Stigma, Literacy and Family Resilience in Childhood Stunting: Insights from a Systematic Review (2019–2024)

Abstract

Aims: To analyze the relationship between literacy, community education, and family resilience in managing social stigma associated with childhood stunting through systematic literature review and bibliometric analysis. Study Design: Systematic literature review with bibliometric analysis. Place and Duration of Study: Analysis of international publications indexed in academic databases, covering the period between 2019 and 2024. Methodology: A comprehensive systematic literature review was conducted using the keywords "stigma management," "communication," "stunting," and "family resilience." Publications from 2019 to 2024 were systematically searched and screened across multiple databases. Twenty-eight articles met the inclusion criteria and were analyzed using VosViewer software for bibliometric mapping and visualization. Overlay visualization identified temporal trends and thematic shifts in the research landscape. Results: The analysis identified four major thematic clusters: (1) community literacy and health communication, (2) stigma management strategies, (3) family coping mechanisms, and (4) social support systems. Overlay visualization revealed a temporal shift in research focus, with studies from 2022-2024 showing stronger linkages between stigma management, stunting, and family resilience compared to earlier publications. Community literacy emerged as a foundational factor that enhances health communication effectiveness and enables families to navigate stigma through improved understanding of stunting causes and prevention. Health education programs that build community knowledge were associated with reduced stigma and strengthened family resilience. However, while stigma research has predominantly originated from mental health literature, the intersection of stunting-related stigma and family resilience remains underexplored, with limited empirical evidence on intervention effectiveness. Conclusion: This bibliometric analysis reveals significant research gaps in understanding how community literacy and health education strengthen family resilience against stunting-related stigma. The emerging research trends suggest a paradigm shift toward integrated approaches considering social determinants and family dynamics. Findings indicate that literacy and education function as protective factors by improving families' capacity to understand, communicate about, and cope with stunting-related challenges. However, further empirical research is urgently needed to develop evidence-based interventions that can inform health educators, policymakers, and community programs seeking to reduce stigma barriers and strengthen family resilience in stunting prevention and management efforts.