Social Capital and Nutritional Status of Child Under 5 Years in Rural Indonesia and Thailand

Prevalensi gizi kurang Balita di pedesaan pada satu dasawarsa terakhir terdapat kecenderungan penurunan, yaitu di Thailand (0.3%) lebih cepat secara signifikan dibanding di Indonesia (3,5%). Diduga ada perbedaan pola pemanfaatan modal sosial dalam upaya perbaikan gizi Balita. Permasalahan dalam penelitian ini adalah apakah ada perbedaan pengaruh modal sosial yang berhubungan dengan status gizi Balita pada urban area di Indonesia dan Thailand. Penelitian ini menggunakan pendekatan kualitatif, dengan strategi penelitian lapangan studi kasus di wilayah kerja Puskesmas Kajen 1, Kabupaten Pekalongan, Indonesia dan di Ongkharak Thailand. Fokus penelitian berupa aspek modal sosial yang terdiri dari: (1) citizenship, (2) asosiasi/organisasi sosial, (3) sosial suport yang mempengaruhi status gizi Balita di masyarakat. Teknik penentuan informan dengan cara purposive sampling dan snowball sampling. Hasil penelitian modal sosial yang berkaitan dengan status gizi Balita di desa di Indonesia dan Thailand mempunyai corak sejenis. Dimana unsur-unsur modal sosial yang mempengaruhi berupa: 1) cytizenship, dalam bentuk partisipasi aktif dan kreatif terutama dari para kader atau relawan, 2) organisasi sosial berupa Posyandu dan Pusat Pengembangan Balita. Sedangkan perbedaan yang tergambar adalah: 1) Organisasi sosial di Thailand merupakan program yang lebih pro aktif, 2) Di Indonesia aspek cytiznship yang berkaitan dengan unsur resiprocyti atau semangat untuk membantu sangat menonjol, dan 3) Program pemerintah Thailand yang sangat menentukan status gizi Balita diperlemah dengan banyaknya masalah bencana alam dan situasi politik. In Indonesia and Thailand, the prevalence trend of malnutrition of children under five in rural area in the last decade has declined, in Thailand (0.3%) was significantly faster than in Indonesia (3.5%). So the problem in this study is whether the different effect of social capital associated with nutritional status of children in rural area in Indonesia and Thailand.This study used a qualitative approach, in Kajen 1 health center, Pekalongan, Indonesia and in Ongkharak, Thailand. The focus of this study was the form of social capital aspect which consists of: (1) citizenship, (2) the association/social organization, (3) social support that affect the nutritional status of children in society. Informants consisted of village heads, heads of health center, village midwives, IHC cadres, community leaders and children's families. The technique of determining the informant by purposive sampling and snowball sampling.Based on result, social capital related to the nutritional status of children in rural area in Indonesia and Thailand had similar patterns. The elements of social capital that influence as follows: 1) citizenship, in the form of active and creative participation, especially from the cadre or volunteers, 2) social organizations such as IHC and Children Development Center. While the differences were illustrated: 1) social organization in Thailand was a more pro-active programs, 2) In Indonesia, citizenship aspects related to the elements reciprocity or passion to help each other was very prominent, and 3) The Thailand government programs that determine the nutritional status of children had been weakened with the many problems of natural disasters and political situation

Risk of latent tuberculosis infection in children living in households with tuberculosis patients: a cross sectional survey in remote northern Lao People's Democratic Republic

ABSTRACT: BACKGROUND: Tuberculosis is highly prevalent in Laos (289 per 100,000). We evaluated the risk of latent tuberculosis infection (LTBI) among children (0-15 years) living with tuberculosis patients in rural northern Laos. METHODS: In a cross sectional survey of 30 randomly selected villages, 72 tuberculosis patients were traced and their 317 contacts (148 were children) investigated using a questionnaire, a tuberculin skin tests (positive: <= 10mm), a 3-day sputum examination for acid-fast bacilli (AFB), and chest radiography. RESULTS: None of the 148 contact-children received prophylaxis, one had cervical tuberculosis; the risk for LTBI was 31.0%. Awareness of the infectiousness of tuberculosis was low among patients (31%) and their contacts (31%), and risky behavior was common. After multivariate logistic analysis, increased LTBI was found in children with contact with sputum positive adults (OR: 3.3, 95% CI: 1.4-7.7), patients highly positive sputum prior to treatment (AFB <2+; OR: 4.7, 95% CI: 1.7-12.3), and living in ethnic minorities (OR: 5.4, 95% CI: 2.2-13.6). CONCLUSION: The study supports the importance of contact tracing in remote settings with high TB prevalence. Suggestions to improve the children's detection rate, the use of existing guidelines, chemoprophylaxis of contact-children and the available interventions in Laos are discussed. Improving education and awareness of the infectiousness of TB in patients is urgently needed to reduce TB transmissio