regarding raising their children in a series of follow-up sessions that included an in-depth interview. The aim of the interview was to broaden the context of the study, deepen an understanding of the problem and strengthen the results of the findings.

Instruments

In addition to the respondent's demographic data, this research uses two scales:

1. The parenting self-efficacy scale employs an ordered reference standard from Anugrah and Wahidah (Anugrah et al., 2024), which is an adaptation of the Self-Efficacy for Parenting Tasks Index (SEPTI) scale in Indonesian and has been used in Pranindita and Ayriza's research regarding parenting self-efficacy in parents of children with special needs in Indonesia (Pranindita & Ayriza, 2019). Examples of measurement items employed: "I believe that I can meet my child's needs so that my child feels safe"; "I feel my child has received love from me"; and "I always have ideas and education for playing with children". The Cronbach's α reliability value for this measuring instrument is 0.873, consisting of 20 items.

2. The grit scale is an adaptation of the ordered reference standard from Duckworth and Baraquia (Baraquia, 2020) and Nastiti (Nastiti et al., 2022) specifically tailored to assess for grit in the context of caring for stunted children. Examples of measurement items employed: "I always seriously try to make my child a healthy child"; “The challenges/difficulties I encountered as a mother made me a weak person" and "I try hard to solve challenges with various alternative solutions". It is known that the Cronbach's α reliability value for this measuring instrument is 0.755, totaling 15 items.

For both measuring instruments, four answer choices will be given, points 1-4, indicating strongly disagree (1) to strongly agree (4). Respondents will be asked to choose one of the answer options that best suits their condition.

Data analysis

Processed by using Jamovi tools, the research approach is quantitative, using descriptive and correlational studies with cross-sectional studies. Data analysis techniques include mean, median, cross-tabulation, correlation, and simple regression.

Results

The following processed data illustrates the distribution of demographic data, descriptive data, and correlation results obtained, as detailed in Tables 1, 2, and 3.

Table 1

Participant Demographic Data

Based on participant demographic data in Table 1, all participants were female and married. The ages vary from 26 years to more than 40 years. The majority were still in their productive years; 31-35 years (29.7%). More than half of the participants' furthest education achieved was high school graduation (56.8%). Most of the children looked after by the participants were around two years old (35.1%). Almost all children were born at an average gestational age of 9 months (91.9%) with growth and development all within the normal range; for example, most children sat at eight months (40.5%) and walked at 12 months (32.4%).

Table 2

Group Descriptives

Table 2 presents descriptive data based on recent education. It indicates that mothers with a bachelor's degree had the highest average measures of grit. In contrast, mothers with a junior high school education had the lowest average grit, followed by mothers with elementary and high school education. Likewise, parenting self-efficacy, mothers with a bachelor's degree had the highest average while mothers with high school education were at the lowest level, followed by mothers with elementary and middle school education. In other words, mothers with a bachelor's degree obtained the highest mean grit and PSE, and the lowest was junior high school. Furthermore, the Shapiro-Wilk normality test found that the data was normally distributed at p=0.160 (p > 0.05).

Table 3

Correlation Matrix

The correlation test results in Table 3 illustrate that maternal education significantly correlates negatively with maternal age (r= -0.397*; p<0.05). It means that the older the mother, the lower her education. And conversely, the younger the mother, the higher her education. Additionally, the child's age is significantly positively correlated with the mother's age (r= 0.348; p< 0.05), which means that the older the mother, the older the child, and vice versa. Regarding maternal education, the higher the mother's education, the younger the child's age (r= -0.376; p<0.05). Highly educated participants tended to have younger children. Another significant correlation was found in the positive correlation between grit and parenting self-efficacy (r= 0.488; p<0.05). Therefore, the higher the grit the participants had, the higher their parenting self-efficacy, and vice versa. Furthemore, neither parenting self-efficacy nor grit correlated with participant demographics. Other demographic data obtained provided no further significant correlational evidence.

In Table 4, presents processed regression test data pertaining to the role of parenting self-efficacy on grit and exhibits the existence of a significant influence model (F= 10.9; p<0.05). The test of collinearity statistics PSE on grit showed that VIF and tolerance values both were 1.00. Therefore, there are no symptoms of multicollinearity because the tolerance value is > 0.10 and the VIF value is < 10.00. Furthermore, adjusted R²= 0,216 means parenting self-efficacy contributes 21.6% to grit.

Table 4

Regression Analysis Test Results

The results of this study confirm that mothers with high parenting self-efficacy tend to feel optimistic when assessing the challenges of parenting. Subjects in this dimension report persistence and diligence in parenting even when encountering difficulties and remains confident in their abilities. The correlation between PSE and grit was 0.488, which can be classified as quite strong. The closer it gets to 1, the stronger the correlation (Gravetter & Wallnau, 2011). Meanwhile, PSE's contribution to grit is 21.6%.

Discussion

Parenting could be more complex and challenging, especially for children experiencing delays in growth and development, such as physical or socio-emotional delays. Parents have high expectations for their children's future, but these expectations may not align with reality when their children have special conditions, needs, or problems (Pranindita & Ayriza, 2019), including children with health problem such as stunting. In response to these challenges, the effect of grit can positively contribute to parenting and child development (Teuber et al., 2021). To overcome developmental challenges, parents would benefit from developing grit which fosters perseverance, consistency, and enthusiasm in reaching their parental objectives (Teuber et al., 2021). Based on interview data, participants often expressed feeling sad, tired, and a sense of failure as mothers. For instance, they experienced these emotions when their child was sick, had tantrums, lacked the desire to eat, or when they felt unable to provide good parenting or effectively guide their child’s behaviour. To overcome these challenges, mothers may employ several methods, including managing their emotions to remain calm and patient, exploring new strategies such as varying food menus, seeking new information related to parenting, and providing advice while serving as a role model for their children.

Perseverance and adaptability in pursuing parenting objectives may allow parents to interact with their children in a manner that is both appropriate and adaptive. In other words, the more self-confidence they have in supporting their children, the more responsive they tend to be. Furthermore, these parents are less likely to experience fatigue related to their parenting. Consequently, the presence of grit among these parents over the long-term contributes positively to child developmental outcomes (Teuber et al., 2021). Environment and family are essential in the development of a child. High achieving children tend to be raised by parents who exhibit grit and motivation. Additionally, grit is a factor that positively impacts parents' subjective well-being (Du et al., 2023).

Interview data indicated that those mothers who practiced positive parenting, such as played, sang, hugged, and kissed their children lovingly. They communicated, provided comfort and security, gave directions, read stories, and provided nutritionally balanced food.​ Teti and Gelfand (1991) confirmed a strong correlation between PSE and parental ability to nurture a child. High PSE found correlated with the practice of effective nurturing, while a low PSE corresponded with rearing strategies lacking in parental​ capability and effectiveness. Other scholars have found that mothers with high PSE tend to be more sensitive to their children (Leerkes & Crockenberg, 2002). Additional Pranindita and Ayriza (2019) found that self-efficacy is predictor in positive parenting performance. They found that by creating a safe, enjoyable, and caring environment, parents that have high self-efficacy parenting will demonstrate positive parenting behaviours.

A mother who gets support will help reduce the psychosocial risk in children (Arimoto & Tadaka, 2023; Teti & Gelfand, 1991). Emotional and instrumental support from friends and family is also found to influence PSE. The more support received, the more the mother's PSE rise. Conversely, mothers who do not have enough support and feels unvalued as a parent is more prone to feel isolated, disinclined to nurture their children and feel burdened with their parental role, whereas, mothers who receive support even from non-relatives are found to be more capable in their efforts to overcome difficulties pertaining to their parenting. Consistent with this observation, participants in this research expressed feeling immensely helped by the support from their husbands and family members including parents, older brothers, sisters, and, in one instance, an oldest child. Previous research also found that high PSE was correlated with lower reported feelings of loneliness and a stronger social network among mothers raising toddlers in Japan (Arimoto & Tadaka, 2023).

Some studies define grit as encompassing a broad set of traits attributed to resilience or other motivational variables, including self-efficacy. However, Fernández-Martín et al. (2023) assert that grit contributes to a unique and pronounced focus on pursuing long-term, higher-level goals which elicits distinct goal-achievement strategies. Self-efficacy is not only a central concept in understanding individual interactions with the environment, but it also mediates the relationship between knowledge and behavior, directs actions, and impacts individual performance. For example, individuals who understand how to entertain children may be unable to do so because of self-doubt. On the other hand, people with self-efficacy will try to do so (Teti & Gelfand, 1991). Some evidence suggests that the capacity to foster autonomy in their children, provide support, warmth, and parental guidance are parenting dimensions that reflect the presence of grit (Fernández-Martín et al., 2023). Therefore, parents who possess parenting self-efficacy will foster beliefs, attitudes, and behaviours that encourage the development of grit in relation to their parenting.

A previous study claimed that parenting self-efficacy is a predictor of resilience in the parents of children with special needs attending inclusive schools (Pranindita & Ayriza, 2019). The strength and potential of protective mechanisms that foster resilience in this population are not as well understood. When parents have children with special needs, their self-confidence can strengthen their resilience. Developing inner resilience involves communication, mutual support, and adjustment to the unique needs of these children. Additionally, strong parental resilience can contribute to helping prevent children's behavioural and academic challenges in school by actively involving parents in their children's upbringing (Pranindita & Ayriza, 2019). Results in this study indicate that the self-efficacy of parents contributes to the development of positive parental grit. Parents can harness self-efficacy, self-confidence, and resilience to strengthen their grit in parenting. Beliefs in one’s abilities, self-confidence, and goal attainment play a pivotal role in self-adjustment and finding meaning in life, particularly in the face of negative experiences. Moreover, confidence in one's abilities is a key factor in achieving goals, and when combined with perseverance, it enables individuals to interpret life events in a positive and optimistic manner, thereby maintaining their grit (Wahidah & Royanto, 2019).

The statistical findings from this study reveal that neither parenting self-efficacy nor grit are related to participant demographics. Therefore, there are no cultural or social criteria that uniquely define mothers who have stunted children and who exhibit high levels of parenting self-efficacy and grit. Evidently, any mother, regardless of background, can respond to her children's problems with self-efficacy and the development of grit. In addition, a systematic review of studies indicates links between child temperament, maternal parenting satisfaction, parenting stress, maternal depression, household income, perceived social support, and PSE. However, evidence concerning the influence of educational level, parity, and the number of children on maternal PSE is inconsistent. No significant relationships were found between child gender, age, parental marital status, or factors such as ethnicity, employment status, and parenting fatigue with PSE in mothers and fathers (Fang et al., 2021)

This study focuses on mothers with child stunting. In the process of collecting data, identifying the specific characteristics that define undernourished or child stunting in the field can be challenging due to strict criteria based on physical conditions, levels of nutrition, and other criteria. The Posyandu cadres, who play a crucial role in this research, also explained that detecting and identifying stunted children caused by physical problems such as short stature and being underweight, is more discernible than in cases where child stunting is due to nutritional problems. They also said that children who experience stunting have several characteristics that are difficult to understand and identify when operating within the parameters of current government health practice regulations. Therefore, the participants in this study are mothers with children who show stunted growth based on physical problems. Stunting is measured by a height-for-age z-score of more than 2 standard deviations below the World Health Organization (WHO) child growth standards median and indicate a restriction in a child’s potential growth. Moreover, child stunting occurring in the first thousand days after conception can be related to many factors, including socioeconomic status, diet, infections, maternal nutritional status, infectious disease, micronutrient deficiencies and the environment (World Health Organization, 2018). A potential limitation of this study may be that the participating subjects do not have children classified as stunted according to government criteria.

Conclusion

The purpose of this study is to determine whether PSE has an influence on the presence of grit exhibited by mothers of children with stunting. The study findings highlight the significant role of parenting self-efficacy (PSE) in fostering grit, particularly in mothers. While the current study does not fully capture the experiences of mothers with undernourished children, it lays the groundwork for future research on mothers who have stunted children due to malnourishment by shedding light on the early relationship between PSE and grit. As far as can ascertained, research concerning this topic in Indonesia is rare. The study can be replicated and expanded to include additional populations, variables, and other factors that could support mothers in nurturing stunted children from a psychological and parenting perspective.

Limitations

This research could be further enhanced if it were replicated in other areas in Indonesia and conducted with a larger sample size to ensure the generalization of results. The current study results were obtained in one of the small regencies among the Indonesian archipelago, which implies limited access and sample data. Moreover, this study did not examine the socioeconomic status background that might influence child stunting. Socioeconomic status, defined as an individual’s access to social and economic resources, is usually determined by educational level, income, and occupation (World Health Organization, 2018). However, the demographic data in this study only accounted for the mother's education.

Ethics Statement

Ethical approval was obtained from the Faculty of Psychology at Universitas Muhammadiyah Purwokerto, reference number C.9-VIII/562-S.PhI/III/2024. Before completing the questionnaires, participants provided their informed consent, acknowledging their voluntary participation after receiving full information about the study. Additionally, participants were assured that they could withdraw their participation at any time.

Author Contributions

FRNW, PR, and ADA designed and directed the project; FRNW, PR, SW, and CHK developed the theoretical framework; FRNW, ADA, IP performed the experiments and performed the analysis; FRNW, IP, and ADA drafted the manuscript; PR, SW, CHK aided in interpreting the results and worked on the manuscript. All authors discussed the results and contributed to the final manuscript.

Conflict of Interest

The authors declare no conflict of interest.

Funding

This research obtained funding from Funding and Implementation of Muhammadiyah National Research Grant Batch VII 2024. Number: 0258.828/I.3/D/2024

Acknowledgements

This research is a grant from the RisetMu Program by Council Diktilitbang PP Muhammadiyah Batch VII in 2024. Thank you to all participants, RisetMu PP Muhammadiyah, and LPPM Universitas Muhammadiyah Purwokerto.

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