Abstract
BACKGROUND: Stunting remains a major public health issue in Indonesia, and the limitations of anthropometric measures highlight the need for alternative tools such as the Child Development Card (KKA). OBJECTIVES: This study aimed to determine the validity and reliability of the KKA as a tool to measure the growth and development of stunted and normal children through direct observation. METHODS: The revised KKA was administered to 262 children aged 13-60 months, including 174 normal and 88 stunted children, from three stunting-locus regencies in West Java Province, Indonesia. The data were analysed using content validity, the Guttman coefficient of reproducibility, and Cronbach alpha to develop a revised KKA observation guideline. RESULTS: A total of 15 conceptually inappropriate items were revised, and an observation guideline was developed as a guide for the direct observation of children. In each aspect of growth and development, age range, and sample category, the reproducibility and scalability coefficients showed values of >0.9 and >0.6, respectively. Meanwhile, Cronbach alpha values for each age range and sample category were >0.7. CONCLUSION: The revised KKA demonstrated both validity and reliability as a tool for the detection, monitoring, and early intervention of growth and developmental delays in children with stunted as well as those with normal development.