Baseline Survey on Nutritional and Health Status of Underfive Children at Poor Communities in DKI Jakarta, Tangerang, and Bogor Year 2004

The high prevalence of anemia and vitamin A deficiency among underfive children is related to their food intake and health status. The situation appeared worst after multiple crisis hit Indonesia in 1997/1998. To obtain factors affecting the nutritional status of children aged 1-5 years, a baseline study was conducted in DKI Jakarta, Bogor, and Tangerang in collaboration with UN-WFP. The sample size was 1337 underfive children consisting of 666 boys and 666 girls. The study showed that malnutrition among underfive children was still high which indicated the high prevalence of underweight and stunting, especially in Bogor District and Tangerang District. The micronutrient intake of vitamin A, iron, and zinc among underfive children were certainly below the Indonesian RDA. The level of poverty and the education of woman as well as husbands were two conditions that were obvious from all areas, mainly Tangerang District

Status Gizi Ibu Hamil dan Penyakit Tidak Menular pada Dewasa

Globally, the concern on high prevalence of chronic diseases on adults is increasing. Current mounting evidence confirmed that nutritional deficiency in early life, i.e. during fetal stage and the first two years of age, contribute significantly to the increasing risk of having chronic noncommunicable diseases (NCD) later in life. The high prevalence of a number of NCDs in Indonesia is high, warrant a special attention. For example, almost one thirdof Indonesian adults having high blood pressure. Hence, Indonesia in the future is facing a considerable financial burden as the result of a high expenditure needed for the treatment and rehabilitation of the diseases, and low productivity related to the disease. The high prevalence of NCDs among poor population in Indonesia indicated that these diseases are not merely the result of unhealthy lifestyle, instead they very likely are the results of undernutrition in early life, which was started since fetal stage. Therefore, an attempt to address these problems through improvement of lifestyle alone will not be effective. Effort directed specifically to the root of the problems,i.e. providing an optimal nutrition environment to the fetus through improvement of maternal nutritional status, and infant 0 – 2 years of age, is recommended

Efektivitas Program Fortifikasi Minyak Goreng dengan Vitamin A terhadap Status Gizi Anak Sekolah di Kota Makasar

Vitamin A deficiency (VAD) remains as one of significant public health problems in Indonesia. Around 50% of under five children are suffering from subclinical VAD. Deficiency of vitamin A will affect several important role in the body, such as immune system, vision, reproductive system and cell differentiation. Therefore, guarding Indonesian children to be free from VAD is crucial for their quality as Human Resources. We assessed the impact of the consumption of vitamin A fortified cooking oil on the improvement of vitamin A and hemoglobin status among school children in urban slum area in Makassar City. The study was an intervention design Before-After. Healthy school children 7-10 years were selected from schools and de-wormed before the intervention. Serum retinol and hemoglobin was measured at baseline and at 3 months after. Fortified oil was made available through distribution at shops and accompanied with social marketing. Eventhough overall there was no change in VAD prevalence, the VAD prevalence is lower among children who consumedfortified oil ³12 weeks (26.6%) compared to those who consumed <12 weeks (42%). Prevalence of anemia decreased from 21.8% to 11.6%. We recommended that fortified oil is made mandatory

Does Excessive Gestational Weight Gain Contribute to Preeclampsia?

Preeclampsia is the leading cause of both maternal and infant mortality and morbidity worldwide. It is a disorder of pregnancy characterized by hypertension and high levels of protein in the urine. Preeclampsia has multifactorial determinants, one of which is excessive gestational weight gain. The purpose of this study was todetermine the relationship between weight gain during pregnancy and the incidence of preeclampsia among patients at Panembahan Senopati Bantul Hospital, D.I.Y. in 2014. The assessment of excessive weight gain during pregnancy was based on the weight gain recommendations given by the Institute of Medicine (IOM).This study was conducted using a case-control design. Based on patient medical records, subjects were included if the length of gestation was greater than or equal to 20 weeks, and were excluded if it was the mother’s first pregnancy, the mother was less than 20 years old, or the gestational weight gain was less than the IOM recommendation. After a process ofrandom selection, there were 55 subjects in the case group that met the inclusion criteria. The case to control ratio was 1:1; thus there were also 55 subjects in the control group after random selection.The case and control groups were selected from the same hospital. Data analysis was conducted using a Chi-Square test. The results of the study showed that 63.6% of mothers with preeclampsia exhibited excessive gestational weight gain,while 16.4% of those without preeclampsia exhibited excessive gestational weight gain (p value &lt;0.05, 95% CI: 3.63-22.06 and OR: 8.94). The results confirmed that excessive weght gain during pregnancy increases the incidence of preeclampsia. Keywords: pregnant women, hypertension, preeclampsia, weight gain during pregnanc

A New Alternative Quac-Stick to Predict the Risk of Chronic Energy Deficiency in Malay Indonesian Women (18-49 Years)

BACKGROUND: Indicators to assess the nutritional status in women of reproductive age (WRA) in particular to identify chronic energy deficiency (CED) were still limited. Upper arm circumference (MUAC) and the Body Mass Index (BMI) had been used to assess the status of CED, but it still has its limitations. This study aimed to develop a new indicator QUAC-Stick (the ratio of MUAC to Upper Arm Length (UAL)) for the risk asesement of CED on WRA in Malay Indonesia women (18-49 years). SUBJECT AND METHODS: The cross sectional study design, used a part of data from National Basic Health Research (Riskesdas) 2013 and primary collecting data among 1009 WRA aged 18-49 years (not pregnant) in Makassar and Tana Toraja, South Sulawesi Province. Analysis used the ROC to get the optimal formula and the cut off point using BMI as the gold standard. RESULTS: MUAC/UAL (named UMMI index) with a cut-off point < 4.25 to detect the risk of CED, had better validity (Sn=80% (95% CI=70.8 to 87.3 ); Sp = 84% (95% CI = 81.4 to 86.3); PPV = 35% (95% CI = 29.2 to 42.0); NPV = 97% (95% CI = 96.1 to 98.4; ROC = 82% (95% CI = 80.0 to 86.1) compared to MUAC < 23,5 with the gold standard was BMI <18.5. Prevalence of CED on WRA 9.9% (BMI <18.5); 22.4% (MUAC/UAL< 4.25). The validity of MUAC < 23.5 was good (Sn = 76%, Sp = 87.2%), but the optimal cut-off point for screening was MUAC < = 24.0 cm (Sn = 90%, Sp = 77%). The correlation (r) between MUAC-weight = 0.82; UAL-Height = 0.45; MUAC-BMI = 0.82 and MUAC/UAL to BMI = 0.80 (P = 0.000). CONCLUSION: The new alternative indicator was MUAC/UAL <4.25 to assess the risk of CED on WRA in Malay Indonesia women (18-49 years). Further revalidation study is needed to be able applying the indicator to the wider population. Keywords: Ratio, MUAC, Women of reproductive, CED, Arm Lengt

A New Alternative Indicator for Chronic Energy Deficiency in Women of Childbearing Age in Indonesia

Background: Indicators for assessment of nutritional status in women of childbearing age (WCA) in particular to detect the risk of chronic energy deficiency (CED) were limited. Currently, we used mid upper arm circumference (MUAC) as a screening tool of CED and Body Mass Index (BMI) for CED status assessment, but have some limitations. This paper aims to develop a new indicator for the risk assessment of CED on WCA in Indonesia.Methods: The design was a cross sectional study. This analysis used a part of National Basic Health Health Research (Riskesdas) 2013 among 1009 WCA (18-49 years) in Makassar and Tana Toraja, South Sulawesi Province. ROC analysis was used to obtain the optimal formula and the cut off point with BMI &lt;18.5 as the gold standard.Results: The study found that the optimal formula was MUAC/√UAL &lt; 4.25 to detect a risk of CED, better validity (Sn = 80%; Sp= 84%) compared to MUAC &lt; 23,5 (Sn = 76%; Sp= 87.2 %) with the gold standard was Body Mass Index (BMI). Prevalence of CED on women of reproductive age 9.9% (BMI&lt;18.5); 22.4% (MUAC/√UAL &lt;4.25). Correlation MUAC to weightr = 0.82; UAL to height r = 0.45; MUAC to BMI r = 0.82 and ratio of MUAC/√UAL to BMI r = 0.80 (P = 0.000). Conclusion: The ratio of MUAC/√UAL &lt; 4.25 can be new alternative indicator that simple and effective for detecting CED on WCA (18-49 years) in Indonesia. (Health Science Indones 2014;2:54-9

Exclusive Breastfeeding Intention Among Pregnant Women

Exclusive breastfeeding intention is a mother's intention to provide her baby only breast milk since the infant was born until at the age of 6 months. Intention in prenatal period is the direct affirmation of exclusive breastfeeding. This study aimed to find out the most dominant factor related to exclusive breastfeeding intention among pregnant women at a mother and child hospital in South Tangerang. A cross-sectional study design was conducted primarily. The samples were 143 pregnant women on their third trimester pregnancy selected by purposive sampling. Intention was measured by the Infant Feeding Intention scalequestionnaire. Meanwhile, attitude, subjective norms, and perceived behavioral control were measured by the modified Breastfeeding Attrition Prediction Tool questionnaire. Data were analyzed using the multivariate logistic regression analysis. It was 61.5% mother had strong exclusive breastfeeding intention. Perceived behavioral control dominantly influenced the exclusive breastfeeding intention (p value = 0.007; Odds Ratio 3.030; 95% CI = 1.361-6.746). The other factors influencing intention were attitude, exposure to exclusive breastfeeding from social media, health workers' support, previous breastfeeding experienceand mothers' occupation. A mother with high perceived behavioral control has three times more likely to have ‘high exclusive breastfeeding intention' than those having the low ones

Does Breastfeeding Intention Among Pregnant Mothers Associated with Early Initiation of Breastfeeding?

Background: Early initiation of breastfeeding is defined as breastfeed started immediately after birth delivery up to one hour , and it will lead to successfull exclusive breastfeeding. Skin-to-skin contact during early initiation of breastfeeding gives positive health impact to both mother dan baby. However, national coverage of early initiation of breasfeeding in Indonesia was 34,5% in 2014 which was lower than global coverage (50%). Objective: To examine the relationship of of breastfeeding intention among pregnant mothers towards early initiation of breastfeeding in two Mother and Child Hospitals, in South Tangerang. Methods: A prospective study conducted in August-November 2016. A sample of 152 third trimester pregnant mothers were from the 2 selected hospitals, taken by purposive sampling. Early breastfeeding initiation (EBI) was measured by interview based structured questionnaire and breastfeeding intention measured by The Infant Feeding Intention scale (IFI). Results: A total of 56.6% of mothers breastfeed during 1 hour after delivery. EBI was done by 71.1% of mothers with high breastfeeding intention. It was the most dominant variable related to early breastfeeding (p = 0.000; OR=5.249;95%CI:2.321-11.870) after controlling other variables. Conclusion: Mother with high breastfeeding intention 5 times more likely to initiate breastfeeding, than those having the low ones. Early promotive, preventive and intervention can be done by measuring breastfeeding intentions during pregnancy. Further research is needed to analyze breastfeeding initiation towards exclusive breastfeeding

The Change of Knowledge and Attitude of Bride and Groom Candidate After Reproductive Health Pre-Marital Course by KUA Officer

Reproductive health in Indonesia is still very poor, as evidenced by the still high maternal mortality rate (MMR). MMR decline was slow, as well as in the province of Central Java. The highest is in Brebes Regency which has as many as 53 cases of maternal decease. One of the causes of high MMR is the lack of reproductive health sensitivity of bride and groom candidates. The purpose of this research is to analyze the influence of counseling on bride and groom candidates knowledge and attitude related to reproductive health. This research is a quasi experimental research with pre and post test without control group design. The population was bride and groom candidates listed in KUA of Brebes Regency in July and August of 2017, with a sample of 100 pairs selected according to the inclusion criteria. The interventions in the form of a one-day course by KUA officers on reproductive health with Bride and Groom Candidates Reproductive Healt booklet and flipcharts as the tools. The data of knowledge and attitude are obtained by interviewing the bride and groom candidates. Analysis is conducted with Wilcoxon Match Paired Test. The results showed that there is a difference of bride and groom candidates knowledge and attitude before and after intervention (p <0,05), with mean value increased 2.58 points (knowledge) and 3,21 points (attitude). Recommended advised are the pre-marital program socialized by KUA officers is expanded and multiplication of the booklet as a tool for the officers in pre-marital courses implementation