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Praktik pemberian makanan pendamping ASI (MP-ASI) bukan faktor risiko kejadian stunting pada anak usia 6-23 bulan Hildagardis M.E Nai; I Made Alit Gunawan; Esti Nurwanti
Jurnal Gizi dan Dietetik Indonesia (Indonesian Journal of Nutrition and Dietetics) VOLUME 2, NOMOR 3, SEPTEMBER 2014
Publisher : Alma Ata University Press

ABSTRACTBackground: Stunting reflects a process of failure to reach linear growth potential as a result of suboptimal health or nutrition conditions. One of causal factors of stunting is inadequate of quality and quantity of complementary foods.Objectives: To identify complementary feeding practices such as introduction age of complementary foods, dietary diversity, and meal frequency as risk factors of stunting among children aged 6-23 months in Sedayu Subdistrict, Bantul, Yogyakarta.Methods: Study design was case-control with ratio (1:1). The study used both quantitative methods as well as case control design and qualitative through interview. Cases were children aged 6-23 months who had length for age z-score <-2SD. Controls were children aged 6-23 months who had length for age z-score ≥-2SD who live adjacent to the case. Data were analyzed by using univariable (descriptive), bivariable (chi-square test), and multivariable analysis (multiple logistic regression).Results: The result of bivariate analysis showed that introduction age of complementary foods (OR=1.07), dietary diversity (OR=1.17), and meal frequency (OR=1.69) were not risk factors of stunting. However, compared with high dietary diversity score, low dietary diversity score (≤2, 3, 4 food groups) associated with increased odds of being stunted among children aged 6-23 months (OR=2.24, 95% CI:1.00-5.01, OR=1.82, 95% CI:0.96-3.45, OR=1.66, 95% CI:0.81-3.46 respectively). The result of multivariate analysis showed that mother’s height (OR=1.86) and story of low birth weight (OR=3.23) were risk factors of stunting.Conclusions: Complementary feeding practices such as age introduction of complementary foods, dietary diversity, and meal frequency were not risk factors of stunting among children aged 6-23 months. Mother’s height and story of low birth weight were risk factors of stunting among children aged 6-23 months.KEYWORDS: stunting, nutritional intake, nutritional status, complementary foods ABSTRAKLatar belakang: Stunting merefleksikan kegagalan proses mencapai potensi pertumbuhan linear sebagai akibat dari kondisi kesehatan dan gizi yang tidak optimal. Salah satu penyebab kejadian stunting adalah kuantitas dan kualitas MP-ASI yang rendah.Tujuan: Untuk mengidentifikasi risiko praktik pemberian MP-ASI seperti usia pengenalan MP-ASI, keragaman MP-ASI, dan frekuensi MP-ASI dengan kejadian stunting pada anak usia 6-23 bulan di Kecamatan Sedayu, Bantul, Yogyakarta.Metode: Rancangan penelitian ini adalah kasus-kontrol dengan perbandingan 1:1 dan menggunakan pendekatan kuantitatif-kualitatif model concurrent embedded. Kasus adalah anak usia 6-23 bulan yang memiliki skor-z PB/U <-2SD. Kontrol adalah anak usia 6-23 bulan yang memiliki skor-z PB/U ≥-2SD yang tinggal berdekatan dengan kelompok kasus. Analisis data menggunakan analisis univariat (deskriptif), bivariat (uji chi-square) dan multivariat (uji regresi logistik berganda).Hasil: Analisis bivariat menunjukkan usia pengenalan MP-ASI (OR=1,07), keragaman MP-ASI (OR=1,17), dan frekuensi pemberian MP-ASI (OR=1,69) bukan faktor risiko kejadian stunting (p>0,05). Skor keragaman MP-ASI yang lebih rendah (kelompok makanan ≤2, 3, 4) berhubungan dengan peningkatan risiko kejadian stunting berturut-turut OR=2,24, 95% CI:1,00-5,01; OR=1,82, 95% CI:0,96-3,45; OR=1,66, 95% CI:0,81-3,46. Analisis multivariat menunjukkan faktor risiko kejadian stunting adalah tinggi badan ibu (OR=1,86) dan riwayat berat badan lahir rendah (BBLR) (OR=3,23,).Kesimpulan: Praktik pemberian MP-ASI seperti usia pengenalan, keragaman, dan frekuensi pemberian MP-ASI bukan merupakan faktor risiko kejadian stunting pada anak usia 6-23 bulan. Faktor risiko kejadian stunting pada anak usia 6-23 bulan yang bermakna adalah tinggi badan ibu dan riwayat BBLR.KATA KUNCI: stunting, asupan makan, status gizi, MP-ASI

Studi ketidakaktifan kader posyandu di Wilayah Kerja Puskesmas Paramasan, Banjar, Kalimantan Selatan Muhammad Ali Akbar; BJ Istiti Kandarina; I Made Alit Gunawan
Jurnal Gizi dan Dietetik Indonesia (Indonesian Journal of Nutrition and Dietetics) VOLUME 3, NOMOR 1, JANUARI 2015
Publisher : Alma Ata University Press

ABSTRACTBackground: Integrated health post is a community empowered health service that also supported by health workers. Cadres are the drive motor of integrated health post. Inactivity of cadres influence the continuity of integrated health post and affect nutritional status early detection of infants and childrenunderfive. Paramasan Primary Health Care is a region in Banjar Regency that has the highest inactivity cadres level (54.5%).Objectives: To examine the knowledge of cadres, comprehensiveness of facilities and infrastructure at integrated health post, head of village and health workers support, incentives and awards, and community participation as the background of integrated health post cadres inactivity in Banjar Regency, SouthKalimantan.Methods: This was a descriptive research with qualitative methods using a case study design. The research was implemented in the Region of Paramasan Primary Health Cares at Banjar Regency, South Kalimantan in April until May 2014. Informants were selected by purposive sampling until get saturateddata. The data collection was done by using 3 methods: in-depth interview of 23 informants, focus group discussion (FGD) of 30 informants, and field observation. Data analysis used in this study was constant comparative method.Results: Cadres had very low knowledge never joined any training, and also illeterate. The facilities and infrastructure in integrated health post were very limited. Head of village support on cadres and integrated health post were also low. Unscheduled and unstable of incentive numbers and awards received bycadres was also a problem. The level of community participation was really depended on the activeness of cadres in reminding the schedule of integrated health post activities.Conclusions: The knowledge of cadres contibuted to the cadres inactivity, such as a poor participation and lack of confidence in attending the activities of the integrated health post.KEYWORDS: cadres, inactivity, integrated health postABSTRAKLatar belakang: Posyandu merupakan wadah pelayanan kesehatan dari, oleh, dan untuk masyarakat dengan dukungan petugas kesehatan. Kader merupakan motor penggerak posyandu. Tidak aktifnya kader menyebabkan ketidaklancaran pelaksanaan posyandu serta tidak terdeteksinya status gizi bayi dan balita sejak dini. Puskesmas Paramasan merupakan salah satu wilayah di Kabupaten Banjar dengan tingkat ketidakaktifan kader tertinggi yaitu sebesar 54,5%.Tujuan: Mengkaji secara mendalam pengetahuan kader, kelengkapan sarana dan prasarana posyandu, dukungan kepala desa dan petugas kesehatan, insentif dan penghargaan kader, serta partisipasi masyarakat ke posyandu sebagai latar belakang ketidakaktifan kader posyandu.Metode: Penelitian ini merupakan penelitian deskriptif dengan metode kualitatif menggunakan rancangan studi kasus. Pelaksanaan penelitian di wilayah kerja Puskesmas Paramasan Kabupaten Banjar Provinsi Kalimantan Selatan pada bulan April hingga Mei 2014. Informan dipilih secara purposive sampling, berlanjut hingga saturasi data. Pengumpulan data dilakukan dengan wawancara mendalam terhadap 23 orang informan, diskusi kelompok terfokus (DKT) terhadap 30 orang informan, dan observasi lapangan. Analisis data menggunakan metode constant comparative method.Hasil: Kader memiliki pengetahuan kurang, tidak pernah mengikuti pelatihan, dan tidak bisa baca tulis. Sarana dan prasarana di posyandu sangat kurang, demikian pula dengan dukungan kepala desa terhadap kader, dan posyandu yang tergolong masih minim. Insentif dan penghargaan yang diterima kader dikategorikan tidak rutin dengan jumlah tidak tetap. Tingkat partisipasi masyarakat ke posyandu masih tergantung pada keaktifan kader dalam mengingatkan tentang hari buka posyandu.Kesimpulan: Pengetahuan kader memberikan kontribusi terhadap ketidakaktifan kader yaitu kurangnya keaktifan dalam menghadiri kegiatan di posyandu.KATA KUNCI: kader, ketidakaktifan, posyandu

Tingkat ketahanan pangan rumah tangga dengan status gizi balita di daerah rawan pangan Kabupaten Indramayu Slamet Rohaedi; Madarina Julia; I Made Alit Gunawan
Jurnal Gizi dan Dietetik Indonesia (Indonesian Journal of Nutrition and Dietetics) VOLUME 2, NOMOR 2, MEI 2014
Publisher : Alma Ata University Press

ABSTRACTBackground: Nutrition is the main pillar of health and welfare of human’s life cycle. The building of quality human resources that are healthy, smart and productive depends on numerous factors; one most essential is the fulfillment of nutritious food. Food security is a problem that has become topic of discussion because it is related to human right and development of human resources.Objectives: To analyze association between level of food security in the household and nutritional status of underfives.Methods: The study used analytical observational approach with cross-sectional design. Population of the study were households at high risk food scarcity area of Indramayu District that had underfives. Subject of the study that became part of the population were underfives of 24-60 months old. Samples were taken randomly, comprising 160 underfives. Data analysis was made in stages using statistical test to prove the hypothesis. The test used univariate with frequency distribution, bivariate with chi-square and Mantel-Haenzel and multivariate with logistic correlation regression.Results: There was signifi cant association between food security of the household and nutrition status of underfives OR=9.5 (CI 95%) and p<0.0001.Conclusions: There was significant association between level of food security of the household and nutritional status of underfives.KEYWORS: food security, household, underfives, nutritional statusABSTRAKLatar belakang: Gizi adalah pilar utama dari kesehatan dan kesejahteraan sepanjang siklus kehidupan. Terbentuknya sumber daya manusia yang berkualitas, yaitu sumber daya manusia yang sehat, cerdas, dan produktif ditentukan oleh berbagai faktor. Salah satu faktor yang sangat esensial adalahterpenuhinya kebutuhan pangan yang bergizi. Ketahanan pangan merupakan salah satu permasalahan yang menjadi agenda pembicaraan karena berkaitan dengan hak azasi manusia, pembangunan sumber daya manusia.Tujuan: Menganalisis hubungan antara tingkat ketahanan pangan rumah tangga dengan status gizi anak balita.Metode: Penelitian ini adalah penelitian analitik dengan jenis penelitian observasional dan rancangan penelitian cross sectional (potong-lintang). Populasi penelitian adalah rumah tangga di daerah rawan pangan Kabupaten Indramayu yang memiliki balita. Subjek penelitian yang merupakan bagian daripopulasi adalah anak balita usia 24-60 bulan. Cara pengambilan sampel dalam penelitian ini dengan menggunakan simple random sampling. Besarnya sampel dalam penelitian ini adalah 160 anak balita. Analisis data dilakukan secara bertahap, yaitu analisis data dilakukan dengan uji statistik untuk membuktikan hipotesis penelitian. Teknik uji statistik yang digunakan adalah univariat dengan distribusi frekuensi, bivariat dengan kai-kuadrat, stratifi kasi-Mantel-Haenszel, sedangkan multivariat dengan regresi korelasi logistik.Hasil: Ketahanan pangan tingkat rumah tangga dengan status gizi anak balita memiliki hubungan yang bermakna dengan OR=9,5 (CI 95%) dan p<0,0001.Kesimpulan: Terdapat hubungan yang bermakna antara tingkat ketahanan pangan rumah tangga dengan status gizi balita.KATA KUNCI: ketahanan pangan rumah tangga, status gizi, anak balita

Pemberian paket gizi masyarakat proyek NICE berpengaruh terhadap kinerja posyandu, tetapi tidak meningkatkan status gizi balita di Provinsi NTB Solikin Solikin; Kristiani Kristiani; I Made Alit Gunawan
Jurnal Gizi dan Dietetik Indonesia (Indonesian Journal of Nutrition and Dietetics) VOLUME 2, NOMOR 1, JANUARI 2014
Publisher : Alma Ata University Press

ABSTRACTBackground: The province of NTB had the prevalence of underweight 30.5% in 2010 for children under five, this figure is above the national prevalence. A nutrition improvement through community empowerment (NICE) has been developed aimed to supporting community nutrition service to overcome nutrition and health problem independently. One of the programs is CNP (community nutrition package) which got the highest fund allocation compared to other NICE program.Objectives: To evaluate the effect of CNP supplementation in NTB Province to the increase of nutritional status of children under five through index of weight by age and performance of posyandu.Methods: The study was evaluative with quantitative and qualitative method and one group pre and post test design, from January to April 2012 at 4 districts/ municipalities area of NICE Project, comprising 72 villages/cities that received CNP in 533 posyandu with 7,975 of children under fives. Posyandu’s performance was measured by baseline data collection for NICE project questionairre, weight measured by scale, and indepth interview was made to individuals administering CNP before and after receiving the package. Samples were randomly selected. Data analysis used paired t-test.Results: There was significant difference in performance of posyandu (p< 0.001, 95% CI: 9.88-11.05) and nutritional status of children under five based on index of weight/age (p<0.001, 95% CI: -1.23 to -1.32) before and after CNP supplementation. CNP supplementation increased performance of posyandu, but did not increase the nutritional status of children under five (index of weight/age). There were supporting factors of community nutrition supplementation such as human resources, participation across sectors, villages and community/religious leaders and integration with other programs (PNPM-Mandiri, GSC, local budget).Conclusions: CNP supplementation affected performance of posyandu but did not increase nutritional status of children under five at Province of NTB in 2011.KEYWORDS: NICE project, nutritional status, performance of posyandu, children under fiveABSTRAKLatar belakang: Provinsi Nusa Tenggara Barat memiliki prevalensi balita underweight di atas prevalensi nasional, yaitu sebesar 30,5 persen tahun 2010. Proyek perbaikan gizi NICE (nutrition improvement through community empowerment) dikembangkan melalui pemberdayaan masyarakat untuk mendukung pelayanan gizi masyarakat. Salah satu programnya adalah paket gizi masyarakat (PGM) yang mendapat alokasi dana paling tinggi dibanding proyek NICE yang lain.Tujuan: Mengevaluasi pengaruh pemberian PGM di Provinsi NTB terhadap peningkatan status gizi balita indeks berat badan menurut umur dan kinerja posyandu.Metode: Penelitian ini merupakan penelitian evaluatif menggunakan metode kuantitatif dan kualitatif pada bulan Januari sampai dengan April 2012. Penelitian menggunakan rancangan one group pre and post test design. Penelitian dilaksanakan di 4 kabupaten/kota wilayah NICE mencakup 72 desa/kota yang mendapat PGM dengan jumlah posyandu sebanyak 533 dan 7.975 balita. Pengukuran kinerja posyandu menggunakan kuesioner yang diadopsi dari baseline data collection for NICE project, pengukuran berat badan menggunakan dacin dan indepth interview dilakukan pada pengelola PGM sebelum dan sesudah PGM. Pemilihan subjek penelitian dilakukan secara simple random sampling. Analisis data menggunakan paired t-test.Hasil: Terdapat perbedaan bermakna kinerja posyandu (nilai p<0,001, 95% CI: 9,885763-11,05232) dan status gizi balita menurut indeks BB/U (nilai p< 0,001, 95% CI: -1,233254-1,321063) antara sebelum dan sesudah pemberian PGM. Kinerja posyandu meningkat setelah pemberian PGM, namun belum mampu meningkatkan status gizi balita (indeks BB/U) di Provinsi NTB tahun 2011. Terdapat faktor pendukung pemberian PGM di antaranya kualitas sumber daya manusia (SDM) kelompok gizi masyarakat (KGM), keterlibatan lintas sektor, desa/ kelurahan, dan tokoh masyarakat/agama serta keterpaduan program lainnya (PNPM-Mandiri, GSC, dana daerah).Kesimpulan: Pemberian paket gizi masyarakat berpengaruh terhadap kinerja posyandu tetapi belum mampu meningkatkan status gizi balita di Provinsi NTB tahun 2011.KATA KUNCI: proyek NICE, status gizi, kinerja posyandu, balita

Pemberian ASI eksklusif tidak berhubungan dengan stunting pada anak usia 6–23 bulan di Indonesia Bunga Astria Paramashanti; Hamam Hadi; I Made Alit Gunawan
Jurnal Gizi dan Dietetik Indonesia (Indonesian Journal of Nutrition and Dietetics) VOLUME 3, NOMOR 3, SEPTEMBER 2015
Publisher : Alma Ata University Press

ABSTRACTBackground: Stunting in children is one of public health problem in Indonesia. Stunting is a serious problem because it is linked with the quality of human capital in future. Objectives: To determine the association between exclusive breastfeeding practice and stunting in young children 6 – 23 months in Indonesia.Methods: This study used a cross-sectional design. Data was obtained from Basic Health Research (Riskesdas) 2013. Riskesdas 2013 used multistage cluster sampling. Subject in this study was 6.956 young children 6 – 23 months in Indonesia which was selected purposively. Data was analyzed by using descriptive analysis, chi-square, and multiple logistic regression by adjusting the sampling weight for survey analysis.Results: Exclusive breastfeeding was protective against stunting, but the result was not significant both for exclusive breastfeeding >6 months (OR=0,99, 95% CI: 0,63–1,59) and exclusive breastfeeding 4-<6 bulan (OR=0,93, 95% CI: 0,63–1,39). Young children with low birth weight history had higher risk to become stunting (OR=1,77, 95% CI: 1,33–2,37). Household economic status which were very poor (OR=1,96, CI: 1,53–2,52), poor (OR=1,62, 95% CI:1,30–2,03) and middle (OR=1,32, 95% CI: 1,06–1,64) were also associated with the risk of stunting.Conclusions: Exclusive breastfeeding is not the only factor contributing to stunting in children. Optimal complementary feeding practice should also be the focus of intervention. Improvement in nutritional status since the preconception and during the pregnancy, and household economy status may reduce stunting problem in children.KEYWORDS: stunting, exclusive breastfeeding, feeding practice, growth ABSTRAKLatar belakang: Stunting pada anak-anak merupakan salah satu masalah kesehatan masyarakat yang utama di Indonesia. Stunting menjadi masalah yang serius karena dikaitkan dengan kualitas sumber daya manusia di kemudian hari.Tujuan: Untuk mengetahui hubungan antara praktik pemberian ASI eksklusif dan stunting pada anak usia 6 – 23 bulan di Indonesia.Metode: Desain penelitian ini adalah cross-sectional. Data didapatkan dari hasil riset kesehatan dasar (Riskesdas) 2013. Teknik pengambilan sampel pada Riskesdas 2013 adalah multistage cluster sampling. Subjek pada penelitian ini berjumlah 6.956 anak usia 6 – 23 bulan di Indonesia yang dipilih secara purposive. Data dianalisis dengan menggunakan analisis deskriptif, chi-square dan regresi logistik berganda dengan mempertimbangkan sampling weight untuk analisis survei.Hasil: ASI eksklusif bersifat protektif terhadap kejadian stunting pada anak, namun hasilnya tidak signifikan, baik untuk ASI eksklusif >6 bulan (OR=0,99, 95% CI 0,63–1,59) maupun ASI eksklusif 4-<6 bulan OR=0,93, 95% CI: 0,63–1,39). Anak yang lahir dengan berat badan lahir rendah (BBLR) memiliki risiko yang lebih tinggi untuk menjadi anak yang stunting (OR=1,77, 95% CI: 1,33–2,37). Status ekonomi rumah tangga sangat miskin (OR=1,96, 95% CI: 1,53–2,52), miskin (OR=1,62, 95% CI: 1,30–2,03) danmenengah (OR=1,32, 95% CI: 1,06–1,64) masing-masing berkontribusi terhadap peningkatan risiko stunting pada anak.Kesimpulan: ASI eksklusif bukanlah satu-satunya faktor yang berkontribusi terhadap kejadian stunting pada anak. Pemberian MPASI yang optimal juga harus diperhatikan. Perbaikan status gizi sejak masa prekonsepsi dan selama kehamilan, serta status ekonomi rumah tangga diharapkan mampu menurunkan kejadian stunting pada anak.KATA KUNCI: stunting, ASI eksklusif, praktik makan, pertumbuhan

NUTRIENT FULFILLMENT OF MOTHERS DURING PUERPURIUM PERIOD IN THE SE’I CULTURE AT SUBDISTRICT OF MOLO SELATAN DISTRICT OF TIMOR TENGAH SELATAN ALBERTH MATUSALAK BAU MALI; I MADE ALIT GUNAWAN; SUMARNI SUMARNI
JURNAL INFO KESEHATAN Vol 12 No 1 (2014): JURNAL INFO KESEHATAN, HALAMAN 500 - 709, ISSN 0216-504X, JUNI
Publisher : Research and Community Service Unit, Poltekkes Kemenkes Kupang

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Background: Se’I culture is a series of activities aimed to take care of mother during puerperium that consisted of abstain from certain foods, warming of mothers and Tatobi (compress) within 40 days. Mother during lactation period belong to age group that are susceptible to lack of nutrition because while breastfeeding the baby, they are undergoing recovery, menstruation and fulfilling their physical needs. Besides, during breastfeeding mother loose micro and macro nutrients such as zinc and calcium exerted throug breast milk. Abstain from food, either in types, amount or frequency, will bring negative impact to the fulfillment of mother during parturition period.Objective: the study aimed to get an overview of the nutrient fulfillment of mother during puerperium in relation to the implementation of Se’I culture among Timor tribe.Method: the study was qualitative that used phenomenological approach with mother during puerperium period of Timor tribe as subject of the study. Data were obtained through indepth interview, observation and food recall 24 hours. Data analysis used Miles and Huberman Model. Result: care that was carried out during the implementation of Se’I culture aimed to support the process of recovery and maintain the physical condition as it was before pregnancy. The fulfillment of nutrients of mother during the practice of Se’I did not meet nutrition sufficiency as recommended.Conclution: intake of nutrition of mothers during the practice of Se’I did not fulfill the need for nutrition and consume other foods that contained equal amount of nutrients when mothers were abstain from certain types of foods.

Meningkatkan Pengetahuan dan Sikap Ibu Hamil tentang Kepatuhan Konsumsi Tablet Fe melalui Media Visual Tri Siswati; I Made Alit Gunawan; Savitri Fatikaningtyas
PUINOVAKESMAS Vol. 2 No. 1 (2021): April
Publisher : Pusat Unggulan Iptek (PUI) Poltekkes Kemenkes Yogyakarta

Prevention and control of anemia can be started by increasing knowledge and attitudes through various programs, one of which is the development of communication, information, and education (IEC) media. This research to determine the differences in the effectiveness of anemia booklets and leaflets on increasing knowledge about anemia and attitudes in consuming iron tablets in pregnant women. This study was quasi-experimental with a pretest-posttest control group design. Data were collected in March 2020 at the Tempel I Health Center and Kalasan Health Center, Sleman Regency, DIY. Subjects were selected purposively. The booklet intervention group was the Tempel I Public Health Centre and the control group/leaflet intervention group was the Kalasan Public Health Centre with 32 subjects each. Data was collected through a google form after obtaining ethics approval. Data were analyzed by Mann-Whitney Test. Booklet intervention increased the mother's knowledge by 3.1 while leaflet by 2.4 there was no significant difference. Intervention with booklet increased mother's attitude about Fe adherence by 4.7 and leaflet by 1 and there was a significant difference (0.002). Booklets are more effective to increase the knowledge about anemia and the attitude of consuming iron tablets in pregnant women than leaflets.

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