PRE PLANNING

IMPLEMENTASI KEPERAWATAN KOMUNITAS PADA AGREGAT BALITA

Pre Planning ini Disusun Untuk Memenuhi Tugas Praktek Klinik Stase Keperawatan
Komunitas Semester 2 kelas 12 PED A

Oleh:

I Made Wahyudi Marta, S. Kep (195140031)

Channe Esphi. R Sirait, S. Kep (195140049)
Kartini, S. Kep(195140038)

PROGRAM STUDI PROFESI NERS

FAKULTAS ILMU KESEHATAN
UNIVERSITAS RESPATI INDONESIA
2021
 PRE PLANNING

KEGIATAN IMPLEMENTASI KEPERAWATAN

PADA BALITA DAN KEGIATAN POSYANDU

Kelompok : KELOMPOK 1 NERS 12 A

Topik Kegiatan : IMPLEMENTASI PADA BALITA DAN KEGIATAN
POSYANDU
Tanggal Kegiatan : 13 JANUARI 2021
Sasaran : MASYARAKAT / RESPONDEN KHUSUSNYA IBU DAN
BALITA

A. LATAR BELAKANG
Keperawatan Komunitas adalah pelayanan keperawatan profesional yang
ditujukan kepada masyarakat dengan pendekatan pada kelompok resiko tinggi
dalam upaya pencapaian derajat kesehatan yang optimal melalui pencegahan
penyakit dan peningkatan kesehatan dengan menjamin keterjangkauan pelayanan
kesehatan yang dibutuhkan dan melibatkan klien sebagai mitra dalam
perencanaan, pelaksanaan, dan evaluasi pelayanan keperawatan. Pelayanan
Keperawatan Komunitas adalah seluruh masyarakat termasuk individu, keluarga
dan kelompok yang beresiko tinggi seperti keluarga penduduk didaerah kumuh,
daerah terisolasi dan daerah yang tidak terjangkau termasuk kelompok bayi,
balita, lansia dan ibu hamil (Veronica, Nuraeni, & Supriyono, 2017).
Salah satu kelompok khusus dalam keperawatan komunitas adalah
kelompok balita. Menurut Sutomo. B. dan Anggraeni. DY,(2018), Balita adalah
istilah umum bagi anak usia 1-3 tahun (batita) dan anak prasekolah (3-5 tahun.
Tahap analisa data merupakan tahap kedua dari proses keperawatan yang didasari
dari hasil pengkajian yang telah dilakukan melalui wawancara, kuesioner dan
observasi. Sedangkan perencanaan dalam proses keperawatan merupakan tahap
penentuan dari rencana-rencana tindakan keperawatan yang akan
diimplementasikan berdasarkan hasil pengkajian dan masalah yang ditemukan.
Berdasarkan hasil pengkajian data melalui kuesioner, observasi dan
wawancara dengan responden ditemukan beberapa permasalahan kesehatan yang
 terjadi di masyarakat. Berdasarkan permasalahan tersebut telah dibuat suatu
analisa dan prioritas masalah, sehingga dapat dirumuskan suatu perencanaan dan
intervensi keperawatan. Perencanaan dan intervensi keperawatan didasari dari
hasil analisa data yang telah diolah. Intervensi keperawatan yang telah
direncanakan diharapkan mampu mengatasi permasalahan yang ditemukan di
masyarakat.
Setelah dilakukan analisa data dari hasil sebaran questioner pada
responden maka didapatkan data tentang masalah kesehatan, salah satunya adalah
Pemeliharaan kesehatan balita tidak efektif, dan koping komunitas tidak efektif
sehingga dari masalah kesehatan yang ditemukan tersebut, akan diberikan
intervensi sesuai dengan kesepakatan dengan masyarakat dan mahasiswa pada
saat kegiatan Musyawarah Masyarakat Desa 2 pada tanggal 07 Januari 2021.
Kesepakatan dengan masyarakat dan Intervensi yang akan di berikan
mengenai, Tumbuh kembang balita, Posyandu dimasa pandemi, Pentingnya
imunisasi dimasa pandemi, PHBS pada balita dimasa pandemi, dan gizi seimbang
pada balita. Peran serta masyarakat dalam kegiatan ini diharapkan mampu
menyelesaikan masalah kesehatan yang dihadapi.

B. TUJUAN UMUM :
Masyarakat mampu mengimplementasikan perilaku kesehatan yang di ajarkan
sesuai dengan masalah kesehatan yang ada di masyarakat, sehingga terbentuknya
perilaku kesehatan yang baik.

C. TUJUAN KHUSUS :
a. Meningkatkan kemandirian pengetahuan, sikap, dan ketrampilan masyarakat
tentang Perilaku Hidup Bersih dan Sehat Balita di masa pandemi
b. Meningkatkan kemandirian pengetahuan, sikap, dan ketrampilan masyarakat
tentang Nutrisi pada Bayi Dibawah Dua Tahun (BADUTA)
c. Meningkatkan kemandirian pengetahuan, sikap, dan ketrampilan masyarakat
tentang Gizi seimbang pada Balita (Usia 2-5 tahun)
D. PELAKSANAAN
Hari/ tanggal : Hari/Tanggal : Rabu, 13 Januari 2021
Waktu : Pukul : 19.15 WIB – 20.45 wib
Tempat : Via zoom
Metode : Diskusi, musyawarah, presentasi/Demonstrasi
Media : Laptop, Link zoom, PPT
Materi : Implementasi dari masalah yang ditemukan dan telah
disepakati dengan responden

E. STRUKTUR PENGORGANISASIAN :
1. Pembawa Acara : Tarida Lestari, S.kep
2. Host Zoominar : Made, S.Kep
3. Time Keeper dan Notulen : Refki, S.Kep
4. Penyaji : Kartini, S.Kep
5. Pembaca Doa : Endah, SKep

F. STRATEGI PELAKSANAAN

No. Acara Kegiatan

1. Pembukaan 1. Mengucapkan salam
10 Menit
2. Membaca Doa
3. Memperkenalkan Team
4. Menjelaskan Tujuan
5. Mengirim Google Form di ruang Chat
Masing-masing untuk menghimbau
responden mengisi daftar hadir
6. Mengirim Google Form di ruang Chat
Masing-masing untuk menghimbau
responden mengisi Pre Test

2 Pelaksanaan Nara Sumber:

65 Menit
1. Channe Esphi Sirait, SKep
Topik: Nutrisi pada Bayi dibawah Dua
 Tahun (BADUTA)
1) Menjelaskan Materi
2) Mendemonstrasikan ketrampilan
3) Meminta tamu undangan untuk
mempraktekkan ulang kegiatan
yang sudah diajarkan

2. Kartini, SKep
Topik: PHBS pada balita dimasa
Pandemi
1) Menjelaskan Materi
2) Mendemonstrasikan ketrampilan
3) Meminta tamu undangan untuk
mempraktekkan ulang kegiatan
yang sudah diajarkan

3. Made, SKep
Topik: Gizi seimbang pada Balita usia
(2-5 thun)
1) Menjelaskan Materi
2) Mendemonstrasikan ketrampilan
3) Meminta tamu undangan untuk
mempraktekkan ulang kegiatan
yang sudah diajarkan

3 Penutup 1. Memberi kesempatan bertanya

15 menit
2. Closing Statement Kesimpulan singkat
dari masing masing pembicara
3. Undangan Mengisi Post test
4. Kesimpulan dibaca notulen
5. Penutup
 G. KRITERIA EVALUASI
1. Evaluasi Struktur
a. Waktu pelaksanaan Implementasi dengan resonden telah ditetapkan.
b. Tempat dan perlengkapan acara telah disiapkan.
c. Materi dan media atau alat bantu telah disiapkan.
d. Undangan elektronik telah dibuat.
e. Pre dan Post test sudah dibuat menggunakan Googgle Form
f. Pre Planning sudah disetujui
g. SAP dan Materi sudah di konsulkan dan disetujui
h. Daftar hadir menggunakan Googgle form
i. Panitia penyelenggara telah dibentuk.
2. Evaluasi Proses
a. Masyarakat yang hadir sesuai dengan undangan
b. Tamu undangan mengikuti kegiatan dari awal sampai akhir.
c. Masyarakat antusias mengikuti proses demonstrasi dan implementasi
d. Masyarakat bisa menerima intervensi yang di ajarkan
e. Media dapat digunakan.
f. Acara dapat berjalan lancar
3. Evaluasi Hasil
a. Tamu undangan yang hadir lebih dari 30
b. Tamu undangan dapat mempraktekkan kembali ketrampilan yang diajarkan
c. Terjadi peningkatan pengetahuan, sikap, dan ketrampilan tamu undangan

Jakarta, 13 Januari 2021

Koordinator Penanggung Jawab Kegiatan

(Channe Espi. R Sirait, S. Kep) (I Made Wahyudi, S. Kep)

Mengetahui,
Pembimbing

(Ns. Samsuni, M. Kep. S.Kep. Kom)

 DAFTAR PUSTAKA

Budiono. (2016). Konsep Dasar Keperawatan. Jakarta: Pusdik SDM Kesehatan

Sudaryanto, G. MPASI Super Lengkap. Penebar Swadaya Grup, Jakarta
Fikawati, D.S., Syafiq, A., & Karima, K. Gizi Ibu dan Bayi. Rajagrafindo Persada,
Depok

Kemenkes, RI. 2011. Makanan Sehat Untuk Bayi. Direktorat Bina Gizi Subdit Bina
Gizi Klinik, Jakarta

Wargiana, R., Susumaningrum, L.A., Rahmawati, I. Hubungan Pemberian MP-ASI

Dini dengan Status Gizi Bayi Umur 0-6 Bulan di Wilayah Kerja Puskesmas
Rowotengah Kabupaten Jember. Jurnal Pustaka Kesehatan, 2013, 1 (1).

Helmyati, S., Hadi, H., & Lestariana, W. Kejadian Anemia pada Bayi Usia 6 bulan
yang Berhubungan dengan Sosial Ekonomi Keluarga dan Usia Pemberian
Makanan Pendamping ASI. Berita Kedokteran Masyarakat, 2007, 23(1) : 35–40.

Jumiyati. 2014. Pemberian MP-ASI Setelah Anak Berumur 6

Bulan. http://180.250.43.170:1782/poltekkes/files/MPASI.pdf

Mufida, L., Widyaningsih, T.D., Maligan, J.M. Prinsip Dasar Makanan Pendamping
Air Susu Ibu (MP-ASI) Untuk Bayi 6-24 Bulan : Kajian Pustaka. Jurnal Pangan
dan Agroindustri, 2015, 3 (4): p.1646-1651.

Yogi, E.D. 2014. Pengaruh Pola Pemberian ASI dan Pola Makanan Pendamping ASI
Terhadap Status Gizi Bayi Usia 6-12 Bulan. Jurnal Delima Harapan, 2(1): 14-18

ASDI,IDAI,Persagi,2016.Penuntun Diet Anak Edisi Ke 3. Badan Penerbit FKUI

Santosa, Sugeng. 2004. Kesehatan dan Gizi. Jakarta: PT.Rieneka Cipta.

Syamsuri, Istamar. 2004. Biologi SMA kelas XI. Jakarta: Erlangga.

Sudiyanto. Dalam membina anak dalam mencapai cita-citanya. Tumbuh kembang

anak, Fakultas Kedokteran UI.

Suhardjo (1992).Pemberian makanan pada bayi dan anak.Jakarta : Kanisius

Supartini.Y. (2002).Buku Ajar : Konsep dasar keperawatan anak. Jakarta : EGC

Soekirman.(2000). Ilmu gizi dan aplikasinya untuk keluarga dan masyarakat.Jakarta :

EGC

Almatsier, Sunita. 2003. Prinsip Dasar Ilmu Gizi. Jakarta : EGC.

Departemen kesehatan RI. 2006. Buku Kader Posyandu Dalam Usaha Perbaikan
Gizi Keluarga. Jakarta : Departemen Kesehatan RI.
Hasan, Rusepno.1985.Buku Kuliah I Ilmu Kesehatan Anak.Jakarta: Infomedika

Juwono, Lilian.2003.Pemberian Makanan Tambahan : Makanan Untuk Anak

Menyusu.Jakarta : EGC

Santoso, Sugeng dan Rianti, Anne Lies. 2004. Kesehatan Dan Gizi. Jakarta : Rineka
Cipta.

Westcott, Patsy. 2003. Makanan Sehat Untuk Bayi dan Balita. Jakarta: Dian Rakyat.

Widjaja, MC. 2006. Gizi Tepat untuk Perkembangan Otak dan Kesehatan Balita.
Jakarta: Agro Media Pustaka.

Kementrian kesehatan RI. 2020. Buku Panduan Gizi Seimbang Pada Masa Pandemi
Covid-19. Jakarta : Kementrian Kesehatan RI.
 SATUAN ACARA PENYULUHAN KESEHATAN LINGKUNGAN PADA
MASYARAKAT KELURAHAN CIPAYUNG
Kamis, 13 Januari 2021

A. Topik : Penkes Gizi Pada Balita

B. Sub topik : Gizi Seimbang Pada Balita
C. Tujuan Instruksional :
1. Umum:
Setelah mengikuti penyuluhan diharapkan peserta yang menghadiri penyuluhan tersebut dapat
memahami dan mengerti tentang pentingnya gizi seimbang bagi balita untuk menjaga dan
meningkatkan status gizi balita.

2. Khusus:
Setelah diberikan penyuluhan sasaran mampu:
a. Pengertian pemenuhan gizi pada balita
b. Karakteristik balita
c. Kebutuhan gizi balita
d. Faktor – faktor yang menyebabkan masalah gizi
e. Akibat gizi tidak seimbang untuk balita
f. Menu seimbang untuk balita
D. Perencanaan Penyuluhan
1. Waktu
a. Hari : Rabu
b. Tanggal : 13 Januari 2021
c. Jam : 19.00-20.00
2. Tampat : Via Zoom
3. Sasaran : Ibu Hamil, Ibu yang memiliki Balita, Ibu Menyusui.
4. Metode : Ceramah dan Tanya Jawab
5. Media : Link Zoom, Laptop, Michropone

E. Kegiatan Penyuluhan:

Tahap Kegiatan
No Waktu Kegiatan Peserta Media
Kegiatan Penyuluhan
1 Pendahuluan 5 menit 1. Memperkenalk 1. Mendengarkan/ Link Zoom
an diri memperhatikan Microphone
2. Menjelaskan 2. Menjawab
topik dan pertanyaan yang
 tujuan diajukan oleh
penyuluhan penyaji.
3. Menggali
pengetahuan
tentang gizi
seimbang
2 Penyajian 15 1. Menjelaskan 1. Mendengarkan/ Laptop
menit memperhatikan Microphone
materi tentang
2. Mengajukan
gizi seimbang: pertanyaan bila
a. Pengertian kurang
pemenuhan mengerti.
gizi pada balita
b. Karakteristik
balita
c. Kebutuhan gizi
balita
d. Faktor – faktor
yang
menyebabkan
masalah gizi
e. Akibat gizi
tidak seimbang
untuk balita
f. Menu
seimbang
untuk balita
3 Penutup 10 1. Melakukan Memperhatikan dan
menit evaluasi dengan menjawab
memberikan pertanyaan
pertanyaan
2. Menyimpulkan
materi yang
telah
disampaikan
3. Memberi
kesempatan
kepada peserta
untuk bertanya
kembali jika
kurang jelas
F. Materi Penyuluhan: Terlampir
G. Evaluasi
1. Evaluasi Struktur
Tim penyuluh datang 30 menit sebelum waktu yang ditetapkan untuk mempersiapkan
sarana dan prasarana kegiatan penyuluhan. Semua peserta datang tepat pada
waktunya. Penyuluhan dimulai 19.00 wib. Peserta yang hadir berjumlah 30 orang.
2. Evaluasi Proses
Pelaksanaan penyuluhan berjalan sesuai rencana. Peserta antusias mendengarkan
materi penyuluhan dan menjawab pertanyaan yang diajukan pemateri.
3. Evaluasi Hasil
Target peserta > 50% mampu menjawab pertanyaan yang diajukan pemateri, meliputi Pre test dan
Post test dalam bentuk pertanyaan tertulis yaitu:
a. Apa yang disebut gizi ?
b. Apa yang disebut gizi seimbang?
c. Apa itu fungsi makanan bergizi?
d. Nutrisi apa saja yang di butuhkan bagi pertumbuhan dan perkembangan balita?
e. Apakah pada bayi umur 0-6 bulan boleh diberikan makanan selain ASI?
 Lampiran 1:
Materi Penyuluhan
GIZI SEIMBANG PADA BALITA

A. Pengertian Gizi
Gizi (nutrient) adalah ikatan kimia yang diperlukan tubuh untuk melakukan fungsinya, yaitu
menghasilkan energi, membangun dan memelihara jaringan serta mengatur proses-proses kehidupan
(Almatsier, 2005).
Menurut Sediaoetama, 1997 (dalam Santoso, 2004), gizi atau makanan merupakan bahan dasar
penyusunan bahan makanan yang mempunyai fungsi sumber energi atau tenaga, menyokong pertumbuhan
badan, memelihara dan mengganti jaringan tubuh, mengatur metabolisme dan berperan dalam mekanisme
pertahanan tubuh.
Dari berbagai definisi tersebut dapat disimpulkan bahwa pengertian gizi adalah komponen kimia
yang terdapat dalam zat makanan yang sangat dibutuhkan oleh tubuh untuk perkembangan dan pertumbuhan.

B. Fungsi Makanan Bergizi

Makanan bergizi adalah makanan yang dimakan secara beraneka ragam, makin beragam tinggi
gizinya. Cara menyusun hidangan yang sehat yaitu dengan menggunakan pedoman “Triguna Makanan“,
yaitu memilih makanan yang berfungsi sebagai zat tenaga, zat pembangun dan zat pengatur.
1) Makanan sebagai zat tenaga ( karbohidrat dan lemak )/ makanan pokok,
Makanan yang berfungsi untuk menghasilkan tenaga, untuk aktifitas sehari-hari, seperti bekerja, berolah
raga dsb.
Sumber zat tenaga : beras, mie, telur, ubi jagung, sagu, terigu, kentang, singkong, roti, kue.
2) Makanan sebagai zat pembangun (protein)/lauk pauk
Makanan yang berfungsi untuk pertumbuhan dan perkembangan dan memperbaiki organ tubuh yang rusak.
Sumber zat pembangun : tempe, tahu, telur, susu, ikan, daging ayam, kacang hijau, kedelai, kacang merah,
dsb.
3) Makanan sebagai zat pengatur (vitamin dan mineral)/sayur dan buah-buahan
Makanan yang berfungsi mengatur organ-organ tubuh untuk melaksanakan fungsinya secara teratur.
Sumber zat pengatur : Kangkung, bayam, daun singkong, wortel, kacang panjang, pepaya, mangga, jeruk,
pisang, dsb.
C. Nutrisi Penting Pada Balita
Beberapa nutrisi penting yang sangat dibutuhkan bagi pertumbuhan dan perkembangan bayi seperti :
1. Vitamin A, D, E, K
Vitamin ini sangat vital bagi balita. Seperti kita ketahui, vitamin A sangat baik untuk penglihatan
dan kesehatan kulit balita. Sedangkan vitamin D berperaan penting dalam meningkatkan penyerapan
kelsium serta membantu pertumbuhan tulang dan gigi. Serta vitamin E memiliki anti oksidan yang
membantu pertumbuhan system syaraf dan pertumbuhan sel. Vitamin K berpengaruh dalam pembekuan
darah.
2. Kalsium
Mineral yang sangat dibutuhkan dalam pembentukan massa tulangnya. Kalsium sangat penting
untuk membentuk tulang yang kuat sehingga balita terhindar dari patah tulang. Sumber kalsium yaitu :
susu, keju, tahu, dll.
3. Vitamin B dan C
Fungsi dari vitamin B antara lain meningkatkan system syaraf dan imun tubuh balita,
meningkatkan pertumbuhan sel, serta mengatur metabolisme tubuh.Sementara vitamin C berfungsi
untuk meningkatkan penyerapan zat besi dalam tubuh balita serta mencegah sariawan.Sumber makanan
yang banyak mengandung vitamin B antara lain beras merah, pisang, kacang-kacangan, ikan, daging
dan telur.Sementara untuk memenuhi gizi balita dengan vitamin C dapat diperoleh dari tomat, kentang,
stroberi, dll.
 4. Zat Besi
Balita sangat membutuhkan zat besi terutama untuk membantu perkembanga otaknya. Jika
kebutuhan gizi balita akan zat besi tidak terpenuhi, kemungkinan ia akan mengalami kelambanan dalam
ungsi kerja otak. Sumber makanam yang yang mengandung zat besi antara lain daging, ikan, brokoli,
telur, bayamkedelai serta alpukat.
D. Macam-macam Makanan dengan Gizi Seimbang
Berikut jumlah rata-rata kebutuhan nutrisi balita yang dibutuhkan setiap harinya berdasarkan
Piramida Panduan Makanan pada balita usia 2-3 tahun :
1. Biji padi-padian
Jumlah yang dibutuhkan per hari pada balita usia 2 tahun: 3 ons (85 gram). Jumlah yang dibutuhkan per hari
pada balita usia 3 tahun: 4-5 ons (110-140 gram).
Contoh makanan dan cara penyajian: 1 ons sama dengan 1 potong roti, 1 gelas takar sereal siap saji, atau 1/2
gelas takar nasi atau jenis pasta yang telah matang.
2. Sayuran
Jumlah yang dibutuhkan per hari pada balita usia 2 tahun: 1 gelas takar. Jumlah yang dibutuhkan per hari
pada balita usia 3 tahun: 1,5 gelas takar.
Contoh makanan dan cara penyajian: untuk memastikannya bisa menggunakan gelas takar. Sajikan sayuran
yang telah halus, dipotong hingga kecil dan dimasak sampai matang untuk mencegah anak tersedak.
3. Buah-buahan
Jumlah yang dibutuhkan per hari pada balita usia 2 tahun: 1 gelas takar.Jumlah yang dibutuhkan per hari
pada balita usia 3 tahun: 1,5 gelas takar.
Contoh makanan dan cara penyajian: untuk memastikan jumlahnya gunakan gelas takar. Pisang dengan
panjang 20-23 cm sama dengan 1 gelas takar.
4. Susu
Jumlah yang dibutuhkan per hari pada balita usia 2 tahun: 2 gelas (400 ml).Jumlah yang dibutuhkan per hari
pada balita usia 3 tahun: 2 gelas (400 ml).
Contoh makanan dan cara penyajian: 1 gelas sama dengan seperti 1 gelas susu, 1 1/2 ons (45 gram) keju
alami, atau 2 ons (60 gram) keju yang sudah diproses.
5. Daging dan kacang-kacangan
Jumlah yang dibutuhkan per hari pada balita usia 2 tahun: 2 ons (65 gram). Jumlah yang dibutuhkan per hari
pada balita usia 3 tahun: 3-4 ons (85-115 gram).
Contoh makanan dan cara penyajian: 1 ons sama dengan 1 ons (300 gram) daging ayam atau ikan, 1/4 gelas
takar kacang-kacangan matang atau 1 butir telur.
Makanan Yang Tepat Untuk Bayi dan Balita :
a. Usia 0 – 6 bulan
Makanan pertama dan terbaik untuk bayi adalah Air Susu Ibu atau ASI, dan semakin lama
seorang bayi mengkonsumsi ASI maka akan semakin baik. Apabila karena sesuatu dan lain hal
anda tidak dapat memberikan ASI maka susu rumusan kedelai (soy formula) adalah pilihan yang
baik dan mudah diperoleh.

b. Usia 6 – 9 bulan
Selain ASI berikan makanan pendamping ASI 2 kali sehari. Makanan pendamping ASI
adalah bubur tim lumat ditambah kuning telur/ ayam/ ikan/ tempe/ tahu/ daging sapi/ wortel/
bayam/ kacang hijau/ santan/ minyak. Perkenalkan sayur, sayur hendaknya dimasak dan
dihaluskan. Kentang, kacang hijau, wortel, dan kacang adalah pilihan pertama yang baik.
Kemudian perkenalkan buah, cobalah pisang, alpokat atau apel. Pada umur 8 bulan, kebanyakan
bayi sudah dapat memakan crackers,roti dan cereal kering, juga pada umur 8 bulan, bayi dapat
mulai memakan makanan tinggi protein seperti tahu atau kacang yang telah dimasak matang dan
dilumatkan.
c. Usia 9 – 12 bulan
Selain ASI berikan bubur nasi ditambah kuning telur/ ayam/ ikan/ tempe/ tahu/ daging sapi/
 wortel/ bayam/ kacang hijau/ santan/ minyak. Makanan diberikan 3 kali sehari dan bubur susu tidak
diberikan lagi.
d. Usia 12 – 24 bulan
Berikan ASI sesuai keinginan anak. Berikan nasi lembek yang ditambah telur/ ayam/ ikan/
tempe/ tahu/ daging sapi/ wortel/ bayam/ kacang hijau/ santan/ minyak. Makanan diberikan 3 kali
sehari.
e. Usia 2 tahun lebih
Diberikan makanan yang biasa yang terdiri dari nasi, lauk pauk, sayur dan buah. Makanan
tersebut diberikan 3 kali sehari. Kebutuhan kalori kurang lebih 100 kkal/kgBB. Anjuran untuk
orangtua dalam pemenuhan kebutuhan nutrisi pada anak usia ini adalah:
 Ciptakan lingkungan makan yang menyenangkan,misalnya memberi makan sambil
mengajaknya bermain.
 Beri kesempatan anak belajar makan sendiri.
 Jangan menuruti kecendrungan anak untuk hanya menyukai satu jenis makanan tertentu.
 Berikan makanan pada saat masih hangat dengan porsi yang tidak terlalu besar.
 Kurangi frekuensi minum susu, dianjurkan 2x sehari saja.
E. Penyebab Balita Kurang Nafsu Makan
 Air Susu Ibu yang diberikan terlalu sedikit sehingga bayi menjadi frustasi dan menangis
 Anak terlalu dipaksa untuk menghabiskan makanan dalam jumlah/ takaran tertentu sehingga anak
menjadi tertekan
 Makanan yang disajikan tidak sesuai dengan yang diinginkan / membosankan
 Susu formula yang diberikan tidak disukai anak atau ukuran / dosis yang diberikan tidak sesuai dengan
sehingga susu yang diberikan tidak dihabiskan
 Suasana makan tidak menyenangkan/ anak tidak pernah makan bersama kedua orang tuanya.
F. Kebutuhan Gizi Balita
Kebutuhan gizi seseorang adalah jumlah yang diperkirakan cukup untuk memelihara kesehatan
pada umumnya. Secara garis besar, kebutuhan gizi ditentukan oleh usia, jenis kelamin, aktivitas, berat
badan, dan tinggi badan. Antara asupan zat gizi dan pengeluarannya harus ada keseimbangan sehingga
diperoleh status gizi yang baik. Status gizi balita dapat dipantau dengan menimbang anak setiap bulan
dan dicocokkan dengan Kartu Menuju Sehat (KMS).
1. Kebutuhan Energi
Kebutuhan energi bayi dan balita relatif besar dibandingkan dengan orang dewasa, sebab pada usia
tersebut pertumbuhannya masih sangat pesat. Kecukupannya akan semakin menurun seiring dengan
bertambahnya usia.
2. Kebutuhan zat pembangun
Secara fisiologis, balita sedang dalam masa pertumbuhan sehingga kebutuhannya relatif lebih besar
daripada orang dewasa. Namun, jika dibandingkan dengan bayi yang usianya kurang dari satu tahun,
kebutuhannya relatif lebih kecil.
3. Kebutuhan zat pengatur
Kebutuhan air bayi dan balita dalam sehari berfluktuasi seiring dengan bertambahnya usia.
4. Beberapa Hal Yang Mendorong Terjadinya Gangguan Gizi
Ada beberapa hal yang sering merupakan penyebab terjadinya gangguan gizi, baik secara langsung
maupun tidak langsung. Sebagai penyebab langsung gangguan gizi, khususnya gangguan gizi pada
bayi dan anak usia dibawah lima tahun (balita) adalah tidak sesuainya jumlah gizi yang mereka
peroleh dari makanan dengan kebutuhan tubuh mereka.
G. Faktor-Faktor Yang Menyebabkan Gangguan Gizi
Berbagai faktor yang secara tidak langsung mendorong terjadinya gangguan gizi terutama pada
anak Balita antara lain sebagai berikut:
a. Ketidaktahuan akan hubungan makanan dan kesehatan
Dalam kehidupan masyarakat sehari-hari sering terlihat keluarga yang sungguhpun berpenghasilan
cukup akan tetapi makanan yang dihidangkan seadanya saja. Dengan demikian, kejadian gangguan gizi
 tidak hanya ditemukan pada keluarga yang berpenghasilan kurang akan tetapi juga pada keluarga yang
berpenghasilan relatif baik (cukup). Keadaan ini menunjukkan bahwa ketidaktahuan akan faedah
makanan bagi kesehatan tubuh mempunyai sebab buruknya mutu gizi makanan keluarga, khususnya
makanan anak balita.
b. Prasangka buruk terhadap bahan makanan tertentu
Banyak bahan makanan yang sesungguhnya bernilai gizi tinggi tetapi tidak digunakan atau hanya
digunakan secara terbatas akibat adanya prasangka yang tidak baik terhadap bahan makanan itu.
Penggunaan bahan makanan itu dianggap dapae menurunkan harkat keluarga. Jenis sayuran seperti
genjer, daun turi, bahkan daun ubi kayu yang kaya akan zat besi, vitamin A dan protein dibeberapa
daerah masih dianggap sebagai makanan yang dapat menurunkan harkat keluarga.
c. Kesukaan yang berlebihan terhadap jenis makanan tertentu
Kesukaan yang berlebihan terhadap suatu jenis makanan tertentu atau disebut sebagai faddisme
makanan akan mengakibatkan tubuh tidak memperoleh semua zat gizi yang diperlukan.
d. Jarak kelahiran yang terlalu rapat
Banyak hasil penelitian yang membuktikan bahwa banyak anak yang menderita gangguan gizi oleh
karena ibunya sedang hamil lagi atau adiknya yang baru telah lahir, sehingga ibunya tidak dapat
merawatnya secara baik.
e. Sosial Ekonomi
Keterbatasan penghasilan keluarga turut menentukan mutu makanan yang disajikan. Tidak dapat
disangkal bahwa penghasilan keluarga akan turut menentukan hidangan yang disajikan untuk keluarga
sehari-hari, baik kualitas maupun jumlah makanan.
f. Penyakit infeksi
Infeksi dapat menyebabkan anak tidak merasa lapar dan tidak mau makan. Penyakit ini juga
menghabiskan sejumlah protein dan kalori yang seharusnya dipakai untuk pertumbuhan. Diare dan
muntah dapat menghalangi penyerapan makanan.Penyakit-penyakit umum yang memperburuk keadaan
gizi adalah: diare, infeksi saluran pernapasan atas, tuberculosis, campak, batuk rejan, malaria kronis,
cacingan. ( Dr. Harsono, 1999).
H. Akibat Gizi yang Tidak Seimbang
a. Kekurangan Energi dan Protein (KEP)
Kekurangan energi dan protein mengakibatkan pertumbuhan dan perkembangan balita
terganggu.Gangguan asupan gizi yang bersifat akut menyebabkan anak kurus kering yang disebut
dengan wasting. Wasting, yaitu berat badan anak tidak sebanding dengan tinggi badannya. Jika
kekurangna ini bersifat menahun ( kronik), artinya sedikit demi sedikit, tetapi dalam jangka waktu yang
lama maka akan terjadi kedaan stunting. Stunting , yaitu anak menjadi pendek dan tinggi badan tidak
sesuai dengan usianya walaupun secara sekilas anak tidak kurus
b. Obesitas
Timbulnya Obesitas dipengaruhi berbagai faktor, diantaranya faktor keturunan dan lingkungan. Tentu
saja, faktor utama adalah asupan energi yang tidak sesuai dengan penggunaan. Menurut Aven-Hen
(1992),

I. Menu Makanan Balita

a. Usia 0 – 6 bulan
Makanan pertama dan terbaik untuk bayi adalah Air Susu Ibu atau ASI, dan semakin lama seorang
bayi mengkonsumsi ASI maka akan semakin baik. Apabila karena sesuatu dan lain hal anda tidak dapat
memberikan ASI maka susu rumusan kedelai (soy formula) adalah pilihan yang baik dan mudah
diperoleh. Jangan memakai susu kedelai komersial. Bayi memiliki kebutuhan spesial dan memerlukan
rumusan kedelai yang dikembangkan untuk kebutuhan tersebut.Tapi tentu saja ASI tetap merupakan
makanan terbaik bagi bayi.ASI merupakan makanan yang paling lengkap mengandung zat-zat gizi yang
sangat dibutuhkan bayi. Kebutuhan kalori bayi antara 100-200 kkal/kgBB.
Berikan ASI sesuai keinginan anak paling sedikit 8 kali sehari, siang maupun malam(ASI saja).
b. Usia 6 – 9 bulan
 Selain ASI berikan makanan pendamping ASI 2 kali sehari. Makanan pendamping ASI adalah bubur
tim lumat ditambah kuning telur/ ayam/ ikan/ tempe/ tahu/ daging sapi/ wortel/ bayam/ kacang hijau/
santan/ minyak. Perkenalkan sayur, sayur hendaknya dimasak dan dihaluskan.Kentang, kacang hijau,
wortel, dan kacang adalah pilihan pertama yang baik.Kemudian perkenalkan buah, cobalah pisang,
alpokat atau apel. Pada umur 8 bulan, kebanyakan bayi sudah dapatmemakancrackers,rotidan cereal
kering. Juga, pada umur 8 bulan, bayi dapat mulai memakan makanan tinggi protein seperti tahu atau
kacang yang telah dimasak matang dan dilumatkan.
c. Usia 9 – 12 bulan
Selain ASI berikan bubur nasi ditambah kuning telur/ ayam/ ikan/ tempe/ tahu/ daging sapi/ wortel/
bayam/ kacang hijau/ santan/ minyak. Makanan diberikan 3 kali sehari dan bubur susu tidak diberikan
lagi.
d. Usia 12 – 24 bulan
Berikan ASI sesuai keinginan anak. Berikan nasi lembek yang ditambah telur/ ayam/ ikan/ tempe/
tahu/ daging sapi/ wortel/ bayam/ kacang hijau/ santan/ minyak. Makanan diberikan 3 kali sehari.
e. Usia 2 tahun lebih
Diberikan makanan yang biasa yang terdiri dari nasi, lauk pauk, sayur dan buah.Makanan tersebut
diberikan 3 kali sehari.Kebutuhan kalori kurang lebih 100 kkal/kgBB.
Anjuran untuk orangtua dalam pemenuhan kebutuhan nutrisi pada anak usia ini adalah:
a. Ciptakan lingkungan makan yang menyenangkan,misalnya memberi makan sambil mengajaknya
bermain.
b. Jangan menuruti kecendrungan anak untuk hanya menyukai satu jenis makanan tertentu.
c. Berikan makanan pada saat masih hangat dengan porsi yang tidak terlalu besar.
d. Berikan ASI ekslusif selama 6 bulan.
e. Berikan makanan tambahan sesuai umur balita
f. Berikan ASI ekslusif selama 6 bulan.
g. Timbang berat badan anak anda secara teratur.

f. Cara Memotivasi Makanan Pada Balita

 Membuat suasana makan menyenangkan.

 Jangan memaksa / mengomeli ketika anak makan.
 Berikan kebebasan anak dalam memilih menu makanan dengan tetap mempertahankan gizi yang
seimbang.

g. Pola Pemberian Makanan Pada Balita Usia 0-2 Thn

Umur (Bulan) Bentuk Makanan Pemberian Dalam Sehari

0–6 ASI Sekehendak
6–8 ASI Sekehendak
Bubur halus, lembut, cukup 2-3x/hari
kental, dilanjutkan bertahap 1-2x selingan
menjadi lebih kasar 2-3 sdm/ kali dan
ditingkatkan sampai ½
mangkuk kecil bayi (125 ml)
9-11 ASI Sekehendak
Makanan yang dicincang 3-4x/hari
halus atau disaring kasar, 1-2x selingan
ditingkatkan semakin kasar ½ sampai ¾ mangkuk (125-
sampai makanan bisa 175 ml
dipegang / diambil dengan
tangan
 12-23 ASI Sekehendak
Makanan Keluarga 3-4x/hari
Bila masih perlu dicincang 1-2x selingan
atau disaring kasar ¾ sampai 1 mangkuk
(175- 250 ml)
Sumber : Penuntun Diet Anak FKUI Edisi ke 3, 2016
Keterangan:
 Makanan keluarga : Mudah dicerna dan tidak merangsang (tidak berbumbu tajam , tidak
pedas , tidak terlalu berlmak
 Makanan kecil (selingan) berupa biscuit, bubur kacang ijo dll
J. Contoh Menu Seimbang Balita
Pagi : Nasi goreng ½ piring
Telur dadar iris
Timun 2 iris
Susu 1 gelas
Selingan Pagi : Bubur kacang hijau 1 gelas
Siang : Nasi ½ piring
Sayur bening ½ mangkuk
Tempe goreng 2 iris
Pepaya 1 potong
Selingan sore : Agar agar buah 2 cup
Pisang goreng 2 buah
Malam : Nasi ½ piring
Sayur sop ayam ½ mangkuk
Perkedel 2 potong
Jeruk 1 buah
Susu 1 gelas

K. Tips Balita Susah Makan

1. Membuat variasi menu yang menarik

Makanan – Sumber Gambar: pixabay.com

Tips balita susah makan yang pertama adalah membuat variasi menu harian yang menarik. Menu yang sama
setiap harinya bisa menjadi faktor anak sulit makan. Bisa jadi balita merasa bosan sehingga nggak mau
menyentuh makanannya. ShopBackers harus siap berkreasi agar anak kembali bersemangat makan.
Jangan lupa untuk penuhi gizi seimbang seperti karbohidrat, sayuran, buah-buahan, protein, dan
lemak. Selain itu, kamu pun harus mengetahui apa makanan kesukaan dan apa makanan yang dibencinya.
Misalnya, ketika anak-anak enggak suka sayur karena rasa dan aromanya. Buat menu sayuran yang kaya
bumbu dan jadikan momen makan sayur sebagai hal yang menyenangkan.

2. Menyertakan peralatan makan yang lucu

Kotak, makanan – Sumber Gambar: pixabay.com

Ternyata, peralatan makan juga berpengaruh terhadap nafsu makan balita, lho. Untuk itu, siasatilah dengan
membeli alat-alat makan yang disukai balita. Contohnya, jika anak-anak menyukai tokoh animasi tertentu,
belikan mereka piring atau sendok bergambar karakter kartun favorit.

Tidak hanya alat makan untuk di rumah, kamu harus menyiapkan peralatan makan lucu ketika pergi jalan-
jalan piknik. Siapkan botol minum berbentuk tokoh kartun kesukaannya dan pastikan mudah digenggam
anak. Selain itu, bawakan kotak bekal makan warna-warni serta bernuansa cerah.

3. Membuat tampilan makanan yang enggak monoton

Makanan – Sumber Gambar: pixabay.com

Selain menyiapkan menu yang unik dan lezat, percuma saja kalau tampilan makanannya berantakan. Hal ini
malah enggak berefek meningkatkan nafsu makan anak. Makanya, mengubah tampilan makanan jadi
menarik dan nggak monoton bisa sangat membantu.

Tips jitu untuk membuat penampilan makanan lebih menarik, yakni mengubah bentuk makanan menjadi
karakter-karakter lucu. Apabila menggunakan roti sebagai menu sarapan, cobalah membentuknya menjadi
kelinci atau kucing. Selain roti, kamu juga bisa membeli cetakan telur berbentuk bunga dan memakainya saat
menggoreng telur. Jika menggunakan sosis, coba sajikan bahan pangan ini dalam bentuk gurita yang imut.
4. Makan bersama

Keluarga – Sumber Gambar: pixabay.com

Sudah mengubah tampilan, memvariasikan menu, dan menggunakan peralatan makan lucu, tapi kenapa
balita tetap sulit makan? Bisa jadi karena ShopBackers nggak makan bersama si kecil. Ciptakan suasana
yang menyenangkan dengan menemani mereka makan.

Kamu bisa mengajak mereka mengobrol selama makan. Mulai dari membahas kosakata baru, mengajarkan
sopan santun, atau mengajarkan rasa syukur. Selain itu, ketika ShopBackers menyantap makanan yang
kurang disukai buah hati dengan sukacita, kemungkinan si kecil akan menirumu secara bertahap.

5. Bersabar dan enggak memaksa

Keluarga – Sumber Gambar: commons.wikimedia.org

Orang tua memang harus sering-sering bersabar ketika menghadapi si kecil, tak terkecuali saat anak susah
makan. Jangan sampai memaksa dan menimbulkan pertengkaran yang pada akhirnya hanya membuat anak
semakin enggak bersemangat. Hal ini juga nantinya membuat anak kurang sensitif pada rasa lapar. Selain itu,
tindakan memaksa malah menimbulkan trauma di kemudian hari.
6. Batasi konsumsi air minum

Anak kecil minum – Sumber Gambar: pixabay.com

Konsumsi air minum memang penting. Namun, kamu harus mengetahui kapan waktu yang tepat untuk
memberikannya pada anak. Sebaiknya jangan memberikan jus atau susu saat mendekati jam makan. Terlalu
banyak minum nantinya membuat buah hati makin cepat merasa kenyang. Kalau sudah kenyang, biasanya
anak jadi enggak semangat untuk makan.

7. Jangan memberikan porsi terlalu banyak

Makanan – Sumber Gambar: flickr.com/photos/mdid

Bedakan porsi makan orang dewasa dengan anak-anak. Balita tentunya makan lebih sedikit sehingga
takarannya harus sesuai. Jika bingung menentukan porsi, kamu bisa menggunakan portion plate untuk anak-
anak. Ketika si kecil menyukai makanannya, tambahkan sedikit demi sedikit. Namun pastikan tidak
berlebihan agar gizi tetap seimbang dan tidak menimbulkan obesitas.
 DAFTAR PUSTAKA

ASDI,IDAI,Persagi,2016.Penuntun Diet Anak Edisi Ke 3. Badan Penerbit FKUI

Santosa, Sugeng. 2004. Kesehatan dan Gizi. Jakarta: PT.Rieneka Cipta.

Syamsuri, Istamar. 2004. Biologi SMA kelas XI. Jakarta: Erlangga.

Sudiyanto. Dalam membina anak dalam mencapai cita-citanya. Tumbuh kembang

anak, Fakultas Kedokteran UI.

Suhardjo (1992).Pemberian makanan pada bayi dan anak.Jakarta : Kanisius

Supartini.Y. (2002).Buku Ajar : Konsep dasar keperawatan anak. Jakarta : EGC

Soekirman.(2000). Ilmu gizi dan aplikasinya untuk keluarga dan masyarakat.Jakarta :

EGC

Almatsier, Sunita. 2003. Prinsip Dasar Ilmu Gizi. Jakarta : EGC.

Departemen kesehatan RI. 2006. Buku Kader Posyandu Dalam Usaha Perbaikan
Gizi Keluarga. Jakarta : Departemen Kesehatan RI.

Hasan, Rusepno.1985.Buku Kuliah I Ilmu Kesehatan Anak.Jakarta: Infomedika

Juwono, Lilian.2003.Pemberian Makanan Tambahan : Makanan Untuk Anak

Menyusu.Jakarta : EGC

Santoso, Sugeng dan Rianti, Anne Lies. 2004. Kesehatan Dan Gizi. Jakarta : Rineka
Cipta.

Westcott, Patsy. 2003. Makanan Sehat Untuk Bayi dan Balita. Jakarta: Dian Rakyat.

Widjaja, MC. 2006. Gizi Tepat untuk Perkembangan Otak dan Kesehatan Balita.
Jakarta: Agro Media Pustaka.

Kementrian kesehatan RI. 2020. Buku Panduan Gizi Seimbang Pada Masa Pandemi
Covid-19. Jakarta : Kementrian Kesehatan RI.

https://www.shopback.co.id/katashopback/tips-balita-susah-makan
Lampiran 2: Materi Power Point
 APA itu Gizi ?

Gizi ADAlAH MAKANAn

DAN ZAT-zAt YANG
DIPERluKAN OLEH tuBUH
YANG BERHuBUNGAn
DENGAn KESEHATAn
untuK
MEMPeRtAHANK an
KEHIDU-PAn,
PERtuMBUHAn DAn
fuNGSI ORGAn tuBuH
Apa itu Gizi Seimbang ?
Gizi seimbang adalah gizi
yang sesuai dengan
kebutuhan tubuh melalui
makanan sehari-hari
sehingga tubuh bisa
aktif, sehat optimal,
tidak terganggu penyakit,
dan tubuh tetap sehat
 PRinsiP Gizi SeIMBANG

Pilar: 4
3

2
1
Pentingnya Gizi Seimbang

Untuk Meningkat meningkat

pertumbu kan kan daya
han dan potensi tahan
perkemba kecerdasa tubuh
ngan n

1 2 3
Akibat Kurang Gizi
Pertumbu
1 han &
perkemban kecerdasan
gan anak
anak kurang
terganggu
atau lambat
3
Anak
mudah
sakit

2
Pola Pemberian Makanan pada Bayi Usia 0-5
Tahun

USIA
 Apa itu gizi???
Pola Pemberian Makanan pada Bayi Usia
0-5 Tahun
Gizi adalah makanan dan zat-zat yang
diperlukan oleh tubuh yang berhubungan
dengan kesehatan untuk mempertahankan
kehidu-pan, pertumbuhan dan fungsi organ
tubuh serta menghasilkan energi.
KEBUTUHAN GIZI SEIMBANG
Guna Makanan bagi Bayi dan Balita
PADA BALITA 1. Sebagai sumber zat tenaga
Umur Jenis Makanan Pemberian
2. Sebagai sumber zat pembangun
(bulan) Dalam Sehari
3. Sebagai sumber zat pengatur
0-6 ASI Sekehendak
ASI Sekehendak
Makanan Bayi Usia 0-6 6-8 Buah 1 kali
Bubur susu 2 kali
Bulan
ASI Sekehendak
Makanan yang paling
Buah 1 kali
sesuai untuik bayi adalah 8-10
Bubur susu 1 kali
air susu ibu, karena ASI
Nasi tim saring 2 kali
memang diperuntukkan
bayi-bayi yang khasiatnya ASI 1 kali
sebagai makanan pokok 10-12 Buah 3 kali
untuk bayi. Nasi tim saring 3 kali
ASI 2-3 kali
Buah 1 kali
OLEH: Makanan Bayi Umur 6-12 12-24 Makanan seperti 3 kali
Bulan
keluarga 1 kali
I MADE WAHYUDI MARTA Makanan kecil
Pada bayi umur 6-12 bulan
tetap berikan air susu ibu Susu 2-3 kali
2
(ASI) sesuai dengan Buah 1 kali
tahun-
keinginan anak. Selain itu beriakan bubur nasi Makanan seperti 3 kali
PROGRAM STUDI PROFESI NERS 5
ditambah telur/ ayam/ ikan/ tempe/ tahu/ keluarga 1 kali
FAKULTAS ILMU KESEHATAN tahun
daging sapi /wortel /bayam/ kacang hajau Makanan kecil
UNIVERSITAS RESPAI INDONESIA
/santan /minyak dan dilumatkan.
 Mengatur Makanan Anak Usia 1-5 Kurang Gizi Cara Memasak yang Tepat
Tahun
Kurang gizi adalah kekurangan zat-zat gizi
Dalam memenuhi kebutuhan gizi usia 1-5 thn yang dibutuhkan oleh tubuh sehingga terjadi
hendaknya digunakan kebutuhan prinsip perubahan tubuh (kurus,lemah,pucat)
sebagai berikut:
1. Bahan makanan sumber kalori harus
dipenuhi baik berasal dari makanan pokok,
minyak dan zat lemak serta gula.
2. Berikan sumber protein nabati dan hewani Dalam mengolah makanan harus di
3. Jangan memaksa anak makan makanan perhatikan jenis bahan makanan yang ada,
yang tidak disenagi, berikan makanan lain misalnya sayuran sebelum dipotong di cuci
Penyebab Kurangnya Gizi
yang diterima anak. terlebih dahulu dan dalam merebus atau
4. Berilah makanan selingan (makanan ringan) ➢ Kurang makan
mengukus tidak boleh dari 20 menit,
misalnya, biscuit dan semacamnya, ➢ Makanan yang tidak seimbang
sedangkan dalam menggoreng ikan tidak
diberikan antara waktu makan pagi, siang ➢ Makanan yang tidak teratur
boleh sampai kering. Agar gizi yang
dan malam ➢ Salah dalam mengolah makanan
terkandungan dalam makanan tidak hilang
sehingga.
Tanda-Tanda Kurang Gizi
Zat Gizi Yang Terkandung dalam Catatan:
1. Badan kurus
Makanan - Cucilah tangan sebelun menyuapkan
2. Kulit kering kusam
 Air makanan pada balita
3. Lemas dan pucat
 Protein - Pakailah bahan makanan yang baik dan
4. Mata bengkak
 Lemak dan asam lemak aman, peralatan masak yang bersih, dan
5. Kaki dan tangan
 Karbohidrat cara memasak yang benar.
bengkak

Akibat Kurang Gizi

1. Gangguan pertumbuhan
2. Mudah sakit
3. Kurang cerdas
I MADE WAHYUDI MARTA, S.Kep

PROGRAM STUDI PROFESI NERS

FAKULTAS ILMU KESEHATAN

UNIVERSITAS RESPATI INDONESIA

2020

Gizi seimbang adalah gizi yang
sesuai dengan kebutuhan tubuh
melalui makanan sehari-hari
sehingga tubuh bisa aktif, sehat
optimal, tidak terganggu
penyakit, dan tubuh tetap sehat
Memiliki 4 pilar utama
1. Pertumbuhan & perkembangan
anak terganggu
2. Anak mudah sakit
3. kecerdasan anak kurang atau
lambat
1. Untuk pertumbuhan dan
perkembangan
2. Meningkatkan potensi
kecerdasan
3. meningkatkan daya tahan tubuh
Lampiran 4:

UNDANGAN ELEKTRONIK
Lampiran 5:
DOKUMENTASI UJIAN
Lampiran 6:
DAFTAR HADIR PESERTA ZOOMINAR

NO TIME STAMP NAMA PESERTA EMAIL/TLP

1 1/11/2021 11:57:18 Leman Sirait channesirait75@gmail.com
2 1/13/2021 11:52:34 Citra Agustine yara.zahira@gmail.com
3 1/13/2021 12:43:12 Marwati marwati81iing@gmail.com
4 1/13/2021 12:45:36 haryati wulanyuni 085779944599
yantiherlianti32@gmail.com
5
1/13/2021 12:58:29 Yanti Herlianti / 089649437787
6 1/13/2021 13:51:47 Tissa marlina yuru beli tissaraditya@gmail.com
7 1/13/2021 15:58:26 Leman 081311312980
8 1/13/2021 16:03:13 MEITA DAHLIA meitadahlia@gmail.com
9 1/13/2021 16:18:37 Marihot Sirait 081315948230
10 1/13/2021 16:19:56 Albert Hasibuan 082111864788
11 1/13/2021 18:18:40 Rizki Resti Puspita Sari rizkirestipuspitasari@gmail.com
12 1/13/2021 18:38:01 Yudi yudhybaso@gmail.com
13 1/13/2021 19:01:37 Fadhilatul Khikmiyyah 085828293230
14 1/13/2021 19:03:16 Anom Ferawati 081314358801
15 1/13/2021 19:20:17 Anfield anfieldmarpaung@gmail.com
16 1/13/2021 19:21:06 Ria lamriamarpaung08@gmail.com
17 1/13/2021 19:24:02 Siti Masyaroh 081316473611
18 1/13/2021 19:25:56 Bobby El Toruan bobby_eltoruan@yahoo.com
19 1/13/2021 19:33:02 Tri 081387152990
20 1/13/2021 19:36:54 Isnani O85885159348
21 1/13/2021 19:36:54 Nurlela Sirait 081210460808
22 1/13/2021 19:37:14 Megawati 085781409939
23 1/13/2021 19:38:54 Desak putu agustini aaghii88@gmail.com
24 1/13/2021 19:39:26 Leman Sirait 081311312980
25 1/13/2021 19:39:58 Yuni triastuti 081806886226
26 1/13/2021 19:40:09 Yemima 085319722969
27 1/13/2021 19:40:17 Bety ayu Betyayu54@gmail.com
28 1/13/2021 19:40:46 Ani Rismayani 081315979067
29 1/13/2021 19:40:52 Anom Ferawati anomferawati@gmail.com
30 1/13/2021 19:40:53 Naomi siregar 082294870491
31 1/13/2021 19:41:52 Emilie Nathania 081311312980
32 1/13/2021 19:42:43 Fadhilatul Khikmiyyah fadhilakhikk@gmail.com
33 1/13/2021 19:42:54 Patmiyanti 085777247767
34 1/13/2021 19:43:24 Hipas 082164648476
35 1/13/2021 19:43:27 Audrina 081283622759
36 1/13/2021 19:44:40 Isnani 085885159348
37 1/13/2021 19:46:56 Syukran fadholi Syukran.fadholi@gmail.com
38 1/13/2021 19:49:23 WAHYU FITRIYANI wahyufit@ymail.com
39 1/13/2021 19:52:01 Audra Isaura 085211911333
40 1/13/2021 19:55:06 Adrian victor adrianvctr@gmail.com
41 1/13/2021 20:02:27 Amelia Nainggolan 081280598824
42 1/13/2021 20:04:25 Elita 082125519624
 43 1/13/2021 20:11:39 Danu asmoro 85780555993
44 1/13/2021 20:17:34 Dewi oktadedew1@gmail.com
45 1/13/2021 20:33:16 Komang Ariyani kmariyani86@gmail.com/083115429642
46 1/13/2021 20:46:10 Fadhilatul Khikmiyyah fadhilakhikk@gmail.com

Lampiran 7:

LINK GOOGLE FORM :

a. Link daftar hadir : https://forms.gle/P1XDxscTB513ciyH9

b. Pre Test : https://forms.gle/P1XDxscTB513ciyH9
c. Post Test : https://forms.gle/DQbbLvBkjyESR2BA6

Lampiran 8:

SOAL PRE DAN POST TEST

1. Apa yang disebut gizi ?

a. gizi atau makanan merupakan bahan dasar penyusunan bahan makanan yang mempunyai
fungsi sumber energi atau tenaga, menyokong pertumbuhan badan, memelihara dan
mengganti jaringan tubuh, mengatur metabolisme dan berperan dalam mekanisme pertahanan
tubuh.
b. gizi yang sesuai dengan kebutuhan tubuh melalui makanan sehari-hari sehingga tubuh bisa aktif,
sehat optimal, tidak terganggu penyakit, dan tubuh tetap sehat
c. makanan yang dimakan secara beraneka ragam
d. nutrisi penting yang sangat dibutuhkan bagi pertumbuhan dan perkembangan

2. Apa yang disebut gizi seimbang?

a. gizi atau makanan merupakan bahan dasar penyusunan bahan makanan yang mempunyai fungsi
sumber energi atau tenaga, menyokong pertumbuhan badan, memelihara dan mengganti jaringan
tubuh, mengatur metabolisme dan berperan dalam mekanisme pertahanan tubuh.
b. gizi yang sesuai dengan kebutuhan tubuh melalui makanan sehari-hari sehingga tubuh bisa
aktif, sehat optimal, tidak terganggu penyakit, dan tubuh tetap sehat
c. makanan yang dimakan secara beraneka ragam
d. nutrisi penting yang sangat dibutuhkan bagi pertumbuhan dan perkembangan

3. Apa itu fungsi makanan bergizi?

a. Makanan sebagai zat tenaga
b. Makanan sebagai zat pembangun
c. Makanan sebagai zat pengatur
d. Semua jawaban bebar

4. Nutrisi apa saja yang di butuhkan bagi pertumbuhan dan perkembangan balita?
a. Vitamin A, D, E, K
b. Kalsium dan Vitamin B dan C
c. Zat Besi
d. Vitamin A, D, E, K , Kalsium, Vitamin B dan C dan Zat Besi

5. Apakah pada bayi umur 0-6 bulan boleh diberikan makanan selain ASI?
a. Boleh
b. Tidak boleh
Lampiran 9:

HASIL PRE DAN POST TEST

a. PRE TEST
b. POST TEST

a. HASIL PRE TEST

Total responden yang mengisi Google form Pre Test pertanyaan pertama ada 46 responden,
dan yang menjawab benar sebanyak 33 (71,7%).
Total responden yang mengisi Google form Pre Test pertanyaan kedua ada 46 responden,
dan yang menjawab benar sebanyak 21 (45,7%).

Total responden yang mengisi Google form Pre Test pertanyaan Ketiga ada 46 responden,
dan yang menjawab benar sebanyak 40 (87%).

Total responden yang mengisi Google form Pre Test pertanyaan keempat ada 46 responden,
dan yang menjawab benar sebanyak 39 (84,8%).
 Total responden yang mengisi Google form Pre Test pertanyaan Kelima ada 46 responden,
dan yang menjawab benar sebanyak 40 (87%).

b. HASIL POST TEST

Total responden yang mengisi Google form Post Test pertanyaan pertama ada 33 responden,
dan yang menjawab benar sebanyak 27 (81,8%).
Total responden yang mengisi Google form Post Test pertanyaan Kedua ada 33 responden,
dan yang menjawab benar sebanyak 20 (60,6%).

Total responden yang mengisi Google form Post Test pertanyaan Ketiga ada 33 responden,
dan yang menjawab benar sebanyak 32 (97%).
 Total responden yang mengisi Google form Post Test pertanyaan keempat ada 33
responden, dan yang menjawab benar sebanyak 31 (93,9%).

Total responden yang mengisi Google form Post Test pertanyaan kelima ada 33 responden,
dan yang menjawab benar sebanyak 30 (90,9%).

BIAYA :

NO IURAN BIAYA

1 Paket Data Rp.300.000

2 Iuran Rp. 250.000

Anas Abdulrahman Aljohani et al, 2020;4(1):007–011. International Journal of Medicine in Developing Countries
https://doi.org/10.24911/IJMDC.51-1541620358

ORIGINAL ARTICLE

The knowledge of mothers about children

malnutrition and associated factors
Anas Abdulrahman Aljohani1*, Mujahid Abdulrahman Aljohani1

ABSTRACT
Background: Normal activities performed in life require a balanced diet and healthy body which should be built
during childhood. Malnutrition is a health problem which develops as a result of insufficient food nutrients
supplied to the body. Mothers are responsible for baby’s nourishment; with sufficient information, they can
protect their children from this health problem. This study was done to assess the knowledge of mothers about
malnutrition and to investigate the associated factors.
Methodology: This cross-sectional study was conducted during the period from June to October 2018 via
an online survey. Eight hundred participants (mothers) were included. The questionnaire included questions
about demographics and malnutrition.
Results: The mean ± SD score of knowledge was 16.2 ± 2.4, 62.25% knew about malnutrition and the main
source of the knowledge was a doctor (62.5%). There were several demographics that significantly influenced
the knowledge of mothers, including age (p = 0.008), educational level (p = 0.02), monthly income (p = 0.001),
number of children (p = 0.01), breastfeeding (p = 0.03), and source of knowledge (p = 0.003).
Conclusion: There was an acceptable level of knowledge of mothers regarding malnutrition of children, and
there were several factors that affected the level of knowledge, including age and educational level of mothers,
monthly income, number of children, breastfeeding, and source of knowledge.
Keywords: Malnutrition, children, mothers, knowledge.

Introduction

Balanced diet is necessary for normal activities that are
performed in life [1]. The nutritional status of children is
an indicator for the economic development [2]. Children
are more prone to suffer from nutritional deficiencies and
problems [1]. Malnutrition is a condition which develops
as a result of insufficient food nutrients supplied to
the body, these nutrients include minerals, vitamins,
proteins, fat, and carbohydrate which are necessary for
maintaining healthy tissues and organ functions [3,4].
Malnutrition is an underlying cause of mortality and
morbidity of children under 5 years of age [1]. It was
estimated that malnutrition was responsible for 60% of
10.9 million deaths annually, either directly or indirectly
among children under 5 years of age [5]. In Saudi Arabia,
the prevalence of being moderate to severe underweight
was 6.9% and 1.3%, respectively, and it was found that
the prevalence rate of malnutrition among children was
higher than that of other countries with less economic
sources [2]. The symptoms that might be experienced in
malnutrition include breathing difficulties, higher risk
of hypothermia, weight loss, and higher susceptibility
to diseases [6]. There are several risk factors and they
should be identified to avoid the bad consequence of
malnutrition, and thus to promote health and prevent
diseases [7,8]. These factors include larger family size,
maternal illiteracy, low monthly income, and paternal
literacy [9]. The main risk factors reported was low
maternal education [10]. Mother is the person responsible
for taking care of child, so it is very important for mothers
to have enough knowledge regarding nutrition of the
child [11]. Mothers who have more knowledge about
nutrition can bring up their children in healthy way [1].
There was no previous study in Saudi Arabia which was
conducted to investigate the knowledge of mothers about
malnutrition and maternal associated factors; hence, this
study was performed.
Correspondence to: Anas Abdulrahman Aljohani
*Taibah University, Madinah Munawwarah, Saudi
Arabia.
Email: Wolf42009@hotmail.com
Full list of author information is available at the end of
the article.
Received: 7 November 2018 | Accepted: 9 February 2019

© IJMDC. https://www.ijmdc.com 7
 Knowledge of mothers about children malnutrition

Subjects and Methods The mean ± SD score of knowledge of mothers was 16.2
± 2.4. The details of the knowledge of mothers are shown
This study is cross-sectional which was conducted on 800 in Table 2. There were 10 questions asked, there were
mothers in the period between June and October 2018. 450 (56.3%) mothers who answered them correctly about
The study was performed via an online survey. The survey the cause of malnutrition, 600 (75%) and 150 (18.8%)
included questions to investigate the demographics of answered correctly about the feature of malnutrition
mothers, such as age, marital status, working status, and and the check for children, respectively. More than half
the other part of questions investigated the knowledge of 550 (68.7%) of mothers correctly answered about the
mothers about malnutrition. foods essential for children growth, 750 (93.7%) and
300 (37.5%) reported correct answers about the time of
Data were analyzed using SPSS software version 16, the
simple descriptive analysis in the form of numbers and
percent for qualitative variables, and median and range
for quantitative variables. The level of knowledge was Table 1. Characteristics of mothers.
calculated using the scoring system; the correct answer
was scored 1 and the wrong one was scored 0, the total Characteristics N (%)
score was then calculated and the average was taken, Age
the range of score was from 0 to 20. Correlations were  20–30 520 (65%)
 31–40 80 (10%)
performed between different variables. The p-value was
 41–50 150 (18.7%)
considered significant at ≤0.05.   ˃50 50 (6.3%)
Results Education level
  Prep school 200 (25%)
  Secondary school 350 (43%)
The present study included 800 mothers whose age  University 250 (32%)
ranged between 20 and >50 years, those in the age group
Working status
of 20–30 years old comprise the dominant group among  Worker 300 (37.5%)
other age groups, representing 520 (65%). There were  Housewife 500 (62.5%)
350 (43%) of mothers who had secondary education,
Marital status
only 300 (37.5%) were workers, whereas more than half  Married 750 (93.7%)
500 (62.5%) were housewives. The large majority 750  Divorced 30 (3.8%)
(93.7%) were married and 31.2% reported had a monthly  Widow 20 (2.5%)
income of ˃15,000 SR. Most of mothers 700 (87.5%) Monthly income
reported having —one to three children and three   ≤5,000 SR 200 (25%)
quarters 600 (75%) reported breastfeeding their children,   6,000–10,000 SR 200 (25%)
demographics of participants are shown in Table 1. Four   10,000–15,000 SR 150 (18.8%)
  ˃15,000 SR 250 (31.2%)
hundred and ninety (61.25%) mothers reported having
knowledge about malnutrition (Figure 1) and the most Number of children
 1–3 700 (87.5%)
common source of their knowledge was doctors 500  4–6 79 (9.9%)
(62.5%) (Figure 2).   ˃6 21 (2.6%)
Did you breastfeed your
children
 Yes 600 (75%)
 No 200 (25%)

Figure 1. Knowledge of mothers about malnutrition. Figure 2. Source of knowledge of mothers.

8
 Knowledge of mothers about children malnutrition

Table 2. Questions about the malnutrition knowledge of mothers.

Questions Answer N (%)
Correct Incorrect
1-Imbalanced diet is the cause of malnutrition 450 (56.3%) 350 (43.7%)
2-Less weight for age is a clinical feature of undernutrition 600 (75%) 200 (25%)
3-Every 3 months, height and weight must be checked for children aged 150 (18.8%) 650 (81.3%)
3–5 years
4-Cereals, pulses, milk, fish, and green leafy vegetables are essential for 550 (68.7%) 250 (31.3%)
the growth of children
5-Breastfeeding should be initiated within half an hour of delivery 750 (93.7%) 50 (6.3%)
6-Supplementary feeding should be initiated at 6 months of age 300 (37.5%) 500 (62.5%)
7-Child should be hospitalized to treat severe malnutrition 440 (55%) 360 (45%)
8-Delayed physical growth and impaired cognitive development are the 420 (52.5%) 380 (47.5%)
complications of malnutrition
9-Adequate breastfeeding, nutritious food, and regular deworming will 690 (86.2%) 110 (13.8%)
prevent malnutrition in children
10-Immunization of children is the best way to protect the child against 700 (87.5%) 100 (12.5%)
infectious diseases

initiating breastfeed and supplementary feed, respectively.
There were 440 (55%) mothers who correctly answered
the question asked if the severe malnutrition of children
needed hospitalization. There were 420 (52.5%), 690
(86.2%), and 700 (87.5%) mothers who were reported
to provide correct answers about the complications of
malnutrition, prevention of malnutrition, and protection
of the child, respectively.
By investigating mother’s characteristics that might be
associated with the knowledge about malnutrition, it was
found that several factors were significantly associated
with mothers’ knowledge, including age (p-value =
0.008), educational level (p-value = 0.02), monthly
income (p-value = 0.001), number of children (p-value
= 0.01), breastfeeding status (p-value = 0.03), and source
of knowledge (p-value = 0.003), as shown in Table 3.
Discussion
The study included 800 mothers, the mean score
knowledge was 16.2, there were 61.25% who reported
that they knew about malnutrition and 62.5% reported
that the main source of knowledge were doctors. These
findings were better than that reported in a previous
study from India [12] which found that the mean score
of knowledge of mothers was 10.54 and the score range
was 3–19, also their results showed that highest percent
of mothers (65%) had average knowledge. Another study
[13] reported mean score of 11.4 and 50% of participants
had average knowledge. Also, the average knowledge of
mothers was dominant (46.1%) in another study [9]. A
study from India reported that the knowledge of mothers
was insufficient and needed to be improved [14]. A
study from Cameron [6] showed that 73% of mothers
had knowledge of malnutrition which was higher than
the present findings. It was reported that inadequate
food intake or intake of non-nutritious food will result
in a reduction in muscle mass [15]. In the current study,
mothers knew more about features of undernutrition,
essential foods for children growth, time of breastfeed
initiation, prevention of malnutrition, and protection of
children by immunization. More than 60% of mothers
correctly answered about each of the previous questions.
It was found in Indian study [12] that more than 60%
of participants answered correctly about clinical features
of malnutrition, essential foods for children growth, time
for breastfeed initiation, and protection of children, and
this was in agreement with the present findings. Another
study reported that 50% of mothers had knowledge about
the effects of malnutrition on children, 67% knew about
the prevention of malnutrition, and 40% knew the time
for breastfeed initiation [6]. By investigating different
factors that may influence knowledge of mothers, it
was found that in the present study, younger age, higher
education, higher monthly income, fewer number of
children, breastfeeding, and the doctors as the source of
information were significantly associated with having
knowledge about malnutrition, whereas marital status
and working status had no association with knowledge of
mothers. In previous studies, association with knowledge
was reported; one study found that knowledge was
associated with the educational status of mothers [16],
another one reported association between knowledge and
educational status, as well as a socioeconomic class [9].
It was found that knowledge increased with number of
children and level of education [6], which was in line
with the present results.
There were strengths and limitations in this study; the
strengths included the large sample size and availability
of online survey to reach all mothers in the society,
whereas the limitations included the few comparisons in
results as there were few studies on this subject, there

9
 Knowledge of mothers about children malnutrition

Table 3. Correlations between different characteristics and knowledge of malnutrition.

Characteristics Knowledge p-value
Yes No
490 (61.25%) 310 (38.75%)
Age 0.008
 20–30 420 (52.5%) 100 (12.5%)
 31–40 40 (5%) 40 (5%)
 41–50 20 (2.5%) 130 (16.3%)
  ˃50 10 (1.2%) 40 (5%)
Education level 0.02
  Prep school 81 (10.1%) 119 (14.9%)
  Secondary school 200 (25%) 150 (18.8%)
 University 209 (26.1%) 41 (5.1%)
Working status 0.07
 Worker 240 (30%) 60 (7.5%)
 Housewife 250 (31.25%) 250 (31.25%)
Marital status 0.09
 Married 460 (57.5%) 290 (36.25%)
 Divorced 20 (2.5%) 10 (1.25%)
 Widow 10 (1.25%) 10 (1.25%)
Monthly income 0.001
  ≤5,000SR 100 (12.5%) 100 (12.5%)
  6,000–10,000 SR 115 (14.4%) 85 (10.6%)
  10,000–15,000 SR 75 (9.4%) 75 (9.4%)
  ˃15,000 SR 200 (25%) 50 (6.2%)
Number of children 0.01
 1–3 430 (53.75%) 270 (33.75%)
 4–6 39 (4.9%) 40 (5%)
  ˃6 21 (2.6%) 0 (0%)
Did you breastfeed your 0.03
children?
 Yes 400 (50%) 200 (25%)
 No 90 (11.25%) 110 (13.75%)
Source of knowledge 0.003
 Doctor 430 (53.75%) 70 (8.75%)
 Friends 20 (2.5%) 80 (10%)
 Media 40 (5%) 160 (20%)

was no previous Saudi study and other studies present Consent for publication
were of different designs. Informed consent was obtained from all participants.
Conclusion Ethical approval
The research was approved by Taibah University, College of
There was an acceptable level of knowledge of mothers Medicine, research ethics committee on 10/2/2019 with
regarding the malnutrition of children; however, this study id 040-1440.
knowledge should be increased, as there were lacking
in some points. Age and educational level of mothers, Author details
monthly income, number of children, breastfeeding, Anas Abdulrahman Aljohani1, Mujahid Abdulrahman
and source of knowledge were important factors that Aljohani1
influenced the knowledge of mothers. 1. Taibah University, Madinah, Saudi Arabia

List of Abbreviations References

None. 1. Khattak AM, Gul S, Muntaha ST. Evaluation of nutritional
knowledge of mothers about their children. Gomal J Med
Conflict of interest Sci. 2007;5(1):17–21.
The authors declare that there is no conflict of interest
2. El Mouzan MI, Foster PJ, Al Herbish AS, Al Salloum AA,
regarding the publication of this article.
Al Omar AA, Qurachi MM. Prevalence of malnutrition
Funding in Saudi children: a community-based study. Ann Saudi
None.

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4947.67076
3. Anderson AS. Pregnancy as a time for dietary change?
Proc Nutr Soc. 2001;60:497–504.
4. Blake W. Malnutrition a cause for concern in Africa and
the world at large. New Jerssy: Minache Printing House;
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Available from: https://www.worldbank.org/en/country/
india/overview
6. Cumber SN, Ankraleh N, Monju N. Mothers’ knowledge
on the effects of malnutrition in children 0–5 years
in Muea health area Cameroon. J Fam Med Health
Care. 2016;2(4):36–42. https://doi.org/10.11648/j.
jfmhc.20160204.13
7. Bharmal F. Inequity and health. Is malnutrition really
caused by poor nutrition? J Pak Med Assoc. 2000;50:273–
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8. Graham VA, Gibbons IK, Marrafia C, Henry L, Myers J.
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years in western metropolitan Melbourne. J Pediatr Child
Health. 1998;34:513–7. https://doi.org/10.1046/j.1440-
1754.1998.00288.x
9. Nath LR, Kanniammal C. Knowledge and practice of
mothers regarding the prevention and management of
malnutrition among preschool children—a cross sectional
survey. Int J Pharm Clin Res. 2017;9(5):410–2. https://doi.
org/10.25258/ijpcr.v9i5.8604
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10. Phengxay M, Ali M, Yagyu F, Soulivanh P, Kuroiwa C,
Ushijima H. Risk factors for protein–energy malnutrition
in children under 5 years. Pediatr Int. 2007;49(2):260–5.
https://doi.org/10.1111/j.1442-200X.2007.02354.x
11. Patali CS. A descriptive study to assess the knowledge of
mothers regarding the nutrition for under five children
in selected areas of Bagalkot with a view to develop
a self instructional module. JOJ Nurse Health Care.
2018;7(3):JOJNHC.MS.ID.555713.
12. Nayak BS, Unnikrishnan B, George A, Shashidhara YN,
Mundkur SC. Mothers knowledge on malnutrition:
community based cross sectional study. Indian J Public
Health Res Develop. 2018;9(1):37–41. https://doi.
org/10.5958/0976-5506.2018.00007.4
13. Kavitha MM. Assess the knowledge on malnutrition
among mothers in Vinayaka Mission Hospital, Salem.
IOSR J Nurs Health Sci. 2015;4(4):27–35.
14. Hoque M, Hossain MW, Parvin MN, Rahman MA,
Monoarul M. Knowledge among mothers on under five
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 pISSN : 2528-3685
eISSN : 2598-3857

PENGARUH PENYULUHAN GIZI SEIMBANG BALITA DENGAN MEDIA LEAFLET

TERHADAP PENGETAHUAN IBU

Farida Utaminingtyas1, Retnaning Muji Lestari2

1
Universitas Aufa Royhan
2
Sekolah Tinggi Ilmu Kesehatan Ar-Rum
Email: diajenk.farida@gmail.com

Abstrak
Kurang gizi merupakan salah satu penyebab utama terhambatnya pertumbuhan dan kematian
pada anak. Balita mengalami proses pertumbuhan yang relatif cepat dan termasuk golongan
yang rentan terhadap masalah gizi. Masalah gizi balita dapat memberikan dampak yang serius,
seperti kegagalan pertumbuhan fisik, tidak optimalnya perkembangan dan kecerdasan, serta
kematian pada balita. Pengetahuan ibu adalah salah satu faktor terpenting dalam pemenuhan
gizi seimbang pada balita, salah satunya dapat diperoleh melalui penyuluhan dengan media
leaflet. Penelitian ini bertujuan untuk menganalisis pengaruh penyuluhan gizi seimbang balita
dengan media leaflet terhadap pengetahuan ibu di Kelurahan Tingkir Lor Kota Salatiga. Metode
yang digunakan pada penelitian ini adalah Pra Eksperimental dengan rancangan one group pre
test and post test design. Sampel yang digunakan sebanyak 34 responden, dengan teknik total
sampling. Instrumen yang digunakan adalah kuesioner pre test, post test dan media leaflet
tentang gizi seimbang pada balita. Analisis data menggunakan statistik nonparametrik dengan
uji Wilcoxon. Hasil penelitian menunjukkan karakteristik ibu dengan rata-rata di usia
reproduktif 20-35 tahun, rata-rata tingkat pendidikan yang ada yaitu tamat SMA, dan ibu yang
tidak bekerja lebih banyak dari pada ibu yang bekerja. Hasil penelitian terkait perbedaan
pengetahuan yang signifikan pada ibu balita nilai (Pvalue=0,005) sebelum dan setelah diberikan
penyuluhan kesehatan dengan media leaflet menggunakan uji Wilcoxon. Simpulan, penyuluhan
gizi seimbang balita dengan media leaflet berpengaruh dalam meningkatkan pengetahuan ibu.

Kata kunci: penyuluhan, gizi seimbang balita, media leaflet, pengetahuan

JIKA, Volume 5, Nomor 1, Agustus 2020 39

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eISSN : 2598-3857

EFFECT OF COUNSELING ABOUT BALANCED NUTRITION FOR UNDER-FIVE

CHILDREN USING LEAFLET MEDIA ON MOTHERS' KNOWLEDGE

Abstract
Malnutrition is one of cause the main stunted growth and death in children. Under-five children
experience a relatively fast growth process and are vulnerable to nutritional problems.
Nutritional problems among under-five children can have serious impacts, such as failure of
physical growth, suboptimal development and intelligence, and under-five mortality. Mothers'
knowledge is one of the most important factors in meeting balanced nutrition need among
under-five children, one of which can be obtained through counseling using leaflet media. This
study aims to analyze the effect of counselling about balanced nutrition for under-five children
using leaflet media on mothers' knowledge in the Tingkir Lor District of Salatiga. This was a
pre-experimental study with one group pre test and post test design. The samples used here were
34 respondents, who were collected using total sampling technique. The instrumentz used were
pre-test and post-test questionnaires as well as a leaflet media about balanced nutrition for
under-five children. Data analysis used nonparametric statistics with the Wilcoxon test. The
results on the characteristics of mothers showed that most of them were in reproductive age of
20-35 years, the mean level of education were high school graduates, and mothers who did not
work were more than working mothers. The result of the study showed that there was a
significant difference in the knowledge of the mothers of under five children (P value = 0.005)
before and after being given health education using leaflet media which was analyzed using
Wilcoxon test. It can be concluded that counseling about balanced nutrition for under-five
children using leaflet media had an effect in increasing mothers'knowledge.

Keywords: counseling, balanced nutrition for under-five children, leaflet media, knowledge

Pendahuluan kebutuhan akan stimulasi yang mencakup

Tingkat kesejahteraan masyarakat di
Indonesia saat ini masih belum merata
sehingga berdampak pada tingkat
kesehatan. Salah satu penyebab utama
terhambatnya pertumbuhan dan kematian
anak-anak prasekolah di negara-negara
berkembang adalah kurang gizi.1 Jika
permasalahan kekurangan gizi tidak
terselesaikan maka dapat mengganggu
pembangunan ekonomi Negara.2 Kelompok
usia yang sering terkena masalah gizi
adalah balita. Pada kelompok tersebut
mengalami siklus pertumbuhan dan
perkembangan berlangsung sangat cepat
dan sering disebut dengan golden age atau
masa keemasan.3 Proses tumbuh kembang
dapat berjalan dengan optimal apabila anak
mendapatkan pemenuhan 3 kebutuhan
pokok, yaitu kebutuhan fisik biologis,
berupa kebutuhan akan nutrisi, imunisasi,
serta kebersihan fisik dan lingkungan,
kebutuhan emosi berupa kasih sayang, rasa
aman dan nyaman, dihargai, diperhatikan
serta didengar keinginan dan pendapatnya,
aktivitas bermain untuk merangsang semua
indra, mengasah motorik halus dan kasar,
melatih ketrampilan berkomunikasi,
kemandirian, berpikir dan berkreasi, maka
harus diperhatikan asupan gizi pada 5 tahun
usia pertama, karena pada masa ini adalah
periode pertumbuhan yang penting dan
akan memengaruhi dan menentukan
perkembangan anak selanjutnya.4
Masalah stunting merupakan salah satu
permasalahan yang dihadapi di dunia saat
ini, khususnya di negara-negara miskin dan
berkembang salah satunya Indonesia. The
United Nations Children’s Fund (UNICEF)
menyatakan bahwa secara global persentase
balita dengan kondisi gizi kurang sebanyak
16% dengan persentase tertinggi dimiliki
oleh Asia Selatan sebanyak 33% atau
sebanyak satu dari tiga balita memiliki
status gizi kurang.5,6
Kondisi di Indonesia saat ini
menggambarkan hal yang tidak jauh
berbeda dengan masalah di dunia. Menurut
data Riskesdas tahun 2018, masalah gizi

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yang di hadapi Indonesia disebut dengan
triple burden atau triple ganda
permasalahan gizi, yaitu prevalensi stunting
(30,8%), wasting atau balita kurus (10,2%),
dan overwight atau balita gemuk (8,0%).
Pemerintah sudah berupaya menuntaskan
masalah gizi tersebut dengan menggalakkan
berbagai macam program. Namun, program
yang telah dilakukan pemerintah ini belum
efektif dalam penanggulangan masalah gizi
tersebut, salah satu penyebabnya kurangnya
pengetahuan ibu mengenai pola makan
yang sehat dan gizi-gizi yang harus
dipenuhi anak pada masa pertumbuhan.7,8
Berdasarkan data dari Dinas Kesehatan
Provinsi Jawa Tengah tahun 2018 masih
ditemukan adanya kasus gizi buruk pada
balita dengan indikator berat badan menurut
tinggi badan sebanyak 961 kasus, dan di
Kota Salatiga masih ditemukan adanya 3
kasus.9 Hasil studi pendahuluan
yang dilakukan peneliti pada bulan April
2019, diperoleh hasil bahwa total
jumlah balita di Tingkir Lor khususnya
di RW 2 dan 3 adalah 50 balita.
Informasi yang didapatkan dari
bidan wilayah Tingkir Lor, menyatakan
bahwa masih kurangnya minat ibu
untuk melakukan kunjungan posyandu
dan mengikuti penyuluhan kesehatan
khususnya tentang gizi balita karena
tidak sempat serta merasa tidak perlu.
Masalah gizi pada balita dapat
menyebabkan efek yang serius, seperti
kegagalan pertumbuhan fisik serta tidak
optimalnya perkembangan dan kecerdasan,
bahkan dapat menimbulkan kematian pada
balita. Namun, masalah gizi pada balita ini
dapat dihindari apabila ibu memiliki
pengetahuan yang cukup tentang cara
pemberian makanan dan mengatur makanan
balita dengan baik. Sehingga, pengetahuan
orang tua tentang gizi merupakan kunci
keberhasilan baik atau buruknya status pada
balita.10
Salah satu faktor yang sangat penting
dalam meningkatkan pengetahuan adalah
dengan metode penyampaian informasi
seperti kegiatan penyuluhan yang
disesuaikan dengan kebutuhan sasaran
dengan menggunakan media promosi
kesehatan yang tepat. Media promosi
kesehatan adalah semua sarana atau upaya
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untuk menampilkan pesan atau informasi
yang ingin disampaikan oleh komunikator,
baik itu melalui media cetak, elektronik
(televisi, radio, komputer, dan sebagainya),
dan media luar ruang, sehingga dapat
meningkatkan pengetahuan dan mengubah
perilaku ibu terhadap kesehatan.11
Hal tersebut sejalan dengan penelitian
yang dilakukan oleh Muthmainah tahun
2015 tentang penyuluhan dengan media
audio visual dan leaflet terhadap
pengetahuan ibu tentang pemberian
makanan pendamping ASI, menyatakan
bahwa terdapat pengaruh penyuluhan
dengan media audio visual dan media
leaflet terhadap pengetahuan MP ASI ibu.12
Penelitian ini didukung oleh hasil penelitian
Sinuhaji tahun 2018, bahwa terdapat
perbedaan pengetahuan pre test dan post
test dengan penyuluhan pada ibu balita
tentang gizi buruk.13
Dalam penelitian ini, peneliti juga
menggunakan media untuk membantu
penyuluhan yang akan dilakukan. Media
tersebut berupa leaflet yang digunakan
peneliti dan materi yang disampaikan
tentang gizi seimbang pada balita.
berdasarkan latar belakang tersebut penulis
bermaksud untuk meneliti apakah
penyuluhan menggunakan media leaflet
dapat meningkatkan minat dan pengetahuan
ibu tentang gizi seimbang pada balita.
Metode
Desain penelitian ini menggunakan
desain penelitian pre-eksperimental
rancangan one group pre-test post-test
dengan pendekatan kuantitatif.
Variabel bebas adalah ibu balita yang
diberikan penyuluhan kesehatan gizi
seimbang balita dengan media leaflet, dan
variabel terikat adalah pengetahuan ibu
balita. Populasi dalam penelitian ini adalah
seluruh ibu yang datang ke posyandu balita
dan memiliki anak usia balita di RW 02 dan
RW 03 Kelurahan Tingkir Lor sebanyak 50
responden yang memenuhi kriteria inklusi
Ibu yang memilki anak usia balita, hadir di
Posyandu dan bersedia menjadi responden,
kriteria eksklusi adalah Ibu yang tidak
mengikuti penyuluhan hingga selesai (drop
out). Sampel diambil dengan sampel jenuh
atau total sampling.
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Data primer pada penelitian ini
dikumpulkan dengan cara penyebaran
kuesioner (lembar pre-test dan post-test)
sebelum dan sesudah diberikan penyuluhan
gizi seimbang balita.
Instrumen penelitian yang digunakan
berupa media leaflet yang peneliti buat
sendiri dan kuesioner yang digunakan
adalah kuesioner hasil penelitian
sebelumnya yang sejenis dengan penelitian
ini. Informasi yang disampaikan adalah
mengenai gizi balita, makanan yang
dibutuhkan balita, pemantauan status gizi
balita, mengatasi masalah gizi pada balita
sedangkan kuesioner berisi 12 pertanyaan.
Analisis data yang digunakan pada
penelitian ini yaitu analisis univariat dan
analisis bivariat. Analisis univariat secara
deskriptif menjelaskan karakteristik
responden dan analisis bivariat untuk
mengetahui pengaruh penyuluhan melalui
media leaflet terhadap pengetahuan ibu
secara non parametrik dengan
menggunakan uji Wilcoxon. Pada akhir
penelitian ini, jumlah total sampel yang
digunakan adalah 34 responden yang
memenuhi kriteria inklusi Ibu yang hadir di
Posyandu dan bersedia menjadi responden.
Penelitian ini dilaksanakan dimulai dari
bulan April sampai Juni 2019.

Hasil
1. Gambaran Karakteristik Responden
Tabel 1. Gambaran Karakteristik Responden Berdasarkan Usia, Tingkat Pendidikan, dan
Status Pekerjaan
Karakteristik Responden Gizi Balita
N %
Umur
20 – 35 tahun 32 94,1
> 35 tahun 2 5,9
Tingkat Pendidikan
Tamat SD 1 2,9
Tamat SMP 2 5,9
Tamat SMA 27 79,4
PT 4 11,8
Status Pekerjaan
Tidak Bekerja 25 73,5
Bekerja 9 26,5
Total 34 100

Pada tabel 1. didapat karakteristik pendidikan menunjukkan bahwa

subjek pada penelitian ini sesuai dengan kebanyakan responden berpendidikan
ketentuan kriteria inklusi dan eksklusi menengah yaitu SMA (79,4%).
penelitian. Penelitian ini dilakukan terhadap Berdasarkan status pekerjaan dapat
34 responden, dengan hasil didapatkan menunjukkan bahwa sebagian besar
responden paling banyak adalah responden responden tidak memiliki pekerjaan atau
yang berumur 20-35 tahun sebanyak 32 sebagai ibu rumah tangga (73,5%).
responden (94,1%). Berdasarkan status

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2. Gambaran Hasil Pengetahuan Ibu Balita Sebelum dan Setelah Diberikan Penyuluhan
dengan Media Leaflet
Tabel 2. Gambaran Hasil Nilai Pengetahuan Ibu Sebelum dan Setelah Diberikan
Penyuluhan dengan Media Leafalet
Kelompok
No Skor Nilai Pengetahuan Ibu Balita Pre-Test Post-Test
N % N %
1 Kurang baik 13 38,2 5 14,7
2 Baik 21 61,8 29 85,3
Total 34 100 34 100

Berdasarkan tabel 2. diperoleh hasil bahwa setelah diberikan penyuluhan (post-test)

hasil pengetahuan ibu dari 34 orang didapatkan 29 responden (85,3%)
responden sebelum diberikan penyuluhan berpengetahuan baik dan 5 responden
(pre-test) didapatkan responden yang (14,7%) lainnya berpengetahuan kurang.
pengetahuannya kurang baik sebanyak 13 Dapat disimpulkan bahwa tingkat
responden (38,2%), dan 21 responden pengetahuan ibu mengalami peningkatan
(61,8%) pengetahuannya baik. Sedangkan sebesar 70,6% dari 14,7% menjadi 85,3%.

Tabel 3. Gambaran Jawaban Benar Ibu Balita Sebelum dan Setelah Diberikan
Penyuluhan dengan Media Lefalet
Variabel Pengetahuan dalam Kuesioner Yang Menjawab Benar Keterangan
(Pertanyaan) Pre-Test % Post-Test %
1 Pengertian Status Gizi 47 91 Meningkat
2 Jenis Status Gizi 56 76 Meningkat
3 Pemantauan Status Gizi 65 79 Meningkat
4 Manfaat Pemantauan Status Gizi 76 85 Meningkat
5 Penimbangan Berat Badan 85 97 Meningkat
6 Tujuan Penimbangan Berat Badan 79 91 Meningkat
7 Cara Menilai Status Gizi 53 82 Meningkat
8 Apa yang Diperoleh dari Pemberian ASI 100 100 Tetap
9 Pengertian MP-ASI 41 68 Meningkat
10 Pilihan Menu Makanan 85 88 Meningkat
11 Pengaturan Menu Makanan 82 88 Meningkat
12 Pemenuhan Gizi Anak Baik 85 91 Meningkat
Total 71 86 Meningkat

Dari tabel 3. tersebut terlihat bahwa
rata-rata terjadi peningkatan pengetahuan
ibu balita. Hampir seluruh pertanyaan yang
diberikan pada saat pre-test dan post-test
mengalami peningkatan jawaban benar
sebesar 15% dari 71% menjadi 86%. Dari
12 pertanyaan yang ada, sebanyak 11 soal
mengalami peningkatan jumlah jawaban
benar sedangkan 1 soal lainnya tidak
mengalami peningkatan ataupun mengalami
penurunan pada saat post-test.

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3. Perbedaan Pengetahuan Ibu Balita Sebelum dan Setelah Diberikan Penyuluhan
dengan Media Leaflet
Tabel 4. Perbedaan Pengetahuan Ibu Balita Sebelum dan Setelah Diberikan Penyuluhan
dengan Media Leaflet
Pengetahuan Ibu Balita Mean
Sebelum 1,62
Setelah 1,85
Keterangan: Uji Wilcoxon
Pembahasan
1. Gambaran Karakteristik Responden
Berdasarkan hasil penelitian yang telah
dilakukan di Posyandu Balita Kelurahan
Tingkir Lor Kota Salatiga diperoleh
gambaran umur responden yaitu dari 34
responden terdapat 32 responden (94,1%)
berusia 20-35 tahun dan responden yang
berusia >35 tahun sebanyak 2 responden
(5,9%). Hasil penelitian menunjukkan
bahwa umur ibu tersebut masih termasuk
kedalam Wanita Usia Subur (WUS)
menurut pembagian yang dilakukan oleh
Riset Kesehatan Dasar (Riskesdas tahun
2018), yaitu 15-49 tahun. Menurut Winarti
tahun 2014, umur ibu tersebut termasuk
dalam kategori dewasa. Hal ini dapat
menunjukkan bahwa ibu yang memiliki
balita sudah memiliki pengalaman dalam
pemberian makan anggota keluarga.
Menurut Notoatmodjo tahun 2011, salah
satu faktor yang berhubungan dengan
pengetahuan adalah umur, semakin tua
umur seseorang, pengetahuan yang dimiliki
akan semakin banyak. Namun di masa
sekarang tidak jarang juga umur muda
memiliki pengetahuan yang lebih banyak
dibandingkan dengan umur yang lebih tua.
Hal tersebut dikarenakan banyak faktor lain
yang juga dapat memengaruhi pengetahuan
seseorang selain faktor umur, seperti media
massa dan juga informasi.10,14
Berdasarkan tingkat pendidikan terakhir
responden didapatkan gambaran tingkat
pendidikan responden yaitu dari 34
responden terdapat ibu yang berpendidikan
rendah (SD) sebanyak 1 responden (2,9%),
SMP sebanyak 2 responden (5,9%), SMA
sebanyak 27 responden (79,4%) dan ibu
yang berpendidikan tinggi (PT) sebanyak 4
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SD P Value N
0,493
0, 005 34
0,359
responden (11,8. Pendidikan ibu merupakan
hal dasar bagi tercapainya gizi balita yang
baik. Tingkat pendidikan ibu tersebut
terkait dengan kemudahan ibu dalam
menerima informasi tentang gizi dan
kesehatan dari luar. Menurut Susilowati dan
Himawati tahun 2017, pengetahuan yang
dimiliki ibu menjadi kunci utama
kebutuhan gizi balita terpenuhi.
Pengetahuan yang didasari dengan
pemahaman yang baik dapat menumbuhkan
perilaku baru yang baik pula. Ibu dengan
tingkat pendidikan yang lebih tinggi akan
lebih mudah menerima informasi dari luar,
dibandingkan dengan ibu yang memiliki
tingkat pendidikan lebih rendah. Pendidikan
yang rendah memengaruhi tingkat
pemahaman terhadap pengasuhan anak
termasuk dalam hal perawatan, pemberian
makanan dan bimbingan pada anak yang
akan berdampak pada kesehatan dan gizi
yang semakin menurun.15
Berdasarkan status pekerjaan ibu
didapatkan gambaran pekerjaan ibu yaitu
dari 34 responden terdapat perbedaan yang
sangat jauh antara responden yang bekerja
dan tidak bekerja, sebanyak 25 responden
(73,5%), dan ibu bekerja sebanyak 9
responden (26,5%), hal ini menunjukkan
bahwa sebagian besar responden tidak
memiliki pekerjaan atau sebagai ibu rumah
tangga. Menurut kepustakaan, ibu yang
tidak bekerja dalam keluarga dapat
memengaruhi asupan gizi balita karena ibu
berperan sebagai pengasuh dan pengatur
konsumsi makanan anggota keluarga. Ibu
yang bekerja tidak memiliki waktu yang
cukup untuk mengasuh dan merawat
anaknya sehingga anaknya dapat menderita
gizi kurang.16
44

2. Gambaran Hasil Pengetahuan Ibu
Balita Sebelum dan Setelah Diberikan
Penyuluhan dengan Media Leaflet
Berdasarkan hasil penelitian, diperoleh
hasil bahwa pengetahuan ibu balita
mengalami peningkatan sebesar 70,6% atau
meningkat 14,7% menjadi 85,3%. Dari
hasil tersebut dapat disimpulkan bahwa
terdapat peningkatan rata-rata skor ibu
balita sebelum dan setelah diberikan
penyuluhan dengan menggunakan media
leaflet sebesar 70,6%. Menurut
Notoatmodjo tahun 2011, seseorang yang
terapar informasi mengenai suatu topik
tertentu akan memiliki pengetahuan lebih
banyak daripada yang tidak terpapar
informasi.10 Penyuluhan dengan media
leaflet merupakan salah satu metode untuk
meningkatkan pengetahuan dengan melalui
tulisan-tulisan dan gambar mengenai suatu
materi. Sehingga dapat disimpulkan,
seseorang yang terpapar suatu materi akan
mengalami peningkatan pengetahuan yang
lebih besar daripada seeseorang yang tidak
terpapar informasi.
Pada tabel 3. menggambarkan tentang
penjabaran jawaban benar ibu balita, dapat
diketahui bahwa terdapat beberapa
pertanyaan yang awalnya hanya dapat
dijawab oleh beberapa responden saja
bertambah beberapa responden lagi, dan
tidak ditemukan adanya penurunan jawaban
benar dari responden. Perubahan
pengetahuan ibu balita per item dapat
dilihat adanya peningkatan setelah
diberikan penyuluhan menggunakan leaflet,
yaitu pada materi 1. Pengertian status gizi
(91%), 2. Jenis status gizi (76%), 3.
Pemantauan status gizi (79%), 4. Manfaat
pemantauan status gizi (85%), 5.
Penimbangan berat badan (97%), 6. Tujuan
penimbangan berat badan (91%), 7. Cara
menilai status gizi (82%), 9. Pengertian
MP-ASI (68%), 10. Pilihan menu makanan
(88%), 11. Pengaturan menu makanan
(88%), 12. Pemenuhan gizi anak baik
(91%) , terdapat skor yang sama sebelum
dan setelah diberikan penyuluhan adalah
pengetahuan ibu pada materi 8. Apa yang
diperoleh dari pemberian ASI (100%).
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3. Pengaruh Penyuluhan dengan Media
Leaflet Terhadap Pengetahuan Ibu
Balita Sebelum dan Setelah Diberikan
Berdasarkan hasil penelitian diketahui
bahwa dari uji statistik yang dilakukan
menggunakan uji Wilcoxon mendapatkan
nilai P-Value sebesar 0,005 dengan
pengetahuan ibu balita di RW 02 dan RW
03 Kelurahan Tingkir Lor Kota Salatiga
sebelum diberikan penyuluhan (pre-test)
dengan nilai mean 1,62 dan setelah
diberikan penyuluhan (post-test) dengan
nilai mean 1,85, sehingga selisih nilai
perubahan meannya 0,23. Hasil uji tersebut
menunjukkan bahwa terdapat perbedaan
yang bermakna antara pengetahuan ibu
balita sebelum dan setelah diberikan
penyuluhan dengan media leaflet gizi
seimbang balita. Hal ini dapat dilihat dari
perubahan pengetahuan seperti yang
diharapkan dari penyuluhan kesehatan
uyang dilakukan dimana dari tidak tahu
menjadi tahu.
Hasil penelitian ini menemukan bahwa
penyuluhan kesehatan tentang gizi
seimbang pada balita yang diberikan
kepada ibu efektif dalam meningkatkan
pengetahuan, dan didukung oleh hasil
penelitian Leokuna tahun 2013,
menyatakan bahwa terdapat perbedaan
pengetahuan ibu yang memiliki balita
sebelum penyuluhan adalah 40,69%
mengalami peningkatan sesudah
17
penyuluhan menjadi 78%. Terdapat
kesesuaian antara teori dan fakta dimana
penggunaan alat peraga yaitu pemberian
leaflet untuk menstimulasi penerimaan
visual responden dalam membaca dan
mendengarkan sehingga mempermudah
responden dalam memahami informasi
yang disampaikan, juga adanya kesempatan
responden untuk berpartisipasi dalam
diskusi dan terjadi komunikasi 2 arah yang
dapat meningkatkan pengetahuan
seseorang, sehingga terdapat peningkatan
pengetahuan responden sebanyak 70,6%
dan tidak terdapat responden yang
mengalami penurunan tingkat pengetahuan.
45

Hal ini membuktikan bahwa pemberian
informasi kesehatan dapat memberikan
kontribusi pada peningkatan pengetahuan
seseorang dan merupakan upaya yang
efektif yang dapat digunakan dalam
penyampaian informasi.
Kesimpulan
Berdasarkan hasil penelitian yang
dilakukan di Posyandu Balita Kelurahan
Tingkir Lor Kota Salatiga, dapat
disimpulkan bahwa dari 34 responden
mayoritas berumur 20-35 tahun,
berpendidikan tamat SMA, dan tidak
bekerja.
Hasil penelitian ini juga didapatkan
pengetahuan ibu tentang gizi seimbang
balita mengalami peningkatan pada saat pre
test dan post test, yaitu sebesar 70,6% dari
14,7% menjadi 85,3%. Penjabaran jawaban
benar ibu balita sebelum dan setelah
diberikan penyuluhan, yaitu hampir seluruh
pertanyaan yang diberikan pada saat pre-
test dan post-test mengalami peningkatan
jawaban benar sebesar 15% dari 71%
menjadi 86%. Dari 12 pertanyaan yang ada,
sebanyak 11 soal mengalami peningkatan
jumlah jawaban benar sedangkan 1 soal
lainnya tidak mengalami peningkatan
ataupun mengalami penurunan pada saat
post-test.
Nilai uji statistik dengan menggunakan
Uji Wilcoxon diperoleh nilai P Value 0,005
dengan pengetahuan ibu tentang gizi
seimbang pada balita di Kelurahan Tingkir
Lor Kota Salatiga sebelum diberikan
penyuluhan (pre-test) dengan nilai mean
1,62 dan sesudah diberikan penyuluhan
(post-test) dengan nilai mean 1,85 sehingga
nilai perubahan mean 0,23. Kesimpulan
hasil penelitian ini menemukan bahwa
terdapat pengaruh penyuluhan gizi
seimbang balita dengan media leaflet
terhadap pengetahuan ibu di Posyandu
Balita Kelurahan Tingkir Lor Kota Salatiga.
Saran yang perlu diberikan penulis
adalah perlu adanya upaya dari berbagai
pihak baik tenaga kesehatan, kader, dan
tokoh masyarakat di Posyandu Balita
Kelurahan Tingkir Lor Kota Salatiga untuk
terus menggalakan kegiatan penyuluhan
kesehatan dalam hal ini tentang gizi
JIKA, Volume 5, Nomor 1, Agustus 2020
pISSN : 2528-3685
eISSN : 2598-3857
seimbang pada balita dengan
mengembangkan metode dan media yang
lebih menarik sesuai sasaran. Sehingga
selain dapat meningkatkan pengetahuan
ibu, membantu pemerintah dalam
menurunkan kasus gizi kurang pada balita,
tapi juga diharapkan dapat meningkatkan
minat orang tua untuk aktif mengikuti
kegiatan posyandu.
Daftar Pustaka
1. S. P. Giri, S. Biswas, and K. Bose. Head
circumference based nutritional status of rural
Bengalee preschool children from Sagar Island,
West Bengal, India. Mankind Q. 2018;58(4):599–
610.
2. S. Winiarti, H. Yuliansyah, and A. A. Purnama.
Identification of Toddlers’ Nutritional Status
Using Data Mining Approach. Int. J. Adv.
Comput. Sci. Appl. 2018;9(1):164–169.
3. P. D. Kartini. Klasifikasi Status Gizi Balita
berdasarkan Indeks Anthropometri BB/U
menggunakan Metode KNN (K- Nearest
Neighbor). Simki-Techsain. 2017;01:6.
4. Novaria, Triton. Menjaga Kesehatan Balita.
Surakarta: Platinum. 2014.
5. UNICEF. Improving Child Nutrition: The
Achievable Imperative for Global Progress.
Division of Communication. 2013. [diunduh 10
Maret 2019] Tersedia dari:
www.unicef.org/publications/index.html.
6. UNICEF Indonesia. Ringkasan kajian kesehatan:
kesehatan ibu dan anak. 2012 [diunduh 10 Maret
2019]. Tersedia dari:
http://www.unicef.org/indonesia/id.
7. Kementerian Kesehatan RI Badan Penelitian dan
Pengembangan. Hasil utama riset kesehatan
dasar, Jakarta: Kementerian Kesehatan Republik
Indonesia. 2018. pp. 1–100. doi: 1 Desember
2013.
8. Depkes RI. Pedoman Gizi Seimbang. 2014.
9. Dinkes Provinsi Jawa Tengah. Profil Kesehatan
Provinsi Jawa Tengah Tahun 2018,
Semarang: Dinas Kesehatan Provinsi Jawa
Tengah.
10. Notoatmodjo, Soekidjo. Kesehatan Masyarakat
Ilmu dan Seni Edisi Revisi 2011. Rineka Cipta:
Jakarta; 2011.
11. Fitriani F. Pengaruh penyuluhan media lembar
balik gizi terhadap peningkatan pegetahuan ibu
balita gizi kurang di Puskesmas Pamulang,
Tangerang Selatan Tahun 2015 [skripsi]. Jakarta:
UIN Syarif Hidayatullah; 2015.
12. Muthmainah. Pengaruh penyuluhan dengan
media audio visual dan leaflet terhadap
46
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pengetahuan ibu tentang pemberian makanan 2008. Ipb.Ac.Id. Institute Pertanian Bogor.
pendamping ASI [skripsi]. Bogor: IPB; 2015. Tersedia dari http://repository.ipb.ac.id.
13. Sinuhaji L. Efektifitas penyuluhan dan media 17. Leokuna, Joice M. Pengetahuan Ibu tentang Gizi
leaflet terhadap pengetahuan dan sikap ibu balita Balita Sebelum dan Sesudah Penyuluhan di RW
tentang gizi buruk di Dusun VII Desa Bangun 10 Kampung Citiis Desa Cihanjuang Rahayu
rejo kecamatan tanjung morawa UtaraTahun Kecamatan Parongpong Bandung Barat. Skripsi
2018. JIK. 2018;1(1). Fakultas Keperawatan: Universitas Advent
14. Winarti, Wahyunita Gani. Aplikasi media edukasi Indonesia. 2013.
untuk peningkatan pengetahuan ibu balita gizi
kurang dan gizi baik di Puskesmas Ciputat Timur,
Kota Tangerang Selatan. Jakarta: UIN Syarif
Hidayatullah; 2014.
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wilayah Kerja Puskesmas Gajah 1 Demak. Jurnal
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16. Handayani, I. Hubungan antara sosial ekonomi
keluarga dengan status gizi balita Indonesia.

JIKA, Volume 5, Nomor 1, Agustus 2020 47

ORIGINAL ARTICLE

The Effect of Family-Based Nutrition Education on the Intention of

Changes in Knowledge, Attitude, Behavior of Pregnant Women and
Mothers With Toddlers in Preventing Stunting in Puskesmas Batakte,
Kupang Regency, East Nusa Tenggara, Indonesia Working Area
AGUSTINA SETIA, INDHIRA SHAGTI, REGINA MARIA BOROA, AGUNG MIRAH ADI, ASMULYATI SALEH, PUTU AMRYTA
SANJIWANY
Department of Nutrition, Poltekkes Kemenkes Kupang, Indonesia
Corespondence to Agustina Setia, Email: agustinasetia64@gmail.com

ABSTRACT
The golden period of development of a child starts from the time the child is in the womb to the age of two.
Pregnant women and children under 5 years of age are at the highest risk of micronutrient deficiencies (MNDs),
growth problems, intellectual decline, perinatal complications and an increased risk of morbidity and mortality.
Therefore, pregnant women and mothers with toddlers need an educational program about proper nutrition for the
health of both mother and fetus. Family-based education according to a healthy family program can increase the
intention to change health behavior. According to Theory of Planned Behavior (TPB), the intention to change
behavior is influenced by attitudes, subjective norms and perceptions of behavior control. This study aims to
identify the effect of family-based education on the intention of pregnant women to optimize nutrition in the first
1000 days of life so as to prevent stunting in the working area of the Batakte Health Center, Kupang Regency. The
research design used a quasi-experimental, pre-test and posttest one group design. Sampling with total sampling
technique of all pregnant women recorded at the Puskesmas amounted to 13 people, and mothers with toddlers
as many as 33 people. Educational activities are carried out through three home visit meetings. Data analysis
using Paired T-Test. The results showed that there was a significant influence between family-based education on
the intention of knowledge, attitudes, behavior of pregnant women and mothers with toddlers to optimize nutrition
in preventing stunting (p = 0.00).
Keyword: pregnant women, mothers with toddlers, nutrition education

INTRODUCTION recommendations to alleviate the problem of stunting in

Stunting or a short child is described as a toddler who has
a height lower than the standard height of his age. Stunting
is one of the characteristics that indicates the occurrence of
recurrent nutritional problems and for a long time. Stunting
in early childhood is known to have lower levels of
intelligence, motor skills, and neurosensory integration.
Thus, stunting during infancy will affect the quality of life at
school age, adolescence, and even adults1.
According to a study by Unicef Indonesia, there are
various obstacles that cause the high rate of stunting
children aged 6-23 months in Indonesia. One of the main
obstacles is inadequate knowledge and inappropriate
nutrition practices. In particular, it was explained that the
knowledge and practice that became the main obstacle
was the lack of exclusive breastfeeding and the lack of
appropriate complementary feeding (41%)2.
Nutrition education is a part of health education
activities, defined as a planned effort to change the
behavior of individuals, families, groups and communities in
the health sector3. Academic Nutrition and Dietetics (AND)
defines nutrition education as a formal process to train
client skills or increase client knowledge in choosing food,
physical activity, and behavior related to health
maintenance or improvement4. Thus, the activities that
must be carried out to improve knowledge, attitudes, and
nutrition behavior are nutrition education. Nutrition
education is able to increase knowledge and feeding
practices of mothers even though children's growth does
not increase directly5. Nutrition education for mothers and
caregivers of toddlers is one of Unicef Indonesia's
Indonesia. Nutrition education can be carried out
individually or in groups. From the research that has been
done, nutrition extension intervention methods have been
shown to be able to improve the knowledge, attitudes, and
behavior of mothers under five years of age6.
The research was aimed at studying the effect of
providing nutrition education on the intention to change the
knowledge, attitudes and behavior of pregnant women and
mothers with toddlers in preventing stunting.
RESEARCH METHODS
This type of research is quantitative research and the
research design used is a quasi-experimental pre-post test.
The independent variable of this research is nutrition
education with the Brief Strategic Family Therapy (BSTF)
model and the dependent variable is behavior change.
Intervention activities are carried out twice a month.
Some of the activities include one pre-test, 2-time
education, one-time cooking demonstration, one-time post
test. One week before the implementation of the
intervention, a pre-test was carried out. The steps for
nutrition education are the researchers asking pregnant
women and mothers under baduta about balanced
nutrition, using the form food frequency (FFQ) and then the
respondents wrote down the type, amount and frequency of
family meals. Furthermore, providing counseling about
balanced nutrition for families, pregnant women and
mothers with toddlers. The frequency of intervention is
enough to be done twice because the repetition is an
optimal measure. If more than three times, it will cause

1001 P J M H S Vol. 14, NO. 3, JUL – SEP 2020

 Agustina Setia, Indhira Shagti, Regina Maria Boro et al

boredom. Furthermore, a balanced nutrition menu cooking number of family members, mostly> 4 people as many as
demonstration was carried out to increase knowledge, 17 people (51.5%). Characteristics of the history of Early
improve attitudes and sampling skills and efforts to improve Breastfeeding Initiation (IMD), most of them performed BMI
the quality of local food-based family menus. A week after of 26 people (78.8%). Characteristics of the history of
the final intervention, a post test was performed. exclusive breastfeeding, most of them did not give
The data that had been collected were analyzed by exclusive breastfeeding as many as 23 people (69.7%).
univariate and bivariate. Univariate analysis using The table above shows the characteristics of pregnant
descriptive analysis. The bivariate analysis used was the women. Based on the job characteristics of the husband,
Paired T-test. all husbands work as much as 100%, the characteristics of
the work of pregnant women, most of them do not work as
RESEARCH RESULT much as 84.6%. Educational characteristics, most of the
Characteristics of Research Subjects husbands have low education as much as 69.2%, some of
The total research subjects of this study were 46 people the pregnant women have high education as much as
with 33 mothers with toddlers and 13 pregnant women. 53.8%. Characteristics of the number of family members,
mostly> 4 people as much as 53.8%. Characteristics of
ANC, most pregnant women performed ANC <4 times as
Table 1. Characteristics of mothers with toddlers much as 53.8%. Characteristics of LiLA, all pregnant
Characteristics Category n % women did not experience KEK as much as 100%, and
Father's occupation Employed 30 91 characteristics received iron tablet tablets, most pregnant
Unemployed 3 9 women received iron tablet as much as 76.9%.
Mother's Employed 4 12.1
occupation Does not work 29 87.9 Table 2. Characteristics of Pregnant Women
Father's education High 9 27.3 Characteristics Category N %
Low 24 72.7 Husband's occupation Employed 13 100
Mother's education Low 19 57.6 Unemployed 0 0
High 14 42.4 Respondent's Employed 2 15.4
Number of family <= 4 people 16 48.5 occupation Unemployed 11 84.6
members > 4 people 17 51.5 Husband's education High 4 30.8
Early Initiation of Yes 26 78.8 Low 9 69.2
Breastfeeding No 7 21.2 Respondent’s High 7 53.8
Breastfeeding Exclusive 10 30.3 education Low 6 46.2
status Not Exclusive 23 69.7 Number of family ≥4 people 6 46.2
members > 4 people 7 53.8
From the table above, it can be seen that based ANC <4 times 7 53.8
on the work of the mothers with toddlers, it is known that ≥4 times 6 46.2
most of the fathers work 30 people (91%) and most of the LILA No KEK 13 100
mothers with toddlers work as housewives as many as 29 KEK 0 0
people (87.9%). Most of the fathers and mothers of Accepts TTD tablets Yes 10 76.9
toddlers have low education, respectively 24 people No 3 23.1
(72.7%) and 19 people (57.6%). Characteristics of the

Table 3. Characteristics of respondents before and after the intervention

Characteristics Category Before After
n % n %
Nutritional knowledge Good 27 58.7 40 87
Less 19 41.3 6 13
Attitude nutrition Good 31 67.4 43 94
Less 15 32.6 3 6
Behavior Good 22 47.8 37 80.4
Less 24 52.2 9 19.6

Table 4 Results of Bivariate Analysis

No. Characteristics Before intervention After the intervention P-Value
1 Knowledge:
Minimum 64.43 67.50
Mean 15 28 0.000
Maximum 85 90
2 Attitude:
Minimum 51.70 54.93
0.000
Mean 25 30
Maximum 75 75
3 Behavior:
Minimum 48.65 53.43
0.000
Mean 30 40
Maximum 56 60

P J M H S Vol. 14, NO. 3, JUL – SEP 2020 1002

Effect of Family-Based Nutrition Education
DISCUSSION
The characteristics of the research sample in terms of
education level, occupation, number of family members did
not differ between groups of women with toddlers and
pregnant women. Most of the parents of toddlers and
pregnant women and their husbands have low education.
This educational history may be a factor affecting the level
of understanding of the sample towards a given
intervention. Most of the mothers with toddlers do IMD but
do not provide exclusive breastfeeding. Most pregnant
women do ANC less than 4 times.
From the results of the paired t test analysis, it is
known that the differences in the pre-test and post-test of
family-based nutrition education on changes in knowledge,
attitudes and behavior of poor women and pregnant
women respectively with a value of p = 0.000 <α 0.05. This
means that there is an effect of family-based nutrition
education on the knowledge, attitudes and behavior
mothers with toddlers and pregnant women in the
prevention of stunting under five in the Batakte Community
Health Center, Kupang Regency.
The higher a person's education level, the easier it
will be for someone to receive the information obtained so
that they can increase their knowledge, conversely, the
lower the level of one's education, the more difficult it will
be for someone to receive information so that the
knowledge obtained is less than optimal. The process of
developing attitudes in response to the new values
introduced will also be hampered. On the other hand, low
education can also cause a person's intellectual power to
be limited so that they are still influenced by the
surrounding environment, such as local culture and the
influence of other people who dominate a person in
shaping their knowledge7.
Knowledge is a stimulus that is obtained by a
person through the senses, giving rise to stimulation of
attitudes and behavior8. The sense of sight is the sense
that most transmits knowledge into the human brain. About
75% -87% of human knowledge is obtained through the
sense of sight, 13% through the sense of hearing and 12%
through the other senses9. Knowledge of balanced nutrition
can be reflected in the way mothers choose food for their
family needs. Therefore, the knowledge of nutrition and the
skills of mothers in choosing food greatly influence the
family's diet so that the knowledge of mothers about
nutrition is very necessary to determine the consumption of
good food in an effort to improve the nutritional status of
children under five.
The results of this study are in line with
Tambuwun's research (2019) where health promotion uses
lecture and leaflet methods, which are very effective for
sharing health information in increasing the knowledge of
pregnant women, because it includes the delivery of oral
and written information10. Another study, Febriantika (2017)
with the results of statistical tests with the t test obtained a
value of p = 0.000, so it can be concluded that there is an
effect of knowledge education about nutrition of pregnant
women11. Azria (2015) where there are differences in
knowledge and behavior between the control and
intervention groups that were given education about
nutrition12.
The level of nutritional knowledge of a person
1003 P J M H S Vol. 14, NO. 3, JUL – SEP 2020
affects the attitude and behavior in choosing food which
determines whether it is easy for a person to understand
the benefits of the nutritional content of the food consumed.
Good nutritional knowledge is expected to affect the
consumption of good food, so that it can lead to a good
nutritional status as well. Nutritional knowledge also has a
very important role in shaping a person's eating habits. So
that the family-based nutrition education that is given can
influence the behavior of mothers about balanced nutrition
so as to prevent stunting.
The results of statistical tests showed that there
were differences in the attitudes of pregnant women and
poor women after being given nutrition education with a
value of p <0.05. The results of this study are in line with
Aindrawati (2014) using the Wilcoxon test that there is an
effect of counseling on the attitude of parenting nutrition for
parents. The improvement of the attitudes of most parents
cannot be separated from the factors that support a positive
attitude, including spiritual factors and enthusiasm /
enthusiasm factors13. In line with Prentice's (2013)
research, there is an effect of nutrition education on
maternal behavior in providing a balanced menu, namely
an increase in knowledge, attitudes, and actions in
providing a balanced menu for toddlers14.
Notoadmodjo (2012) states that analyzing human
behavior starts from the health level. Health is influenced
by 2 factors, namely behavior causes and non-behavior
causes15. Adriani (2012) states that there are 3 factors that
determine a behavior, in this case the behavior in question
is the fulfillment of nutrition in toddlers16.
Based on statistical analysis, there is an effect of
nutrition education on the behavior of pregnant women and
mothers with toddlers at Batakte Health Center. These
results are in line with research conducted by Pratiwi
(2020) that there is a change in behavior in pregnant
women after being given education about balanced
nutrition in early prevention of stunting 17. Another study
similar to Amalia (2018) where there is an effect of nutrition
education on the behavior of prospective mothers in
preventing SEZ for pregnant women18.
Nutrition education interventions include providing
knowledge and providing motivation towards changing
attitudes and feeding behavior. Nutrition education with
media in the form of booklets and direct samples (food
samples) will be easier for the research subjects to
understand because it attracts attention and is not boring.
This was shown by the two groups through an increase in
the scores of knowledge, attitudes and behavior of
pregnant women and mothers with toddlers. According to
sensory experts, 75% to 87% of human knowledge is
transmitted through the sense of sight. Images contained in
the PMBA book, how to wash hands properly and sample
dishes are stimuli that may be easily remembered by the
sample so that the value of knowledge, attitudes and
behavior of feeding increases19.
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P J M H S Vol. 14, NO. 3, JUL – SEP 2020 1004
 Selçuk Ün. Sos. Bil. Ens. Der. 2020; (43): 270-278
- Beslenme ve Diyetetik / Araştırma -

Knowledge of Mothers with Children Aged 0-24 Months on Child

Nutrition
Gülperi DEMİR*
Hülya YARDIMCI**
Funda Pınar ÇAKIROĞLU***
Ayşe Özfer ÖZÇELİK****

ABSTRACT
Adequate and balanced nutrition plays an important role in the healthy growth and development of children. The main
problem related to nutrition in children derives from the fact that mothers do not have enough knowledge on nutrition.
Determining the nutritional knowledge of the mothers, identifying the deficiencies and mistakes and transferring the correct one
instead of them is important for raising healthy generations. The aim of this study is to determine the knowledge of mothers with
children between 0-24 months old about child nutrition and to evaluate them according to various variables.
The descriptive study was conducted on mothers (n:250) with children between 0-24 months old. Data were obtained via
questionnaire form. The questionnaire included 20 knowledge statements on child nutrition. The data were analyzed using IBM-
SPSS 20.0 for statistical program. Ages of mother’s and children’s, mothers’ employment status and educational levels, birth order
of children in the family and the mother's knowledge sources were used as variables to evaluate the maternal nutritional
knowledge of the mothers. For the analysis, independent sample t-test and One-way Anova were used.
The average knowledge scores of the mothers was 15.4±1.5; 75.0.% of the highest possible score of 20. When knowledge
scores of the mothers were analyzed by variables, a significant difference was found between their scores according to age. This
difference was due to the 26-30 age group (15.7±1.2 score, p<0.05). The knowledge scores of the mothers increased as the level
of education increased (p<0.01); and the knowledge scores of working mothers (16.3±1.1 score) were higher than housewives
(15.3±1.5 score)(p<0.01).
The results of our study reveal that in general, mothers included in the study had a good level of nutritional knowledge. On
the other hand, they had some mistakes in breastfeeding and complementary feeding. It is important that mothers, who are one of
the main factors in raising healthy generations, are educated by health professionals about nutrition and health, and that these
pieces of training are disseminated and sustained through the government and its other stakeholders.
Keywords: Nutrition, Knowledge, Mother, child.

0-24 Aylık Çocuğa Sahip Olan Annelerin Çocuk Beslenmesi

Konusundaki Bilgileri
ÖZ
Yeterli ve dengeli beslenme, çocukların ağlıklı büyüme ve gelişiminde önemli bir rol oynar. Çocuklarda beslenmeye bağlı
oluşabilecek sağlık sorunları, annelerin beslenme konusunda yeterince bilgilerinin olmamasıyla ilişkilidir. Annelerin beslenme
bilgilerinin belirlenerek eksiklerin ve hataların saptanması ve yerine doğru bilgilerin aktarılması, sağlıklı nesillerin yetişmesi
açısından önemlidir. Bu çalışmanın amacı iki yaşından küçük çocuğa sahip olan annelerin çocuk beslenmesi konusundaki
bilgilerinin belirlenmesi ve çeşitli değişkenlere göre değerlendirilmesidir.
Tanımlayıcı tipte olan bu çalışma, 0-24 aylık bebeği olan 250 anne üzerinde yürütülmüştür. Araştırmanın verileri anket formu
ile elde edilmiştir. Ankette çocuk beslenmesine yönelik 20 bilgi cümlesi yer almıştır. Araştırma sonucu elde edilen veriler, IBM
SPSS 20.0 programı kullanılarak analiz edilmiştir. Annelerin beslenme bilgisinin değerlendirilmesinde açıklayıcı değişken olarak
annelerin ve çocukların yaşları, annelerin çalışma durumu, eğitim düzeyleri, çocuğun ailedeki sırası ve annenin başvurduğu bilgi
kaynakları ele alınmıştır. Verilerin analizinde Independent sample t test ve Oneway anova testi kullanılmıştır.
Yapılan analiz sonucuna göre, annelerin bilgi testinden aldıkları ortalama bilgi puanı (15.4±1.5) alınabilecek en yüksek puanın
%75.0’idir. Annelerin bilgi puanları değişkenler tarafından incelendiğinde; yaşa göre puanları arasında anlamlı bir fark bulunmuştur
(p<0.05). Bu fark 26-30 yaş aralığındaki annelerin bilgi puanlarının daha yüksek olmasından (15.7±1.2) kaynaklanmaktadır. Eğitim
düzeyine göre, annelerin eğitim düzeyi arttıkça bilgi puanlarının da arttığı (p<0.01); çalışan annelerin bilgi puanlarının (16.3±1.1)
çalışmayan annelerin bilgi puanından (15.3±1.5) daha yüksek olduğu (p<0.01) saptanmıştır.
Araştırmanın sonucunda, annelerin genel olarak çocuk beslenmesi bilgi düzeylerinin iyi olduğu ortaya çıkmıştır. Diğer taraftan,
annelerin emzirme ve tamamlayıcı beslenme konusunda bazı hataları bulunmaktadır. Sağlıklı nesiller yetiştirmede temel

* Assist. Prof. Dr., corresponding author, Selçuk University, orcid no: 0000-0002-2664-4176, gulperi@selcuk.edu.tr
** Assoc.. Prof. Dr., Ankara University, orcid no: 0000-0002-2664-4176, hulya_yardimci@yahoo.com
*** Prof. Dr., Ankara University, orcid no: 0000-0003-2324-6874, ozferozcelik@gmail.com
**** Prof. Dr., Ankara University, orcid no: 0000-0002-9087-2042, scakir64@hotmail.com

Makalenin Gönderim Tarihi: 23.01.2020; Makalenin Kabul Tarihi: 19.02.2020

 Gülperi DEMİR, Hülya YARDIMCI, Funda Pınar ÇAKIROĞLU, Ayşe Özfer ÖZÇELİK

faktörlerden olan annelerin beslenme ve sağlık konusunda sağlık profesyonelleri tarafından eğitilmesi, bu eğitimlerin devlet ve
diğer paydaşları aracılığıyla yaygınlaştırılması ve sürdürülebilirliğinin sağlanması önemlidir.
Anahtar Kelimeler: Beslenme, Bilgi, Anne, Çocuk.

1. Introduction
Adequate and balanced nutrition plays an important role in the healthy growth and development of
children. Children particularly in the first two years of life, suffer nutritional deficiency in many countries
around the world. Inadequate and unbalanced nutrition causes malnutrition, growth and developmental
retardation, long-term health problems, and deaths in children (Nicklasand Hayes, 2008; World Health
Organization [WHO], 2009).

Parents have an impact on their children's nutrition. Mothers are the primary health care providers of
children and they are role models of their children in eating behaviours ((Nicklasand Hayes, 2008;
Karaağaoğlu and Samur, 2015). Primary care is strongly influenced by mother’s nutrition knowledge level
(Appoh and Krekling, 2005; Vereecken and Maes, 2010; Williams et al., 2012). Various studies reported
that mothers who have a higher level of nutritional knowledge feed their children more effectively (Sule et
al., 2009; Siagian and Halisitijayani, 2015; Chinnasami et al., 2016; Türker et al., 2016). However, mother’s
limited knowledge on child nutrition leads to negative health outcomes in children in most developing
countries (Fadare et al., 2019). Also, improper eating habits that occur in childhood and adolescence
periods increase the risk of future chronic disease (Yabancı et al., 2014).
It is well known that socio-demograpghic factors such as age, sex, education, marital status, and
socioeconomic status influence nutritional knowledge and eating behaviours (Parmenter et al., 2000;
Wardle et al., 2000). Therefore, it is important to determine the mothers’ nutritional knowledge and
related factors to identify the deficiencies, mistakes and to teach the correct information, in terms of
raising healthy generations (Sukandara et al., 2015).
In this context the aim of this study is to determine the knowledge of mothers with children between
0-24 months old on child nutrition and to evaluate them according to some variables.

2. Material and Methods

This study was planned as descriptive research. The planning phase of the study began in January 2017
and data was collected in June–August 2017. Evaluation of data was completed in March 2018. The
research sample comprises mothers (n:250) with children between 0-24 months old, who registered at two
family health centers in Aksaray province in Central Anatolia. The subjects participated on a voluntary
basis after being fully informed about the objectives and methods of the study. They signed the informed
consent and filled in questionnaires, which adhered to Declaration of Helsinki protocols (World Medical
Association).
The mother's participation in the study according to the following criteria was included, that the
mothers have 0-24 month’s old child, there is no communication barrier, and mothers are literate and
accept to participate in the study. In determining the children to be included in the study, attention was
paid to the fact that the child was born at term, did not have any nutritional or other health problems and
did not apply any special dietary treatment.
Data were obtained via questionnaire form by using face to face technique. The questionnaire form
included information about the mother and child, knowledge statementsrelated with child nutrition
prepared by authors after a review of the literature (Özdoğan et al., 2012). The child nutrition knowledge
section consisted of 20 statements. “One” point was given for each correct statement and “0” point for
incorrect statements. The highest possible score was “20”.
The data were analyzed using SPSS 20.0 for statistical analysis. Frequencies, means, and standard
deviation were calculated. Maternal nutritional knowledge was examined by six variables: The ages of the
mothers and children, the mothers’ employment status and levels of education, the children’ birth order in
the family and the mother's knowledge sources.
In order to examine the nutritional knowledge of the mothers included in the research, the study tested
whether their scores from nutritional knowledge statements dispersed normally. For this purpose, the

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Kolmogorov–Smirnov One-Sample Test was used in the study. Accordingly, the test results indicated that
the mean scores of nutritional knowledge disperse normally (p>0.05). Therefore, parametric tests
(independent sample t-test one-way ANOVA and post hoc test (Tukey) were used in the analysis
(Büyüköztürk, 2003). p-values<0.01 and <0.05 were accepted as statistically significant.

3. Results
3.1. Characteristics of Mothers and Children
The mean age of the mothers involved in the research was 28.5±5.4 years. A majority of them (88.0%)
were housewives, and 66.4% of them had attended high school or higher education. All of them were
married. The majority of their families (91.2%) were nuclear with an average of 4.3±1.2 members.
The mean age of the children was 10.3±6.4 months. The average birth weight was 3.260±491.4g and
lenght was 49.9±2.2 cm. 34.4% of them were aged 0–6 months, 29.6% of them were aged 7-12 months,
22.4% of them were aged 13-18 months, and 13.6% of them were aged 19-24 months. The children
involved in the research were the families’ second child on average.
When the knowledge sources of mothers about infant nutrition were examined, it was determined that
the most frequently used source of knowledge was the health personnel (39.2%). Family elders (38.8%)
ranked number two and media (22.0%) ranked number three.

3.2. Knowledge of Mothers on Child Nutrition

Table 1: Distribution of Mothers based on True and False Answers about Child Nutrition (n=250)
Statements True False
n /(%) n /(%)
Knowledge statements on breastfeeding
Breastfeeding alone is sufficient for the first six months 245 (98.0) 5 (2.0)
Breastfeeding is very beneficial for children 244 (97.6) 6 (2.4)
Newborn infants should be breastfed paying attention to body movements 90 (36.0) 160 (64.0)
The infant who is breastfed alone should not be given water 172 (68.8) 78 (31.2)
Breast milk is more beneficial than formulas 250 (100.0) -
Colostrum is the best food for infants 244 (97.6) 6 (2.4)
Breastfed infants are fatter than the infants fed with formulas 154 (61.6) 96 (38.4)
The infant with diarrhea should not be breastfed 238 (95.2) 12 (4.8)
Knowledge statements on complementary food
Tea and biscuits are good for children 230 (92.0) 20 (8.0)
Formula cooked with water and starch is useful for children 146 (58.4) 104 (41.6)
Cow milk should not be given to children without diluting whenever it is started 216 (86.4) 34 (13.6)
Eggs should be fed to children hard-boiled for the first time. 156 (62.4) 94 (37.6)
The gravy of a meal is more nutritious than the meal itself 37 (14.8) 213 (85.2)
Dry legumes can be given to 2-month-old children 248 (99.2) 2 (0.8)
Oil and sugar should be added to diluted milk 27 (10.8) 223 (89.2)
Honey is more nutritious than molasses for 0-1-year-old children 216 (86.4) 34 (13.6)
First sugar water should be given after birth 246 (98.4) 4 (1.6)
Giving salt to the child until the age of one is a good thing 244 (97.6) 6 (2.4)
The infant with diarrhea should not be given water 225 (90.0) 25 (10.0)
Confectionery foods are healthy for children 222 (88.8) 28 (11.2)

Mothers’ mean knowledge score on breastfeeding was 6.5±0.8; mean knowledge score on
complementary food was 8.9±1.2. All mothers (100.0%) agreed with the following statement; “Breast milk
is more beneficial than formulas”. Most of the mothers disagree with the following statement; “Newborn
infants should be breastfed whenever they want” (64.0%). The item correctly known best in the section of
knowledge on complementary food was “Dry legumes can be given to the 2-month-old child” (99.2%),
and the item most of inaccurately identified as correct was, “Oil and sugar should be added to diluted
milk” with the rate of 89.2%. This was followed by, “The gravy of the meal is more nutritious than the
meal itself” with a rate of 85.2%. Except for these items, the mothers mostly responded about child
nutrition correctly (Table 1).

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Table 2: Mothers' Knowledge Scores and Analysis Results by Variables (n=250)

Variables X±SD t/F p
Age of Mothers
≤25 yearsa 15.3±1.4 3.383 0.036
26-30 yearsb 15.7±1.2
31-43 yearsc 15.2±1.8
Educatioanal Status
Secondary school and below 15.0±1.6 -2753 0.006
High school and higher 15.6±1.4
Working Status
Working 16.3±1.1 -3.428 0.001
Housewife 15.3±1.5
Age of Children (month)
0-6 15.4±1.6 1.820 0.144
7-12 15.1±1.6
13-18 15.7±1.3
19-24 15.6±1.5
Child Birth Order in the Family
1. 15.3±1.5 0.302 0.740
2. 15.5±1.5
≥3. 1534±1.4
Source of Mothers’ Nutritional Knowledge
Health Personnel 15.6±1.6 1.031 0.358
Media 15.2±1.5
Family Elders 15.5±1.4
Total score 15.4±1.5 - -
* b>a, c

The average knowledge scores of the mothers were 15.4±1.5; 75.0% of the highest possible score of
20. When knowledge scores of the mothers were analysed by variables, a significant difference was found
between their scores according to age. This difference was due to the 26-30 age group (15.7±1.2 score)
according to the Tukey analysis result (p:0.036). The knowledge scores of the mothers increased as the
level of education increased (p:0.006); and the knowledge scores of working mothers were (16.3±1.1
score) higher than (15.3±1.5 score) housewives (p:0.001). There are no significant differences between the
children, the birth order of children in the family, and the mother's source of knowledge in nutrition
(Table 2).

4. Discussion
Children particularly in the first two years of life, suffer from nutritional deficiency for social,
economic and cultural, behavioral reasons in many countries around the world. Breast milk is the most
important food contributing to the healthy growth and development of children. The most correct feeding
style for babies is breastfeeding alone for the first six months postpartum (WHO, 2009). Breastfed
children have much lower mortality from diarrhea and other diseases and are less likely to be obese or
catch diabetes in adolescence and adulthood (Arenz et al., 2004; Monasta et al., 2010). The type and
duration of infant feeding may have an important role in biological and behavioral development and affect
subsequent growth and health (Savage et al., 2007). Breast milk should be supported with suitable
complementary foods beginning in the sixth months of age in infants (WHO, 2009).
One of the most important factors affecting the behavior of mothers on child nutrition is the
knowledge levels of mothers on breastfeeding and complementary foods (American Academy of
Pediatrics, 2012; Bertini et al., 2003; Dunn et al., 2006).
The majority of the mothers involved in the research were determined to have correct knowledge on
the importance of breast milk. Some studies, demonstrated that mothers generally answered the questions
on breast milk correctly too. For example, Eker and Yurdakul (2006), Şahin (2008), Mohammed et al.
(2014), Şengül et al. (2005), Chinnasami et al. (2016) observed that mothers in their studies generally gave

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the correct answer that breast milk is the most beneficial nutrient for infants. These studies and the results
of our study raise the thought that mothers are aware of the importance of breast milk for infants. It was
noted that the remarkable high rate of not knowing these expressions is as follows; “Newborn infants
should be breastfed paying attention to body movements (64.0%)”, “The infant who is breastfed alone
should not be given water (31.2%)”, and, “Breastfed infants are fatter than the infants fed with formulas
(38.4%)”. Supplying the correct information in training and consultation by health staff could be useful.
Formula-fed infants have particular difficulties in taking breast milk, and this leads to the early
introduction of complementary foods (Clayton et al., 2013). The knowledge that “future obesity risk is
higher in the infants fed with formula (Weng et al, 2012) should be shared with mothers. Whereas the
early introduction of complementary foods and formula feeding of infants are important risk factors
according to the results of scientific research, breastfeeding is considered as one of the protective factors
(Arenz et al., 2004; Griffiths et al., 2009). Furthermore, the intellectual and social development scores of
the children fed with formula are lower than those who were breastfed (American Academy of Pediatrics,
2012). Mothers should be educated about the content of breast milk especially.
The mothers have incorrect and insufficient knowledge about complementary foods (Table 1). Of
them, 41.6% believe that formula cooked with water and starch is good for infants. However, formula
cooked by this way has no nutritional value. The rate of mothers, who wrongly believe that the gravy is
more nutritious than the meal itself, is also very high (85.2%). Giving the meal itself to infants is the
correct way to meet their need for nutrients. In cases of a requirement of giving other kinds of milk in the
first few months postpartum because of breast-milk insufficiency or lack of adequate nutrition, it is
appropriate to add oil and sugar in certain measures in order to meet the energy and liken it to breast milk
(WHO, 2018). However, most of the mothers in the study (89.2%) did not know when and how to start
cow's milk. Except for these items, the mothers’ knowledge was generally correct.
Mothers’ knowledge and practices on child nutrition are known to be affected by age, educational level
and socioeconomic status (Karaçam, 2008; Bramson et al., 2010; Hauck et al., 2011). Age effects one's
mindset, increasing age and experience increases individual well which means it can influence the attitudes
and behavior of individuals. The ages of the mothers effect their knowledge levels (Jahangeer et al., 2009).
Although the scores were close to each other between the age groups in this study, the mothers between
the ages of 26 and 30 had more knowledge (p<0.05, Table 2). In the study conducted by Örsdemir (2011)
found that the difference between the knowledge scores according to the education and working status of
mothers is important (p<0.05), whereas the difference according to age is not important. In another study,
Özer et al. (2010) stated that the knowledge score of mothers in the 20-34 age group on breastfeeding to
be higher than those of the mothers in other age groups. Also, Siagian and Halisitijayani (2015) stated that
the level of knowledge of mothers was associated with age; for the age of 26-35 years as many as 49 (94%)
with a good level of knowledge.
The average knowledge scores of mothers were analyzed according to their educational level and it was
determined that the knowledge scores of mothers increased as their level of education increased (p<0.01,
Table 2). Many studies have indicated maternal levels of education as the single most important factor
affecting child nutrition behavior (Bonuck et al., 2005; Wen et al., 2009; Al Ketbi et al., 2018). According
to the results of the Turkey Demographic Health Survey (2013), there is a positive relationship between
early breastfeeding and education level since 40.0% of the children of mothers with no education or who
completed only primary school, and 54.0% of the children of mothers with at least high school education
were breastfed within the first hour postpartum (Hacettepe Üniversitesi Nüfus Etütleri Enstitüsü, T.C.
Kalkınma Bakanlığı ve TUBİTAK, 2014). In addition, WHO and The United Nations International
Children’s Emergency Fund [UNICEF] believe that the education of mothers regarding nutrition by
health professionals lead to sustainable child nutrition which is an important issue against undernutrition
(WHO, 2009; UNICEF, 2019). In studies, it was determined that the education given to mothers about
child nutrition had a positive effect on mothers' knowledge and behavior and the nutritional status of
children (Sethi et al., 2003; Kulwa et al., 2014; Sukandara et al., 2015).
Employment was identified as an important factor that affects breastfeeding. The knowledge scores of
working mothers were higher. Considering the levels of education of mothers, these high knowledge

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scores are an expected result since all working mothers (100.0%) were high school and university
graduates. In their study, Al Ketbi et al. (2018) found that better breastfeeding knowledge was seen among
mothers who were employed too (p<0.01). Siagian and Halisitijayani (2015), also found that employed
mothers have higher nutritional knowledge than non-employed mothers.
The mean knowledge score of the mothers did not change statistically according to the age of the
children (months) (p:0.740) and the birth order of the child in the family (p>0.05). However, as the age of
the child increases, the average knowledge scores of the mothers increase (Table 2). This may be due to
the increased experience of the mother in child care as the child's age increases and due to the ranking
secondly in the birth order. Al-Ayed (2010) also found no significant relationship between mothers'
nutritional knowledge score and child rankings. On the other hand, Moawed and Saeed (2000) and Siagian
and Halisitijayani (2015) found that there was a statistically significant relationship between the mothers'
knowledge and the order of birth of the children and that the mothers' nutritional knowledge increased as
the number of children in the family increased. This difference may be due to the use of different research
methodologies (sample selection, data collection, etc.).
Parents provide the strongest influence on beliefs of mothers of infants and toddlers in feeding
(Duncanson et al., 2013; Ball et al., 2017), as their most regular sources of nutrition knowledge are the
internet, family, and friends (Duncanson et al., 2014). Mothers obtain their knowledge of child nutrition
from health staff (39.2%), their own mothers (38.8%) and mass media (22.0%). Mothers have been found
to prefer similar knowledge sources on child nutrition in other studies (Jarosz et al., 2004; Bağ et al., 2006;
Chinnasami et al., 2016). In this study, the rates of referring the health personnel and their parents as
knowledge sources of the mothers are close to each other. Al-Ayed (2010), on the other hand, found that
the primary source of knowledge for most mothers was family elders, that the rate of mothers who
portray health professionals as the primary source of health information was very low. These results can
be explained by the fact that mothers attach importance to the use of their own parents' experiences.
Health-related behaviors in child feeding are affected by peers, social norms and attitudes. (Duncanson et
al., 2013). Duncanson et al. (2013) explained this phenomenon by the Theory of Planned Behaviour
(TPB). The complex interaction between attitudes perceived control, normative beliefs, motivation to
comply with norms and interactions between these factors are all the key factors in the determination of
behaviour. Mothers usually have mistaken in the selection of knowledge sources which is important for
providing the correct information. To provide the aforementioned support by influencing decisions about
feeding behaviors among mothers is the main role of health care professionals. Thus, every meeting with
mothers should be accepted as an opportunity that exists for educational purposes.

5. Conclusion and Recommendations

The results of our study reveal that mothers included in the study had a good level of nutritional
knowledge (X±SD=15.4±1.5). It is considered that this result is due to the trainings given in health care
institutions. And it is gratifying in terms of raising a healthy generation. On the other hand, although
mothers' overall child nutrition knowledge scores were good; they had some mistakes in breastfeeding and
complementary feeding.
We find it important for mothers to raise their awareness about the content of breast milk and its’
protective properties against obesity in terms of providing exclusively breastfeeding. Similarly, it was
determined that the mother needs to be informed about the healthy formula preparation in the absence of
milk. In addition, it is thought that mothers need to be informed about starting complementary nutrition
at the right time and with appropriate nutrients.
Mothers' nutritional knowledge differs statistically depending on their age, educational level and
working status. The fact that the average knowledge scores increase with the education level and ages of
the mothers reveals the importance of education and age range. In conclusion, it is especially considered
that mothers should be more aware of child nutrition as a result of factors such as having a baby in the
age range where the consciousness level can occur more, increasing educational level, socializing by
participating in employment.

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It is important that mothers, who are one of the main factors in raising healthy generations, are
educated by health professionals about nutrition and health, and that these pieces of training are
disseminated and sustained through the government and its other stakeholders.

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 Jurnal Gizi dan Pangan, Maret 2010 5(1): 61 – 68

ANALISIS HUBUNGAN PENERAPAN PESAN GIZI SEIMBANG KELUARGA DAN

PERILAKU KELUARGA SADAR GIZI DENGAN STATUS GIZI BALITA DI PROVINSI
KALIMANTAN BARAT
(Relationship Analysis of The Implementation of Balanced Nutrition Messages Family and
Behavior Family Nutrition Awareness with Under Five Years Child Nutritional Status
in West Kalimantan Province)

Didik Hariyadi1, M Rizal Damanik2*, dan Ikeu Ekayanti2

1
Jurusan Gizi Politeknik Kesehatan Pontianak, Kemeterian Kesehatan Republik Indonesia.
2**
Alamat korespondensi: Departemen Gizi Masyarakat, Fakultas Ekologi Manusia, Institut Pertanian
Bogor, Bogor 16680. Telp: 0251-8621258; Fax: 0251-8622276
2
Departemen Gizi Masyarakat, Fakultas Ekologi Manusia, Institut Pertanian Bogor, Bogor 16680.

ABSTRACT

The present study aims to analyze of relationship of the implementation of balanced

nutrition messages family and behavior family nutrition awareness with under five years
child nutritional status in West Kalimantan Province. The study uses Health Research Data
Base of West Kalimantan Province in year 2007 with the design of cross-sectional study. The
total of 1992 household samples were recruited in the study with criteria having child aged 6
to 59 months. Weight for height, weight for age and height for age indicators were used to
measure child nutritional status. The results showed that three messages did not meet
criteria as required by the Indonesian Food Guideines. Three messages did not meet criteria
as required by the Indonesian Food Guidelines. They were eat food withr energy needs
requaired, eat half of food sources of carbohydrate for energy needs and eating one of
fourth of food sources of fat for energy needs. Logistic multiple regression analysis showed
that failure to follow the the Family Nutrition Awareness had 1.21 risk for children to
became stunting than family to follow to guideline properly.
Key words: under five years child, nutritional status, balanced nutrition messages, family
nutrition awareness, Indonesian Food Guidelines.

PENDAHULUAN anak-anaknya dan harus memberikan kasih

Gizi merupakan salah satu penentu
kualitas Sumber Daya Manusia (SDM). Makanan
yang diberikan sehari-hari harus mengandung
semua zat gizi sesuai kebutuhan, sehingga
menunjang pertumbuhan yang optimal dan
dapat mencegah penyakit defisiensi, mence-
gah keracunan dan juga mencegah timbulnya
penyakit yang dapat mengganggu kelangsungan
hidup anak (Soekirman 2000).
Masa bayi dan anak adalah masa mereka
mengalami pertumbuhan dan perkembangan
yang cepat dan sangat penting sebagai lan-
dasan yang menentukan kualitas generasi pe-
nerus bangsa (Azwar 2000).
Status gizi balita sangat dipengaruhi
oleh lingkungan sosial terdekat. Di samping itu
peran keluarga sangat besar dalam membentuk
kepribadian anak. Pola pendidikan yang tepat
yang diterapkan oleh orang tua akan sangat
membantu anak dalam menghadapi kondisi
lingkungan pada masa yang akan datang.
Orang tua merupakan tempat bergantung
sayang dan perhatian sepenuhnya pada anak
hingga remaja.
Penyebab langsung status gizi yaitu ma-
kanan anak dan penyakit infeksi yang mungkin
diderita anak. Penyebab gizi kurang tidak ha-
nya disebabkan makanan yang kurang tetapi
juga karena penyakit. Anak yang mendapat
makanan yang baik tetapi sering menderita
penyakit infeksi dapat menderita kurang gizi.
Demikian pula pada anak yang makannya tidak
cukup baik, maka daya tahan tubuh akan me-
lemah dan mudah terserang penyakit. Sehing-
ga makanan dan penyakit merupakan penye-
bab kurang gizi (Supariasa et. al. 2002).
Perilaku gizi yang baik dan benar pada
tiap individu dapat mengacu pada pesan gizi
seimbang dalam Pedoman Umum Gizi Seim-
bang (PUGS) yang terdiri dari 13 pesan (Dep-
kes, 2005), meskipun untuk mendukung upaya
penilaian dan pemantauan praktek pesan gizi
seimbang perlu penelitian lebih lanjut tentang
penilaian penerapan pesan-pesan gizi seim-

61
Jurnal Gizi dan Pangan, Maret 2010 5(1): 61 – 68

bang untuk kelompok ibu hamil, anak sekolah, Riskesdas 2007 dengan desain cross sectional,
remaja dan usia lanjut (Hardinsyah, 1998). dimana pengukuran outcome dan potential
predictor dilakukan secara simultan pada wak-
Salah satu sasaran prioritas Rencana
tu yang bersamaan (Aswin 1997) sesuai dengan
Strategi Departemen Kesehatan dalam rangka
desain Riskesdas 2007 di Provinsi Kalimantan
mencapai sasaran menurunkan prevalensi gizi
Barat. Wilayah penelitian di Provinsi Kaliman-
kurang adalah Keluarga Sadar Gizi (KADARZI)
tan Barat yang dilaksanakan bulan Januari
(Depkes 2007) yang merupakan penyederhana-
2010 sampai Maret 2010.
an dari pesan gizi seimbang (Minarto 2009).
Penelitian tentang penerapan pesan gizi Jumlah dan Cara Penarikan Sampel
seimbang dan pengaruh perilaku KADARZI ter-
Populasi dalam Riskesdas Provinsi Kali-
hadap status gizi balita khususnya di Kali-
mantan Barat 2007 adalah seluruh rumah
mantan Barat belum pernah dilakukan. Hasil
tangga di wilayah Provinsi Kalimantan Barat.
RISKESDAS di Kalimantan Barat 2007, ditemu-
Sampel adalah rumah tangga dan anggota ru-
kan data sebagai berikut: prevalensi balita
mah tangga yang diambil dengan menggunakan
dengan gizi kurang dan buruk (underweight)
metodologi penghitungan dan cara penarikan
berdasar berat badan menurut umur (BB/U)
sampel identik dengan two stage sampling
sebesar 22.6%, status pendek dan sangat pen-
yang digunakan dalam Susenas 2007. Setiap
dek (stunting) berdasar tinggi badan menurut
kabupaten/kota yang masuk dalam kerangka
umur (TB/U) mencapai 36.8%, kurus dan sa-
sampel kabupaten/kota, diambil sejumlah blok
ngat kurus (wasting) berdasar berat badan me-
sensus yang proporsional terhadap jumlah
nurut tinggi badan (BB/TB) sebanyak 17.3%,
rumah tangga di kabupaten/kota tersebut.
sedangkan prevalensi gizi lebih berdasar BB/U
Jumlah rumah tangga pada sebuah kabupaten/
didapat sebesar 5% dan berdasarkan BB/TB
kota diambil dengan metode probability pro-
14%. Secara nasional Kalimantan Barat terma-
portional to size. Setiap blok sensus terpilih
suk salah satu dari 25 provinsi di Indonesia
kemudian dipilih 16 (enam belas) rumah tang-
dengan prevalensi underweight, wasting, gizi
ga secara acak sederhana.
lebih dan gemuk di atas rata-rata nasional
(masing-masing 18.4%, 13.6%, 36.8%, 4.3% dan Jumlah rumah tangga yang mempunyai
12.2%). balita berdasarkan data yang diperoleh dari
Badan Penelitian dan Pengembangan Kese-
Peneliti ingin melihat apakah penerap-
hatan (Balitbangkes) Depkes RI sebanyak 2.375
an gizi seimbang keluarga dan perilaku KADAR-
rumah tangga. Selanjutnya ditetapkan sampel
ZI rumah tangga balita mempunyai hubungan
rumah tangga dengan kriteria inklusi adalah
dengan status gizi balita dan apakah ada per-
rumah tangga yang mempunyai balita umur 6 –
bedaan determinan faktor penerapan gizi se-
59 bulan, mempunyai data BB dan TB dengan
imbang keluarga dan perilaku KADARZI hubung-
cut off point sesuai indikator z-score status
annya dengan Status Gizi balita. Penelitian ini
gizi BB/TB, TB/U dan BB/U pada WHO (World
bertujuan untuk menganalisis hubungan pene-
Health Organization) Anthro 2009 dan mempu-
rapan pesan gizi seimbang keluarga dan peri-
nyai data sosial ekonomi dan pendidikan orang
laku KADARZI terhadap status gizi balita di
tua, sehingga jumlah sampel diperoleh seba-
Provinsi Kalimantan Barat.
nyak 1992 rumah tangga balita (Gambar 1).

Pengolahan dan Analisis Data

METODE
Pengolahan data pesan gizi seimbang
Desain, Tempat, dan Waktu mengacu pada cara penilaian penerapan 13
pesan PUGS Hardinsyah (1998) yang dimodifi-
Jenis penelitian ini adalah penelitian ob-
kasi. Data tentang pesan gizi seimbang yang
servasional menggunakan data sekunder hasil

Jumlah total sampel

2375 Kriteri eksklusi :
0 – 5 bulan = 168
Data BB & TB tdk sesuai = 163
Data Orang tua missing = 52
Jumlah sampel
1992

Gambar 1. Skema Jumlah dan Pengambilan Sampel

62
 Jurnal Gizi dan Pangan, Maret 2010 5(1): 61 – 68

diperoleh dari Riskesdas 2007 terdapat 8 pesan Science) for windows versi 16.0 tahun 2007.
dari 13 pesan yang dapat dinilai, sedangkan 5 Penentuan nilai z-score berdasarkan BB/TB,
pesan yang lain tidak dapat diperoleh datanya. BB/U dan TB/U menggunakan software Anthro
Delapan pesan tersebut adalah 1) Makanlah WHO versi 3.0.1 tahun 2009.
aneka ragam makanan; 2) Makanlah makanan
untuk memenuhi kecukupan energi; 3) Makan-
lah makanan sumber karbohidrat setengah dari HASIL DAN PEMBAHASAN
kebutuhan energi; 4) Batasi konsumsi lemak
dan minyak ¼ dari kecukupan energi; 5) Guna- Karakteristik Sampel
kan garam beriodium; 6) Makanlah sumber zat
Rata-rata umur balita dalam penelitian
besi; 7) Lakukan aktifitas fisik secara teratur;
ini adalah 30.9 ± 14.6 bulan dengan kelompok
dan 8) Hindari minum minuman beralkohol.
umur tertinggi antara 25 – 43 bulan (37.9%)
Masing-masing pesan diberi skor 1, sehingga
dan jenis kelamin laki-laki 52.2%. Berat badan
skor total adalah 8. Masing-masing pesan dika-
rata-rata 12.1 ± 3.7 kg dan tinggi badan 86.6 ±
tegorikan secara nominal dengan skor 0, jika
12.4 cm. Prevalensi status gizi balita (6 – 59
tidak memenuhi dan skor 1 jika memenuhi ma-
bulan) yang diukur berdasarkan indeks BB/TB,
sing-masing pesan PUGS. Selanjutnya kategori
BB/U dan TB/U menunjukkan bahwa sebagian
penerapan gizi seimbang dikatakan baik jika
besar balita mempunyai status gizi normal dan
total skor 4 – 8 dan kurang baik jika total skor
baik dibandingkan dengan kategori status gizi
< 4. Data perilaku KADARZI rumah tangga dika-
yang lain, masing-masing sebesar 70.4%, 73.2%
tegori baik dan kurang baik menggunakan in-
dan 56.5% (Tabel 1). Berdasarkan kriteria ma-
dikator yang dipakai Depkes (2007) dengan
salah gizi yang ditetapkan Depkes (2009) ber-
empat dari lima indikator pengukuran. Data
dasarkan WHO, Kalimantan Barat menghadapi
Status gizi menggunakan kategori baku antro-
masalah gizi akut-kronis dengan karakteristik
pometri WHO (2006) yang didasarkan pada ni-
masalah gizi sebagi berikut : prevalensi balita
lai z-score berdasarkan BB/TB, TB/U dan
wasting mencapai 17.0% (> 5%), balita stunting
BB/U. Data infeksi yang diambil adalah data
mencapai 43.4% (> 20%) dan balita status gizi
infeksi saluran pernapasan atas (ISPA), diare,
underweight sebesar 24.1% (> 10%) dengan
demam thypoid, malaria, campak dan demam
prevalensi status infeksi balita di Kalimantan
berdarah. Penilaian menggunakan kuesioner
Barat menyebar antara yang infeksi dan tidak
dengan menanyakan pernah menderita atau
infeksi masing-masing 47.8% dan 52.2%. Infeksi
pernah didiagnosa oleh tenaga medis mende-
merupakan salah satu faktor penyebab lang-
rita. Selanjutnya dikategorikan pernah atau ti-
sung status gizi balita disamping konsumsi.
dak pernah menderita satu atau lebih penyakit
Pada masa anak-anak yang sedang tumbuh
ISPA, diare, demam thypoid, malaria, campak
umumnya akan mengalami lebih dari 100 ma-
atau demam berdarah. Data konsumsi gizi akan
cam infeksi sebelum mencapai masa dewasa.
didasarkan pada kelompok zat gizi energi, pro-
Kejadian ini akan lebih buruk jika terjadi pada
tein dan vitamin A sesuai dengan ketersediaan
daerah miskin, sanitasi yang buruk dan daerah
data Riskesdas 2007. Selanjutnya kebutuhan
dengan masalah gizi (Linder 1992).
masing-masing zat gizi dihitung berdasarkan
kelompok umur menggunakan standar AKG Konsumsi energi dan vitamin A balita se-
tahun 2004. bagian besar masih defisit (66.5% dan 68.2%)
dibandingkan dengan konsumsi protein yang
Analisis data hasil penelitian disajikan
sebagian besar (66.9%) sudah baik. Zat gizi
dalam bentuk deskriptif dan inferensial. Ana-
protein merupakan salah satu zat gizi penting
lisis univariat untuk melihat distribusi freku-
terutama pada masa pertumbuhan dan per-
ensi masing-masing variabel penelitian. Anali-
kembangan balita. Kalimantan Barat merupa-
sis bivariat digunakan untuk mengetahui hu-
kan salah satu wilayah yang kaya akan hasil la-
bungan antara masing-masing variabel inde-
ut dan sungai, sehingga dimungkinkan konsum-
penden dan variabel dependen. Uji kemaknan
si protein balita lebih baik dari konsumsi ener-
digunakan metode Chi-Square (2) (Selvin,
gi dan vitamin A.
1996). Analisis multivariat menggunakan reg-
resi logistik ganda. Kriteria kemaknaan statis- Tabel 1 juga menunjukkan bahwa pro-
tik yang dipakai adalah  < 0.05. Nilai confi- porsi tingkat pendidikan orang tua balita baik
dence interval (CI) ditetapkan 95%. Pengolah- ayah maupun ibu sebagian besar tamat SD atau
an dan analisis data masing-masing mengguna- dibawahnya masing-masing 60.9% dan 62.7%
kan software Microsoft Office Excell 2007 dan sedangkan pengeluaran rumah tangga rata-rata
software SPSS (Statistic Program for Social sebesar Rp 925 000 ± 426 800.

63
Jurnal Gizi dan Pangan, Maret 2010 5(1): 61 – 68

Tabel 1. Sebaran Karakteristik Sampel

n (%) Mean
Balita )N = 1992(
Umur (bulan) 31.5 ± 14.6
6 – 24 704 (35.3)
25 – 43 777 (39.0)
44 – 59 511 (25.7)
Jenis Kelamin
Laki-laki 1026 (51.5)
Perempuan 966 (48.5)
Berat Badan (BB) 11.7 ± 3.2
Tinggi Badan (TB) 86.4 ± 12.4
Status Gizi (BB/TB) -0.29 ± 1.97
Normal 1403 (70.4)
Kurus 170 (8.5)
Sangat Kurus 169 (8.5)
Gemuk 250 (12.6)
Status Gizi (BB/U) -1.09 ± 1.46
Baik 1459 (73.2)
Kurang 340(17.1)
Buruk 140(7.0)
Lebih 54 (2.7)
Status Gizi (TB/U) -1.34 ± 2.44
Normal 1126 (56.5)
Pendek 389 (19.5)
Sangat Pendek 477 (23.9)

Status Infeksi
Infeksi 952 (47.8)
Tidak Infeksi 1040 (52.2)
Konsumsi )N = 1879(
Energi 675.6 ± 676.2
Baik (≥ 100% AKG) 341(17.1)
Sedang (80 – 90% AKG) 129(6.5)
Kurang (70 – 79.9% AKG) 85(4.3)
Defisit (< 70%AKG) 1324(66.5)
Protein 51.1 ± 29.3
Baik (≥ 100% AKG) 1333(66.9)
Sedang (80 – 90% AKG) 73(3.7)
Kurang (70 – 79.9% AKG) 38(1.9)
Defisit (< 70%AKG) 435(21.8)
Vitamin A 250.9 ± 216.5)
Baik (≥ 100% AKG) 335(16.8)
Sedang (80 – 90% AKG) 125(6.3)
Kurang (70 – 79.9% AKG) 61(3.1)
Defisit (< 70%AKG) 1358(68.2)
Orang Tua )N = 1992(
Pendidikan Ayah
≤ SD 1213 (60.9)
SMP 348 (17.5)
≥ SMA 431(21.6)
Pendidikan Ibu
≤ SD 1248 (62.7)
SMP 354 (17.8)
≥ SMA 390(19.6)
Pengeluaran RT 925000 ± 426800
≥ Rata-rata 844 (42.4)
< Rata-rata 1148 (57.6)

Penerapan Pesan Gizi Seimbang
Penerapan pesan gizi seimbang dari 8
pesan yang dinilai menunjukkan tingginya ru-
mahtangga yang tidak memenuhi pesan nomor
2, 3 dan 4, yaitu makan makanan untuk meme-
nuhi energi, makan makanan sumber karbo-
hidrat ½ dari kebutuhan energi dan konsumsi
lemak dan minyak ¼ dari kecukupan energi
masing-masing 60.1%, 66.3% dan 76.5% sedang-

64
 Jurnal Gizi dan Pangan, Maret 2010 5(1): 61 – 68

kan pesan yang paling banyak terpenuhi adalah
pesan nomor 8 (menghindari minum minuman
beralkohol) mencapai 88.9% (Tabel 2). Kon-
sumsi energi perkapita sebesar 1.644.1 ± 654.2
kal, masih dibawah rata-rata nasional (1735.5
kal) sedangkan konsumsi lemak, karbohidrat
dan zat besi masingmasing 34.9 ± 30.2 gr,
272.8 ± 118.9 gr dan 5.5 ± 3.4 mg.
Pesan gizi seimbang yang mengacu pada
PUGS merupakan salah satu pengembangan
strategi dalam mencapai perubahan pola kon-
sumsi makanan yang ada di masyarakat dengan
tujuan akhir adalah tercapainya status gizi
masyarakat yang lebih baik (Depkes, 2005).
Tidak ada satu jenis makanan apapun di dunia
ini yang dapat memenuhi jumlah zat gizi yang
dibutuhkan oleh tubuh manusia. Menkonsumsi
makanan yang beraneka ragam sangat berman-
faat bagi kesehatan, sebab kekurangan zat gizi
tertentu pada satu jenis makanan akan dileng-
kapi oleh zat gizi serupa pada makanan yang
lain (Depkes, 2005) dan kekurangan satu jenis
zat gizi dalam konsumsi makanan sehari-hari
akan menyebabkan penggunaan zat gizi lain-
nya tidak optimal. Makan makanan yang ku-
rang aneka ragam akan berdampak pada me-
tabolisme zat-zat gizi yang lain terganggu, se-
hingga dalam waktu lama dimungkinkan akan
berakibat timbulnya masalah gizi. Pada pesan
menghindari minum minuman beralkohol da-
lam penelitian ini sejalan dengan penelitian
Emilia (1998) di Ciomas kabupaten Bogor yang
menunjukkan bahwa penerapan pesan gizi se-
imbang menghindari minum minuman beralko
hol pada ibu sebesar 99% tertinggi dibanding
pesan lainnya.
Penerapan pesan gizi seimbang di rumah
tangga balita secara umum masih kurang baik
(52.6%) (Tabel 3). Kondisi ini hampir sama de-
ngan penelitian Hardinsyah et al (1998) yang
mengemukakan masing-masing sekitar 45.2%
bapak dan 49.1% ibu yang mempraktekkan 13
pesan gizi seimbang dengan baik.
Tabel 2. Sebaran Penerapan Pesan Gizi Seim-
bang Rumah Tangga
Jumlah
Penerapan Pesan Gizi
Seimbang n %
Baik 945 47.4
Kurang Baik 1047 52.6
Perilaku KADARZI
KADARZI adalah suatu keluarga yang
mampu mengenal, mencegah dan mengatasi
masalah gizi setiap anggotanya (Depkes, 2007).
Tabel 4 menunjukkan sebaran perilaku KADAR-
ZI rumah tangga dengan kriteria memenuhi
dan tidak memenuhi. Perilaku menggunakan
garam beriodium mempunyai proporsi tertinggi
(86.1%) dibanding dengan 3 perilaku lainnya
(menimbang berat badan secara teratur, ma-

Tabel 3. Sebaran Penerapan Gizi Seimbang Rumah Tangga Berdasarkan Kriteria PUGS
Kriteria
Kriteria PUGS Memenuhi Tdk memenuhi
n % n %
1. Makan aneka ragam makanan 1287 64.6 705 35.4
2. Makan makanan untuk memenuhi 795 39.9 1197 60.1
kecukupan energi
3. Makan makanan sumber karbohidrat 672 33.7 1320 66.3
setengah dari kebutuhan energi
4. Konsumsi lemak dan minyak ¼ dari 469 23.5 1523 76.5
kecukupan energi
5. Menggunakan garam beriodium 1715 86.1 277 13.9
6. Makan sumber zat besi 1064 53.4 928 46.6
7. Melakukan aktifitas fisik secara teratur 1515 76.1 477 23.9
8. Menghindari minum minuman beralkohol 1771 88.9 221 11.1

Tabel 4. Sebaran Perilaku KADARZI Rumah Tangga Berdasarkan Indikator KADARZI

Kriteria
Indikator KADARZI Memenuhi Tdk memenuhi
n % n %
1. Menimbang berat badan secara teratur 516 25.9 1476 74.1
2. Menggunakan garam beriodium 1715 86.1 277 13.9
3. Makan aneka ragam makanan 1287 64.6 705 35.4
4. Memberikan suplement gizi sesuai anjuran 551 27.7 1441 72.3

65
Jurnal Gizi dan Pangan, Maret 2010 5(1): 61 – 68

kan aneka ragam makanan dan memberikan
suplement gizi sesuai anjuran). Penggunaan
garam beriodium di Kalimantan Barat sudah le-
bih tinggi dari rata-rata nasional (24.5%) mes-
kipun belum sesuai target Universal Salt Iodi-
zation 2010 sebesar 90%.
Tabel 5 menunjukkan perilaku KADARZI
rumah tangga balita, dimana kurang baik
(56.9%) lebih besar dibandingkan dengan peri-
laku KADARZI baik (43.1%). Hasil ini sejalan
dengan penelitian deskriptif yang telah dilaku-
kan oleh Nurmayati (2002) di Kelurahan Betet
Kota Kediri yang menyebutkan bahwa imple-
mentasi KADARZI hanya dilakukan oleh seba-
gian masyarakat dengan kendala faktor pendi-
dikan dan ekonomi yang rendah.
Tabel 5. Sebaran Perilaku KADARZI Rumah-
tangga
Jumlah
Perilaku KADARZI
n %
Baik 859 43.1
Kurang Baik 1133 56.9
Hasil uji regresi logistik binary menun-
jukkan bahwa pengaruh penerapan pesan gizi
seimbang keluarga terhadap status gizi pada
indek BB/TB, BB/U dan TB/U tidak signifikan
secara statisrtik. Perilaku KADARZI mempunyai
pengaruh terhadap status gizi balita pada in-
deks TB/U. Perbandingan nilai signifikan anta-
ra penerapan pesan gizi seimbang dan perilaku
KADARZI dalam mempengaruhi status gizi ba-
lita pada indek TB/U masing-masing 0.49 ( >
0.05) dan 0.04 ( < 0.05). Analisis ini mem-
berikan makna bahwa perilaku KADARZI meru-
pakan faktor yang mempengaruhi status gizi
balita pada indek TB/U. Perilaku KADARZI yang
kurang baik mempunyai peluang risiko 1.21
kali terhadap kejadian stunting dibandingkan
dengan perilaku KADARZI yang baik.
Status gizi balita dengan indeks TB/U
adalah indikator masalah gizi kronis sebagai
akibat dari keadaan yang berlangsung cukup
lama (Depkes 2009), sehingga dampak dari
perilaku KADARZI rumah tangga mempunyai
kecenderungan mempengaruhi status gizi bali-
ta dalam jangka waktu yang panjang. UNICEF
(1997) mengemukakan bahwa status gizi balita
dipengaruhi secara langsung oleh 2 faktor yaitu
konsumsi gizi dan infeksi. Dua faktor ini meru-
pakan faktor yang dapat mengakibatkan ma-
salah gizi akut. Perilaku KADARZI yang baik da-
lam rumah tangga balita dengan 4 indikator
penilaian KADARZI berhubungan langsung de-
ngan faktor konsumsi balita dan pemantauan
berat badan sebagai indikasi dini terjadinya
perubahan status gizi yang cepat yang disebab-
kan oleh faktor konsumsi dan infeksi.

Tabel 6. Hasil Analisis Regresi Logistik

Odds Ratio Cofidence
Variabel Independent Sig.
Exp (B) Interval 95%
n = 1992
Variabel Dependent Status Gizi Indeks BB/TB
Penerapan Pesan Gizi Seimbang
Baik (0)
Kurang Baik (1) 1.08 (0.84 – 1.38) 0.56
Perilaku Kadarzi
Baik (0)
Kurang Baik (1) 0.79 (0.61 – 1.02) 0.66
Variabel Dependent Status Gizi Indeks BB/U
Penerapan Pesan Gizi Seimbang
Baik (0)
Kurang Baik (1) 0.91 (0.73 – 1.14) 0.43
Perilaku Kadarzi
Baik (0)
Kurang Baik (1) 0.98 (0.79 – 1.22) 0.88
Variabel Dependent Status Gizi Indeks TB/U
Penerapan Pesan Gizi Seimbang
Baik (0)
Kurang Baik (1) 0.90 (0.77 – 1.26) 0.49
Perilaku Kadarzi
Baik (0)
Kurang Baik (1) 1.21 (1.01 – 1.46) 0.04*
*
signifikan  < 0.05

66
 Jurnal Gizi dan Pangan, Maret 2010 5(1): 61 – 68

Beberapa rangkaian analisis tentang Ada pengaruh signifikan perilaku KADAR-

hubungan perilaku KADARZI, penerapan pesan ZI rumah tangga terhadap status gizi balita
gizi seimbang dan status gizi balita dapat pada indeks TB/U ( < 0.05) sedangkan pene-
mempertegas apa yang dikemukakan Minarto rapan pesan gizi seimbang secara signifikan
(2009) bahwa KADARZI merupakan penyeder- tidak berpengaruh terhadap status gizi balita
hanaan dari PUGS yang valid dan reliabel serta pada indek BB/TB, BB/U, dan TB/U.
dapat diaplikasikan dalam rangka menanggu-
langi masalah gizi pada balita terutama pada
masalah gizi kronis sebagai ciri dari indeks DAFTAR PUSTAKA
pengukuran status gizi balita TB/U.
Azwar A. 2000. Review Peningkatan Pengguna-
Program KADARZI cenderung lebih apli-
an ASI dan MP-ASI. Bogor.
katif dan terukur dengan adanya indikator
KADARZI sebagaimana yang telah ditetapkan
Aswin S. 1997. Metodologi Penelitian Kedokter-
dengan Kepmenkes RI No. 747/Menkes/SK/
an. FK, UGM, Yogyakarta.
VI/2007, meliputi menimbang berat badan ba-
lita secara teratur, Memberikan ASI eksklusif,
[Depkes RI] Departemen Kesehatan Republik
makan aneka ragam makanan, menggunakan
Indonesia. 2005. Pedoman Umum Gizi
garam beriodium dan memberikan suplemen
Seimbang (PUGS). Direktorat Bina Gizi
gizi sesuai anjuran. Hal ini juga didukung de-
Masyarakat. Jakarta
ngan beberapa program lain seperti posyandu
yang mempunyai 5 kegiatan utama, yaitu Ke-
[Depkes RI] Departemen Kesehatan Republik
sehatan Ibu dan Anak (KIA), Keluarga Beren-
Indonesia. 2007. Keputusan Menteri Ke-
cana (KB), imunisasi, gizi dan pencegahan dan
sehatan Republik Indonesia Nomor: 747/
penanggulangan diare. Disamping itu terdapat
Menkes/SK/VI/2007 Tentang Pedoman
beberapa kegiatan yang dapat mendukung
Operasional Keluarga Sadar Gizi Di Desa
program KADARZI yaitu penimbangan balita
Siaga, Jakarta.
setiap bulan, pemberian makanan tambahan
dan suplementasi gizi, penyuluhan gizi dan ke-
[Depkes RI] Departemen Kesehatan Republik
sehatan serta pelayanan kesehatan dasar. Se-
Indonesia. 2008. Laporan Hasil Riset Ke-
cara teknis kegiatan posyandu meliputi pen-
sehatan Dasar (Riskesdas) Propinsi Kali-
daftaran, penimbangan, pencatatan, penyu-
mantan Barat Tahun 2007. Badan Pene-
luhan dan pelayanan kesehatan (Depkes,
litian dan Pengembangan Kesehatan
2006).
Departemen Kesehatan RI, Jakarta.

[Depkes RI] Departemen Kesehatan Republik

KESIMPULAN
Indonesia. 2008. Laporan Hasil Riset Ke-
sehatan Dasar (Riskesdas) Indonesia Ta-
Penerapan pesan gizi seimbang yang
hun 2007. Badan Penelitian dan Pengem-
masih kurang terutama pada pesan konsumsi
bangan Kesehatan Departemen Kesehat-
lemak dan minyak ¼ dari kecukupan energi,
an RI, Jakarta.
makan makanan sumber kerbohidrat ½ dari
kebutuhan energi dan makan makanan untuk
[Depkes RI] Departemen Kesehatan Republik
memenuhi energi masing-masing 76.5%, 66.3%
Indonesia. 2009. Buku Saku Gizi. Kapan-
dan 60.1% sedangkan paling besar terjadi pada
kah Masalah Ini Berakhir. Badan Peneliti-
penerapan pesan menghindari minum minuman
an dan Pengembangan Kesehatan,
beralkohol 88.9%, menggunakan garam beriodi-
Jakarta.
um 86.1%, melakukan aktifitas fisik secara ter-
atur 76.1% dan makan aneka ragam makanan
Emilia E. 1998. Cara Penilaian Penerapan Pe-
64.6%. Perilaku KADARZI menggunakan garam
san-pesan Pedoman Umum Gizi Seim-
beriodium dalam rumah tangga mempunyai
bang (PUGS) pada Pasangan Usia Subur
proporsi lebih tinggi (86.1%) dibandingkan de-
di Kecamatan Ciomas Kabupaten Bogor.
ngan perilaku menimbang berat badan secara
[Tesis]. Pascasarjana. IPB. Bogor.
teratur, makan aneka ragam makanan dan
memberikan suplement gizi sesuai anjuran.
Hardinsyah 1997. Pengembangan Cara Penilai-
Secara umum terdapat 43.1% rumah tangga
an Penerapan PUGS. Makalah pada Pra-
dengan perilaku KADARZI kurang baik diban-
Widya Karya Nasional Pangan dan Gizi
dingkan dengan perilaku KADARZI baik.
VI. 4 November. Jakarta.

67
Jurnal Gizi dan Pangan, Maret 2010 5(1): 61 – 68
Hardinsyah et al. 1998. Cara Sederhana Peni-
laian Praktek PUGS Bagi Pasangan Usia
Subur. Media dan Gizi Keluarga, XXII (2)
: 28 – 35. Bogor.
Linder. Maria C. 1992. Biokimia Gizi dan
Metabolisme. Dengan Pemakaian secara
Klinis. UI Press. Jakarta.
Minarto 2009. Keluarga Sadar Gizi Solusi Atasi
Masalah Gizi. www Promkes. http://
www.promosikesehatan.com/?act=news
&id=489 [27 Nov 2009]
Nurmayati, Yeti. 2002. Implementasi Program
Keluarga Sadar Gizi (KADARZI) Dalam
Upaya Meningkatkan Kesejahteraan Ke-
luarga (Studi Kasus Tentang Implemen-
tasi Program KADARZI di Kelurahan Betet
Kota Kediri). [Abstrak]. Program Pasca
sarjana. Universitas Sebelas Maret.
Surakarta.
68
Soekirman. 2000. Ilmu Gizi dan Aplikasinya
Untuk keluarga dan Masyarakat. Dirjen
Pendidikan Tinggi. Jakarta.
Supariasa I, Bakri, Bachyar, Fajar, Ibnu. 2002.
Penilaian Status Gizi. EGC Jakarta.
Selvin S. 1996. Statistical Analysis of Epidemi-
ologic Data. Second Edition. Oxford :
Oxford University Press.
UNICEF. 1998. The State of The World’s
Children 1998: Focus of Nutrition.
Oxford Uiversity Press. UK.
Zahraini, Y. 2009. Hubungan Status KADARZI
dengan Status Gizi Balita 12 – 59 Bulan
di Provinsi DI Yogyakarta dan Nusa
Tenggara Timur. [Skripsi]. UI. Jakarta.
Jurnal Gizi dan Pangan, 2011, 6(3): 192-199 Journal of Nutrition and Food, 2011, 6(3): 192-199

PERILAKU HIDUP BERSIH DAN SEHAT (PHBS) SERTA PERILAKU GIZI SEIMBANG
IBU KAITANNYA DENGAN STATUS GIZI DAN KESEHATAN BALITA DI
KABUPATEN BOJONEGORO, JAWA TIMUR
(Clean and Healthy Lifestyle Behavior, and Balance Diet Behavior of Mothers
and it’s Relation to Nutritional and Health Status of Children Under Five Years
in Bojonegoro, East Java)

Linda Dwi Jayanti1, Yekti Hartati Effendi2*, dan Dadang Sukandar2

1
Program Studi Gizi Masyarakat, Fakultas Ekologi Manusia (FEMA), IPB
2
Departemen Gizi Masyarakat, Fakultas Ekologi Manusia (FEMA), IPB
* Alamat korespondensi: Departemen Gizi Masyarakat, Fakultas Ekologi Manusia, Institut Pertanian
Bogor, Bogor 16680. Telp: 0251-8621258; Fax: 0251-8622276; Email: yh.effendi@gmail.com

ABSTRACT

The purpose of this study was to determine nutritional knowledge, clean and healthy
lifestyle behavior, and balanced diet on maternal behavior, as well as its relationship with
nutritional and health status and children under 5 years health. The cros sectional study was
conducted during March-April 2011. The population in this study consist of all the children
under five living in Campurejo village, Bojonegoro districts East Java Province. The
respondents were mothers of toddlers who were selected as samples. Total samples in this
study were 55 toddlers. The results showed that maternal nutrition knowledge is positively
correlated with clean and healthy lifestyle behavior (p<0.05 and r=0.706), and also correlated
with balanced diet on behavior (p<0.05 and r=0537). Clean and healthy lifestyle behavior is
positively correlated with nutritional status of samples (p<0.05 and r=0.325), but not
correlated with the incidence of illness in the samples. Balanced diet on maternal behavior is
not correlated with the nutritional status of samples and the incidence of illness in the
samples.
Key words: clean and healthy lifestyle, balance diet, health status, children under five.

PENDAHULUAN lima tahun pertama setelah kelahiran. Jika

Salah satu tujuan pembangunan nasional
di Indonesia adalah meningkatkan kualitas
sumber daya manusia Indonesia sebagai modal
dasar pembangunan di masa mendatang. Tuju-
an pembangunan nasional tersebut kemudian
direalisasikan dalam Tujuan Pembangunan Mi-
lenium atau Millennium Development Goals
(MDGs). Adapun target utama MDGs dalam hal
menurunkan angka kematian anak adalah me-
nurunkan angka kematian balita sebesar dua
pertiganya antara tahun 1990 hingga tahun
2015 (Stalker 2008).
Menurut Hardinsyah dan Martianto
(1988), status gizi merupakan salah satu pe-
tunjuk untuk menilai kualitas sumber daya
manusia, dan perilaku konsumsi pangan seseo-
rang akan menentukan status gizi orang terse-
but. Pada tingkat rumah tangga, status gizi
dipengaruhi oleh kemampuan rumah tangga
dalam menyediakan makanan yang cukup baik
dari segi kualitas dan kuantitasnya, pola asuh
anak, pengetahuan gizi, serta faktor sosio bu-
daya lainnya. Periode kritis anak berada pada
pertumbuhan dan perkembangan anak pada
periode ini optimal, maka akan dapat tumbuh
menjadi individu yang berkualitas (Khomsan et
al. 2009).
Perilaku hidup bersih dan sehat (PHBS)
pada hakikatnya merupakan perilaku pence-
gahan oleh individu atau keluarga dari ber-
bagai penyakit. Salah satu sasaran penerapan
program PHBS adalah pada tatanan rumah
tangga, yang bertujuan untuk meningkatkan
derajat kesehatan keluarga dan produktivitas
kerja setiap anggota keluarga (Depkes RI
2006). Cakupan PHBS di Kabupaten Bojonegoro
masih tergolong rendah, sebab berdasarkan
survei pada tahun 2008 terhadap 23947 rumah
yang dipantau, jumlah keluarga yang me-
lakukan PHBS baru mencapai 9425 rumah
(39.36%) (Dinkes Kabupaten Bojonegoro 2008).
Masalah kurang gizi pada balita dapat
juga disebabkan oleh perilaku ibu dalam pemi-
lihan bahan makanan. Menurut Khomsan
(2009), ibu yang memiliki pengetahuan gizi
yang baik akan mempraktekkan perilaku gizi
yang baik dalam hal memilih makanan yang

192
Journal of Nutrition and Food, 2011, 6(3): 192-199
bergizi, beragam, dan berimbang untuk balita-
nya, dan sebaliknya ibu yang pengetahuan gi-
zinya kurang akan cenderung memiliki perila-
ku gizi yang kurang baik, termasuk dalam hal
memilih makanan untuk anak sehingga mem-
berikan dampak yang kurang baik pada status
gizi balita. Persentase balita dengan status gi-
zi kurang di Kabupaten Bojonegoro masih ter-
golong cukup tinggi, yaitu 14.22 persen
(Bappeda 2008).
Berdasarkan beberapa hal tersebut di
atas, penelitian ini akan mengkaji tentang pe-
rilaku hidup bersih dan sehat (PHBS) dan pe-
rilaku gizi seimbang ibu serta kaitannya de-
ngan status gizi dan kesehatan balita di Kabu-
paten Bojonegoro.
METODE
Desain dan Lokasi
Desain penelitian ini adalah population
survey dengan teknik wawancara. Penelitian
dilaksanakan di Desa Campurejo, Kecamatan
Bojonegoro, Kabupaten Bojonegoro. Pemilihan
lokasi penelitian tersebut berdasarkan pertim-
bangan ada 1.8 persen balita dengan status gi-
zi buruk dan 10.9 persen balita dengan status
gizi kurang, serta cakupan penerapan PHBS ibu
masih tergolong rendah. Penelitian dilaksana-
kan pada bulan Maret hingga April 2011.
Cara Pemilihan Contoh
Contoh dalam penelitian ini adalah bali-
ta yang tercatat di posyandu Desa Campurejo,
Kecamatan Bojonegoro, Kabupaten Bojonego-
ro. Adapun populasi pada penelitian ini adalah
seluruh balita yang tinggal di Desa Campurejo,
Kecamatan Bojonegoro, yaitu sebanyak 242
balita. Responden adalah ibu balita yang
terpilih sebagai contoh. Perkiraan jumlah mi-
nimal contoh ditentukan menggunakan rumus
Lemeshow et al. (1997), yaitu 49 contoh yang
dipilih dari tiga posyandu di desa terpilih. Kri-
teria pemilihan contoh adalah balita berusia
13-60 bulan yang tinggal bersama ibunya, ter-
catat di posyandu di desa terpilih, dan respon-
den bersedia untuk diwawancarai. Calon con-
toh diambil dari populasi yang memenuhi kri-
teria, yaitu sebanyak 190 balita, kemudian di-
pilih sebagai contoh menggunakan metode
acak stratifikasi dengan alokasi proporsional
sehingga diperoleh 55 contoh yang memenuhi
kriteria.
Jurnal Gizi dan Pangan, 2011, 6(3): 192-199
Jenis dan Cara Pengumpulan Data
Data primer meliputi karakteristik con-
toh (umur dan jenis kelamin), karakteristik ke-
luarga (umur, pendidikan, besar keluarga, pe-
kerjaan, dan pendapatan orang tua), pengeta-
huan gizi, PHBS dalam keluarga, perilaku gizi
seimbang ibu, konsumsi pangan balita, status
gizi, dan kesehatan balita. Data sekunder me-
liputi gambaran umum lokasi penelitian dan
daftar nama pasangan ibu dan balita yang me-
menuhi kriteria penelitian. Pengambilan data
primer dilakukan dengan wawancara langsung
menggunakan kuesioner dan recall 2x24 jam,
sedangkan data sekunder diperoleh dari pen-
catatan arsip desa dan data yang tersedia di
puskesmas dan posyandu.
Pengolahan dan Analisis Data
Pengolahan data yang dilakukan meli-
puti editing, coding, entry, cleaning dan ana-
lisis. Hubungan antar variabel dianalisis meng-
gunakan uji korelasi Pearson dan Rank
Spearman.
Data karakteristik balita dan karakteris-
tik keluarga ditabulasi dan dianalisis secara
deskriptif. Data mengenai pengetahuan gizi
ibu diukur menggunakan 20 pertanyaan ten-
tang definisi dan jenis zat gizi dalam pangan,
manfaat zat gizi dan akibat kekurangan zat gi-
zi tertentu, serta periode pemberian ASI
eksklusif. Berdasarkan 20 pertanyaan terse-
but, jawaban benar diberikan skor 1 dan ja-
waban salah diberikan skor 0, sehingga diper-
oleh total nilai terendah 0 dan skor tertinggi
20. Pengetahuan gizi ibu kemudian diklasifika-
sikan menjadi tiga kategori berdasarkan total
nilai, yaitu kategori rendah apabila total nilai
<60 persen, kategori sedang apabila total nilai
antara 60-80 persen, dan tinggi apabila total
nilai >80 persen (Khomsan 2000).
Perilaku hidup bersih dan sehat (PHBS)
diukur menggunakan 16 pertanyaan indikator
PHBS tatanan rumah tangga yang mencakup 9
pertanyaan indikator perilaku dan 7 pertanya-
an indikator lingkungan. Pertanyaan diberikan
dalam bentuk tertutup dengan pilihan jawab-
an “ya” atau “tidak”. Berdasarkan 16 perta-
nyaan yang diajukan, apabila responden men-
jawab “ya” antara 1-4 pertanyaan, maka ter-
masuk klasifikasi keluarga sehat 1; apabila
menjawab “ya” antara 5-8 pertanyaan, maka
termasuk klasifikasi keluarga sehat 2; apabila
menjawab “ya” antara 9-12 pertanyaan, maka
termasuk klasifikasi keluarga sehat 3; dan apa-
bila menjawab “ya” antara 13-16 pertanyaan,
193
Jurnal Gizi dan Pangan, 2011, 6(3): 192-199
maka termasuk klasifikasi keluarga sehat 4
(Depkes 2008 dalam Effendi dkk 2010).
Perilaku gizi seimbang ibu diukur de-
ngan 10 pertanyaan tentang penganekaragam-
an makanan, pola hidup bersih, aktivitas fisik,
dan pemantauan berat badan balita. Pengu-
kuran perilaku gizi seimbang dilakukan meng-
gunakan pertanyaan tertutup dalam bentuk
multiple choice, dengan pilihan jawaban: a)
selalu, b) kadang-kadang, dan c) tidak pernah.
Berdasarkan 10 pertanyaan yang diajukan, di-
berikan skor 1 untuk pilihan jawaban yang ter-
masuk kategori rendah, nilai 2 untuk pilihan
jawaban yang termasuk kategori sedang, dan
nilai 3 untuk pilihan jawaban yang termasuk
kategori baik, sehingga diperoleh total nilai
terendah 10 dan total nilai tertinggi 30. Ada-
pun kategori total nilai, yaitu kategori rendah
10-16, kategori sedang 17-23, dan kategori
baik (Slamet 1993).
Data jumlah konsumsi balita dihitung
menggunakan metode recall selama 2x24 jam.
Data konsumsi pangan yang diperoleh dikon-
versikan ke dalam bentuk energi, protein,
vitamin A, vitamin C, dan Fe menggunakan
DKBM dan kemudian dibandingkan dengan ke-
cukupan konsumsi zat gizi berdasarkan tabel
AKG 2004.
Menurut Depkes (1996), tingkat kecukup
an energi dan protein dibedakan menjadi lima
cut-off points yaitu defisit tingkat berat (<70%
AKG), defisit tingkat sedang (70-79% AKG),
defisit tingkat ringan (80-89% AKG), normal
(90-119% AKG), serta berlebih ≥( 120% AKG).
Adapun klasifikasi tingkat kecukupan zat besi
(Fe), vitamin A, dan vitamin C dibagi menjadi
dua kategori menurut Gibson (2005), yaitu
defisit apabila <77 persen AKG serta cukup
apabila ≥77 persen AKG.
Status gizi contoh dihitung berdasarkan
indeks BB/U, TB/U, dan BB/TB, menggunakan
software WHO Anthroplus 2007. Status kese-
hatan balita diamati berdasarkan kejadian sa-
kit pada satu bulan terakhir yang meliputi
jenis penyakit yang diderita, pernah/tidaknya
sakit, frekuensi sakit, serta lama menderita
sakit.
HASIL DAN PEMBAHASAN
Karakteristik Sosial Ekonomi Keluarga
Sebaran umur orang tua contoh dike-
lompokkan menjadi empat golongan, yaitu ke-
lompok remaja (<20 tahun), kelompok dewasa
muda (20-30 tahun), kelompok dewasa madya
194
Journal of Nutrition and Food, 2011, 6(3): 192-199
(31-50 tahun), dan dewasa lanjut (>50 tahun)
(WKNPG 2004). Lebih dari separuh ayah
(54.5%) tergolong kelompok umur dewasa
madya dengan rata-rata umur 33 tahun, se-
dangkan sebanyak 67.3 persen ibu tergolong
kelompok umur dewasa muda dengan rata-
rata umur 30 tahun.
Rata-rata pendidikan terakhir orang tua
contoh, baik ayah maupun ibu adalah tamat
SMU/sederajat. Keseluruhan orang tua contoh
memiliki pendidikan minimal 9 tahun atau se-
tingkat tamat SMP. Selain itu, terdapat seki-
tar 12.7 persen ayah dan 10.9 persen ibu con-
toh yang memiliki pendidikan terakhir hingga
sarjana.
Jenis pekerjaan ayah contoh yang paling
banyak adalah sebagai pegawai swasta
(41.8%), sedangkan jenis pekerjaan ibu contoh
yang paling banyak adalah sebagai ibu rumah
tangga (76.4%). Selain itu, diketahui pula ter-
dapat 12.7 persen ayah dan 7.3 persen ibu
contoh yang berprofesi sebagai pegawai negeri
(PNS).
Rata-rata penghasilan perkapita per bu-
lan keluarga contoh (72.73%) berada di atas
batas garis kemiskinan Provinsi Jawa Timur,
yaitu Rp 219 727 (BPS 2010). Sebanyak 56.36
persen keluarga contoh tergolong keluarga
sedang (5-7 orang). Sementara itu, 41.82 per-
sen keluarga contoh tergolong keluarga kecil
(≤4 orang), dan 1.82 persen lainnya meru-
pakan keluarga besar, yaitu ≥ 9 orang.
Karakteristik Balita
Jumlah contoh dengan jenis kelamin
laki-laki lebih banyak (54.54%) dibandingkan
jumlah contoh dengan jenis kelamin perem-
puan (45.45%). Hampir separuh contoh beru-
mur antara 25-36 bulan dengan standar deviasi
7.7 dan hanya 9 persen contoh yang berusia
antara 13-24 bulan.
Lebih dari separuh balita tidak diberikan
ASI eksklusif oleh ibunya hingga berumur 6
bulan. Sebagian besar balita hanya diberikan
ASI eksklusif hingga umur 3-4 bulan. Balita
yang tidak mendapatkan ASI eksklusif hingga
umur 6 bulan adalah sebanyak 72.7 persen,
sedangkan balita yang mendapatkan ASI
eksklusif hingga umur 6 bulan hanya sebanyak
27.3 persen.
Pengetahuan Gizi Ibu
Rata-rata pengetahuan gizi ibu tergo-
long sedang (61.82%), sedangkan responden
yang pengetahuan gizinya baik sebanyak 38.18
Journal of Nutrition and Food, 2011, 6(3): 192-199
persen. Secara keseluruhan, tidak terdapat
responden yang memiliki pengetahuan gizi
rendah. Seluruh responden yang tingkat pendi-
dikan terakhirnya SMP/sederajat memiliki
tingkat pengetahuan gizi sedang. Sebanyak
43.64 persen responden yang tingkat pendidik-
an terakhirnya adalah SMU/sederajat memiliki
tingkat pengetahuan gizi sedang, dan seba-
nyak 20 persen lainnya memiliki tingkat
pengetahuan gizi baik. Responden yang memi-
liki tingkat pendidikan terakhir diploma atau
sarjana, seluruhnya memiliki tingkat pengeta-
huan gizi baik. Hal ini menunjukkan bahwa
responden yang memiliki tingkat pendidikan
lebih tinggi, memiliki tingkat pengetahuan
lebih baik dibandingkan dengan responden
yang tingkat pendidikannya lebih rendah.
Perilaku Hidup Bersih dan Sehat (PHBS)
dalam Keluarga
Sebanyak 60 persen responden termasuk
ke dalam kategori keluarga sehat 3, dengan
penerapan PHBS kategori sedang. Sementara
itu, 40 persen responden lainnya termasuk ke
dalam kategori keluarga sehat 4, dengan pe-
nerapan PHBS kategori baik. Tidak terdapat
responden yang termasuk ke dalam kategori
keluarga sehat 1 dan keluarga sehat 2, sehing-
ga dapat diketahui bahwa tidak ada responden
yang penerapan PHBS dalam keluarganya ter-
golong buruk atau kurang.
Berdasarkan 16 pertanyaan yang diaju-
kan tentang indikator PHBS, dapat diketahui
bahwa seluruh responden melakukan imunisasi
lengkap pada bayi dan balitanya, baik di pos-
yandu, bidan, atau dokter. Selain itu, seluruh
responden menggunakan air yang masak untuk
keperluan minum keluarga. Semua responden
juga menjawab melakukan perilaku seksual
secara sehat, serta tidak pernah menggunakan
narkotika dan obat-obatan terlarang. Hanya
9.09 persen responden yang memeriksakan ke-
sehatan secara berkala dengan pap smear, dan
hanya 10.9 persen yang melakukan SADARI
(periksa payudara sendiri) secara berkala. Hal
ini menunjukkan bahwa kesadaran responden
akan kesehatan organ tubuh dan alat repro-
duksi masih sangat kurang.
Perilaku Gizi Seimbang Ibu
Hampir semua responden (87.3%) memi-
liki gizi seimbang baik dan hanya 12.7 persen
yang memiliki perilaku gizi seimbang kategori
sedang. Tidak ada responden yang memiliki
perilaku gizi seimbang rendah. Rata-rata peri-
laku gizi seimbang responden termasuk ke
Jurnal Gizi dan Pangan, 2011, 6(3): 192-199
dalam kategori baik, yakni dengan total nilai
rata-rata 25 dan standar deviasi 1.56.
Menurut Kurniasih dkk (2010), perilaku
gizi seimbang ibu dibedakan menjadi empat,
yakni dalam hal penganekaragaman makanan,
pola hidup bersih keluarga, aktivitas fisik, ser-
ta pemantauan berat badan balita. Dalam hal
penganekaragaman makanan, tidak terdapat
responden yang perilaku gizi seimbangnya ter-
masuk kategori rendah. Hal ini menunjukkan
bahwa semua responden telah memperhatikan
pola penganekaragaman jenis makanan untuk
balita dan keluarga. Dalam hal pola hidup ber-
sih keluarga, sebanyak 87.27 persen menja-
wab selalu membiasakan balita untuk mencuci
tangan dengan air bersih dan sabun setelah
makan dan bermain, serta sebanyak 98.18
persen menjawab selalu melatih anak untuk
buang air kecil dan buang air besar di kamar
mandi.
Aktivitas fisik responden dan keluarga
masih tergolong sangat rendah. Hal ini ditun-
jukkan dengan hampir seluruh responden
(92.73%) menjawab melakukan olahraga/ak-
tivitas fisik≤1 kali setiap minggunya. Rata-
rata responden tidak pernah melakukan olah-
raga secara rutin setiap minggunya dengan
alasan tidak memiliki waktu untuk melakukan
aktivitas fisik akibat terlalu sibuk dengan ke-
perluan rumah tangga. Selain itu, terdapat pu-
la responden yang beralasan tidak pernah atau
jarang melakukan aktivitas fisik bersama ke-
luarga karena malas. Hampir seluruh respon-
den (94.55%) menjawab selalu memantau be-
rat badan balitanya ke posyandu atau klinik
setiap bulannya. Selain itu, lebih dari separuh
responden (50.91%) selalu memantau kebia-
saan jajan anak balitanya. Hal tersebut me-
nunjukkan perilaku gizi seimbang ibu dalam
hal pengontrolan berat badan balita termasuk
ke dalam kategori baik.
Konsumsi dan Tingkat Kecukupan Energi dan
Zat Gizi
Tingkat kecukupan energi dan zat gizi
contoh dihitung dengan cara membandingkan
konsumsi energi dan zat gizi dengan angka
kecukupannya. Rata-rata tingkat kecukupan
energi contoh masih lebih rendah yaitu hanya
84.6 persen, serta tergolong defisit tingkat
ringan (<90% angka kecukupan energi). Semen-
tara itu, tingkat kecukupan protein contoh
tergolong berlebih (151%). Kecukupan protein
yang berlebih salah satunya disebabkan karena
rata-rata contoh lebih banyak mengonsumsi
makanan sumber protein baik protein hewani
maupun nabati dibandingkan dengan makanan
195
Jurnal Gizi dan Pangan, 2011, 6(3): 192-199 Journal of Nutrition and Food, 2011, 6(3): 192-199

sumber energi. Rata-rata tingkat kecukupan (Tabel 2). Selain itu, batuk disertai dengan flu
vitamin A, vitamin C, dan zat besi contoh ter- juga sering dialami oleh contoh (45.45%).
golong cukup karena >77 persen angka kecu- Rata-rata frekuensi contoh mengalami sakit
kupan, yaitu masing-masing 96.1 persen, 102.9 adalah antara 1-2 kali dalam 1 bulan. Tidak
persen, dan 130.5 persen. terdapat jenis penyakit yang diderita contoh
>2 kali dalam waktu satu bulan, kecuali diare
Status Gizi Balita (1.82%). Rata-rata lama contoh mengalami sa-
kit adalah antara 1-3 hari.
Berdasarkan pengukuran dengan indeks
BB/U, diketahui bahwa rata-rata balita ber-
Tabel 2 Jenis Penyakit yang Pernah Diderita
status gizi normal (83.64%). Meski demikian,
Balita dan Frekuensi Sakit dalam
masih terdapat sebanyak 1.82 persen balita
Satu Bulan Terakhir
dengan status gizi buruk, 10.91 persen dengan
Frekuensi
status gizi kurang, serta 3.64 persen dengan
tidak
status gizi lebih (Tabel 1). Jenis penyakit
pernah
1-2 kali > 2 kali
n % n % n %
Tabel 1 Status Gizi Balita berdasarkan Panas/ demam 29 52.73 26 47.27 - -
Pengukuran Z-Skor dengan Indeks Pilek 35 63.64 20 36.36 - -
Batuk biasa 49 89.09 6 10.91 - -
BB/U, TB/U, dan BB/TB Batuk & flu 30 54.55 25 45.45 - -
Status Gizi dgn indeks BB/U n % Diare 36 65.45 18 32.73 1 1.82
Gizi Buruk (Z ≤ -3 SD) 1 1.82 Sakit kulit 48 87.27 7 12.73 - -
Gizi Kurang (-3 SD < Z < -2 SD) 6 10.91 Lainnya 53 96.36 2 3.64 - -
Gizi Baik (-2 SD < Z < 2 SD) 46 83.64
Gizi Lebih (Z ≥ 2 SD) 2 3.64 Hubungan Pengetahuan Gizi dengan PHBS
Total 55 100.00 Keluarga dan Perilaku Gizi Seimbang Ibu
Rata-rata ± SD -0.93 ± 1.26
Status Gizi dgn indeks TB/U n % Berdasarkan uji korelasi Spearman, di-
Sangat pendek (Z ≤ -3 SD) 15 27.27 ketahui bahwa terdapat hubungan signifikan
Pendek (-3 SD < Z < -2 SD) 10 18.18
dan positif antara pengetahuan gizi ibu de-
Normal (-2 SD < Z < 2 SD) 30 54.55
Tinggi (Z ≥ 2 SD) 0 0.00 ngan PHBS dalam keluarga (p<0.05 dan
Total 55 100.00 r=0.706) (Tabel 3).
Rata-rata ± SD -2.05 ± 1.50
Status Gizi dgn indeks BB/TB n % Tabel 3 Hubungan Pengetahuan Gizi Ibu
Kurus (-3 SD < Z < -2 SD) 1 1.82
Normal (-2 SD < Z < 2 SD) 45 81.82
dengan PHBS dan Perilaku Gizi
Gemuk (Z ≥ 2 SD) 9 16.36 Seimbang Ibu
Total 55 100.00 Tingkat Pengetahuan Gizi
PHBS Total
Rata-rata ± SD 0.44 ± 1.88 Sedang Baik
keluarga
n % n % n %
Sedang 29 52.73 4 7.27 33 60.00
Berdasarkan indeks TB/U, sebanyak
Baik 5 9.09 17 30.91 22 40.00
54.55 persen contoh memiliki status gizi nor- Total 34 61.82 21 38.00 55 100.00
mal, sedangkan 45.45 persen lainnya berstatus Tingkat Pengetahuan Gizi
Perilaku Gizi Total
gizi stunting (pendek). Menurut Riyadi (2003), Seimbang Ibu
Sedang Baik
stunting mencerminkan proses kegagalan da- n % n % n %
lam mencapai pertumbuhan linear sebagai aki- Sedang 5 9.09 2 3.64 7 12.73
Baik 29 52.73 19 34.55 48 87.27
bat dari keadaan gizi atau kesehatan yang ab-
Total 34 61.82 21 38.18 55 100.00
normal. Berdasarkan pengukuran dengan in
deks BB/TB, dapat diketahui bahwa sebagian
Terdapat hubungan signifikan antara
besar balita (81.82%) berstatus gizi normal.
tingkat pengetahuan gizi ibu dengan perilaku
Sebanyak 16.36 persen balita berstatus gizi
gizi seimbang ibu (p<0.05 dan r=0.537). Hal ini
gemuk, dan sebanyak 1.82 persen contoh lain-
berarti bahwa responden yang memiliki ting-
nya berstatus gizi kurus (wasting).
kat pendidikan dan pengetahuan gizi lebih
tinggi, maka penerapan PHBS dalam keluarga
Status Kesehatan Balita
serta perilaku gizi seimbangnya semakin baik
Hampir semua balita (96.36%) pernah pula.
mengalami sakit, dan hanya 3.64 persen yang
tidak mengalami sakit dalam satu bulan ter- Hubungan Perilaku Gizi Seimbang dengan
akhir. Jenis penyakit yang paling sering dia- Tingkat Kecukupan Energi dan Zat Gizi
lami adalah demam (47.27%), baik demam
Salah satu penerapan perilaku gizi seim-
yang disertai dengan penyakit lain atau tidak
bang ibu yang ikut mempengaruhi konsumsi

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serta tingkat kecukupan energi dan zat gizi Tabel 4. Hubungan PHBS dalam keluarga
balita antara lain dalam hal penganekaragam- dengan Status Gizi dan Kejadian
an makanan yang meliputi penyediaan makan- Sakit Balita
an yang beragam serta frekuensi makan yang PHBS Keluarga
teratur setiap hari. Namun, berdasarkan hasil Status Gizi Total
Sedang Baik
uji korelasi Pearson, dapat diketahui bahwa (BB/TB)
n % n % n %
tidak terdapat hubungan yang signifikan an- Kurus 1 1.82 0 0.00 1 1.82
tara perilaku gizi seimbang dengan tingkat ke- Normal 30 54.55 15 27.27 45 81.82
cukupan energi dan zat gizi contoh. Terdapat Gemuk 2 3.64 7 12.73 9 16.36
faktor-faktor lain yang diduga juga mempe- Total 33 60.00 22 40.00 55 100
ngaruhi tingkat kecukupan energi dan zat gizi PHBS Keluarga
contoh, seperti kondisi sakit, kondisi sosial Total
Kejadian sakit Sedang Baik
ekonomi keluarga, kesukaan contoh memakan n % n % n %
jajanan yang hanya tinggi kalori atau protein Pernah sakit 31 56.36 22 40.00 53 96.36
saja, serta ketidaksukaan terhadap sayur atau Tidak pernah sakit 2 3.64 0 0.00 2 3.64
buah-buahan tertentu. Total 33 60.00 22 40.00 55 100

Hubungan Tingkat Kecukupan Energi dan Zat

Hubungan Perilaku Gizi Seimbang dengan
Gizi dengan Status Gizi
Status Gizi dan Kejadian Sakit Balita
Menurut Soekirman (2000), faktor gizi
Berdasarkan uji korelasi Spearman, di-
yang secara langsung mempengaruhi status
ketahui bahwa tidak terdapat hubungan signi-
gizi seseorang adalah konsumsi makanan dan
fikan antara perilaku gizi seimbang ibu dengan
keadaan kesehatan. Akan tetapi, berdasarkan
status gizi contoh (Tabel 5), yang berarti bah-
uji statistik menggunakan korelasi Pearson, di-
wa status gizi balita yang baik tidak selalu
ketahui bahwa tidak terdapat hubungan yang
karena ibu berperilaku gizi seimbang dengan
signifikan antara tingkat kecukupan energi dan
baik, melainkan juga dapat disebabkan oleh
zat gizi dengan status gizi balita.
banyak faktor lain.
Status gizi contoh selain dipengaruhi da-
ri tingkat kecukupan energi dan zat gizi juga Tabel 5. Hubungan Perilaku Gizi Seimbang dengan
dipengaruhi oleh faktor-faktor lain seperti Status Gizi dan Kejadian Sakit Balita
kondisi kesehatan dan kualitas serta kuantitas Prilaku Gizi Seimbang
Total
makanan yang dikonsumsi. Kondisi sakit atau Status Gizi (BB/TB) Sedang Baik
infeksi akan mempengaruhi nafsu dan selera n % n % n %
makan sehingga kemudian berdampak pada Kurus 1 1.82 0 0 1 1.82
kurangnya asupan energi dan zat gizi dari Normal 6 10.91 39 70.91 45 81.82
makanan. Gemuk 0 0 9 16.36 9 16.36
Total 7 12.73 48 87.27 55 100
Hubungan PHBS keluarga dengan Status Gizi Prilaku Gizi Seimbang
Total
dan Kejadian Sakit Balita Kejadian Sakit Sedang Baik
n % n % N %
Analisis uji korelasi yang dilakukan me-
Pernah sakit 7 12.73 46 83.64 53 96.36
nunjukkan bahwa terdapat hubungan signifi-
Tidak pernah sakit 0 0 2 3.64 2 3.64
kan dan positif antara PHBS dalam lingkungan
Total 7 12.73 48 87.27 55 100
keluarga dengan status gizi contoh (p<0.05
dan r=0.325) (Tabel 4). Hal ini berarti bahwa
semakin baik PHBS di dalam keluarga maka Hasil uji korelasi Spearman juga menun-
status gizi contoh akan semakin baik pula. jukkan bahwa tidak terdapat hubungan yang
Hasil uji korelasi Spearman menunjukkan bah- signifikan antara perilaku gizi seimbang ibu
wa tidak terdapat hubungan yang signifikan dengan kejadian sakit contoh. Hal tersebut
antara PHBS dalam lingkungan keluarga de- berarti bahwa ibu yang berperilaku gizi seim-
ngan kejadian sakit balita (p>0.05 r: -0.170). bang dengan baik belum tentu balitanya tidak
Hal ini berarti bahwa keluarga yang selalu me- pernah sakit.
nerapkan PHBS dengan baik, belum tentu ba-
litanya tidak pernah sakit, sebab kejadian sa-
kit balita juga dipengaruhi oleh faktor lain se- KESIMPULAN
lain PHBS dalam keluarga.
Sebagian besar pengetahuan gizi ibu
tergolong sedang, yakni sebanyak 61.82 per-

197
Jurnal Gizi dan Pangan, 2011, 6(3): 192-199
sen, serta tidak terdapat ibu yang memiliki
pengetahuan gizi rendah. Lebih dari 50 persen
ibu memiliki PHBS dalam lingkungan keluarga
yang tergolong sedang dan termasuk ke dalam
kategori keluarga sehat 3. Sementara itu,
87.27 persen perilaku gizi seimbang ibu ter-
golong ke dalam kategori baik.
Rata-rata tingkat kecukupan energi con-
toh masih tergolong defisit tingkat ringan
sebab hanya mencapai 84.6 persen (< AKE ak-
tual), sedangkan rata-rata tingkat kecukupan
protein contoh tergolong berlebih. Rata-rata
kecukupan vitamin dan mineral contoh tergo-
long cukup, yakni >77 persen angka kecukupan
vitamin dan mineral. Sebagian besar status
gizi contoh tergolong normal, namun meski
demikian, pada indeks BB/U masih terdapat
sebanyak 1.82 persen contoh yang termasuk
gizi buruk. Hampir semua contoh pernah
mengalami sakit selama satu bulan terakhir,
dengan rata-rata frekuensi sakit 1-2 kali dalam
satu bulan, serta dengan lama sakit rata-rata
1-3 hari.
Pengetahuan gizi berkorelasi positif de-
ngan PHBS dalam keluarga (p<0.05 dan
r=0.706), serta berkorelasi dengan perilaku
gizi seimbang ibu (p<0.05 dan r=0.537). Hal
tersebut menunjukkan bahwa semakin baik
pengetahuan gizi ibu maka semakin baik pula
penerapan PHBS dalam keluarga serta perilaku
gizi seimbangnya. Perilaku gizi seimbang ibu
tidak berhubungan dengan kecukupan energi
dan zat gizi contoh. Hal ini diduga karena
adanya faktor-faktor lain yang ikut mempe-
ngaruhi kecukupan energi dan zat gizi, selain
perilaku gizi seimbang ibu. Kecukupan energi
dan zat gizi juga tidak berkorelasi terhadap
status gizi contoh (p>0.05). Beberapa faktor
lain yang diduga ikut mempengaruhi status gizi
antara lain kondisi sakit atau infeksi tertentu,
serta kualitas dan kuantitas makanan yang
dikonsumsi.
PHBS dalam lingkungan keluarga berko-
relasi positif dengan status gizi contoh (p<0.05
dan r=0.325), namun PHBS keluarga tidak ber-
korelasi dengan kejadian sakit pada contoh
(p>0.05). Perilaku gizi seimbang ibu tidak ber-
korelasi dengan status gizi contoh (p>0.05)
serta kejadian sakit pada contoh (p>0.05). Hal
tersebut menunjukkan bahwa tidak selalu ibu
yang berperilaku gizi seimbang akan memiliki
balita dengan status gizi yang selalu baik serta
tidak pernah sakit.
Saran yang dapat diberikan adalah me-
ngenai pengetahuan gizi ibu yang masih tergo-
long kurang, khususnya tentang fungsi zat-zat
198
Journal of Nutrition and Food, 2011, 6(3): 192-199
gizi bagi tubuh serta jenis-jenis pangan sum-
ber zat gizi. Oleh karena itu, sebaiknya perlu
adanya sosialisasi di posyandu atau puskesmas
dengan intensitas yang cukup sering kepada
para ibu agar dapat benar-benar memahami
dan mengingat materi yang berkaitan dengan
pengetahuan gizi tersebut, sehingga dapat
meningkatkan konsumsi pangan, status gizi,
serta kesehatan balita.
Tidak semua ibu yang memiliki tingkat
pendidikan dan pengetahuan gizi yang tinggi,
melakukan perilaku gizi seimbang dengan ba-
ik. Rata-rata ibu yang bekerja di luar rumah,
cenderung memiliki waktu yang kurang untuk
mengontrol pola makan dan pola hidup bersih
anak balitanya. Hal ini seharusnya lebih diper-
hatikan oleh para kader, tenaga kesehatan,
serta para ibu, khususnya yang memiliki ba-
lita. Sosialisasi mengenai perilaku gizi seim-
bang dalam keluarga perlu dilakukan untuk
meningkatkan kesadaran serta kepedulian ibu
terhadap gizi dan kesehatan anggota keluarga.
DAFTAR PUSTAKA
[Bappeda] Badan Pembangunan Daerah. 2008.
Rencana Strategis Kabupaten Bojonego-
ro 2007-2012. Badan Pembangunan
Daerah, Bojonegoro.
[BPS] Badan Pusat Statistik Provinsi Jawa
Timur. 2010. Berita Resmi Statistik:
Profil Kemiskinan di Jawa Timur tahun
2010.
[Depkes RI] Departemen Kesehatan RI. 2006.
Promosi Kesehatan: Buku Saku Bidan
Poskesdes. Departemen Kesehatan RI,
Jakarta.
[Dinkes] Dinas Kesehatan Kabupaten Bojone-
goro. 2008. Profil Kesehatan Kabupaten
Bojonegoro Tahun 2008.
Effendi YH, Ekayanti I, & Nurdin NM. 2010.
Bioetika dan Kesehatan Masyarakat. Fa-
kultas Ekologi Manusia, Institut Perta-
nian Bogor, Bogor.
Hardinsyah & Martianto D. 1988. Menaksir
Kecukupan Energi dan Protein serta
Mutu Gizi Konsumsi Pangan. Wirasari,
Jakarta.
Khomsan A. 2000. Teknik Pengukuran Penge-
tahuan Gizi. Fakultas Ekologi Manusia,
Institut Pertanian Bogor, Bogor.
Journal of Nutrition and Food, 2011, 6(3): 192-199
Khomsan A, Anwar F, Sukandar D, Riyadi H, &
Mudjajanto ES. 2009. Studi Peningkatan
Pengetahuan Gizi Ibu dan Kader Posyan-
du serta Perbaikan Gizi Balita. Fakultas
Ekologi Manusia, Institut Pertanian
Bogor, Bogor.
Kurniasih D, Hilmansyah H, Astuti MP, & Imam
S. 2010. Sehat dan Bugar Berkat Gizi
Seimbang. Gramedia, Jakarta.
Lemeshow S, David WH, & Janelle K. 1997.
Besar Sampel dalam Penelitian Kesehat-
an (Pramoni D, penerjemah). UGM
Press, Yogyakarta.
Riyadi H. 2003. Metode Penilaian Status Gizi
secara Antropometri. Fakultas Ekologi
Jurnal Gizi dan Pangan, 2011, 6(3): 192-199
Manusia, Institut Pertanian Bogor,
Bogor.
Slamet Y. 1993. Analisis Kuantitatif untuk Data
Sosial. Dabara Publisher, Solo.
Soekirman. 2000. Ilmu Gizi dan Aplikasinya:
untuk Keluarga dan Masyarakat. Direk-
torat Jenderal Pendidikan Tinggi, De-
partemen Pendidikan Nasional.
Stalker P. 2008. Millennium development goals
MDGs). www.undp.or.id/pubs/docs/Let
SpeakOutforMDGs.pdf [2 Feb 2011].
[WHO] World Health Organization. 2006. WHO
Anthro 2005 for personals computers
manual. http:/who.int/childgrowth/soft
ware [11 Feb 2011].
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7229

PENYULUHAN KESEHATAN TENTANG GIZI SEIMBANG DI

POSYANDU BALITA KINASIH RW 29 WILAYAH KELURAHAN
KADIPIRO SURAKARTA

Erinda Nur Pratiwi1, Siti Nurjanah2, Atiek Murharyati3

1,2
Program Studi Kebidanan Program Sarjana dan Pendidikan Profesi Bidan Program Profesi, Fakultas Ilmu
Kesehatan, Universitas Kusuma Husada Surakarta
3
Program Studi Keperawatan Program Sarjana, Fakultas Ilmu Kesehatan, Universitas Kusuma Husada
Surakarta
Email: pratiwierinda@gmail.com

Abstrak
Permasalahan kesehatan di Indonesia adalah kematian anak usia bawah lima tahun (balita).
Berdasarkan hasil Riset Kesehatan Dasar prevalensi gizi kurang pada usia dibawah 5 tahun di Indonesia sebesar
17,9% (3,7 juta balita), sebanyak 6800 balita di Jawa Timur mengalami gizi buruk yang 25%nya disebabkan
oleh asupan gizi kurang. Status gizi buruk pada balita dapat menimbulkan pengaruh yang sangat menghambat
pertumbuhan fisik, mental maupun kemampuan berpikir yang pada akhirnya akan menurunkan produktivitas
kerja. Makanan seimbang pada usia ini perlu diterapkan karena akan mempengaruhi kualitas pada usia dewasa
sampai lanjut sehingga pengabdian kepada masyarakat diharapkan dapat meningkatkan status kesehatan balita.
Tujuan dari pengabdian kepada masyarakat berupa penyuluhan tentang gizi seimbang yaitu setelah
mendapatkan penyuluhan diharapkan ibu – ibu yang mempunyai balita mampu menanamkan kebiasaan makan
yang baik dan benar kepada anak mengenai gizi yang seimbang sesuai kebutuhan untuk tumbuh kembang anak
yang optimal, memelihara dan meningkatkan daya tahan tubuh anak terhadap penyakit. Manfaat dari
pengabdian kepada masyarakat untuk menambah pengetahuan khususnya tentang gizi seimbang bagi balita
sesuai kebutuhan untuk tumbuh kembang anak yang optimal sehingga dapat memelihara dan meningkatkan
daya tahan tubuh anak terhadap penyakit. Metode pengabdian masyarakat ini dengan ceramah, tanya jawab dan
media leaflet. Hasil pelaksanaan pengabdian masyarakat tentang gizi seimbang pada balita bahwa ibu balita
menjadi lebih mengerti tentang gizi seimbang pada balita dengan nilai rata-rata pengetahuan tentang Gizi
seimbang pada balita dengan persentase 75%. Kesimpulan dari pengabdian masyarakat ini adalah ibu balita
penting memahami gizi seimbang pada balita karena dapat meningkatkan status kesehatan balita.
Kata Kunci: Gizi Seimbang, Balita

Abstract
A health problem in Indonesia is the death of children under five years of age (toddlers). Based on the
results of Basic Health Research, the prevalence of malnutrition under 5 years of age in Indonesia is 17.9% (3.7
million children under five), as many as 6800 children under five in East Java experience malnutrition, 25% of
which is caused by malnutrition intake. Malnutrition status in toddlers can have an effect that greatly inhibits
physical, mental and thinking skills which in turn will reduce work productivity. Balanced food at this age needs
to be implemented because it will affect the quality at adulthood to advanced age so that community service is
expected to improve the health status of toddlers. The goal of community service in the form of counseling on
balanced nutrition is that after receiving the counseling, it is hoped that mothers with toddlers are able to instill
good and correct eating habits in their children regarding balanced nutrition according to the needs for optimal
child development, maintaining and increasing endurance. child against disease. The benefits of community
service to increase knowledge, especially about balanced nutrition for toddlers according to the needs for
optimal child growth and development so as to maintain and increase the child's resistance to disease. This
community service method includes lectures, questions and answers and leaflet media. The results of the
implementation of community service regarding balanced nutrition for toddlers show that toddlers' mothers
understand better about balanced nutrition in toddlers with an average value of knowledge about balanced
nutrition in toddlers with a percentage of 75%. The conclusion from this community service is that it is

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important for mothers under five to understand balanced nutrition in toddlers because it can improve the health
status of toddlers.
Keywords: Balance Nutrition, Toddler
PENDAHULUAN
Permasalahan kesehatan di
Indonesia adalah kematian anak usia
bawah lima tahun (balita). Angka
kematian balita di negara-negara
berkembang khususnya Indonesia masih
cukup tinggi. Salah satu penyebab yang
menonjol diantaranya karena keadaan gizi
yang kurang baik atau bahkan buruk.
Kondisi gizi anak-anak Indonesia ratarata
lebih buruk dibanding gizi anak-anak
dunia dan bahkan juga dari anak-anak
Afrika. Berdasarkan hasil Riset
Kesehatan Dasar prevalensi gizi kurang
pada usia dibawah 5 tahun di Indonesia
sebesar 17,9% (3,7 juta balita), sebanyak
6800 balita di Jawa Tengah mengalami
gizi buruk yang 25%nya disebabkan oleh
asupan gizi kurang.1 Dari data Dinas
Keseatan Kota Surakarta tahun 2018
terdapat 3,2% balita kekurangan gizi
yaitu sebanyak 495 balita.
Tercatat satu dari tiga anak di dunia
meninggal setiap tahun akibat buruknya
kualitas nutrisi. Sebuah riset juga
menunjukkan setidaknya 3,5 juta anak
meninggal tiap tahun karena kekurangan
gizi serta buruknya kualitas makanan.2
Badan kesehatan dunia (WHO)
memperkirakan bahwa 54 persen kematian
anak disebabkan oleh keadaan gizi yang
buruk.Sementara masalah gizi di Indonesia
mengakibatkan lebih dari 80 persen
kematian anak.3,8 Status gizi buruk pada
balita dapat menimbulkan pengaruh yang
sangat menghambat pertumbuhan fisik,
mental maupun kemampuan berpikir yang
pada akhirnya akan menurunkan
produktivitas kerja. Balita hidup penderita
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gizi buruk dapat mengalami penurunan
kecerdasan (IQ) hingga 10 persen. Keadaan
ini memberikan petunjuk bahwa pada
hakikatnya gizi yang buruk atau kurang
akan berdampak pada menurunnya kualitas
sumber daya manusia. Selain itu, penyakit
rawan yang dapat diderita balita gizi buruk
adalah diabetes (kencing manis) dan
penyakit jantung koroner. Dampak paling
buruk yang diterima adalah kematian pada
umur yang sangat dini. Prevalensi balita
gizi buruk merupakan indikator Millenium
Development Goals (MDGs) yang harus
dicapai disuatu daerah (kabupaten/kota)
pada tahun 2015, yaitu terjadinya
penurunan prevalensi balita gizi buruk
menjadi 3,6 persen atau kekurangan gizi
pada anak balita menjadi 15,5 persen.4
LANDASAN TEORI
Masa balita adalah periode
perkembangan fisik dan mental yang pesat.
Pada masa ini otak balita ibu telah siap
menghadapi berbagai stimuli seperti belajar
berjalan dan berbicara dengan lancar. Masa
balita juga merupakan kelompok yang
menunjukkan pertumbuhan badan yang
pesat, sehingga memerlukan zat-zat gizi
yang tinggi setiap kilogram berat
badannya. Anak balita ini justru merupakan
kelompok umur paling sering menderita
akibat kekurangan gizi (KKP). Di
Indonesia anak kelompok balita
menunjukkan prevalensi paling tinggi
untuk penyakit KKP dan defisiensi
Vitamin A serta anemia defisiensi Fe.5
Kelompok umur ini sulit dijangkau oleh
berbagai upaya kegiatan perbaikan gizi dan
kesehatan lainnya, karena tidak dapat
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datang sendiri ke tempat berkumpul yang
ditentukan tanpa diantar, padahal yang
mengantar sedang libur semua. Masa balita
adalah periode perkembangan fisik dan
mental yang pesat. Pada masa ini otak
balita ibu telah siap menghadapi berbagai
stimuli seperti belajar berjalan dan
berbicara lebih lancar. Perlunya perhatian
lebih dalam tumbuh kembang di usia balita
didasarkan fakta bahwa kurang gizi yang
terjadi pada masa emas ini, bersifat
irreversible (tidak dapat pulih). Ada usia
balita juga membutuhkan gizi seimbang
yaitu makanan yang mengandung zat-zat
gizi yang dibutuhkan oleh tubuh sesuai
umur. Makanan seimbang pada usia ini
perlu diterapkan karena akan
mempengaruhi kualitas pada usia dewasa
sampai lanjut sehingga pengabdian kepada
masyarakat diharapkan dapat
meningkatkan status kesehatan balita.
Masa balita juga merupakan kelompok
yang menunjukkan pertumbuhan badan
yang pesat sehingga memerlukan zat-zat
gizi yang tinggi setiap kilogram berat
badannya. Gizi seimbang bagi balita
merupakan susunan makanan sehari-hari
yang mengandung zat-zat gizi dalam jenis
dan jumlah yang sesuai dengan kebutuhan
tubuh dengan memperhatikan prinsip
keanekaragaman atau variasi makanan,
aktivitas fisik, kebersihan, dan berat badan
ideal. Pemberian gizi seimbang pada balita
dengan pedoman gizi seimbang (PGS)
sehingga memberikan gizi yang optimal
bagi balita. Pedoman Gizi Seimbang
diterapkan untuk seluruh usia termasuk
bayi dengan memasukkan ASI sebagai
penyusunnya. Prinsip Gizi Seimbang
adalah aneka ragam makanan sesuai
kebutuhan, kebersihan, aktivitas fisik,
memantau berat badan ideal. Jika menemui
anak yang sulit makan maka dapat dengan
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cara memotivasi makanan pada anak yaitu
membuat suasana makan anak
menyenangkan, jangan memaksa atau
mengomeli anak ketika anak makan,
berikan kebebasan anak dalam memilih
menu makanan dengan ettap
mempertahankan gizi yang seimbang
sesuai Pedoan Gizi Seimbang (PGS).7
METODE PELAKSANAAN
Metode pelaksanaan pengabdian
kepada masyarakat dilaksanakan dengan
metode ceramah, tanya jawab dan alat
peraga. Ceramah, metode ini digunakan
sebagai pengantar untuk memberikan
penekanan penjelasan gizi seimbang.
Metode tanya jawab, metode ini
digunakan baik pada saat
dilangsungkannya penyuluhan atau pada
saat diakhiri penyuluhan yang
memungkinkan ibu-ibu dari balita di
Posyandu Balita Kinasih RW 29 Wilayah
Kelurahan Kadipiro Kota Surakarta
mengemukakan hal-hal yang belum
dimengerti. Media yang digunakan dalam
kegiatan pengabdian kepada masyarakat
ini adalah LCD dan laptop, dan leaflet
gizi seimbang.
METODE PENDEKATAN
Metode pendekatan yang
digunakan dalam pelaksanaan pengabdian
kepada masyarakat ini adalah pertemuan
lintas sektoral puskesmas bersama
Program Studi Kebidanan Program
Sarjana dan Pendidikan Profesi Bidan
Program Profesi dengan melaksanakan
perencanaan dan pembahasan terkait
pelaksanaan kegiatan pengabdian kepada
masyarakat di Posyandu Balita Kinasih
RW 29 Wilayah Kelurahan Kadipiro Kota
Surakarta.
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PROSEDUR KEGIATAN
Prosedur kegiatan pengabdian
kepada masyarakat yaitu dimulai dengan
penyusunan proposal pengabdian kepada
masyarakat. Kualifikasi proposal
pengabdian kepada masyarakat dilakukan
dengan presentasi dengan reviewer
institusi yang memberikan dana
pengabdian kepada masyarakat,
pertemuan lintas sektoral puskesmas
bersama Program Studi Kebidanan
Program Sarjana dan Pendidikan Profesi
Bidan Program Profesi, koordinasi surat
tugas dengan LPPM dan Puskesmas
untuk menentukan jadwal pelaksanaan
pengabdian kepada masyarakat, persiapan
alat dan materi, persiapan pelaksanaan
pengabdian kepada masyarakat dilakukan
dengan mengumpulkan seluruh tim,
melakukan apersepsi mengenai kegiatan
yang akan dipersiapkan seperti leaflet
sebagai media. Dalam tahap ini
koordinator beserta anggota tim akan
menyusun satuan acara penyuluhan,
leaflet, serta materi penyuluhan tentang
Gizi Seimbang pada Balita. Selain itu
penyuluh akan mempersiapkan alat-alat
yang diperlukan saat penyuluhan,
pelaksanaan pengabdian kepada
masyarakat berupa penyuluhan maupun
pengajaran tentang Gizi Seimbang pada
Balita bertempat di Posyandu Balita
Kinasih RW 29 Wilayah Kelurahan
Kadipiro Kota Surakarta. Kegiatan
diawali dari pengarahan dari koordianator
penyuluhan kepada anggota tim. Kegiatan
berupa penyuluhan Gizi Seimbang pada
Balita bagi ibu-ibu Balita di Posyandu
Kinasih RW 29 Wilayah Kelurahan
Kadipiro Kota Surakarta dengan
menggunakan metode ceramah dan Tanya
jawab. Monitoring dan evaluasi yaitu
setelah dilakukan proses pengajaran dan
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penyuluhan tentang Gizi Seimbang pada
Balita selanjutnya akan dilakukan
monitoring dan evaluasi pada 1 bulan
setelah penyuluhan dengan kunjungan
rumah pada keluarga yang mempunyai
bayi/balita. Didalam proses monitoring
kunjungan rumah maka ketua tim beserta
anggota tim mendatangi rumah warga
untuk mengevaluasi tingkat pengetahuan
dan perilaku dalam hal pemenuhan gizi
seimbang pada balita.
HASIL KEGIATAN
Pelaksanaan pengabdian
masyarakat yang dilakukan oleh Program
Studi Kebidanan Program Sarjana dan
Program Studi Pendidikan Profesi Bidan
Program Profesi yaitu tentang penyuluhan
kesehatan tentang Gizi Seimbang pada
Balita di Posyandu Balita Kinasih RW 29
Wilayah Kelurahan Kadipiro Kota
Surakarta dan monitoring evaluasi pada 1
bulan setelah penyuluhan dengan
kunjungan rumah pada keluarga yang
mempunyai bayi/balita bekerjasama
dengan pihak puskesmas dengan hasil
sebagai berikut bahwa pelaksanaan sudah
dapat kami laksanakan sepenuhnya
(100%). Dari hasil pelaksanaan
pembinaan dan penyuluhan selama 1 hari
yang diikuti oleh 40 orang, ternyata
kegiatan tersebut mendapatkan respon
yang baik oleh ibu-ibu Balita di Posyandu
Balita Kinasih RW 29 Wilayah Kelurahan
Kadipiro Kota Surakarta. Ibu menjadi
lebih mengetahui tentang Gizi Seimbang
pada Balita. Hal ini dapat diketahui dari
hasil tanya jawab, dimana sebelum
dilakukan penyuluhan tentang Gizi
Seimbang pada Balita di ibu-ibu Balita di
Posyandu Balita Kinasih RW 29 Wilayah
Kelurahan Kadipiro Kota Surakarta, ibu
belum mengerti tentang Gizi Seimbang
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pada Balita, tetapi setelah dilakukan mempertahankan gizi yang seimbang

penyuluhan Gizi Seimbang pada Balita, sesuai Pedoan Gizi Seimbang (PGS).
ibu balita menjadi lebih tahu tentang Gizi
Seimbang pada Balita dengan nilai rata- KESIMPULAN DAN SARAN
rata pengetahuan tentang Gizi Seimbang Kesimpulan
pada Balita pada ibu-ibu Balita di 1. Bidan harus memberikan penyuluhan
Posyandu Balita Kinasih RW 29 Wilayah gizi seimbang balita pada ibu balita,
Kelurahan Kadipiro Kota Surakarta karena pada masa balita merupakan
dengan persentase 75%. periode perkembangan fisik dan mental
Makanan seimbang pada usia ini yang pesat, pada masa ini otak balita
perlu diterapkan karena akan telah siap menghadapi berbagai
mempengaruhi kualitas pada usia dewasa stimulus.
sampai lanjut sehingga pengabdian 2. Gizi seimbang pada balita dapat
kepada masyarakat diharapkan dapat meningkatkan status kesehatan balita.
meningkatkan status kesehatan balita.
Masa balita juga merupakan kelompok Saran
yang menunjukkan pertumbuhan badan Ibu balita dimotivasi untuk memberikan
yang pesat sehingga memerlukan zat-zat makanan yang mengandung gizi seimbang
gizi yang tinggi setiap kilogram berat agar pertumbuhan dan perkembangan
badannya. Gizi seimbang bagi balita balita dapat tercapai optimal.
merupakan susunan makanan sehari-hari
yang mengandung zat-zat gizi dalam jenis Gambar 1. Kegiatan Penyuluhan Gizi
dan jumlah yang sesuai dengan kebutuhan Seimbang pada Balita oleh Narasumber
tubuh dengan memperhatikan prinsip dan Tim Pengabdian Kepada Masyarakat
keanekaragaman atau variasi makanan,
aktivitas fisik, kebersihan, dan berat
badan ideal. Pemberian gizi seimbang
pada balita dengan pedoman gizi
seimbang (PGS) sehingga memberikan
gizi yang optimal bagi balita. Pedoman
Gizi Seimbang diterapkan untuk seluruh
usia termasuk bayi dengan memasukkan
ASI sebagai penyusunnya. Prinsip Gizi
Seimbang adalah aneka ragam makanan
sesuai kebutuhan, kebersihan, aktivitas
fisik, memantau berat badan ideal. Jika
menemui anak yang sulit makan maka
dapat dengan cara memotivasi makanan
pada anak yaitu membuat suasana makan
anak menyenangkan, jangan memaksa
atau mengomeli anak ketika anak makan,
berikan kebebasan anak dalam memilih
menu makanan dengan tetap

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Gambar 2. Kegiatan Penyuluhan Gizi Gambar 3. Kegiatan Penimbangan Balita

Seimbang pada Balita oleh Narasumber oleh kader Posyandu
dan Tim Pengabdian Kepada Masyarakat

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Jakarta. 2013.
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Asosiasi Dietisien Indonesia. PT. Gramedia Pustaka Utama. Jakarta. 2007.
3. WHO-UNICEF. Modul Pelatihan Konseling Pemberian ASI, Makanan Bayi dan Anak.
WHO-UNICEF, 2012.
4. Pergizi Pangan Indonesia, PERSAGI, PDGMI dan PDGMI. Naskah Akademik Pekan
Sarapan Nasional (PESAN). Bogor, Pergizi Pangan Indonesia, 2012.
5. Kementerian Kesehtan RI. Strategi Nasional Penerapan Pola Konsumsi Makanan dan
Aktivitas Fisik untuk Mencegah Penyakit Tidak mneular. Jakarta: Kemenkes. 2012.
6. Kementerian Kesehatan RI. Peraturan Menteri Kesehatan RI Nomor 75 Tahun 2013
Tentang Angka Kecukupan Gizi Yang Dianjurkan Bagi Bangsa Indonesia. Jakarta. 2014.
7. Institute Danone, Nakita. Sehat dan Bugar Berkat Gizi Seimbang. Kompas Gramedia,
Jakarta 2010.
8. World Health Organization (WHO). Nutrion Landscape Information System (NLIS)
Country Profile Indicators : Interpretation Guide. Geneva, WHO, 2010.

Prodi IKM FKM Universitas Jambi 66

 PENGARUH PENDIDIKAN KESEHATAN GIZI SEIMBANG
TERHADAP TINGKAT PENGETAHUAN IBU DENGAN BALITA USIA 6-24
BULAN DI WILAYAH KERJA PUSKESMAS KARYA MULYA KOTA
PONTIANAK
THE EFFECT OF BALANCED NUTRITION HEALTH EDUCATION ON MOTHER
KNOWLEDGE WITH THE AGE OF 6-24 MONTHS IN THE WORKING AREA OF
KARYA MULYA HEALTH CENTER PONTIANAK CITY
Yuvita Anggraini*, Faisal Kholid Fahdi**, Ikbal Fradianto***
*Mahasiswi Prodi Keperawatan Fakultas Kedokteran Universitas Tanjungpura, Pontianak
yuvitaanggraini03@gmail.com ** Dosen Keperawatan Fakultas Kedokteran Universitas Tanjungpura,
Pontianak faisal.psikuntan@gmail.com *** Dosen Keperawatan Fakultas Kedokteran Universitas
Tanjungpura, Pontianak ikbal.fradianto@ners.untan.ac.id

ABSTRAK
Latar Belakang: Faktor yang mempengaruhi pertumbuhan dan perkembangan balita
menjadi baik adalah makanan yang dikonsumsi. Apabila makanan yang dikonsumsi
seimbang, maka status gizi balita pun akan baik. Untuk itu, peran ibu sangat diperlukan
dalam memenuhi kebutuhan makanan pada balita. Salah satu faktor yang mempengaruhi
status gizi balita adalah pengetahuan.

Tujuan: Mengetahui Pengaruh pendidikan kesehatan gizi seimbang terhadap tingkat

pengetahuan ibu dengan balita usia 6-24 bulan Wilayah Kerja Puskesmas Karya Mulya.

Metode: Penelitian kuantitatif quasi eksperimen pre and post test without control dengan
metode purposive sampling. Responden pada penelitian ini sebanyak 73 responden. Analisis
statistik menggunakan uji wilcoxon.

Hasil: Usia terbanyak ibu yaitu 26-35 tahun sebesar 37% dengan tingkat pendidikan
terbanyak SMA sebanyak 51 sebesar 69.9%, jumlah pekerjaan terbesar adalah ibu rumah
tangga sebanyak 60 orang sebesar 82,2%, pengalaman ibu yang mempunyai 1 anak 33 orang
sebesar 45,2%. Hasil analisis uji wilcoxon menunjukan nilai p = 0,00 yang berati p < 0,05.

Kesimpulan: Ada pengaruh pendidikan kesehatan gizi seimbang terhadap tingkat

pengetahuan ibu pada anak usia 6-24 bulan di Wilayah Kerja Puskesmas Karya Mulya

Kata Kunci: pendidikan kesehatan, gizi seimbang , pengetahuan

1
 ABSTRACT

Background: factors that influence the growth and development of toddlers to be good are
foods consumed. If the food consumed is balanced, then the nutritional status of the toddler
will be good. For this reason, the role of mothers is very necessary in fulfilling the food needs
of infants. One of the factors that influence toddlers nutritional status is knowledge.

Objective: to know the effect of balanced nutrition health education on the level of knowledge
of mothers with infants aged 6-24 months Working Area of Karya Mulya Health Center.

Method: Quantitative quasi-experimental research pre and post test without control using
purposive sampling method. Respondents in this study were 73 respondents. Statistical
analysis using the Wilcoxon test.

Results: The highest number of ages was 26-35 years old with 37% with the highest level of
education at 51 as much as 69.9%, the largest number of jobs were housewives as many as
60 people at 82.2%, experiences of mothers who had 1 child 33 people amounting to 45 , 2%.
The results of the Wilcoxon test showed a value of p = 0.00 which means p <0.05.

Conclusion: There is an influence of balanced nutrition health education on the level of

knowledge of mothers in children aged 6-24 months in the Work Area of Karya Mulya Health
Center

Key Word: Health Education, Balance Nutrition , Knowledge

PENDAHULUAN serta tidak mengimbanginnya

Usia bayi berusia 6 bulan ibu
akan mulai memberikan makan
tambahan untuk bayinya. Syarat
makanan yang seharusnya
diberikan untuk balita adalah
makanan yang memiliki protein
yang tinggi, vitamin, dan mineral
dalam jumlah cukup, dan terbuat
dari bahan yang alami, serta
mengandung 360 kkal per 100 g.1
Peneliti menemukan bahwa
banyak ibu yang memberikan
makanan tambahan untuk
balitanya hanya dengan makan
bubur nasi saja, sedangkan bubur
nasi tersebut hanya mengandung
karbohidrat. Peneliti juga
menemukan bahwa ibu biasanya
memberikan makanan yang enak
kepada anaknya, tanpa tahu
apakah makanan tersebut
mengandung gizi-gizi yang cukup
dengan makanan sehat yang
mengandung banyak gizi.2 Hal
tersebut sangat jauh dari syarat
makanan yang seharusnya
diberikan ibu untuk balitanya, jika
keadaan ini berlangsungg terus
menerus maka menyebabkan gizi
balitanya tidak seimbang. Gizi
yang tidak seimbang
menyebabkan berbagai masalah
gizi pada balita.3
Kasus gizi di Dunia masih
menjadi masalah yang belum juga
terselesaikan, berdasarkan data
WHO (2018), terdapat 150,8 juta
anak-anak yang usianya dibawah
5 tahun menderita stunting, 50,5
juta anak-anak usia dibawah 5
tahun juga menderita wasting,
serta 38,3 juta anakdibawah 5
tahun menderita overweight.
Benua yang menempati urutan

2
pertama penderita gizi di dunia
adalah asia dengan 83,6 juta anak
menderita stunting, 35,0 juta anak
menderita wasting, dan 17,5 juta
anak menderita overweight. Di
Benua Asia sendiri Asia Selatan
menempati urutan pertama
penderita gizi buruk paling
banyak yaitu mencapai 33,3%,
lalu urutan kedua ditempati oleh
Asia Tenggara yaitu mencapai
25,7 %, dan yang ketiga ditempati
oleh Asia Barat yaitu mencapai
15,5%.
Tahun 2017 Nusa Tenggara
Timur (NTT) merupakan provinsi
tertinggi dengan kasus gizi kurang
sebesar 16 %, setelah NTT ada
Kalimantan Barat dan Aceh
dengan persentase 15,7% anak
balita usia 0-23 bulan pada tahun
2017 mengalami gizi kurang
(Kementrian Kesehatan RI, 2018).
Data dinas kesehatan Provinsi
Kalimantan Barat Pada tahun
2018, ada 401 kasus gizi buruk.
Untuk penyebaran gizi buruk di
kabupaten yang ada di
Kalimantan Barat, kasus gizi
buruk paling banyak ada di
Kabupaten Kapuas Hulu,
Kabupaten Ketapang, Kabupaten
Mempawah, Kabupaten Sanggau
dan di ikuti oleh Kota Pontinak, di
Kabupaten Kapuas Hulu terdapat
89 kasus gizi buruk, Kabupaten
Ketapang 55 kasus, Kabupaten
Mempawah 50 kasus, Kabupaten
Sanggau 48 kasus dan Kota
Pontianak 41 Kasus.
Suatu wilayah dikatakan
mengalami masalah gizi akut bila
prevalensi balita pendek kurang
dari 20% dan prevalensi balita
kurus lebih dari 5%.5
3
Di Kalimantan Barat sendiri
persentase balita sangat kurus
6,1% dan 10,3% balita kurus,
serta 10,9% balita sangat pendek,
balita pendek 17,4 % hal tersebut
menunjukkan karakteristik
masalah gizi di Kalimantan barat
dalam kategorik akut-kronis. Kota
pontianak sendiri karakteristik
masalah gizi nya termasuk dalam
kategori Akut Kronis. Di Kota
Pontianak 21,8% terdapat balita
Underweight, 28,4 % balita balita
di Kota Pontianak mengalami
Stunting, dan 11,3% balita di Kota
Pontianak mengalami wasting.
Dalam kategori masalah gizi di
beberapa puskesmas di Kota
Pontianak yaitu Puskesmas Karya
Mulya termasuk dalam kategori
kronis di peringkat pertama, yang
di dalamnya terdapat 4,96% balita
kurus, peringkat kedua adalah
Puskesmas Tambelan sampit
dengan persentase 3,98%,
peringkat ketiga Puskesmas Pal 5
dengan persentase 3,88%,
Peringkat keempat Puskesmas
Saigon dengan persentase 3,42%,
peringkat kelima Puskesmas Parit
Mayor dengan persentase 3,37
dan yang keenam Puskesmas
Perumnas 2 dengan persentase
2,88.
Gizi buruk merupakan salah
satu masalah yang yang
mengakibatkan 54% kematian
pada bayi dan anak (WHO, 2012).
Hasil data WHO tahun 2012 49%
dari 10,4 juta kematian di Negara
berkembang berhubungan dengan
gizi buruk. Ada beberapa
klasifikasi dari gizi buruk yaitu
stunting (anak yang kerdil), kurus,
kegemukan, anemia wanita usia
produktif, berat badan lahir
rendah, pemberian asi ekslusif,
dan berat badan dibawah normal.5
Status gizi seseorang
dipengaruhi oleh konsumsi
makanan. Status gizi baik atau
status gizi optimal terjadi bila
tubuh memeroleh cukup zat-zat
gizi yang digunakan secara
efisien, sehingga memungkinkan
pertumbuhan fisik, perkembangan
otak, kemampuan kerja, dan
kesehatan secara umum pada
tingkat setinggi mungkin.
Kekurangan zat-zat gizi esensial
pada tubuh akan menyebabkan
status gizi seseorang kurang/
buruk.6
Berdasarkan data United
Nations International Children's
Emergency Fund (UNICEF)
tahun 2012 ditemukan 1 dari 23
anak di Indonesia meninggal
sebelum usia 5 tahun dan 1 dari 3
anak balita mengalami gizi buruk
yang menyebabkan terhambatnya
pertumbuhan balita tersebut.7 Gizi
buruk tidak ditangani maka akan
menimbulkan beberapa dampak di
berbagai aspek, yaitu dapat
menurunkan imunitas balita,
menimbulkan kecacatan, angka
kesakitan dan kematian balita
tinggi.8 Mencegah terjadinya gizi
buruk maka harus dilakukan
pemenuhan gizi seimbang
berdasarkan prinsip piramida gizi
seimbang yang diatur dalam
Undang-Undang Kesehatan No 36
Tahun 2009 yang di Indonesia
dikenal dengan tumpeng gizi
seimbang. Sedangkan saat ini
banyak masyarakat terutama ibu-
ibu yang masih menggunakan
prinsip 4 sehat 5 sempurna,
padahal prinsip 4 sehat 5
sempurna sudah sejak tahun 1990-
4
an telah diganti dengan piramida
gizi seimbang dikarenakan susu
bukan lagi merupakan makanan
sempurna. 9
Penelitian Suzanna,
Budiastutik & Marlenywati
(2017) Salah satu faktor yang
mempengaruhi pertumbuhan dan
perkembangan balita menjadi baik
adalah makanan yang dikonsumsi.
Apabila makanan yang
dikonsumsi seimbang, maka
status gizi balita pun akan baik.
Untuk itu, peran ibu sangat
diperlukan dalam memenuhi
kebutuhan makanan pada balita.
Salah satu faktor yang
mempengaruhi status gizi balita
adalah pengetahuan orangtua
terutama ibu.
Penelitian In’Am (2016)
terdapat hubungan yang
signifikan antara tingkat
pengetahuan orangtua dengan
status gizi anak dibawah 5 tahun
di Posyandu Wilayah Kerja
Puskesmas Nussukan Surakarta,
hal ini juga didukung dengan
penelitian yang dilakukan oleh
Tantejo, Chriastianto, &
Restuastuti (2014) yang hasilnya
terdapat hubungan antara
pengetahuan ibu tentang gizi
dengan status gizi balita di
Wilayah Kerja Puskesmas XIII
Kota Kampar Tahun 2013. Serta
berdasarkan hasil penelitian yang
dilakukan Oleh Puspitasari &
Andriani (2017) yang hasilnya
terdapat hubungan pengetahuan
ibu tetang gizi dan asupan makan
balita dengan status gizi balita
usia 12-24 bulan. Hasil penelitian
Pratiwi tahun 2017 pengetahuan
dapat ditingkatkan dengan cara
memberikan pendidikan
kesehatan, salah satu media yang distribusi frekuensi dan bivariat
dapat digunakan dalam dengan uji wilcoxon.
memberikan pendidikan
kesehatan adalah media booklet.
Hasil penelitian-penelitan tersebut HASIL PENELITIAN
Tabel 1 Karakteristik Responden
dijelaskan bahwa untuk mengatasi Penelitian Pendidikan Kesehatan Gizi
kurangnya pengetahuan ibu Seimbang Terhadap Tingkat
diperlukannya peningkatan Pengetahuan Ibu dengan Balita Usia 6-
pengetahuan ibu tentang gizi 24 Bulan di Wilayah Kerja Puskesmas
melalui pendidikan kesehatan gizi Karya Mulya Kota Pontianak
seimbang. Peneliti memberikan Karakteristik f %
pendidikan kesehatan tentang gizi Usia
seimbang terhadap ibu yang <25 Tahun 27 37
memiliki balita usia 6-24 bulan di 26-35 Tahun 38 52
36-45 Tahun 8 11
Wilayah Kerja Puskesmas Karya
>46Tahun 0 0
Mulya (Pratiwi, 2017)
Pekerjaan
PNS 3 4.1
Wiraswasta 4 5.5
METODE Pegawai Swasta 4 5.5
Jenis penelitian ini adalah Ibu Rumah Tangga 60 82.1
penelitian kuantitatif quasi Petani/Buruh 1 1.4
eksperimen pre and post test PRT 1 1.4
Pendidikan
without control. Populasi dalam
Tidak Sekolah 1 1.4
penelitian ini adalah ibu yang SD 2 2.7
mempunyai balita usia 6-24 bulan SMP 10 13.7
yang terdata dan berada di SMA 51 69.9
wilayah kerja Puskesmas Karya Perguruan Tinggi 9 12.3
Mulya Kota Pontianak yang
Pengalaman
berjumlah 90 orang. Peneliti 1 33 45.2
menggunakan teknik purposive 2 27 37.0
sampling dan menggunakan 3 8 11
rumus slovin sehingga didapatkan 4 1 1.4
sampel 73 responden. 5 2 2.7
Lain-lain 2 2.7
Variabel independen pada
penelitian ini adalah Pendidikan Menunjukkan bahwa kategori
Kesehatan Gizi Seimbang, usia responden sebgaian besar
variabel dependen penelitian ini pada usia 26-35 tahun sebanyak
adalah tingkat pengetahuan ibu 38 dengan persentase 52%.
dengan balita usia 6-24 bulan. Kategori pekerjaan responden
Data pada penelitian ini sebagian besar ibu rumah tangga
dikumpulkan dengan lembar sebanyak 60 responden dengan
observasi dan kuesioner tingkat persentase 82.2%. Kategori
pengetahuan ibu yang telah diuji pendidikan responden sebagian
validitas dan reabilitas. Data besar berpendidikan sekolah
dianalisis secara univariat dengan menengah atas sejumlah 51
responden, dengan persentase

5
 69,9%, jumlah anak
responden sebagian besar 1 Tabel 4 Pengaruh Pendidikan
Kesehatan Gizi Seimbang Terhadap
sejumlah 33 responden dengaan Tingkat Pengetahuan Ibu dengan Balita
persentase 45.2%. Usia 6-24 Bulan di Wilayah Kerja
Tabel 2 Pengetahuan Ibu Sebelum Puskesmas Karya Mulya
diberikan Pendidikan Kesehatan Gizi
Seimbang di Wilayah Kerja Puskesmas
Karya Mulya Kota Pontianak Median
Tingkat Sebelum Variabel n (Min- Rerata±s. P
Pengetahua F % Maks) b.
n Ibu Wilcoxo
0-6 33 45.2 n
7-14 40 54.8 Tingkat 7(4-10) 6.71±1.458
pengetah
73
uan
Berdasarkan tabel 4.2 Pretest
Karakteristik tingkat 0,000
Tingkat 11(9-14) 10.88±1.35
pengetahuan sebelum diberian Pengetah 3
73
pendidikan kesehatan uan
menunjukkan 33 responden Posttest
pengetahuannya dalam rentang 0-
6 sebesar 45.2%, dan 40 Berdasarkan tabel 4
responden dengan 54.8% menunjukkan bahwa responden
pengetahuan responden dalam penelitian pada kelompok intervensi
rentang 7-14. sebelum dilakukan intervensi
Tabel 3 Pengetahuan Ibu Sesudah mempunyai nilai rerata 6.71±1.458,
diberikan Pendidikan Kesehatan Gizi setelah dilakukan intervensi nilai
Seimbang di Wilayah Kerja Puskesmas rerata terjadi peningkatan menjadi
Karya Mulya Kota Pontianak
10.88±1.353.
Tingkat Sesudah Setelah dilakukan uji statistik
Pengetahuan F % mengunakan uji Wilcoxon nilai=0.00
Ibu
yang menunjukkan terdapat
0-6 0 0
7-14 73 100 perbedaan pengetahuan yang
bermakna antara sebelum dan
Berdasarkan tabel 3 sesudah pendidikan kesehatan gizi
Karakteristik tingkat pengetahuan seimbang.
sesudah diberikan pendidikan
kesehatan 100% menunjukkan PEMBAHASAN
tingkat pengetahuan responden Karakteristik Ibu Yang
dalam rentang 7-14. Mempunyai Anak Usia 6-24 Bulan
di Puskesmas Karya Mulya
Mayoritas responden berusia
26-35 tahun dimana usia merupakan
salah satu faktor yang
mempenggaruhi pengetahuan selain
pendidikan, pekerjaan dan
pengalaman. 10
Seiring bertambahnya usia
seseorang maka akan terjadi

6
perubahan pada aspek fisik dan
psikologis.11 Usia 26-35 tahun adalah
usia yang paling baik untuk
membesarkan anak, karena
kesehatannya optimal dengan
harapan hidup yang cukup dan
memadai untuk membangun sebuah
keluarga serta dapat menjalankan
peran pengasuhan yang optimal
diperlukannya kekuatan fisik dan
psikologis.12
Mayoritas pendidikan
responden adalah SMA yang
dianggap sebagai tingkat pendidikan
menengah atas, sehingga semakin
mudah pula mereka menerima
informasi yang diberikan.13 Menurut
Suwanti & Wahyuni (2012) ada
hubungan yang signifikan antara
pendidikan dan pengetahuan, karena
pendidikan seseorang mempengaruhi
sikap atau respon yang diberikan
terhadap informasi yang ia peroleh.
Ibu harus memiliki pendidikan yang
baik agar dapat menjalankan
fungsinya dengan efektif sehingga
akan mendatangkan perilaku
kesehatan yang baik pula. Sebagian
besar responden menjadi ibu rumah
tangga, sehingga akses untuk
mendapatkan informasi lebih kecil
dibandingkan ibu yang bekerja diluar
rumah.14 Lingkungan perkerjaan
dapat menjadikan seseorang
memperoleh pengalaman dan
pengetahuan baik secara baik secara
langsung maupun tidak langsung.
Seorang ibu rumah tangga yang
sehari-harinya terbiasa menyiapkan
makanan bagi anggota keluarganya
haruslah mempunyai pengetahuan
tentang gizi seimbang sehingga
dapaat meningkatkan serta
meempertahankan derajat kesehatan
anggota keluarganya.15 Semakin
banyak pekerjaan ibu sebagai ibu
7
rumah tangga, maka ibu semakin
banyak waktu untuk mengasuh dan
merawat anaknya sehingga
pemenuhan gizi anak terpantau dan
tercukupi.
Pengetahuan adalah suatu hal
yang berasal dari pancaindra dan
pengalaman.16 Pengalaman
merupakan salah satu faktor yang
mempengaruhi pengetahuan dengan
cara mengulang kembali pengalaman
yang diperoleh dalam memecahkan
permasalahan yang dihadapi pada
masa yang lalu.17 Seiring
pertambahan usia maka pengalaman
dan kematangan jiwa akan semakin
meningkat. Ibu yang mempunyai
anak lebih dari satu cenderung
pengetahuannya lebih tinggi
dikarenakan pengalamannya yang
sudah pernah mengasuh anaknya dan
mempunyai informasi yang lebih
luas .18
Pengetahuan Ibu Sebelum
Diberikan Pendidikan Kesehatan
Gizi Seimbang di Wilayah Kerja
Puskesmas Karya Mulya
Sebelum dilakukan pendidikan
kesehatan sebagian besar
pengetahuan ibu sudah baik yang
dipengaruhi oleh faktor usia,
pendidikan, pekerjaan dan
pengalaman, tetapi ada beberapa
item pertanyaan yang rata-rata
jawaban responden salah hal ini
menunjukkan bahwa ibu belum tahu
secara mendalam mengenai gizi
seimbang.10 Tingkat pendidikan ibu
sebagian besar SMA, tingkat
pendidikan tersebut termasuk dalam
kategori baik, dimana tingkat
pendidikan baik tersebut akan
mempengaruhi pengetahuan
seseorang menjadi baik juga.19
Faktor lain dari pengetahuan adalah
usia ibu yang mana rata-rata usia ibu
26-35 dimana usia tersebut ibu dalam
kelompok usia yang memiliki
kematangan dalam hal rasional
maupun motoric.20 Menurut
penelitian yang dilakukan oleh
Rahmawati, Dasuki, & Candrasari,
(2016) usia 26-35 tahun merupakan
usia produktif sehingga mudah untuk
menerima informasi yang baru yang
berhubungan dengan kesehatan
anaknya.
Pengetahuan Ibu Sesudah
Diberikan Pendidikan Kesehatan
Gizi Seimbang di Wilayah Kerja
Puskesmas Karya Mulya
Berdasarkan hasil jawaban
reponden dalam kuesioner dapat
dikatakan reponden memahami
pendidikan kesehatan yang diberikan
oleh peneliti, hal ini dikarenakan
setelah diberikan pendidikan
kesehatan gizi seimbang
pengetahuan ibu meningkat.21
Peningkatan pengetahuan
disebabkan oleh faktor penyuluh
yaitu persiapan yang matang, materi
mengusai materi, bahasa yang
digunakan dan kepercayaan sasaran
kepada pemateri.22 Peningkatan
pengetahuan juga berhubungan
dengan minat, semakin tinggi minat
seseorang terhadap suatu hal, maka
semakin tinggi pula tingkat
pengetahuannya.23
Pengaruh Pendidikan Kesehatan
Gizi Seimbang Terhadap Tingkat
Pengetahuan Ibu Dengan Balita
Usia 6-24 Bulan
Penelitian ini membuktikan
bahwa pendidikan kesehatan gizi
seimbang berpengaruh terhadap
tingkat pengetahuan ibu, hal ini
ditandai dengan peningkatan rerata
yang awalnya 6,71 menjadi 10,88
8
dan serupa dengan penelitian yang
dilakukan oleh Azria & Husnah
(2016) dan Zulaekah (2012).
Peningkatan pengetahuan ini
disebabkan karena faktor pendidikan,
pendidikan kesehatan merupakan
salah satu upaya pemecahan masalah
kesehatan melalui pendidikan.
Pendidikan kesehatan sangat penting
karena akan menunjang program-
program kesehatan lainnya.24
Melalui pendidikan kesehatan
informasi-informasi penting akan
sampai kepada klien sehingga
pengetahuannya meningkat.
Pengetahuan seserang dapat
mempengaruhi pola pikir ke arah
yang positif sehingga akan
menumbuhkaan perilaku atau
kebiaasaan hidup sehat.25 Media
merupakan salah satu faktor penting
dalam penerimaan informasi
seseorang. Salah satu media yang
dapat digunakan adalah booklet yang
berisi panduan gizi seimbang untuk
balita usia 6-24 bulan. Proses
membaca akan menghasilkan
pengetahuan, proses yang masuk
dalam otak manusia yaitu 10%
proses dari hal-hal yang didengar
dan dilihat serta 50% dari yang
dilihat dan didengar, sehingga
seseorang mudah untuk memahami
pengetahuan yang didapat pada saat
diberikan pendidikan kesehatan
menggunakan media.26
Media merupakan sarana untuk
menampilkan pesan yang akan
disampaikan oleh pemateri, sehingga
membuat sasaran lebih memahami
apa yang ingin disampaikan oleh
pemateri.26 Media booklet merupakan
salah satu media yang dapat
membuat seseorang memahami isi
materi yang diberikan karena
materinya lebih terperinci dan jelas
serta menampilkan lebih banyak dilakukan pendidikan kesehatan gizi
informasi dibandingkan media cetak seimbang 100% skor
yang lain seperti poster, atau pengetahuannya dalam rentang 7-14.
leaflet.27 Terdapat pengaruh pendidikan
Pengetahuan merupakan hal yang kesehatan gizi seimbang terhadap
sangat penting dalam membentuk tingkat pengetahuan ibu pada balita
tindakan seseorang, terutama ibu jika usia 6-24 bulan di Wilayah Kerja
pengetahuan ibu gizi seimbang ibu Puskesmas Karya Mulya.
baik maka perilaku pemenuhan gizi
balitanya juga baik.28 Hal ini DAFTAR PUSTAKA
didukung oleh penelitian yang
1. Sudaryanto, G. (2017). 200
dilakukan oleh Farhan, (2014) yang
Makanan Sehat Bayi dan
menyatakan bahwa ada hubungan
Balita. Jakarta: Penebar Plus.
yang bermakna antara pengetahuan
2. Sitorus, R. H. (2011).
ibu rumah tangga tentang gizi
Pedoman Perawatan Balita.
seimbang dengan perilaku
Bandung: Nuansa Aulia.
pemenuhan gizi pada balita. Jika
3. Lestari, T. W., Hartati, L. E.,
perilaku pemenuhan gizi balita baik
& Budiyati. (2014). Pengaruh
maka akan mengurangi kekurangan
Pemberian Makan Balita dan
gizi dan penyakit infeksi pada
Pengetahuan Ibu Terhadap
balita.29
Status Gizi Balita Di
Kelurahan Meteseh
KESIMPULAN Kecamatan Tembalang Kota
Semarang. 310-319.
Karakteristik ibu yang 4. Kementerian Kesehatan RI.
mempunyai anak usia 6-24 bulan di (2017). Buku Saku
Wilayah Kerja Puskesmas Karya Pemantauan Status Gizi
Mulya pada usia 26-35 tahun dengan Tahun 2017. Jakarta:
persentase 52.1%, karakteristik Kementerian Kesehatan RI.
pekerjaan ibu adalah ibu rumah 5. WHO. (2012, 7 5). Levels &
tangga dengan persentase 82.2%, Trends In Child Malnutrition.
karakteristik pendidikan ibu adalah pp. 1-35.
SMA dengan persentase 69.9%, dan 6. Almatsier, S., Soetardjo, S.,
karakteristik pengalaman ibu & Soekatri, M. (2011). Gizi
mempunyai anak 1 persentasenya Seimbang Dalam Daur
45.2%. Karakteristik tingkat Kehidupan. jakarta:
pengetahuan ibu dengan anak usia 6- Gramedia.
24 bulan di Wilayah Kerja 7. UNICEF, WHO,WORDL
Puskesmas Karya Mulya sebelum BANK GROUP. (2018).
dilakukan pendidikan kesehatan gizi Level And Trends In Child
seimbang sebagian besar memiliki Malnutrition. Washington:
rentang 7-14 dengan persentase Joint Child Malnutrition
54.8%.Karakteristik tingkat Estimates.
pengetahuan ibu dengan anak usia 6- 8. Rahim, F. K. (2014). Faktor
24 bulan di Wilayah Kerja Risiko Underweight Balita
Puskesmas Karya Mulya setelah Umur 7-59 Bulan. Jurnal

9
 Kesehatan Masyarakat, 115- 15. Azria, C. R., & Husnah.
121. (2016). Pengaruh Penyuluhan
9. Kementrian Kesehatan RI. Gizi Terhaadap Pengetahuan
(2014). Pedoman Gizi dan Perilaku Ibu Tentang
Seimbang. Jakarta: Gizi Seimbang Balita Kota
Kementerian Kesehatan RI. Banda Aceh. Jurnal Unsyiah,
10. Mubarak, W. I. (2011). 87-92.
Promosi Kesehatan Untuk 16. Lestari , T. (2015). Kumpulan
Kebidanan. Jakarta: Salemba Teori Untuk Kajian Pustaka
Medika. Penelitian Kesehatan.
11. Suwanti, E., & Wahyuni, S. Yogyakarta: Nuha Medika.
(2012). Karakteristik Ibu 17. Suryaningsih, C. (2013).
Kaitannya Pengetaahuan Ibu Pengaruh Pendidikan
Tentang Posyandu. Jurnal Kesehatan Terhadap
Terpadu Ilmu Kesehatan, 1- Pengetahuan Ibu Post Partum
94. Tentang ASI Eklusif. Jurnal
12. Salafiah, N., Widodo, A., & Keperawatan Soedirman, 77-
Suryandari, D. (2014). 86.
Pengaruh Pendidikan 18. Suriyana, Y. (2015). Metode
Kesehatan Terhadap Penelitian. Bandung: CV
Pengetahuan Dan Sikap Ibu Pustaka Setia.
Tentang Pola Asuh Anak 19. Ni'mah, C., & Muniroh, L.
Usia Bayi (INFANT) di (2016). Hubunan Tingkat
Wilayah Kerja Puskesmas Pendidikan, Tingkat
Kartasura. Jurnal UMS, 1-16. Pengetahuan dan Pola Asuh
13. Pamarta, D. (2018). Pengaruh Ibu dengan Wasting dan
Faktor Predisposisi (Usia, Stunting Pada Balita
Pendidikan, Pekerjaan, Keluarga Miskin. Jurnal
Pengetahuan, SIkap) Ibu Unair, 84-70.
Terhadap Ketetapan 20. Saputra, W. I., & Irdawati.
Pemberian Makanan (2017). Hubungan Tingkat
Pendamping Air Susu Ibu Pengetahuan Ibu dengan
(MPASI) Di Desa Kenep Tumbuh Kembang Bayi
Kecamatan Sukoharjo Prematur Usia 6-12 Bulan di
Kabupaten Sukoharjo. Jurnal Wilayah Kerja Puskesmas
UMS, 1-14. Se-Kecamatan Banjarsari.
14. Novita, M. R., Ambarwati, Jurnal UMS, 50-57.
W. N., & Listyorini, D. 21. Farhan, M. (2014). Hubungan
(2013). Pengaruh Pendidikan Pengetahuan Ibu Rumah
Kesehatan Terhadap Tangga Tentang Gizi
Pengetahuan Ibu Tentang Seimbang Dengan Perilaku
Kandungan Air Susu Ibu Di Pemenuhan Gizi Seimbang
Desa Kaliwuluh Pada Balita Usia 3-5 Tahun
Kebakkramat Karangayar. Di Dessa Banjarsari
Jurnal UMS, 1-13. Kecamatan Ciawi Kabupaten
Bogor. Skripsi.

10
22. Sidiq, R. (2018). Efektivitas Gonilan Kartasura. Jurnal
Penyuluhan Kesehatan UMS, 1-20.
Dalam Meningkatkan 29. In'Am , M. (2016). Hubungan
Pengetahuan Kader Posyandu Tingkat Pengetahuan
Tentang Pencegahan Orangtua Dengan Status Gizi
Pneumonia Pada Balita. Aceh Anak Di Bawah 5 Tahun Di
Nutrrition Journal, 22-27. Posyandu Wilayah Kerja
23. Wardani, N. I., SR, D. S., & Puskesmas Nusukan
Masfiah, S. (2014). Faktor- Surakarta. Universitas
Faktor Yang Berhubungan Muhammadiyah Surakarta,
Dengan Tingkat Pengetahuan 1-11.
Kader Kesehatan Tentang
Thalassaemia Di Kecamatan
SUmbang Kabupaten
Banyumas. Jurnal
Kesmaindo, 194-206.
24. Notoatmodjo, S. (2011).
Promosi Kesehatan dan Ilmu
Perilaku. Jakarta: PT Rineka
Cipta.
25. Pratiwi, Y. F. (2017).
Efektivitas Penggunaan
Media Booklet Terhadap
Pengetahuan Gizi Seimbang
Pada Ibu Balita Gizi Kurang
Di Keluarahan Semanggu
Kecamatan Pasar Kliwon
kota Surakarta. Universitas
Muhammadiyah Surakarta,
1-12.
26. Suiraoka, I. P., & Supariasa,
I. D. (2012). Media
Pendidikan Kesehatan.
Yogyakarta: Graha Ilmu.
27. Kusrianto, A. (2009).
Pengantar Desain
Komunikasi Visual.
Yogyakarta: Andi.
28. Rahmawati, A. K., Dasuki,
M. S., & Candrasari, A.
(2016). Hubungan Antara
Pengetahuan Ibu Tentang
Gizi Seimbang Dan Asupan
Zat Gizi Makro Pada Anak
Usia 2-5 Tahun Di Posyandu

11
Journal of Community Medicine and Primary Health Care. 32 (2) 17-26
https://dx.doi.org/10.4314/jcmphc.v32i2.2

JOURNAL OF
COMMUNITY MEDICINE AND
PRIMARY HEALTH CARE
ORIGINAL ARTICLE
Knowledge of Factors Contributing to Child Malnutrition among
Mothers of Under-five Children in Sokoto Metropolis, North-West
Nigeria
Raji IA1, Abubakar AU1, Bello MM1, Ezenwoko AZ1, Suleiman ZB1, Gada AA1,
Auwal BU1, Kaoje AU1,2
1Department of Community Medicine, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria
2 Department of Community Health, Usmanu Daonfodiyo Univesity, Sokoto, Nigeria

ABSTRACT
Background: Malnutrition remains a killer of children, especially in Sub-Saharan Africa.
Keywords In Nigeria, malnutrition is among the top five killers of children under five years of age.
This study aimed to assess the knowledge of factors contributing to child malnutrition
Awareness; among mothers of under-fives.

Factors; Methods: A cross-sectional study was conducted among 347 mothers of under-five
children who were selected using a multistage sampling technique from January to March
Knowledge; 2018. Data were collected using an interviewer-administered questionnaire. Data were
analysed using IBM SPSS® version 20.0. Descriptive statistics, crude and adjusted Odds
Malnutrition; Ratio (OR) with 95% Confidence Interval (CI) in cross-tabulation and binary logistic
regression analysis, respectively, were estimated.
Mothers;
Results: More than half, 198 (57.0%) were aged 40 years and below. Most, 324 (93.4%)
Under-five of the respondents were Hausas, with only 45 (13.0%) having tertiary education. Majority
of the respondents, 326 (93.9%) knew that diarrhoea-causing diseases could lead to
malnutrition. About two-thirds, 222 (64.0%) knew that deworming could protect a child
from malnutrition. Less than half, 169 (48.7%) did not know that overeating starchy food
can cause malnutrition. Overall, majority 216 [62.2% (95% CI = 56.9% - 67.4%)] of the
respondents had good knowledge of factors associated with malnutrition. There were no
statistically significant predictors of knowledge of factors contributing to malnutrition.

Conclusion: Mothers of under-five children in Sokoto metropolis had a high level of

knowledge of the factors contributing to child malnutrition. However, there is still a need
to continue educating mothers of under-five children on the importance of maintaining
proper nutrition for their children.

Correspondence to:
Dr Ismail Abdullateef Raji
Department of Community Medicine,
Usmanu Danfodiyo University Teaching Hospital Hospital,
Sokoto, Nigeria
Email: stainless.raji@gmail.com
Telephone: +2348034517237

INTRODUCTION second birthday.1 About half of the deaths

occurring in children under five years of age
A great start in life can be achieved by
are linked to undernutrition.1,2
optimising nutrition early in life including
Undernutrition puts children at higher risk
the 1000 days from conception to a child’s

17 JOURNAL OF COMMUNITY MEDICINE AND PRIMARY HEALTH CARE VOL. 32, NO 2, SEPTEMBER 2020
of dying from common infections, increasing assessed caregivers’ knowledge of the
the frequency and severity of such diseases, importance of colostrum, initiation of
and delaying recovery.2 Malnutrition breastfeeding, knowledge of malnutrition
increases health care costs, reduces and its management; however, there is a
productivity and slows economic growth, dearth of literature on caregivers’ knowledge
which can perpetuate a cycle of poverty and of factors contributing to malnutrition.
ill-health.1 These are most prevalent in low- Caregivers’ knowledge of risk factors of
and middle-income countries, including malnutrition plays a vital role in the
Nigeria.1 In Nigeria, only 64% of children prevention of undernutrition among under-
under five years are thriving without any fives by allowing the mothers to make an
nutritional problems, implying that roughly informed decision on a balanced diet and
one out of every 3 children has some form of appropriate meal for age and also avoiding
nutritional deficit.3 The highest burden of practices that are detrimental to a child’s
malnutrition in Nigeria is in the north, nutritional status.14 Sokoto is one of the
especially north-west and north-east where epicentres of malnutrition in the country,15
the prevalence of acute malnutrition among hence the need for this study. Therefore, the
children 6-59 month is above the national objectives of this study were to assess the
average of 7% and prevalence of stunting knowledge of factors contributing to
above 40%.3 Sokoto State, located in north- malnutrition among mothers of under-five
western Nigeria, has the highest prevalence children and to determine the factors that
(20%) of wasting.4 predict their knowledge.

Poverty, food insecurity, and illiteracy are METHODOLOGY

the top three leading causes of
Study area: This study was conducted in
malnutrition.5 Other factors contributing to
Sokoto metropolis, which consists of four
malnutrition are financial constraints,
LGAs: Sokoto-north, Sokoto-south,
inadequate food intake, ill-health and
Wamakko and some parts of Dange Shuni.
improper care of children. Furthermore, a
Sokoto State has a low literacy rate of 20.1%
heavy workload for mothers, local cultural
in western education among women, which
beliefs that severe malnutrition is due to
is far below the national average of 59.3%.15
witchcraft and the violation of sexual taboos
Women in the area are mostly financially
are other factors contributing to
dependent on their husbands, and the
malnutrition.6 Studies have shown that
husband and his parents make most
illiterate mothers are more likely to have
decisions on how to run the family and
inadequate knowledge about the nutritional
health issues. The typical food crops in
requirement of their children, which results
Sokoto State include millet, guinea corn,
in unhealthy feeding practices.7-9 There are
maize, rice, beans, wheat, cassava,
several studies on caregivers’ knowledge of
potatoes, groundnut and sugar cane. Fruits
malnutrition.10-14 These studies have

18 JOURNAL OF COMMUNITY MEDICINE AND PRIMARY HEALTH CARE VOL. 32, NO 2, SEPTEMBER 2020
and vegetables grown in Sokoto include of households was made using a systematic
oranges, mangoes, bananas, lettuce, sampling method after proportionate
spinach, cabbage and pawpaw. Weaning allocation for each of the selected settlement
practice is poor in Sokoto with almost 50% was done. When a house was picked, and it
of mothers introducing complementary happened to be ineligible (i.e. no mother of
feeds at the wrong time (too early or too late) under-five in the household), the next
and giving poorly fortified or unfortified household was chosen, and then the
pap.16 sampling interval was continued. Where
more than one mother was eligible in a
Study design and population: A cross-
household, simple random sampling by
sectional study design was used and the
balloting was used to choose a respondent
study population comprised of all the
among them. A total of 212 households
mothers of under-five children in Sokoto
(Gwiwa, 115 and Badon ukku-ukku, 97) in
metropolis. The study spanned from
Arkilla ward and 138 in Kalambaina (Bakin
January to March 2018.
kusu, 82 and Gidan gamba, 56) were
Sample size determination and sampling selected and one mother from each
technique: The sample size for the study household was the unit of enquiry.
was determined using Fisher’s formula for
Data collection and analysis: An interviewer-
calculating sample size for a cross-sectional
administered structured questionnaire was
study,17 n=Zpq/d2 with a 31.8% prevalence
used to collect information on the
of good knowledge observed from a previous
sociodemographic profile, awareness and
study,18 a precision level of 5%, and an
knowledge of factors associated with
anticipated response rate of 95%. A total of
malnutrition. The level of knowledge of
350 mothers were enrolled in the study.
respondents was determined by scoring the
Eligible mothers were selected using a
questions that assessed knowledge. For any
multistage sampling technique. At the first
response, a correct answer was scored 1,
stage, Wammako LGA was selected by
and a wrong answer was scored 0. The
balloting out of the four metropolitan LGAs;
aggregate score for each respondent in
the second stage involved a random
percentage was graded into good knowledge
selection of two wards, Arkilla and
(score ≥75%) and poor knowledge (score
Kalambaina from eleven wards through
<75%).19 Six final year medical students
balloting. At the third stage, four
were trained for data collection. The content
settlements, two from Arkilla (Gwiwa, 240
of the training included objectives of the
households and Badon ukku-ukku, 203
studies, ethics of research and the use of
households) and two from Kalambaina
Open Data Kit (ODK) that was used for data
(Bakin kusu, 172 households and Gidan
collection. The questionnaire was pretested
gamba, 118 households) were selected by
in 21 households in communities not
balloting; and the fourth stage, the selection
selected for the study. Following the

19 JOURNAL OF COMMUNITY MEDICINE AND PRIMARY HEALTH CARE VOL. 32, NO 2, SEPTEMBER 2020
pretesting, some ambiguous questions were mothers and fathers respectively, had
modified, and some unnecessary questions tertiary education. More than two-thirds,
were expunged. Descriptive statistics such 303 (87.3%) of the mothers were married,
as mean, median, standard deviation (SD) and 228 (65.7%) were housewives (Table 1).
and interquartile range were done for The majority of the respondents 326 (93.9%)
continuous variables, whereas, categorical knew that malnutrition could be caused by
variables were presented in frequencies and the presence of diseases and infections that
proportions. Crude Odds Ratio (cOR) and cause diarrhoea. Three hundred and
adjusted Odds Ratio (aOR) were reported for twenty-one, (92.5%) knew that poor
bivariate and multivariate analysis, maternal understanding of nutritious diet
respectively, with 95% Confidence Interval could predispose their child to malnutrition.
(CI). For all analyses, the level of significance Most, 318 (91.6%) knew that neglected
was set at p < 0.05. children and orphans are at risk of
malnutrition; and inadequate food intake
Ethical consideration: Ethical approval
can predispose a child to malnutrition.
was obtained from the Sokoto State Ministry
Three hundred and fourteen (90.5%) knew
of Health Research Ethics Committee.
that malnutrition was common among the
Written informed consent was obtained
low-income group. More than half, 222
from the respondents before the
(64.0%) knew that deworming can protect a
questionnaire was administered. All
child from malnutrition. Less than half, 169
information sought were handled with the
(48.7%) did not know that overeating
utmost confidentiality. Research assistants
starchy food can cause malnutrition.
were trained not to disclose any information
Overall, 216 (62.2%; 95% CI = 56.9% -
or make comments or any judgments with
67.4%) of the respondents had good
regards to anything observed at the
knowledge of factors associated with
residence of the respondents.
malnutrition with a mean knowledge score
of 78.3 ± 14.2 (Table 2).

RESULTS A higher proportion of mothers with formal

education, 122 (63.9%) compared to those
A total of 350 mothers of under-five children
with no formal education, 94 (60.3%) had
were recruited into the study. Three of the
better knowledge; however, this was not
mothers declined, giving a response rate of
statistically significant, p = 0.489. Similarly,
99% (347 respondents). The median age was
a higher proportion of fathers with formal
30 years (with an interquartile range of 25-
education, 155 (62.8%) compared to those
40 years). More than half of the
with no formal education, 61 (60.1%) had
respondents, 198 (57.0%) were aged 40
good knowledge; and this finding was also
years and below. Most, 324 (93.4%) of the
not statistically significant, p = 0.760. A
respondents belong to the Hausa ethnic
higher proportion of respondents in a
group. Only 45 (13.0%) and 150 (43.3%) of

20 JOURNAL OF COMMUNITY MEDICINE AND PRIMARY HEALTH CARE VOL. 32, NO 2, SEPTEMBER 2020
polygamous setting, 79 (63.7%) had good the highest prevalence of wasting in
knowledge compared to those in Nigeria.4
Monogamous setting, 137 (61.4%); but the
difference was not statistically significant, p
Table 1: Socio-demographic profile of
= 0.675 (Table 3). Respondents who were respondents

less than 40 years were more likely to have Frequency

Variables
(n = 347) Percent
good knowledge of factors contributing to
Age group (years)
child malnutrition (aOR: 1.2; 95%CI = 0.7 - ≤40 198 57.0
>40 149 43.0
2.0); however, this was not statistically Ethnic group
Hausa 324 93.4
significant, p = 0.576. Similarly, mothers Others* 23 6.6
with formal education were more likely to Religion
Islam 342 98.6
have good knowledge (aOR: 1.5; 95%CI = 0.9 Christianity 5 1.4
Mother’s Education
-2.7) also, this was not statistically None 31 8.9
Quranic school only 125 36.0
significant. (Table 4) Primary 48 13.8
Secondary 98 28.3
DISCUSSION Tertiary 45 13.0
Father’s Education
none 33 9.5
This study assessed the knowledge of Quranic school only 67 19.3
factors contributing to child malnutrition Primary 13 3.7
Secondary 84 24.2
among mothers of under-five children and Tertiary 150 43.3
Marital status
to also identify factors that predict their Married 303 87.3
Separated 4 1.2
knowledge. We found that almost all the Divorced 19 5.5
mothers knew that disease conditions that Widowed 21 6.0
Family type
cause diarrhoea could lead to malnutrition. Monogamous 223 64.3
This finding is of significant public health Polygamous 124 35.7
Mother’s occupation
importance because, mothers can take Student 31 8.9
Self employed 66 19.0
appropriate early actions when their babies Housewife 228 65.7
Civil servant 20 5.8
are sick with diarrhoea – a disease that is Others 2 0.6
quite common in our environment. Father’s occupation
Student 9 2.6
However, it has been shown that having Farmer 42 12.1
Self employed 89 25.6
such knowledge does not always translate Civil servant 152 43.8
Unemployed 29 9.6
into practice.20 We also found in this study Others 26 6.3
that the majority of mothers of under-five Monthly income (N)
<18,000 140 40.3
children knew that inadequate intake could ≥ 18,000 207 59.7
*Others = Yoruba, Ibo, Nupe, Igbira
predispose a child to malnutrition. This
finding is surprising, as Sokoto State has

21 JOURNAL OF COMMUNITY MEDICINE AND PRIMARY HEALTH CARE VOL. 32, NO 2, SEPTEMBER 2020
Table 2: Knowledge of factors associated with malnutrition among respondents

Correct
Variables responses
n Percent
The presence of diseases and infections that cause diarrhoea can lead to
malnutrition 326 93.9
Mother’s poor understanding of nutritious diet can predispose their
children to malnutrition 321 92.5
Neglected children, orphans and those living in care homes are at risk of
malnutrition 318 91.6

Inadequate food intake can predispose a child to malnutrition 318 91.6

Malnutrition is common among the low-income group 314 90.5

There is a link between breastfeeding and optimal growth of the children 314 90.5

Living in a large household family setting can restrict mothers’ ability to

monitor her children’s feeding habit 303 87.3

Lack of immunisation to specific disease can lead to malnutrition 290 83.6

Inadequate financial resources limiting access to healthy food can result

in malnutrition 289 83.3
Long term breastfeeding without complementary feeding contributes to
malnutrition 288 83.0

Fruits can protect your child from infectious diseases

277 79.8
Keeping a child with alternate caregivers or nannies can predispose the
child to malnutrition 257 74.1
Children who were not exclusively breastfed can be malnourished 233 67.1

Deworming can protect a child from malnutrition 222 64.0

Overeating starchy food can cause malnutrition 169 48.7

Overall knowledge grading

Good knowledge 216 62.2
Poor knowledge 131 37.8
(n =347)

Therefore, other factors such as poverty, polygamous setting. Empirical evidence

cultural practices and social dependence of
women, especially in Northern Nigeria could
be contributing to the high prevalence of
malnutrition, despite adequate knowledge.5,6
A high proportion of the mothers knew that
having children in a large household family
could affect the mothers’ ability to monitor
the feeding of their children. However,
knowledge seems not to be translated to
practice as it is common for people in
northern Nigeria to have lots of children in a
shows that having more children tend to
increase competition for childcare resources
within the household such that a child is
denied adequate nutritional care.21 Most of
the mothers were aware that there is a link
between breastfeeding and optimal growth
of their children. This finding is
encouraging, as it has been shown that
mothers’ knowledge of feeding is vital for a
positive nutritional outcome for the child.22

22 JOURNAL OF COMMUNITY MEDICINE AND PRIMARY HEALTH CARE VOL. 32, NO 2, SEPTEMBER 2020
Table 3: Association between knowledge of factors contributing to child malnutrition and
respondents’ sociodemographic profile
Knowledge
Variables Good Poor Chi- square p-value
(n=216) (n=131)
n (%) n (%)
Age group (years)
<40 151 (61.6) 94 (38.4)
≥40 0.134 0.714
65 (63.7) 37 (36.6)
Tribe
Hausa 200 (61.7) 124 (38.3)
Others 0.561 0.454
16 (69.6) 7 (30.4)
Mother’s education
No formal education 94 (60.3) 62 (39.7)
0.478 0.489
Formal education 122 (63.9) 69 (36.1)
Father’s education
No formal education 61 (60.1) 39 (39.0)
0.093 0.760
Formal education 155 (62.8) 92 (37.2)
Marital status
Not married 23 (52.3) 21 (47.7)
2.134 0.144
Married 193 (63.7) 110 (36.3)
Family type
Monogamous 137 (61.4) 86 (38.6)
0.175 0.675
Polygamous 79 (63.7) 45 (36.3)
Monthly income (N)
<18,000 88 (62.9) 52 (37.1)
0.037 0.847
≥18,000 128 (61.8) 79 (38.2)
Mother’s occupation
Unemployed 204 (62.4) 123 (37.6)
0.046 0.831
Employed 12 (60.0) 8 (40.0)
Father’s occupation
Unemployed 119 (61.0) 76 (39.0)
0.283 0.595
Employed 97 (63.8) 55 (36.2)

Table 4: Logistic regression analysis of predictors of respondents’ knowledge of risk factors of child
malnutrition

Variables cOR (95%CI) aOR (95%CI) p-value

Age less than 40 years 0.9 (0.6 - 1.5) 1.2 (0.7 -2.0) 0.576
Hausa tribe 0.7 (0.3 - 1.8) 1.5 (0.6 -3.9) 0.365
Mother having formal education 0.9 (0.6 - 1.3) 1.5 (0.9 -2.7) 0.160
Father having formal education 0.9 (0.6 - 1.5) 0.9 (0.5 -1.7) 0.790
Not being married 0.6 (0.3 - 1.2) 2.0 (1.0 -4.2) 0.053
Income less than 18 thousand Naira
1.0 (0.7 - 1.6) 0.9 (0.5 -1.5) 0.671
monthly
Mother being unemployed 1.1 (0.4 - 2.8) 1.1 (0.6 -1.8) 0.825
Father being unemployed 0.9 (0.6 - 1.5) 1.7 (1.0 -3.0) 0.063
Having a monogamous family setting 0.9 (0.6 - 1.4) 1.2 (0.7 -1.9) 0.562
cOR = crude Odds Ratio aOR = adjusted Odds Ratio

Less than half of the mothers knew that that health talks on nutrition are focused on
overeating starchy food could cause only protein-energy malnutrition, and less
malnutrition. This could be an indication attention is given to obesity which is also a

23 JOURNAL OF COMMUNITY MEDICINE AND PRIMARY HEALTH CARE VOL. 32, NO 2, SEPTEMBER 2020
form of malnutrition. This finding indicates this study may be due to better access to
that mothers do not have adequate transportation (which increases their access
knowledge concerning the types of food or to health facilities and health workers) and
healthy diets required by their children for electricity which increases their access to
healthy growth and development. Due to health information passed through mass
this poor knowledge, mothers may not be media such as radio, television and internet.
giving the right combination of foods to their The higher proportion of good knowledge
children which could be contributing to observed in this study may also be
malnutrition. attributable to the previous efforts of the
Sokoto State government and partners in
We found that more than 60% of mothers
raising public awareness about
had good overall knowledge of factors
malnutrition and its causative factors
contributing to malnutrition among under-
through mass media. It is impressive that a
fives. This finding is encouraging because a
high proportion of the mothers had good
high proportion of the mothers do not have
knowledge of factors contributing to
formal education. This finding is similar to
malnutrition; however, this does not reflect
what was reported in a study in Ethiopia,
the nutritional status in the state with one
where most of the respondents had good
of the worst nutritional indices in Nigeria.4
knowledge regarding child nutrition.23
However, the result contradicts the findings A higher proportion of mothers with formal
of a study conducted in Ghana, where only education were more likely to have good
31.8% of the respondents had good knowledge of factors contributing to
knowledge regarding child malnutrition.18 malnutrition. Although this finding did not
The difference in the mothers’ knowledge achieve statistical significance, a previous
level may be because our study was study in Oman showed that mothers’
conducted in an urban area. In contrast, the educational status was associated with
study in Ghana was conducted in a rural nutritional knowledge.24 The finding in this
area. study is worrisome as almost half of the
mothers do not have formal education.
People in the urban areas have better
Although it has been shown that mothers’
access to hospitals, health professionals
knowledge of health and nutrition may
and other health care services where health
substitute for formal education in reducing
talks and health education are given more
malnutrition; however, the present level of
attention. These could reflect favourably in
mothers’ education in Nigeria, especially in
terms of the type and quality of health
rural areas appears insufficient to reinforce
information provided to mothers in the
knowledge in producing better nutrition
urban settings and thus their knowledge
outcomes for children.22 None of the
levels. In addition, the higher proportion of
sociodemographic characteristics was
mothers with good knowledge observed in

24 JOURNAL OF COMMUNITY MEDICINE AND PRIMARY HEALTH CARE VOL. 32, NO 2, SEPTEMBER 2020
significant predictors of knowledge in this
study.
Conclusion: The mothers of under-five
children in Sokoto metropolis had a high
level of knowledge of factors contributing to
child malnutrition. We recommend that
government at all levels, as well
healthcare workers at all levels of healthcare
delivery, increase their effort in reinforcing
mothers knowledge on the common health
problems of children including
malnutrition, and the factors contributing
to its causation. Health talks should also
include sessions incorporating education of
mothers on elemental food compositions
and how to combine locally available food
products to achieve a balanced meal.
Acknowledgements: We would like to
acknowledge Wamakko LGA community
leaders for their cooperation when carrying
out this study. We also acknowledge the
contribution of our data collectors and
community guides.
Conflict of interest: The authors declare
that they have no conflict of interest
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Volume 9 Number 11 November 2018
 Indian Journal of Public Health Research & Development
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Associate Professor, Dr Baba Saheb Ambedkar, Medical College & Hospital, Rohinee, Delhi
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Botany and Microbiology Deptt, College of Science, King Saud University,
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Public Health and Community Medicine, University of Buraimi, Oman
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BP Koirala Institute of Health Sciences, Nepal
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 I

Indian Journal of Public Health

Research & Development

www.ijphrd.com
CONTENTS

Volume 9, Number 11 November 2018

1. Is there any Difference between Revised Indian and WHO BMI Classification? A Study
on Male Desk Job Workers .................................................................................................................. 01
Akilesh Anand Prakash, B M S Nagraj

2. Dermatophytosis in a Tertiary Care Teaching Hospital of Odisha: A Study of 100 Cases of Superficial
Fungal Skin Infection .......................................................................................................................... 07
Ajaya Kumar Jena, Rajesh Kumar Lenka, Mahesh Chandra Sahu

3. Evaluation of Deferral Pattern among Blood Donor Population in a Hilly Terrain of Solan Region,
North India ........................................................................................................................................... 12
Sushant Kumar Meinia, Anuj Sharma

4. Evaluating the Impact of HR Practices on Employee Deviant Behavior: An Exploratory Study on

Employees of IT Industry .................................................................................................................... 17
Sainath Malisetty, Malathi Narayanan, CH.Bala Nageswara Rao

5. Role of Physical Activity in Management of Musculoskeletal Disorders:

An Association with BMI .................................................................................................................... 22
Pooja Sharma, Supriti Aggrawal, Sadhana Meena

6. An Empirical Study on Retail Demand for Store Brand Pickles in Tirunelveli, Tamil Nadu ............. 27
Varadarajan Rangarajan, K Thulasi Krishna

7. Knowledge of Disease Management among Maintenance Hemodialysis Patients in Coastal Karnataka

– A Cross Sectional Pilot Study ........................................................................................................... 33
Bryal D’Souza, Rajesh Kamath, Ravindra Prabhu, Unnikrishnan, Sagarika Kamath

8. Study on Global Public Health Threats due to Emerging or Re-Emerging Infectious Diseases and the
Strategies to Reduce Threats ............................................................................................................... 38
Manas Kumar Kundu, Tarit Kr Mandal, Malavika Bhattacharya

9. A Study to Compare the Efficacy of Dynamic Soft Tissuse Mobilization Vs Self Myofascial Release
Techniques for Hamstring Tightness in Healthy Male ........................................................................ 44
G Yasmeen Imtiaz, S Prabhakar, V Balachander

10. Estimation of Vitamin D Levels in Children with and without Early Childhood Caries – A Case
Control Study ....................................................................................................................................... 51
Anitha Jayakumar, Deepa Gurunathan, EMG Subramainan
 II

11. Clinical, Echocardiographic and Risk Profile of Five Hundred Cases of Dilated Cardiomyopathy in a
Tertiary Care Centre: Our Experience ................................................................................................ 57
Srikant Kumar Dhar, Akshaya Kumar Samal Chandan Das, Sobhitendu Kabi, Swati Samant,
Kamalkant Jena, Mahesh Chandra Sahu

12. Interdependence of Communicable and Non-Communicable Diseases among Elderly Population in

Declared Slum in Mysuru City, Karnataka .......................................................................................... 62
Meghana Narendran, Savitha Rani B B, Praveen Kulkarni, Renuka M, Narayana Murthy M R

13. Intimate Partner Violence: Factors and Types of Abuse Women Face in and around Coimbatore
District, Tamilnadu .............................................................................................................................. 67
Suji Prasad, Rangasami Periyan

14. Stress Level and Coping Strategies of IT Sectors ............................................................................... 71

15. Factors Affecting Dental Attitudes of the Adults of South India: A Cross Sectional Study ................ 77
Nishu Singla, Shashidhar Acharya, Prajna Nayak, Ritesh Singla

16. Regional Dimensions of Health Status of Children in Haryana .......................................................... 82

Manju Sharma, Sandeep Kumar

17. Effectiveness of Structured Exercise Program on Insulin Resistance in Type 2 Diabetes Mellitus – A
Pilot Study ........................................................................................................................................... 88
A Sampath Kumar, Arun G Maiya, B.A. Shastry, Vaishali K, Animesh Hazari, Radhika Jadhav

18. Postural Pain in Computer Users: Role of Preventive and Curative Physiotherapy ........................... 92
Pooja Sharma, Supriti Aggrawal, Sadhana Meena

19. Management of Patient with Pneumonia and Hypothyroidism – A Case Study ................................. 97
Manisha Vikrant Mistry, A Seeta Devi

20. Prevalence of Chronic Obstructive Pulmonary Disease (COPD) and Risk Factors in Non-Smokers at a
Tertiary Care Teaching Hospital of Eastern India ............................................................................. 100
Banani Jena, Rabi Narayan Mania, Pritam Chhotray, Syed Umer Ahmed, Mahesh Chandra Sahu

21. Assessment of Self-Care Practices among Diabetic Patients, Suraram, Telangana State, India ........ 105
Suguna Dumpala, Padmavathi Vutukuru

22. Comparison of Stress Patterns in the Edentulous Mandibular Bone around Four Implant Retained
Over Denture and All-On-Four Concept – A Three Dimensional Finite Element Analysis ............... 111
Puneeth Hegde, Dhanasekar B, Satish Shenoy, Aparna I.N, Lokendra Gupta, Shobha J Rodrigues,
Thilak Shetty

23. Enablers of Telemedicine Technology Adoption: A Case-Based Conceptualization in

Indian Context .................................................................................................................................. 116
Samyadip Chakraborty, Vaidik Bhatt

24. An Empirical Relationship between Organisational Culture and Performance Management ........... 121
M Jayanthi, G.S. Maheswari

25. Three Dimensional Finite Element Stress Analysis of Two and Four Implant
Supported Prosthesis ......................................................................................................................... 126
Puneeth Hegde, Dhanasekar B, Satish Shenoy, Aparna I.N, Lokendra Gupta, Umesh Y, Mahesh M
 III

26. Awareness of Smoke-free Legislation (Section 4 of COTPA) among Owners or Person in-Charge of
the Public Places in Ramanagara City .............................................................................................. 132
Usha S, Sindhu R

27. Dens Evaginatus on a Permanent Mandibular Molar-Report of a First Case ................................... 139
Karuna Y M, Shailaja Datta, Arathi Rao

28. Knowledge and Perception of Patients in a Tertiary Hospital about Radiation and its Effects –A
Survey ............................................................................................................................................... 142
Suveen, Fatema M Satchoo, Sachin Davis, Suresh Sukumar

29. Uncovering the Burden of Healthcare Associated Infections (HAIs) in Indian Hospitals:
A Review ........................................................................................................................................... 148
Soumya Christabel, Christopher Sudhaker, Muralidhar Varma, Anice George, Elsa Santatombi

30. Women Empowerment through Step Programme of Government with Special Reference to Kanpur
(Uttar Pradesh) .................................................................................................................................. 154
Monica Tiwari, P Shalini

31. A Mixed Method Study on Utilization of Maternal Health Services and Barriers among Women of
Reproductive Age in Gujarat State- Pilot Study ............................................................................... 159
Sapnaben Bhavin Patel, Anil Sharma, Jogindra Vati

32. A Study on Stress and its Effect on Private School Teachers ........................................................... 165
S Kosalai, G S Maheswari

33. Evaluation of the Influence of Surface Treatment of Artificial Tooth on the Adhesive Bond Strength to
a Commercially Available Denture Base Resin-In Vitro .................................................................. 169
Gurkaran Singh, Veena Hegde

34. Prevalence of Depression among the Post-Menopausal Women in the Field Practice Area of Saveetha
Medical College and Hospital, Thirumazhisai, Tamil Nadu ............................................................. 175
Ruma Dutta, Prashanth Rajendran, S.Ramya, Navukkarasu Sabapathy, S.Kesava, S.Senthilraja

35. Is India Ready for Telerehabilitation? ............................................................................................... 180

Sona Ayanikalath, Mershen Pillay, M. Jayaram

36. Impact of Government Policies on Job Insecurity in Alcoholic Beverages & Its Allied Industries in
Tamil Nadu ........................................................................................................................................ 187
A Shanmugam, N Kalyanaraman

37. Effectiveness of Social Media Marketing ......................................................................................... 192

R Sharmila, M.Kavitha

38. Clinical Profile and Antibiotic Sensitivity Pattern in Pediatric Urinary Tract Infection of a Tertiary
Care Hospital in Bhubaneswar, Odisha .......................................................................................... 197
Chinmay Kumar Behera, Manas Kumar Nayak, Seba Ranjan Biswal, Natabar Swain,
Sibabrata Pattnaik

39. Effectiveness of Nutritional Ball among Adolescent Girls with Anemia in Selected Government
Schools, Greater Noida .................................................................................................................... 204
Renu Gurung, Pauline Sharmila

40. Analysis of Heavy Metal Distribution and Content in Coastal Area of Makassar, Indonesia .......... 210
Ridwan Bohari, Sukri Palutturi
 IV

41. Knowledge of Critical Care Nurses on Cardiac Medications-Need For Reinforcement Workshop.. 214
Melita Sheilini, Elsa Sanatombi Devi, Janet Pramila D’souza

42. Knowledge on Practice of Urinary Catheter Care and Compliance to Urinary Catheter Care
Guidelines- A Hospital based Study .................................................................................................. 218
Maryl Candida Cutinho, Melita Sheilini, Harish B

43. TB Iris: A Clinical Outcome among HIV Patients Receiving Antiretroviral Therapy in a Tuberculosis
Prevelant Area ................................................................................................................................... 225
Yadlapati Sujani, Achappa Basavaprabhu, Bajpai Sukrit, Mahalingam Soundarya, Jain Simran

44. The Use of Education Booklet for Anemia Prevention on Teenage Girls ........................................ 230
Riyanti, Riny Natalina

45. A Preliminary Host Toxicity Study of Pterocarpus Marsupium on Lymphocytes Isolated from Cord
Blood ................................................................................................................................................. 235
Sujita Pradhan, Santosh Kumar Sahu, Mahesh Chandra Sahu, Sudhansu Sekhar Mishra,
Prafulla Kumar Chinara

46. Comparative Study of Indian Hospital Planning Guidelines for Inpatient Wards ............................ 239
Lalit Varma, A P Pandit

47. Correlation of Hematological Profile with CD4 Counts in Human Immunodeficiency Virus-Positive
Patients in a Rural Area of South India ............................................................................................. 247
Abilash Sasidharananir Chandrakumari, Pammy Sinha, Shreelakshmidevi Singaravelu, Jaikumar S

48. Mammogram Analysis using Diffusion Wavelets ............................................................................ 252

G.Prathibha , B.Chandra Mohan

49. Two Phase Therapy for Skeletal Class II Malocclusion – A Case Report ........................................ 259
Ritesh Singla, Arun S Urala, Nishu Singla

50. In Vitro Study of Antimicrobial Activity of Lactobacillus Fermentum against Germ Tube

Positive Candida spp ........................................................................................................................ 262
Suresh P, V Sreenivasulu Reddy, V Praveen Kumar, P Vamsimuni Krishna

51. Effect of Auditory Verbal Working Memory Training on Speech Perception in Noise in
Older Adults ...................................................................................................................................... 268
Ashwini Sandra, Somashekara Haralakatta Shivananjappa, Arivudai Nambi Pitchaimuthu

52. Cognitive Functions after Neonatal Encephalopathy in a Coastal City of South India-A Retrospective
Cohort Study ..................................................................................................................................... 274
Aby Dany Varghese,Vaman Kulkarni, Sowmini P.Kamath, Rathika D Shenoy, Shanthram Baliga B

53. Evaluation of Differentiation Tests for Mycobacterium tuberculosis from Non tuberculous
Mycobacteria by MPT64 TB Rapid Test and Selective Inhibition with p-nitrobenzoic Acid .......... 281
V Praveen Kumar, V Sreenivasulu Reddy, P Suresh, P Vamsi Muni Krishna, E Prabhakar Reddy

54. Effect of Flexibility with Resisted Exercise on Foot Vibration Perception Threshold in Diabetic
Neuropathy in Type II Diabetus : A Pilot Study ....................................................................................... 285
Kannan Dhasaradharaman, Prathapsuganthirababu, K Mohanraj

55. Bone Grafts in Periodontal Regeneration ......................................................................................... 289

Prabhu Manickam Natarajan
 V
56. Improvement Efforts of Hazardous Waste Management Implementation in Karimun Regency
Fabrication Yard, Indonesia .............................................................................................................. 293
Sharyne Sylvani, Haryoto Kusnoputranto

57. Distribution and Seasonal Variations of Copepoda in Euphrates River at Samawah City, Iraq ....... 298
Sahib Shanon Ibrahim

58. Sociodemographic the Characteristics of “Slum and Urban Area”Customer Behavior Depot and
Identification of Escherchia Coli with RT-PCR by Gen EF-Tu ........................................................ 304
Alfina Baharuddin, Anwar Daud, Thahir Abdullah, Mochammad Hatta

59. Prevalence and Determinants of High-Risk Women in Pregnancy, Labor and Postpartum with
Premarital Screening in Semarang City, Central Java, Indonesia ..................................................... 311
Dewi Puspitaningrum, Nuke Devi Indrawati, Indri Astuti Purwanti

60. Mothers’ Behaviour Regarding School-Aged Children’s Nutrition: in Indonesia ............................ 317
Eka Mishbahatul Marah Has, Della Febien Prahasiwi, Sylvia Dwi Wahyuni, Nursalam, Ferry Efendi

61. Spatial Variation of Human Cancer Incidence across Babylon State in (2010) ................................ 323
Samah Ibrahim Shamki, Afrah Ibrahim Shamki

62. Characteristics of Overweighed and Obese Adults attended Nutritional Clinic in Al-Qadisiyah
Governorate, Iraq, 2014 ..................................................................................................................... 329
Fatima A. Alkhalidi, Rami S. Alshemerty

63. Floating Prostitution and the Potential Risk of HIV Transmission in a Religious Society
in Indonesia ....................................................................................................................................... 334
Hardisman Dasman, Firda Firdawati, Ilma Nuria Sulrieni

64. The Effect of Training on Efforts to Reduce Maternal Mortality Risk to Behavior of Community-
Based Safe Motherhood Promoters (SMPs) ...................................................................................... 339
Yusriani, Muhammad Khidri Alwi, Heru Santoso Wahito Nugroho

65. Medulloblastoma of the Posterior Fossa in Children: Perioperative Surgical Complications .......... 346
Asa’ad F. Albayati, Ahmed Hilal Kamel, Yaseen M. Taher, Sadiq Fadhil Hammoodi,
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 VI
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 VII
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 VIII
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Abdul Rohim Tualeka, Febi Dwirahmadi, Arief Wibowo, Fransisca Anggiyostiana Sirait

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Shayhana Ganesh, Renitha Rampersad

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Lenny Irmawaty Sirait, Muh Nasrum Massi, Mochammad Hatta , Prihantono

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Nursalam Nursalam, Kartika Harsaktiningtyas, Iqlima Dwi Kurnia, Harif Fadhillah,
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 IX
114. Gender Differences in Relationship between Commuting and Health Outcomes in Jakarta
Metropolitan Area, Indonesia ........................................................................................................ 617
Milla Herdayati, Tris Eryando

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Romokalisari, Surabaya ................................................................................................................... 624
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 Balanced Nutrition Menu Intervention for Toddlers in
Children Daycare Center

Dhini1, Munifa1, Ismi Rajiani2

1
Department of Nutrition, Poltekkes Palangka Raya, Indonesia,
2
Department of Business Administration, STIAMAK Barunawati Surabaya, Indonesia

ABSTRACT

Background: Children Daycare Centers are alternatives for parents to entrust their children. However,
children at the golden age of must be fulfilled their nutritional intake as experiencing lack of food at
that time will have a serious impact. This way, efforts should be made to ensure that Children Daycare
Centers or in Indonesia is known as Tempat Penitipan Anak (TPA), are able to provide the best services
to children, both in terms of care and provision of food intake. The research aims at providing intervention
needed to change the situation in the site so that the implementation of meals served have a good impact
on the children.

Method: This is a pre experimental one group pretest posttest observing children aged 4-6 years.
Interventions provided in the form of balanced nutrition food 1 menu cycle for 30 days in accordance with
the nutritional adequacy of lunch and snacks. The analysis used was the T- test.

Results: There was a relationship between energy intake and children’s nutritional status (P -value 0.024),
there was a difference in nutritional status between before and after the intervention (P -value 0.004) .

Conclusion: Childcare places need to apply balanced nutritional food in an effort to maintain and improve
the nutritional status of children. The application of a suitable diet is very necessary so that food intake in
children becomes optimal. Modification of types of food that can be adjusted to the child’s desires based on
the nutrition adequacy rate for children.

Keywords-: Children Daycare , Balanced Nutrition, Nutritional Status, Intervention

INTRODUCTION development where the children cared for by parents

Children daycare, known in Indonesia as Tempat
Penitipan Anak (TPA), is an alternative for parents
to entrust their children for family replacement for a
certain period of time for children during parents work
as well as the implementation of educational programs
(including care) against children from birth to 6 years
of age (1). Children aged 0-6 years are in the golden
and critical period. Toddler raised by parents with
care for other than parents showed differences in the
Corresponding author:
Dhini
Department of Nutrition, Poltekkes Palangkaraya,
Indonesia, Email: andendhini@yahoo.com
become better than children being cared by others than
parents (2). Therefore parenting and organizing meals
in children daycare are one of the factors in child
development.
For every food administration, both performed
non-commercially and commercially such as in the
daycares, completeness and the adequacy of nutrients
in the food served must be in accordance with the
guidelines in the preparation of the food menu being
served. In fact, in the city of Palangkaraya, the results
of research (3) on food remaining analysis using the
Comstock method indicated that the energy served on
the first, third and sixth day are meeting the standard
(≥80%) while the second day, fourth and fifth is not
appropriate (<80%). Proteins served on the first,
 Indian Journal of Public Health Research & Development, October 2018, Vol. 9, No. 11
second, third, fifth and sixth days are fitted (80%)
while the fourth day is not suitable (<80%). For leftover
food remnant based on 6 days of lunch served on the
second day is that the remaining food staple is 48.86%,
vegetable side dish is 48.86%, vegetable is 56.82%,
fruit is 31.82% and on the sixth day, the animal side
dish is 51.04 %. Thus, it is concluded that the energy
and protein served do not meet the standards. These
results also blatantly indicated that that the availability
and the intake of children nutrition in the daycare is
less than the nutritional adequacy rate . Based on the
aforementioned matters, the authors are interested in
conducting a research on the intervention of a balanced
nutrition menu in the daycares located in Palangkaraya,
the capital of central Kalimantan Province, Indonesia.
METHODOLOGY
This research uses quantitative methodology with
design pre-experiment one group pretest posttest, held
in September 2017 in Darussalam Child Daycare Center
Palangkaraya , Indonesia. Interventions are given in
the form of a balanced nutritional food cycle which is
calculated using the nutrition adequacy rate based on
age. Balanced nutrition food is given at lunch 30 times in
30 days. The average adequacy of nutritional substances
for children lunch each cycle consists of energy = 358.29
Kcal and protein of 12.18 gr. The nutritional content is
made in a portion of food consisting of lunch and dessert
snacks. Every 1 week children are given six times lunch
on Monday to Saturday, with different menus every day.
The intervention of the effectiveness of the provision of
a balanced nutrition diet is measured by assessing the
child’s weight between before and after the intervention.
In addition, the child’s intake of balanced nutrition is
also measured in the form of percentage of intake.
Table 1. Average Difference Analysis on Nutritional Status of Children
Mean
Variable Intake Weight /
Age
≥75% Energy Intake
(n = 13) 13
Z-Score
(Weight /
Age) Energy intake < 75%
(n = 5) -1.09
148
The sample size to be analyzed is 18 samples.
Univariate analysis is used to analyze data by describing
the results of research on each variable studied.
Percentage value is used to display data on children’s food
intake as well as the mean, standard deviation, confident
interval and minimum-maximum for numerical data on
children’s weight. Bivariate analysis is used to analyze
the relationship between two variables. Statistical test
of paired t-test analyzed the difference in average body
weight between before and after the intervention as
well as the difference in average body weight between
adequate intake and poor intake based on nutrients, the
degree of significance using α (alpha) = 0.05.
RESULTS
Food nutrition in children is converted into a
percentage of intake by comparing nutrient intake with
standard intake for the children generating the results
of 72.2% of energy intake which is ≥ 75%, and 44.4%
protein intake which is also ≥75%.
Table 1 shows that children with ≥ 75% energy
intake have an average of Z-Score 0.207, while energy
intake < 75% has Z-Score -1.09. Both of these Z-Score
values in anthropometric standards assess the nutritional
status of children is still in the range of good nutrition.
There is a significant difference in the mean score of
Z-Score between energy intake ≥ 75% and energy intake
< 75%. Table 1 also shows that children with a protein
intake of ≥ 75% had an average of Z -Score 0.126,
while protein intake < 75% had an average of Z-Score
-0.38. There was no significant difference in the average
Z-score value between protein intake ≥ 75% and protein
intake < 75%.
Levene
SD Difference P Value
Test
0.69
1.305 0.024
0.121
1.57
 149 Indian Journal of Public Health Research & Development, October 2018, Vol. 9, No. 11
Cont... Table 1. Average Difference Analysis on Nutritional Status of Children
Protein intake ≥75%
Z-Score (n = 8) 0.126
(Weight /
Age) Protein Intake <75%
(n = 10) -0.38
Table 2. Analysis of Differences in Body Mass Index (BMI) of Children Before and After Intervention
Mean
Variable Description
Age
BMI - 0.43
Before
Z Score
(Body
4-6 years After -0.15
weight /
Age)
The average Z score before intervention was
- 0.43 while after the intervention the average Z
score is -0.15. The difference in knowledge scores
after treatment is t an increase of 0.28. Statistically
there are differences in the average Z score before
treatment and after treatment with p -value = 0.004.
The correlation value (r) square produced 95.1. This
shows that the provision of balanced nutritional
food and eating regulations play a role of 95.1% in
improving the nutritional status of children in child
daycare while the rest is caused by other factors.
DISCUSSIONS
Organizing meals is a series of activities ranging
from menu planning to distribution of food to consumers,
including recording, reporting and evaluation activities
aimed at achieving optimal health status through proper
feeding. Based on its function, organizing meals can
be divided into two, namely commercial and non-
commercial. The organization of meals at Darussalam
Child Daycare is a non-commercial operation, namely
the provision of food that is not profitable. Looking at the
conditions as in the results of the study, it is concluded
that the food administration program still does not
follow the standard pattern of service management and
technical instructions. This is stated in the results of the
study that food management depends on the available
funds and menu planning and there are no standard
portions or prescription standards.
Results showed that children’s energy intake was
mostly > 75%. Children’s energy intake is derived from
modification of food that has been provided for 30
0.37
0.507 0,507
0.005
1.48
Score Difference
Min - Max Correlation P- Value
Value (R)
-2.72 - 1.39
-2.5 - 1.58 0.951 0.280 0.004
times, namely in the form of food types which has been
processed in such a way as to increase children’s interest
in consuming it. The results also showed that there were
differences in the average nutritional status between
energy intake ≥75% and <75%. There was a significant
relationship between energy intake and nutritional status
in children.
Food substances needed by the human body include
carbohydrates, proteins, fats, vitamins, minerals and
water. Food consumed by children is metabolized by the
body so that it becomes energy and is useful for child
growth and development. Energy in the human body
arises due to the burning of carbohydrates, proteins and
fats. Thus, in order to fulfill their energy needs, it is
necessary to consume enough food substances into the
body. Childhood age 4-6 years is a time when children
are very active in carrying out various activities together
with their peers (4). When a child has more energy than
is consumed, it can cause weight loss. If the child has
a lack of energy, it will have an impact on physical
growth, mental and endurance (5). This research is in line
with the previous research results showing that 91.7%
of adequate energy consumption has nutritional status
will not experience underweight (6). Another research
also shows that there is a significant relationship
between energy intake and nutritional status of children
(7)
. Further, children with less chance of energy intake
is 2.43 times to experience less nutrition compared to
children with adequate energy intake (8). From the results
of the study it is concluded that adequate energy intake
affects the nutritional status of toddlers better.
 Indian Journal of Public Health Research & Development, October 2018, Vol. 9, No. 11
Results showed that there was no difference in the
average nutritional status between children with protein
intake ≥ 75% and <75%. Children with an intake of ≥
75% are 8 people and <75% are 10 people, if it is nearly
equal it is 1: 1.25. The results of this study are in line
with the results which showed no relationship between
protein intake and nutritional status (9). Also another
study showed no relationship between protein intake and
nutritional status (10) and no correlation between protein
intake and nutritional status (11).
In fact, proteins chemically have atoms that are
the same as fat and carbohydrates, only the difference
is the element of nitrogen. One of the important food
substances for the body is protein. Protein is a part of
living cells and is the largest part after water. Enzymes,
hormones, nutrient transporters and blood are proteins.
The main function of protein is to build and maintain
body tissues. Protein is also the same source of energy as
carbohydrates. If the body is in a state of lack of energy
zumber such as carbohydrates and fats, the body will use
protein to form energy and exclude its main function as
a building agent. In children this condition can have an
impact on growth disorders. Consumption of adequate
protein intake will have an impact on good growth the
body’s immune system increases, creativity increases
and has a strong mentality (12) supporting previous
research that children with good food intake, as many
as 75% were in the category of good nutrition as well
(13)
and children with less protein intake is 2.63 times
risk of experiencing poor nutritional status compared to
children with adequate protein intake (14).
Protein intake in the child daycare is a protein intake
as long as the children receives a balanced nutrition
food modification intervention. Protein intake in the
landfill during part of the study was good enough >
75% . The protein is derived from animal protein so
that it can provide a fairly good intake. The absence of
a relationship between protein and children’s nutritional
status was due to the average nutritional status of children
at both < 75% and > 75% intake. In this study, food
directly affects the nutritional status of children. This is
because the researchers have since sampled the samples
by selecting research locations in child care centers so
that other confounding variables can be minimized.
Balanced nutrition foods that have been modified have
an effect on the nutritional status of children, indicated
by the difference in Z score value of 0.280. Nutritional
150
status is a balance between food intake and body needs
(output). Children with inadequate food intake both in
terms of the amount of intake and in terms of nutritional
value will weaken their endurance and easily suffer from
pain. If a child experiences a weak immune system, it
will certainly affect the child’s nutritional status (15).
Previous research also showed that feeding patterns
affect the nutritional status of children. The feeding
pattern in question is from the type of food, amount
of food (nutritional adequacy) and meal schedule (16).
Children with the right diet were 122 children (89.7%)
had nutritional status in the normal category . Food
consumption affects a person’s nutritional status. Good
nutritional status or optimal nutritional status occurs
when the body produces enough nutrients that are
used efficiently so as to enable physical growth, brain
development, work ability and general health at the
highest level possible.
CONCLUSION
Child Care Centers in Central Kalimantan Indonesia
does not apply a balanced nutritional food in an effort to
maintain and improve the nutritional status of children.
This may due to lack of the knowledge and feeding
toddler may be considered as a social activity only.
The Daycare unit should apply a suitable diet is needed
so that food intake for children is optimal by modifying
types of food that can be adjusted to the child’s desires,
still based on the nutrition adequacy rate in children.
Ethical Clearance: The Ministry of Health
Polytechnic approved this research in Central
Kalimantan, Indonesia. Ethical clearance was obtained
from the Faculty of Medicine Palangkaraya University,
Indonesia. A research permit was requested from the
local health authorities. We also wish to thank all the
participants who contributed to this study.
Conflict of Interest: Nil.
Source of Funding: The Ministry of Health
Polytechnic Palangkaraya, Indonesia.
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Predictors of Knowledge, Attitude and Practice of
Mothers with Under 5 Years Malnourished Children
in Kiribati
Antje Reiher 
Ministry of Health
Masoud Mohaammadnezhad  (  masraqo@hotmail.com )
Fiji National University https://orcid.org/0000-0002-5048-9719
Nasser Salem Alqahtani 
Northern Border University

Research

Keywords: Predictors, Mothers behavior, Malnutrition, Children, Kiribati

DOI: https://doi.org/10.21203/rs.3.rs-79353/v1

License:   This work is licensed under a Creative Commons Attribution 4.0 International License.  
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Abstract
Background: Malnutrition among under 5 years old children is a common public health issue in both
developed and developing countries. As mothers are the key persons responsible for their young children,
this study aimed to assess the levels and predictors of knowledge, attitude and practice (KAP) of mothers
of malnourished children less than 5 years old on South Tarawa, Kiribati.

Methods: This study is a cross sectional prospective design. This study conducted in pediatric ward and
public health clinics of 11 public health centers on South Tarawa in Kiribati and among 82 mothers with
under 5 years old malnourished children who were admitted to the Pediatric ward and public health
clinics. The knowledge, attitude and practice on breastfeeding, weaning, diet and immunization was
collected using a self-administrated validated questionnaire. Bivariate correlation and linear regression
were applied and the signi cance level for this study was 5%.

Results: Majority of the mothers (66%) were 19-32 years old, 69.5% were Roman Catholics, 67% had
attended high-school, 46% had husbands as breadwinners and 85% were married. The participants had a
low level of knowledge and middle level of attitude and practice on breastfeeding, weaning, diet and
immunization. Education level (r=0.319, p=0.004) and breadwinner at home (r=-0.239, p=0.031) were
positively correlated with attitude. The results of linear regression were signi cant, F (2, 81) = 6.757, p=
0.002, r2 = 0.146, suggesting that education level and breadwinner accounted for 15% of the variance in
attitude score.

Conclusion: This study showed the importance of mothers’ attitude towards malnutrition. Encouraging
female education could be a potential target for future policies to reduce malnutrition in Kiribati.  

Introduction
Malnutrition among under 5 years old children is a common public health issue in both developed and
developing countries [1, 2]. In developing countries, children are 8 times more likely to die before reaching
5 years of age compared to children in developed countries. Each year more than 2 million children die as
an outcome of undernutrition before the age of 5 years, especially in low and middle income countries [3].
Malnutrition can affect children in many ways such as: increasing susceptibility to infection, decreasing
child development, raising mortality rate and individuals will function in insu cient ways [2, 4, 5]. In 2014,
1 in 4 children (156 million) was estimated to be affected by stunting, and 1 in 7 (93 million) is
underweight [3]. For example; in the Paci c Island Countries (PICs), Papua New Guinea (PNG) had a “very
high” rate of chronic undernutrition with 40% and Solomon categorized as “high” rate with 30%-39%, as
per the World Health Organization (WHO) classi cation [6].

In 2013, Kiribati had 11,000 under 5 years old children approximately 14% of the total population and
6,934 of children aged 0–4 were living in South Tarawa alone [7]. Kiribati faces challenges to promote its
people’s health care as malnutrition and diarrhea remain major problems [8]. The results of a health
survey in Kiribati showed that 23% of children are underweight or severely underweight [9]. This number
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placed Kiribati above the WHO threshold (10%), making the prevalence of underweight children a major
public health problem [10]. It was reported that Kiribati contributed to 28% of all under 5 deaths worldwide
of which 15% were severely malnourished [11]. More children are underweight amongst the poorer
families than in richer ones [12, 13]. Therefore, it is essential for the decision makers to detect
malnutrition at an early stage for developing health promotion interventions at the community level.
Inadequate accessibility and affordability of nutritious foods play a major role on both adult and
childhood malnutrition [14, 15].

World Food Program (WFP) revealed that malnutrition has numerous causes, besides lack of access to
food and nutrition [16, 17]. Therefore, to prevent and treat it properly, one needs a broad range of
treatment methods and other variables, such as access to basic health services and better feeding
practices. Mothers, as the primary caretakers to young children, need to be knowledgeable in looking after
their children, especially earlier in life and also must have proper attitude and practice towards child-care
in terms of nutrition especially. The Kiribati National Statistical O ce (KNSO), claims that poor nutrition
of children is linked to lack of breastfeeding, poor weaning practices, diet and morbidity, which is further
exacerbated with the high rate of infectious diseases [18].

Essential health promotion interventions to improve child health and nutritional status is mostly focused
on the mother behavior [19, 20]. Since a mother’s care begins at home, interventions on behavior should
begin in the home. As mothers are the key persons responsible for their young children, it is required to
establish their level of Knowledge, Attitude, and Practice (KAP) on breastfeeding, complementary feeding,
dietary practice and immunization in children and identify signi cant factors that affect their KAP.
Consequently, this study aimed to examine the predictors of KAP of mothers of children under 5 years old,
who suffer from malnutrition on South Tarawa, Kiribati in 2016.

Methods
A descriptive cross-sectional study was conducted for eight weeks from the 21st of December 2015 to the
12th of February 2016 at 11 different public health clinics on South Tarawa, the capital island of Kiribati.
The inclusion criteria were all I-Kiribati women with children under 5 years old who were identi ed as
being malnourished (registered under the public health clinics). The exclusion criteria were mothers who
were not willing to participate in the study and had critically ill children. This study recruited participants
by purposive sampling. In total, there were 120 malnourished children under 5 years old registered from
the public health clinics, however, only 82 participants were available for this study.

A self-administered questionnaire was used to collect data which was structured in 4 parts - socio-
demographic questions and KAP related questions. The knowledge score was out of 12 questions, with a
minimum score of 0 and maximum score of 12. The scores, with their respective knowledge levels, were
12–9 as high knowledge, 8–6 as medium knowledge and 5–0 as low knowledge. The attitude was
assessed by 20 questions using a Likert scale ranged from positive to negative responses such as:
strongly agree, agree, neutral (neither agree nor disagree), disagree and strongly disagree. The scoring

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system used with respect to participant’s responses to positive items was as follows: strongly agree
scored 4, agree scored 3, neutral scored 2, disagree scored 1 and strongly disagree scored 0. For the
negative statements strongly disagree scored 5 and coming down to 1 for strongly agree. The total score
obtained for respondents was a maximum of 80 with a minimum of 0. Combined scores less than 40
were categorized as low level attitude, from 40 to 60 as middle level attitude, and above 60 as high level
attitude. The practice score was out of 19 questions. The correct answer was given a 1 and a wrong
answer was given a 0. The total points to be scored was 19 and the minimum was 0. As a result, the
score with their respective practice levels, were as follows; 19–13 was high practice, 12–9 was medium
practice and 8–0 was low practice [21, 22].

A pilot test on the questionnaire was carried out at the Bikenibeu West public health clinic and Pediatric
ward to test its face validity and effectiveness on 10 participants, of which 5 were mothers from the
hospital while the other 5 were mothers from the public health side of the hospital. Content validity was
done by 3 academic experts to support with their opinions. The Cronbach alpha score was 0.78.

The mothers who met the study inclusion criteria were informed about the study using an information
sheet. If they volunteered to take part in the interviews they were asked to sign the consent form. The
questionnaires, information sheets and consent forms had 2 versions, both in Kiribati and English
language. Cross translation was carried out (English to Kiribati language and then Kiribati to English
language) by bilingual translators to ensure the questions were clearly understandable to the
participants. The questionnaire was carried out by the researcher for those mothers that were unable to
read in English or Kiribati language and illiterate mothers, questionnaires were given to them to ll in and
then returned to the researcher on the same day.

All responses from questionnaires were rst entered into Microsoft Excel and then exported to SPSS
Version 22 for data cleaning and analysis. For data analysis, descriptive analysis was used to determine
the frequency of responses and displayed in tables and graphs by percentage distribution. Multiple linear
regression was conducted on variables that predict the KAP score. Signi cant values (alpha value) were
performed to prove or disprove any null hypothesis (if there is one) and a p-value of less than 0.05 was
considered signi cant.

This study was conducted according to the guidelines laid down in the Declaration of Helsinki and all
procedures involving research study participants were approved by the Fiji National University’s College
Health Research Ethics Committee (CHREC) and Kiribati Ministry of Health. Written informed consent was
obtained from all subjects who were 18 and over and those who were under 18 years. Those who were
under 18 years old were provided consent forms to obtain parental consent and were also requested to
sign the assent form for participation in the study.

Results
Sociodemographic characteristics
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Two thirds of the women in the study were between 19–32 years of age, the highest percentage of
mothers were Roman Catholic (69.5%), 85% were married, 67% had high school level of education and
46% had breadwinners as husbands (Table 1).

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 Table 1
Sociodemographic status of respondent
Demographic Status (n = 82) Frequency Percentage

Age    

< 18 years 2 2.4

19–25 years 27 32.9

26–32 years 27 32.9

33–39 years 19 23.2

> 40 + years 7 8.5

Religion    

Bahai 1 1.2

Kiribati United Church 15 18.3

Latter Days Saints 2 2.4

Seventh Day Adventist 2 2.4

Roman Catholic 57 69.5

Others 5 6.1

Marital Status    

Married 70 85.4

Divorced 1 1.2

Separated 1 1.2

Single 6 7.3

Widowed 4 4.9

Education level    

Graduate school 2 2.4

High school 55 67.1

Primary school 24 29.3

No education 1 1.2

Breadwinner    

Husband 38 46.3

parents 12 14.6
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 Demographic Status (n = 82) Frequency Percentage

sister/brothers 8 9.8

son/daughter 1 1.2

None 18 22.0

Others 5 6.1
 

Levels of KAP
The mean knowledge score was 5.43 (± 1.39) which shows that mothers had a low level of knowledge.
The mean attitude score was 54.17 (± 4.78) which shows that mothers had a middle level of attitude. The
mean practice score was 9.83 (± 2.21) which shows that mothers had a middle level practice on
breastfeeding, weaning, diet and immunization.

Table 2
Mean and SD of KAP
Item Mean SD

Knowledge 5.43 1.39

Attitude 54.17 4.78

Practice 9.83 2.21

Predictors of KAP
Table 3 shows the correlation coe cient (r) between demographic variables and KAP using correlation
test. Education level (r = 0.319; p = 0.004) and Breadwinner at home (r=-0.239; p = 0.031) was positively
correlated with attitude scores.

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 Table 3
Results of correlation test of mother’s demographic status with knowledge,
attitude and practice
Variables Knowledge Attitude Practice

  r P-value r P-value R P-value

Age -0.061 0.589 -0.027 0.812 0.102 0.362

Religion 0.005 0.967 0.147 0.186 0.083 0.458

Marital status -0.078 0.485 -0.193 0.083 -0.115 0.305

Education level -0.023 0.834 0.319 0.004** 0.158 0.156

Breadwinner -0.114 0.307 -0.239* 0.031* -0.125 0.263

The result of multiple linear regression was signi cant, F (2, 81) = 6.757, p = 0.002, r2 = 0.146, suggesting
that education level and breadwinner accounted for 15% of the variance in attitude score. As Table 4
describes, education level and breadwinner were signi cant predictors of attitude, β = 2.3, p < 0.005; β
=-0.4, p < 0.05, suggesting that mothers who graduated from school were 2.3 times more likely to have an
increased attitude score compared to mothers with no formal school. Mothers with no breadwinner at
home were 0.4 times more likely to have a decreased attitude score compared to mothers that have
breadwinners at home.

Table 4
Results for Multiple Linear Regression with Education
Level and Breadwinner predicting Attitude score
Variables B P-value 95% CI

Education level 2.336 0.005 0.717 3.995

Breadwinner -0.407 0.046 -0.807 -0.008

Discussion
In this study, mothers of malnourished children less than 5 years had a low level of knowledge and a
medium level of attitude and practice in regard to breastfeeding, complementary feeding, dietary practice
and immunization. Education level and having a breadwinner at home are the 2 variables that correlated
with attitude of the participants.

The level of mothers’ knowledge might be affected by the socioeconomic status of the individual
including their education level, if there is a breadwinner at home and employment status [23]. According
to this study, the highest percentages of mothers were high school level educated mothers and
breadwinners at home were husbands, while 22% had no breadwinner at home. As reported in a study by

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Frost, Forste and Haas, socioeconomic status is the most important pathway linking maternal education
and child nutritional status [24]. “A low level of maternal education and a lack of knowledge on good
childcare practices means children do not receive optimal nutrition and care” [25].

In this study, mother’s attitude showed a medium level of attitude with a mean score of 54.17, SD = ± 
4.78. Mother’s attitude showed the majority of them had neutral ideas or do not know that colostrum is
best for the child and the best time to initiate breastfeeding is soon after birth. As recommended by the
WHO, breastfeeding should be initiated 1 hour after birth and ensures that the infant receives the
colostrum or “ rst milk” which is rich in protective factors [26].

Mothers should have a good basic perspective on cooking lessons, carried out in the community during
child health care visits, so that they could gain proper approaches on how to make a healthy and
balanced diet for their children. If mothers had neutral ideas about a balanced diet, then the food they
provided to their children was not healthy, which then leads to malnutrition. Therefore, health talk by
nurses or health professionals is needed at the community level, especially for mothers on healthy foods
at home, or to run a workshop that they could attend and could motivate and change the way of thinking
towards a balanced diet for their children.

To change people’s attitudes, persuasion is one of the most common types of communication. Its’
success depends on the source, the communicator and the message. In order to understand why people
would attempt to understand, remember and accept persuasive messages, it is necessary to study the
characteristics of the person presenting the message, the content of the message and the characteristics
of the receiver of the message [27]. The three simple goals of risks communication such as sharing
information, change beliefs and change behavior need to be applied to ow the communication well to
the other person to be effective [28].

Mother’s attitude had 2 signi cant predictors: mother’s education level β = (2.3, p < .005) and having a
breadwinner at home (β =-0.4, p < 0.05). This study showed that mothers who graduated from school
were 2.3 times more likely to have increased attitude scores compared to mothers with no school.
Mothers without a breadwinner at home were 0.4 times more likely to have decreased attitude scores
compared to mothers which have a breadwinner at home.

Similarly, in another study by Abuya, Onsomu, Kimani and Moore, there was an association between
mother’s attitude and maternal education. They explained that children born to mothers with only a
primary education were 2.17 times more likely to be fully immunized compared to those whose mothers
lacked any formal education (p < 0.001) [29]. A similar study was conducted by Molcho, Kelly & Gabhain,
among 10,334 school children, enrolled from 215 schools in Ireland, found that positive perceptions
towards school and local area increased the chance of reporting excellent health seen in both immigrant
groups (p < 0001) [30]. Nutritional education of mothers shows a negative relationship with malnutrition
of children specifying that the better the dietary health awareness of the mothers the lesser the child’s
malnutrition [31].

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Practice of mothers in this study showed a medium level of practice with a mean score of 9.83, SD = ± 
2.21. Nutrition is crucial and a generally recognized factor in the child’s right to the enjoyment of the
highest achievable standard of health, as stated in the Convention on the Rights of the Child (CRC) [25].
Children have the right to adequate nutrition and access to safe and nutritious food, and both are
essential for ful lling their right to the highest attainable standard of health. Women, in turn, have the
right to proper nutrition, to decide how to feed their children, and to full information and appropriate
conditions that will enable them to carry out their decisions. These rights are not yet realized in many
settings [32].

Mothers play a major role in their child’s lives and it is their responsibility to ful ll and give the best to
their child, according to the CRC, not only in concern to their child but for themselves, as well as to have
the full potential and capability to carry out their duties for their children in everyday lives.

According to Kimani-Murage et al., a mother’s ability to feed have been linked with maternal nutritional
knowledge [33]. Therefore, caregivers such as mothers, should also be educated not only on the
adequacy of food but also the way they prepare food including: a safe manner to minimize risk of
contamination, giving appropriate ways that foods are the proper texture for the age of the child and
applying responsive feeding.

According to the causal model of malnutrition adopted by the United Nations Children's Fund (UNICEF),
was stated that the immediate cause of malnutrition are inadequate dietary intake and disease [34]. This
study showed that inadequate dietary intake is the only immediate cause of malnutrition in their study
setting, as disease was not included in this study. As stated by the Department of Foreign Affairs and
Trade in Kiribati, economic and environmental status is linked with malnutrition [11]. South Tarawa,
where the survey was conducted among mothers of undernourished children, is a largely populated
center and lived differently than people from outer islands. South Tarawa has the second highest poverty
incidence of 17% of households [18]. In 2006 the basic poverty line was 22% and in 2010 was 66%. A
typical household in South Tarawa has a big family, 1 or 2 members earning a salary, more likely to have
health issues from poor water, sanitation and overcrowding and have limited access to land [15]. Thus
these determinants of health have an impact on the current problem of malnutrition in Kiribati and hence
need a more streamlined approach to tackle it strategically rather than opting for short-term solutions.

This is the rst study conducted in Kiribati using a validated questionnaire. All mothers with
malnourished children from different locations were included in this study. There are several limitations
to this study. The small sample size was not representative of the population. This study was a cross
sectional study so that the results of this study can’t be generalized to all population. Data was collected
during working hours and was disrupted more with staff entering the room.

Conclusion
From the study, it is seen mothers had a low level of knowledge with a medium level of attitude and
practice towards breastfeeding, complementary feeding, dietary practice and immunization. There were 2
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variables found to be signi cantly correlated with attitude: education level of mother and the breadwinner
at home. It is con rmed from this study that in order to e ciently and effectively decrease the incidence
of malnutrition among children residing on South Tarawa, mother’s knowledge need to be enhanced,
attitudes need to be changed, as well as developing practices to have a very clear role and understanding
on breastfeeding, weaning, dietary and immunization. This could be ful lled with the assistance from
health professionals, the ministry of health, community and different stakeholders for a bright future for
the young generation of Kiribati who are the future assets of tomorrow. The policy needs to address the
maternal education aspect particularly since this is one of the critical components of attacking
malnutrition.

Malnutrition is a result of the environment, socioeconomic status, and culture that surrounds the
caretakers. Basic nutrition education helps caretakers make more informed dietary decisions within their
households to improve the nutritional status of their children. This study provides information essential
to enhanced decision making, health care delivery planning and has policy implications for the
improvement of quality of health care in the province.

Abbreviations
CRC: Convention on the Rights of the Child; KAP: Knowledge, Attitude and Practice; KNSO; Kiribati
National Statistical O ce; PICs: Paci c Island Countries; PNG: Papua New Guinea; UNICEF: United
Nations Children's Fund; WFP: World Food Program; WHO: World Health Organization.

Declarations
Acknowledgements

Authors are extremely grateful to the participating women who gave so freely of their time and without
their support this research would not have been possible. We would also like to extend our gratefulness to
all nurses and village nurses in the public health clinic for their time in informing mothers to attend the
study.

Authors’ contributions

All authors took part in the design of the study. Research proposal was guided by MM. The data was
collected and analysed by AR and revised by MM and N.S.A. All authors participated in the preparation
and approved the final manuscript for publication.

Funding

The author(s) received no speci c funding for this work.

Availability of data and materials

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The datasets generated and analysed during the current study are not publicly available due to
institutional requirements but are available from the corresponding author on reasonable request.

Ethics approval and consent to participate

This study was approved by the Fiji National University’s College Health Research Ethics Committee
(CHREC) and Kiribati Ministry of Health. Written informed consent was obtained from all subjects who
were 18 and over and those who were under 18 years. Those who were under 18 years old were provided
consent forms to obtain parental consent and were also requested to sign the assent form for
participation in the study.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

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 HUBUNGAN TINGKAT PENGETAHUAN IBU TENTANG
GIZI SEIMBANG PADA BALITA DENGAN STATUS GIZI
BALITA DI POSYANDU RIMBARAYA WILAYAH
KERJA PUSKESMAS KLAPANUNGGAL
TAHUN 2018

Nura Suciati Fauzia, S.ST,. M.KM

Akademi Kebidanan Annisa Jaya
Jl. Kranggan No. 30 Desa Puspasari Citeureup-Bogor

ABSTRAK
Masa balita merupakan periode penting dalam proses tumbuh kembang manusia. Setiap
balita memerlukan nutrisi dengan menu seimbang disesuaikan dengan kebutuhan. Jika
pemberian nutrisi pada anak balita kurang baik dari segi kualitas maupun kuantitasnya
maka pertumbuhan dan perkembangan balita akan berjalan lambat.Hasil penelitan seksi
gizi dinas kesehatan di Provinsi Jawa Barat pada tahun 2014, menunjukkan bahwa 17,39%
balita kurang gizi dan 8,76% balita gizi buruk.Tujuan penelitian untuk mengetahui hubungan
tingkat pengetahuan ibu tentang gizi seimbang pada balita dengan status gizi balita di
Posyandu Rimbaraya wilayah kerja Puskesmas Klapanunggal tahun 2018. Metode
penelitianini adalah deskriptif analitik dengan pendekatan cross sectional.Teknik
pengambilan sampel adalah random sampling dengan jumlah responden 56 ibu dan 56
balita. Pengolahan data dilakukan dengan cara editing, coding, entry, dan tabulating.
Analisa data dilakukuan secara univariat dan bivariat. Menggunakan rumus presentasi dan
uji chi-square.Hasil penelitian univariat menunjukkan bahwa sebagian besar ibu balita
memiliki pengetahuan yang cukup tentang gizi seimbang sebanyak 28 responden (50%),
dan sebagian besar responden memiliki balita dengan status gizi normal sebanyak 41 balita
(73,2%). Sedangkan hasil analisis uji chi-square menyebutkan terdapat hubungan antara
tingkat pengetahuan ibu tentang gizi seimbang balita dengan status gizi balita di Posyandu
Rimbaraya wilayah kerja Puskesmas menunjukkan nilai ρ = 0,017. Namun walaupun
sebagian besar responden memiliki pengetahuan yang cukup tentang gizi seimbang pada
balita namun tidak sedikit pula responden yang memiliki pengetahun kurang tentang gizi
seimbang pada balita. Dari hasil penelitian dapat disimpulkan bahwa tingkat pengetahuan
tentang gizi seimbang pada balita dapat berpengaruh terhadap status gizi balita. Masih
banyaknya pengetahuan ibu yang cukup tentang gizi seimbang maka di perlukan
peningkatan pengetahuan terutama tentang gizi balita baik melalui media masa maupun
penyuluhan oleh tenaga kesehatan.

Kata Kunci : Pengetahuan Ibu, Status Gizi

 ABSTRACT
Infancy is an important period in the process of human growth and development. Each toddler
requires nutrition with a balanced menu tailored to the needs. If the provision of nutrition in children
under five is not good in terms of quality and quantity then the growth and development of children
will run slowly. The result of study of nutrition section of health office in West Java Province in
2014, showed that not less than 17,39% malnourished children under five and 8.76% balita
malnutrition.The purpose of the study was to determine the relationship between the level of
maternal knowledge about balanced nutrition in children under five with nutritional status of
toddlers in the Rimbaraya Posyandu the working area of the Klapanunggal Health Center in
2018.The method of this research is analytical descriptive with cross sectional approach. Sampling
technique is random sampling with the number of respondents 56 mothers and 56 children under
five. Data processing is done by editing, coding, entry, and tabulating. Data analysis is done
univariat and bivariate. Using presentation formulas and chi-square test.The result of univariate
research showed that most of the mothers have enough knowledge about balanced nutrition as much
as 28 respondents (50%), and most of the respondents have children with normal nutrition status of
41 balita (73,2%).While result of chi-square test analysis mention there is correlation between
mother knowledge level about balita balita nutrition with child nutrition status at Posyandu
Rimbaraya working area of health center show value ρ = 0,017. However, although most
respondents have sufficient knowledge about balanced nutrition in toddlers but not a few
respondents who have less knowledge about balanced nutrition in toddlers
From the research results can be concluded that the level of knowledge about balanced nutrition in
infants can affect the nutritional status of children.There is still sufficient knowledge of mothers
about balanced nutrition then in need of increased knowledge, especially about the nutrition of the
toddler either through mass media or counseling by health personnel.

Keywords :Maternal Knowledge, Nutritional Status of Children

PENDAHULUAN tahun 2014, menunjukkan bahwa tidak

Menurut laporan organisasi
kesehatan World Health Organization
(WHO), permasalahan gizi dapat
ditunjukkan dengan besarnya angka
kejadian gizi buruk yang menunjukkan
kesehatan masyarakat Indonesia terendah
di ASEAN, dan menduki peringkat ke
142 dari 170 negara.Data yang terdapat di
dalam WHO 2016 yaitu, Prevalensi gizi
buruk dan gizi kurang pada Balita
terdapat sebesar 17,8%(Primadi, 2017).
Data yang terdapat di dalam Hasil
Pemantauan Status Gizi (PSG) 2016
balita di Indonesia yang mengalami
masalah gizi, terutama balita dengan
tinggi badan kurang sebesar 23,4%,
balita dengan gizi buruk 3,4% dan 14,4%
gizi kurang, terdapat 8,5% balita sangat
pendek dan 19,0% balita
pendek(Primadi, 2017).
Hasil penelitan seksi gizi dinas
kesehatan di Provinsi Jawa Barat pada
kurang dari 17,39% balita kurang gizi
dan 8,76% balita gizi buruk (Kemenkes RI,
2015).
Penimbangan balita di Kabupaten
Bogor pada tahun 2016, dengan jumlah
balita yang ditimbang sebanyak 443.241
balita, dengan hasil penimbangan untuk
klasifikasi berat badan sangat kurang
sebanyak 4.011 balita (0,90%), untuk
klasifikasi berat badan kurang sebanyak
23.302 balita (5,26%), klasifikasi berat
badan normal sebanyak 408.414 balita
(92 %), dan klasifikasi berat badan lebih
sebanyak 7.513 balita (1,70%)(Dinkes,
2016).
Pengetahuan gizi ibu yang
kurang akan berpengaruh terhadap status
gizi balitanya dan akan sukar memilih
makanan yang bergizi untuk anaknya dan
keluarganya. Gizi yang baik adalah gizi
yang seimbang, artinya asupan zat gizi
harus sesuai dengan kebutuhan tubuh.
Gizi kurang pada balita menyebabkan
pertumbuhan otak dan tingkat kecerdasan Teknik pengumpulan data
terganggu, hal ini disebabkan karena menggunakan data primer.Data primer
kurangnya konsumsi protein dan penelitian ini adalah data yang diperoleh
kurangnya energi yang diperoleh dari dari ibu memiliki balita yang masuk pada
makanan(Nainggolan, 2011). sampel penelitian melalui kuesioner.
Berdasarkan hasil penelitian
tentang pengetahuan ibu tentang gizi
seimbang pada balita yang di lakukan di HASIL DAN PEMBAHASAN
Desa Citereup Kec. Dayeuhkolot Kab. Tabel 1Distribusi Frekuensi
Bandung. Hasil penelitian menunjukkan Responden Berdasarkan Tingkat
bahwa 102 orang yang memiliki Pengetahuan Ibu Tentang Gizi
pengetahuan yang baik 70 orang Seimbang pada Balita
(68,6%), 24 orang (23,5%) yang Pengetahuan f %
memiliki pengetahuan yang cukup, dan 8
orang (7,9%) yang memiliki 24 42,9
Kurang
pengetahuan (Fikri, 2016).
Berdasarkan hasil penelitian 28 50
Cukup
tentang status gizi pada balita
menunjukkan bahwa dari 112 responden 4 7,1
Baik
terdapat 76 responden (67.85%) yang
memiliki balita yang berstatus gizi baik 56 100
dan 35 responden (31.25%) memiliki Total
balita yang berstatus gizi cukup Pada tabel 1 bahwa responden
sedangkan 1 responden (0.89%) yang sebagian besarmempunyai pengetahuan
memiliki balita berstatus gizi kurang yang cukup, yaitu sebanyak 28 orang (50
(Nurfanny, 2015). %), responden yang mempunyai
Berdasarkan hasil studi pendidikan kurang sebanyak 24 orang
pendahuluan tentang tingkat (42,9%) dan responden dengan
pengetahuan ibu tentang gizi seimbang pengetahuan yang baik sebanyak 4 orang
pada balita yang dilakukan di Posyandu (7,1%).
Rimbaraya tahun 2018 dari 7 responden,
yang memiliki pengatahuan baik Tabel 2 Distribusi Frekuensi
sebanyakan 4 responden (57,1%), dan
Responden Berdasarkan Status
yang memiliki pengetahuan kurang
sebanyak 3 responden (42,9%). Gizi Balita
Status Gizi f %
METODE PENELITIAN Tidak normal 15 26,8
Penelitian ini menggunakan
metode deskriptif analitik dengan 41 73,2
Normal
rancangan penelitian cross sectional.
Penelitian dilakukan di Posyandu 56 100
Total
Rimbaraya Desa Bantarjati, Ke.
Klapanunggal Kab. Bogor. Pada tabel 2 bahwa sebagian
Populasi dalam penelitian ini besar responden memiliki balita dengan
adalah semua Ibu yang memiliki balita, status gizi normal, yaitu sebanyak 41
yaitu sebanyak 123responden. orang (73,2%).Sedangkan yang meiliki
Pengambilan sampel dengan teknik gizi tidak normal sebanyak 15 orang
pengambilan sample secara accidental (26,8%).
sampling.
Tabel 3Hubungan Tingkat Pengetahuan Ibu Tentang Gizi Seimbang pada
Balita dengan Status Gizi Balita di Posyandu Rimbaraya
Status Gizi Total Pvalue
Tidak
Normal
Pengetahuan Normal
f % F % f %
Kurang 11 19,6 13 23,2 24 64 0.017
Cukup 3 5,4 25 44,6 28 50
Baik 1 1,8 3 5,4 4 36
Total 17 26,8 39 73,2 56 100
Pengetahuan
Berdasarkan hasil penelitian
menunjukkan bahwa dari 56 responden
terdapat sebagian besar responden
memiliki tingkat pengetahuan yang cukup
yaitu sebanyak 28 responden (50%)
tentang pengetahuan ibu tentang gizi
seimbang pada balita, responden yang
memiliki pengetahuan kurang yaitu
sebanyak 24 responden (42,9%), dan
sebagian kecil responden memiliki
pengetahuan yang baik sebanyak 4
responden (7,1%).
Hasil penelitian tersebut selaras
dengan penelitian yang dilakukan oleh
Melati pada tahun 2014 tentang hubungan
pengetahuan ibu dan katersediaan pangan
denggan status gizi balita di kelurahan
Kurao yang menyatakan bahwa responden
dengan pengetahuan rendah 18 orang
(46,2%)(Melati, 2014).
Hasil penelitian tersebut selaras
dengan penelitian Wahyani 2015
tentang hubungan ibu tentang gizi
seimbang dengan status gizi balita di
wilayah kerja Puskesmas Pleret
diketahui bahwa sebagaian besar
tingkat pengetahuan ibu tentang gizi
balita dalam kategori tinggi yaitu
sebanyak 254 responden (76,5%) ,
responden dengan pengetahuan sedang
sebanyak 77 responden (23,2%), dan
responden dengan pengetahuan rendah
sebanyak 1 responden (0,3%)(Wahyani
2015).
Menurut Notoatmodjo (2010), ada
beberapa faktor yang mempengaruhi
pengetahuan seseorang yaitu pendidikan,
media masa/sumber informasi, sosial
budaya dan ekonomi, lingkungan, dan
pengalaman.
Dari hasil penelitian yang dilakukan
dapat diketahui bahwa masih banyak ibu
dengan pengetahuan kurang karena sumber
informasi yang diperoleh masih kurang dan
kurangnya pengetahuan dapat pula
disebabkan oleh sebagian besar responden
adalah iburumah tangga yang lebih banyak
di dalam rumah dari pada berada di luar
rumah sehingga memungkinkan responden
memiliki pengetahuan terbatas, dan
kurangnya minat membaca buku terutama
buku tentang kesehatan yang berkaitan
dengan gizi.
Status Gizi
Berdasarkan hasil penelitian
menunjukkan bahwa sebagian besar
responden memiliki balita dengan status
gizi normal yaitu sebanyak 41 balita
(73,2%), sedangkan lainnya memiliki
status gizi tidak normal yaitu sebanyak 15
balita (26,8%).
Status gizi adalah keadaan tubuh
sebagai akibat konsumsi makanan dan
penggunaan zat-zat gizi. Dibedakana
antara status gizi buruk, kurang, baik, dan
lebih. Konsumsi makanan berpengaruh
terhadap status gizi seseorang. Status gizi
baik atau status gizi optimal terjadi bila
tubuh memperoleh cukup zat-zat gizi yang
digunakan secara efisien, sehingga
memungkinkan petumbuhan fisik,
perkembangan otak, kemampuan kerja dan
kesehatan secara umum pada tingkat
setinggi mungkin. (Paradiba 2012).
Hasil penelitian tersebut sesuai
dengan penelitian yang dilakukan oleh
Devi pada tahun 2010 tentang hubungan
pengetahuan ibu tentang gizi seimbang
dengan status gizi balita yang menyatakan
bahwa dari 1200 terdapat 582 (49%)
dengan masalah gizi kurang.Masalah gizi
kurang pada balita ini disebabkan oleh
berbagaipenyebab, salah satu penyebab
masalah gizi pada balita ialah akibat
konsumsi makanan yang tidak baik,
sehingga energi yang masuk dan keluar
tidak seimbang. Tubuh memerlukan
pemilihan makanan yang baik agar
kebutuhan gizi terpenuhi dan fungsi tubuh
berjalan dengan baik. (Devi, 2010).
Status gizi yang tidak normal
dapat dipengaruhi oleh faktor kejadian
infeksi dan asupan zat gizi. Secara tidak
langsung dipengaruhi oleh ketersediaan
pangan, higiene sanitasi lingkungan, dan
tingkat pendidikan ibu. Sedangkan status
gizi normal mendapatkan asupan yang baik
dan terpenuhi.
Dari hasil penelitian yang
dilakukan dapat diketahui bahwa sebagian
besar balita berada pada status gizi normal
karena dapat di pengaruhi oleh asupan gizi
yang cukup terpenuhi oleh balita karena
sumber bahan makanan tidak terlalu sulit
untuk didapatkan oleh ibu untuk memenuhi
kebutuhan makanan sehari-hari. Dan ada
pun balita yang memiliki status gizi tidak
normal hal ini dapat dipengaruhi oleh
asupan makanan yang masuk kedalam
tubuh makanan yang tidak baik misalnya
jajan sembarangan atau makan hanya
seadanya
Hubungan Antara Tingkat
Pengetahuan Ibu Tentang Gizi
Seimbang pada Balita dengan Status
Gizi Balita di Posyandu Rimbaraya
Berdasarkan hasil penelitian
menunjukan bahwa dari 56 responden
dijelaskan bahwa responden dengan
pengetahuan kurangsebanyak 24
responden (42,9%) diantaranya memiliki
balita dengan status gizi tidak normal
sebanyak 11 balita (19,6%) dan balita
dengan status gizi normal sebanyak 13
balita (23,2%). Responden yang
pengetahuannya cukup sebanyak 28
resoponden (50%) diantaranya memiliki
balita dengan status gizi tidak normal
sebanyak 3 balita (5,4%) dan balita dengan
status gizi normal sebanyak 25 balita
(44,6%). Dan responden dengan
pengetahuan baik sebanyak 4 responden
diantaranya memiliki balita dengan status
gizi tidak normal sebanyak 1 balita (1,8%)
dan balita yang status gizi normal sebanyak
3 balita (5,4%). Hasil uji data dengan
menggunakan uji chi-square menunjukkan
nilai ρ = 0,017 yang berarti terdapat
hubungan yang bermakna antara tingkat
pengetahuan ibu tentang gizi seimbang
dengan status gizi balita.
Hasil penelitian ini sesuai dengan
penelitian yang dilakukan Oktalinda dan
Triwibowo (2012) tentang hubungan
pengetahuan ibu balita tentang gizi dengan
status gizi balita di Posyandu Dusun
Modopuro Kecamatan Mojosari Mojokerto
terdapat 70 orang responden. Hasil
penelitian tersebut menjelaskan bahwa ada
hubungan yang bermakna antara
pengetahuan ibu dengan status gizi balita
dengan p value 0,001. (Oktalinda dan
Triwibowo, 2012).
Adanya hubungan antara tingkat
pengetahuan ibu tentang gizi balita dengan
status gizi balita di Posyandu wilayah kerja
Puskesmas Klapanunggal. Semakin baik
tingkat pengetahuan ibu tentang gizi balita
maka akan semakin baik status gizi balita.
Hal tersebut disebabkan semakin baik
tingkat pengetahuan tentang gizi balita,
maka ibu akan semakin dapat memberikan
makanan dengan kandungan gizi
yangdibutuhkan balita. Asupan makanan
yang bergizi pada balita akan sangat
berpengaruh terhadap status gizi balita.
Perilaku ibu ditentukan oleh
pengetahuannya mengenai suatu hal.
Penelitian sebelumnya menunjukkan
bahwa sebagian besar ibu memiliki
pengetahuan baik dengan status gizi balita
normal dan sebagian besar ibu dengan
status balita tidak normal memiliki
pengetahuan yang kurang. Tingkat
pengetahuan ibu tentang gizi yang tinggi
dapat mempengaruhi pola makan balita dan
akhirnya akan mempengaruhi status gizi
balita. Jika pengetahuan ibu baik, maka ibu
dapat memilih dan memberikan makan
bagi balita baik dari segi kualitas maupun
kuantitas yang dapat memenuhi angka
kecukupan gizi yang dibutuhkan oleh balita
sehingga dapat mempengaruhi status gizi
balita tersebut.
Ibu yang berpengetahuan baik
maka akan memberikan makanan yang
baik sesuai kebutuhan sehingga balita
memiliki status gizi normal. Sedangkan
balita yang memiliki status gizi tidak
normal bisa karena kurangnya pengetahaun
ibu tentang gizi seimbang sehingga
makanan yang diberikan kepada balita
tidak diatur sesuai kebutuhannya. Adapun
ibu yang memiliki pengetahuan kurang
tetapi memiliki balita dengan status gizi
normal itu karena asupan makanan yang di
dapatkan oleh balita cukup terpenuhi
karena sumber makanan mudah didapatkan
sehingga balita tidak kekurangan makanan.
Saran dalam penelitian ini adalah
ibu balita setiap bulan datang ke posyandu
agar dapat terus memantau status gizi
balitanya terutama ibu yang memiliki balita
dengan status gizi kurus, memperhatikan
pola makan balita sehari-hari. Saran untuk
tenaga kesehatan untuk lebih
meningkatkan pelayanan kesehatan dan
lebih sering mengadakan penyuluhan
tentang gizi seimbang pada balita agar ibu
balita mendapatkan banyak wawasan
tentang gizi seimbang.

SIMPULAN DAN SARAN

Dari hasil penelitian mengenai hubungan
tingkat pengetahuan ibu tentang gizi
seimbang dengan status gizi balita di
Posyandu Rimbaraya wilayah kerja
Puskesmas Klapanunggal tahun 2018
sebagai berikut:
1. Sebagian besar memiliki tingkat
pengetahuan cukup yaitu sebanyak
28 responden (50%), sedangkan
sebagian kecil responden memiliki
tingkat pengetahuan yang baik yaitu
sebanyak 4 responden (7,1%).
2. Sebagian besar responden memiliki
balita dengan status gizi normal
sebanyak 41 balita (73,2%), sedangkan
lainnya berada pada status gizi tidak
normal sebanyak 15 balita (26,8%).
3. Hasil uji data dengan menggunakan uji
chi-square menunjukkan nilai ρ =
0,017 sehingga hasil menyatakan
terdapat hubungan yang bermakna
antara tingkat pengetahuan ibu tentang
gizi seimbang dengan status gizi balita.
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Journal of Physics: Conference Series

PAPER • OPEN ACCESS

Implementation of simplex algorithm to optimize toddler’s balanced

nutrition needs with minimum costs
To cite this article: Q A A Ruhimat et al 2020 J. Phys.: Conf. Ser. 1539 012038

View the article online for updates and enhancements.

This content was downloaded from IP address 125.160.231.52 on 07/01/2021 at 02:31

The 5th Hamzanwadi International Conference of Technology and Education 2019 IOP Publishing
Journal of Physics: Conference Series 1539 (2020) 012038 doi:10.1088/1742-6596/1539/1/012038

Implementation of simplex algorithm to optimize toddler’s

balanced nutrition needs with minimum costs

Q A A Ruhimat1, R J Riftana2 and T Dharmawan3

1
Department of Informatics, University of Jember, Jember, Indonesia
2
Department of Biology Education, University of Jember, Jember, Indonesia
3
Department of Information Technology, University of Jember, Jember, Indonesia

Abstract. Nutrition is an important element needed by humans, including toddlers. The

unfulfilled nutritional needs can cause several diseases, such as malnutrition and stunting. It
was caused because of human inability to fullfill the nutrition needs of all family members with
good quality and the lack of parental knowledge about nutritious food ingredients and how to
feed properly. It is necessary to optimize the fulfillment of food nutrition for infants with a
minimum cost. One of the efforts is to make the right combination of food ingredients with
cost minimum so that it can be reached by all levels of society. This research was analyzed
using Simplex algorithm with QM for Windows software. The results was obtained in the form
of the amount of food that can be consumed by user to fullfill the nutritional intake needs along
with the minimum cost.

1. Introduction
Nutrition is a balance proportion substance in the human body. Balanced nutrition is the composition
of food consumed by humans that contains nutrients in their type and amount needed. [5] stated that
the level of nutrition fulfillment for each person is different. It is because the human body has the
ability to absorb different nutrients at each stage of age. One of the causes of malnutrition, known as
malnutrition, is a lacking or not fulfilling balanced nutritional needs condition. Poor nutritional status
in toddlers can cause many effects that can inhibit physical growth, mental and thinking ability which
will ultimately the reduce work productivity. The increasing in the price of food needs has also an
impact on the decline in purchasing power, especially in groups of people in poverty line. Households
with children under age five years need more costs to be able to meet the intake of nutritional needs
optimally. Fulfillment of nutrition at the age of five is considered very important.
Delay in fulfilling good nutrition can lead to diseases such as poor nutrition and stunting in infants,
whereas adult human growth depends on nutritional and health conditions as a toddler. Based on the
description above, optimization techniques are needed to meet the nutritional intake of toddler foods at
the lowest possible cost. One of the effort is to make the right food ingredients combination with
minimum cost so that it is available for all levels. As a first step, a mathematical model was developed
to find the optimum food combination model with a minimum cost and match with the nutritional
requirements set by the AKG (Nutrition Requirement Number). This research is expected to be one of
efforts to choose the right food menu to improve the nutritional status of children under five with
minimum cost. In this research, the cost minimization in fulfilling balanced nutritition for toddlers was
reviewed and analyzed by looking the levels of the elements contained in several foods. This study is
analyzed using the concept of a linear program, which uses the Simplex Algorithm with the help of QM

Content from this work may be used under the terms of the Creative Commons Attribution 3.0 licence. Any further distribution
of this work must maintain attribution to the author(s) and the title of the work, journal citation and DOI.
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The 5th Hamzanwadi International Conference of Technology and Education 2019 IOP Publishing
Journal of Physics: Conference Series 1539 (2020) 012038 doi:10.1088/1742-6596/1539/1/012038

for Windows software. The Simplex is one of the Algorithms in a linear program used to optimize. The
Simplex algorithm will provide results in the form of (number) of food that can be consumed by the
user to meet the nutritional intake needs along with the minimum costs.

2. Related Works

2.1. Toodler’s Nutrition

According to [6], toddlers are children who have reached the age of one year or more popular with
children under five years old. Toddler age is a stage of development of children who are quite
susceptible to various diseases, including malnutrition. This is because the body has different nutrient
absorption abilities at each stage of age. Nutrition Adequacy Rate (RDA) or Recommended Dietary
Allowances (DRA) is a daily average adequacy of nutrients for all people according to age group, sex,
body size, body activities to achieve optimal health degrees. The RDA for Indonesians consists of:
energy, protein, fat, carbohydrates, water, fiber, 14 types of vitamins including vitamin A, vitamin D,
vitamin E, vitamin K, vitamin B1, vitamin B2, niacin, vitamin B6, folic acid, vitamins B12,
pantothenic acid, biotin, choline and vitamin C; and 13 types of minerals including calcium,
phosphorus, magnesium, sodium, potassium, iron, iodine, zinc, copper, chromium, selenium,
manganese, and fluorine [5].

2.2. Causes and Effects of Bad Nutrition

Another indication of the lack of adequate nutrition in infants and toddlers can be seen from the
changes in body weight over time. Infants or toddlers who do not gain weight twice their initial weight
in a 6-month period are at risk of experiencing malnutrition 12.6 times compared to toddlers who gain
weight continuously. Some of the causes that influence the occurrence of malnutrition include
inadequate food intake, lack of parents' knowledge of nutritious food ingredients, and lack of
knowledge about how to properly feed. In 2017, the World Health Organization (WHO) revealed that
Indonesia in fifth rank in the world with a number of toddlers suffering from stunting. Stunting is
indeed a chronic problem for Indonesian toddlers. As a result of inadequate nutritional intake, physical
growth of infants is stunted (stunting) which also affects brain performance. Poor nutritional status can
arise as a result of low food security at the household level, namely the ability of households to meet
the food needs of all family members in sufficient quantities and good quality, especially if there are
still family members who are under five [8].

2.3. Simplex Algorithm

The Simplex algorithm is used to solve linear program problems that involve many inequalities and
many variables. Linear programming problems consist in maximizing or minimizing a linear objective
function subject to a set of linear constraints. In 1947, George Dantzig proposed the Simplex algorithm
for solving linear programming problems. The Simplex algorithm is a pivoting method that proceeds
from a first feasible extreme point solution of a linear program problem to another feasible solutions,
by using matrix manipulations, the so-called pivoting operations, in such a way as to continually
increase the objective value [3].
In using the Simplex, the linear program model must be changed to a general form called "standard
form". The characteristics of the standard form of a linear program model are all the constraints in the
form of equations with the non-negative Right Hand Side (RHS), the objective function can maximize
or minimize. The form of a standard model in the Simplex is to provide additional variables to the
constraint function, in the form of: slack variable for the constraint function with the sign " ", a
surplus variable for the constraint function with the sign " ", and an artificial variable for the
constraint function with the sign " ". Standard forms that have been obtained, must be made in the
form of tables. All variables that are not base variables have a solution (right value) equal to zero and
the coefficient of the base variable on the destination row must be 0. Therefore, the establishment of

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The 5th Hamzanwadi International Conference of Technology and Education 2019 IOP Publishing
Journal of Physics: Conference Series 1539 (2020) 012038 doi:10.1088/1742-6596/1539/1/012038

the initial table must be distinguished based on the initial base variable. The next following are the
stages in the Simplex algorithm [1][9][10].
1. Check the feasibility of the table
2. Determine the pivot column
3. Determine the pivot line
4. Determine the pivot element
5. Form a new Simplex table
6. Check table optimization

3. Methodology
The data that has been collected was analyzed using the Simplex algorithm in accordance with the
constraints faced and the objectives to be achieved. The assumptions used in making the model is the
nutritional content of each fixed ingredient. The steps are as follows:
a. Arranging the objective function to minimize the cost of spending for the purchase of food with
nutritional content that still meets the health requirements of toddlers.
b. Arranging the function constraints and model parameters will be used.
c. Constructing a constraint or limitation function:
d. Designing the data into mathematical models in the form of linear programs.
e. Obtaining the optimal solution

4. Results and Discussion

4.1. Data Collection

The data needed is the composition of the nutrient content from the ingredients
of selected food, nutritional adequacy rate for toddlers and the food prices. The following two tables
presents nutritional adequacy figures for toddlers (12 - 60 months) per person per day [2][4][7].

Table 1. Nutritional Content of Each Food Item

Nutrient Rice Tofu Tempe Fish Egg Spinach Carrot Banana Papaya
Nutrient-1 (Energy) 3,6 0,68 1,49 1,13 1,62 0,36 0,42 1,18 0,46
Nutrient-2 (Protein) 0.068 0,078 0,183 0,17 0,128 0,035 0,012 0,012 0,05
Nutrient-3 (Fat) 0,007 0,046 0,04 0,045 0,115 0,005 0,003 0,002 0
Nutrient-4 (Carbohydrate) 0,789 0,016 0,127 0 0,007 0,065 0,093 0,31 0,122
Nutrient-5 (Calcium) 0,06 1,24 1,29 0,2 0,54 2,67 0,39 0,07 0,23
Nutrient-6 (Vit A) 0 0 0,5 1,5 9 60,9 1800 1,12 3,65
Nutrient-7 (Vit.C) 0 0 0 0 0 0,8 0.06 0,04 0,78
Nutrient-8 (Fe) 0,008 0,08 0,1 0,01 0,027 0,039 0,008 0,003 0,017

Table 2. AKG Value of Toddlers by Age

Nutrient 1-3 year 4-5 year Nutrient 1-3 year 4-5 year
Nutrient 1 (Energy) 1125 1600 Nutrient 5 (Calcium) 650 1000
Nutrient 2 (Protein) 26 35 Nutrient 6 (Vit A) 400 450
Nutrient 3 (Fat) 44 62 Nutrient 7 (Vit.C) 40 45
Nutrient 4 (Carbohydrate) 155 220 Nutrient 8 (Fe) 8 9

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Journal of Physics: Conference Series 1539 (2020) 012038 doi:10.1088/1742-6596/1539/1/012038

Table 3. List of Food Prices Oct-Nov 2019 (Based on Survey)

Kepatihan Market Tanjung Market Mean
Food
Price (kg) Price (g) Price (kg) Price (g) Price (kg) Price (g)
Rice 11.500 11,5 11.000 11 11.250 11,25
Tofu 12.000 12 10.000 10 11.000 11
Tempe 10.000 10 10.000 10 10.000 10
Fish 24.000 24 20.000 20 22.000 22
Egg 18.500 18,5 19.500 19,5 19.000 19
Spinach 10.000 10 10.000 10 10.000 10
Carrot 14.000 14 16.000 16 15.000 15
Banana 10.000 10 8.000 8 9.000 9
Papaya 8.000 8 9.000 9 8.500 8,5

4.2. Linear program model in food nutrition

1. The combination of food ingredients that are formed:
a. Main food: rice
b. Side dishes, consisting of 2 types. Main side dishes and side dishes.
1) Main side dishes, consisting of two choices namely fresh fish and chicken eggs.
2) Side dishes, consisting of two choices namely tofu and tempeh.
c. Vegetables, consisting of two choices, namely spinach and carrots.
d. Fruits consist of two choices, banana and papaya
2. Decision Variable Determination =1,2,3,4,5.
In stating the decision variable stated as follows:
= Main foods (Rice)
= Types of main side dishes in food combinations.
= Types of side dishes in food combinations
= Types of vegetables in a food combination
= Types of fruit in food combinations
From these variables, an optimum food combination for toddlers will be calculated with a
minimum cost provisions on the nutritional requirements set by AKG.
3. Toddler Food Combination Model
Here the 16 combinations and the constraints were obtained for each food combination.
a. Rice + Tofu + Fish + Spinach + Banana
b. Rice + Tofu + Fish + Spinach + Papaya
c. Rice + Tofu + Fish + Carrot + Banana
d. Rice + Tofu + Fish + Carrot + Papaya
e. Rice + Tofu + Egg + Spinach + Banana
f. Rice + Tofu + Egg + Spinach + Papaya
g. Rice + Tofu + Egg + Carrot + Banana
h. Rice + Tofu + Egg + Carrot + Papaya
i. Rice + Tempe + Fish + Spinach + Banana
j. Rice + Tempe + Fish + Spinach + Papaya
k. Rice + Tempe + Fish + Carrot + Banana
l. Rice + Tempe + Fish + Carrot + Papaya
m. Rice + Tempe + Egg + Spinach + Banana
n. Rice + Tempe + Egg + Spinach + Papaya
o. Rice + Tempe + Egg + Carrot + Banana
p. Rice + Tempe + Egg + Carrot + Papaya

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The 5th Hamzanwadi International Conference of Technology and Education 2019 IOP Publishing
Journal of Physics: Conference Series 1539 (2020) 012038 doi:10.1088/1742-6596/1539/1/012038

The following are the objective functions, constraint functions, and mathematic equation form of 8
combination from 16 combinations above which are solved by using QM for windows software.

Based on each objective functions, constraint functions, and mathematical equation form of each
16 combinations above, we obtained the optimal solution for as explained in the
following table.

Table 4. Optimal Solution for Each Combination

Type of Combination (g) (g) (g) (g) (g) RHS (Rp)
1st combination 173,58 924,67 0 50 0 12.624
2nd combination 169,9 930,25 0 3,72 47,4631 12.585
3rd combination 0 913,04 0 0 1000 19.043
4th combination 169,63 930,69 0 0,12 51,27 12.583
5th combination 179,56 0 364,47 165,69 0 10.602
6th combination 179,56 0 364,47 165,69 0 10.602
7th combination 0 378,8 215,69 0 1000 17.210
8th combination 178,2 416,7 205 0 51,28 10.921
9th combination 16,75 1090,82 0 50 0 11.597
10th combination 11,79 1097,936 0 0 51,28 11.548
11th combination 0 1049,99 0 0 999,99 19.500

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Journal of Physics: Conference Series 1539 (2020) 012038 doi:10.1088/1742-6596/1539/1/012038

12th combination 11,79 1097,93 0 0 51,28 11.548

13th combination 145,04 278,66 274,68 50 0 10.137
14th combination 145,04 278,66 274,68 50 0 10.137
15th combination 0 347,30 244,40 0 999,99 17.117
16th combination 123,85 388,54 239,91 0 51,28 10.273

Based on calculations using QM for windows, as shown in the table, it is known that the optimal
solution is obtained in the 13th and 14th combinations. The minimum cost obtained in the 13th and
14th food combinations is Rp. 10,137 with as many menu compositions: Rice (145,04 g), Tempe
(278,66 g), Egg (274,68), and Spinach (50 g).

5. Conclusion
Based on the discussion, the optimization model used to determine the nutritional needs of toddlers
with a minimum cost that meets the optimal nutritional content for toddlers is the 13th and 14th
combination. It compositions are: Rice (145,04 g), Tempe (278,66 g), Egg (274,68), and Spinach (50
g) with minimum cost Rp. 10.137.

6. References
[1] Dantzig G B 2002 Linear Programming Operation Research 50 (1) 42-47.
[2] Indonesian Nutritionists Association 2009 Indonesian Food Composition Table 2 pp 1-22
(Jakarta: Elex Media Komputindo)
[3] M E Lalami, V Boyer and D E Baz 2011 Efficient Implementation of the Simplex Method on a
CPU-GPU System IEEE International Parallel & Distributed Processing Symposium
Anchorage United States hal-01151614 pp 1994-2001
[4] Ministry of Health of Republic of Indonesia 2013 Academic Guidelines for Nutrition Guidelines
Balanced (Jakarta: Directorate General of Maternal Nutrition and Health Development and
Child Ministry of Health of Republic of Indonesia)
[5] Ministry of Health of Republic of Indonesia 2014 Regulation of The Minister Of Health Of The
Republic Of Indonesia Number 75 About Nutritional Fitness Recommended For The
Indonesian Nation (Jakarta: Ministry of Health of Republic of Indonesia)
[6] Ministry of Health of Republic of Indonesia 2015 Infodatin: Situasi Kesehatan Anak Balita di
Indonesia (Jakarta: Information and Data Center of Ministry of Health of Republic of
Indonesia)
[7] National Food and Drug Agency of Republic of Indonesia 2013 Pedoman Pangan Jajanan
Anak Sekolah untuk Pencapaian Gizi Seimbang (Jakarta: National Food and Drug Agency of
Republic of Indonesia)
[8] Secretariat of the Vice President of the Republic of Indonesia 2017 100 Priority Districts/Cities
for Stunted Child Intervention (A Summary) 1 pp 5-7 (Jakarta: National Team for the
Acceleration of Poverty Reduction)
[9] T Sriwidadi and E Agustina 2013 Analisis Optimalisasi Produksi dengan Linear Programming
Melalui Metode Simpleks J. Binus 4 725-741
[10] N Susilowati 2014 Penerapan Metode Simpleks untuk Mengoptimalkan Kebutuhan Gizi
Seimbang pada Usia Lanjut di Kota Palu JIMT 11 pp 62-71

Acknowledgments
The authors would like to thank the University of Jember for funding this research in the academic
year of 2019.

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 EurAsian Journal of BioSciences
Eurasia J Biosci 14, 2507-2512 (2020)

The relationship of mother behavior in breastfeeding with

baby’s nutrition status aged 0-6 months
Indriani Kencana Wulan 1, Yuni Sufyanti Arief 1*, Kristiawati Kristiawati 1
1
Faculty of Nursing, Universitas Airlangga, Surabaya, INDONESIA
*Corresponding author: yuni_sa@fkp.unair.ac.id

Abstract
Breast milk is the perfect and best food for babies. Many mothers have given complementary breast
milk before the age of 6 months, so that the nutritional content in breast milk is not optimal. Data
found in Kebraon Surabaya, found 0-6 months old infants (16%) of 11 infants experiencing
undernourished status based on body weight/body length. This study aims to identify the relationship
between breastfeeding behavior and nutritional status of infants aged 0-6 months. The design of this
study was cross-sectional with a quantitative approach. Samples were taken by purposive sampling
technique and found 15 mothers who have babies aged 0-6 months. The independent variable is
maternal behavior in breastfeeding, and the dependent variable is the nutritional status of infants
aged 0-6 months. Data collected through questionnaires and observation sheets. Data analysis using
Spearman’s Rho test with a significance level of 0.05. This study shows that there is a significant
relationship between knowledge (p=0.004) and attitude (p=0.000) with the nutritional status of infants
aged 0-6 months, and there is no meaningful relationship between the actions (p=0.462) of mothers
in breastfeeding with nutritional status babies aged 0-6 months. The mothers’ behavior in giving good
milk can make the nutritional status of babies aged 0-6 months well. Mothers are expected to provide
exclusive breastfeeding to babies to optimize growth and development in infants aged 0-6 months.

Keywords: breast milk, mother’s behavior in breastfeeding, nutritional status

Wulan IK, Arief YS, Kristiawati K (2020) The relationship of mother behavior in breastfeeding with
baby’s nutrition status aged 0-6 months. Eurasia J Biosci 14: 2507-2512.

© 2020 Wulan et al.

This is an open-access article distributed under the terms of the Creative Commons Attribution License.

INTRODUCTION make the nutritional status of babies aged 0-6 months

Breast milk is the perfect and best food for babies.
Many mothers have given complementary breast milk
before the age of 6 months, so that the nutritional
content in breast milk is not optimal. Data found in
Kebraon Surabaya, found 0-6 months old infants (16%)
of 11 infants experiencing undernourished status based
on body weight/body length. This study aims to identify
the relationship between breastfeeding behavior and
nutritional status of infants aged 0-6 months. The design
of this study was cross-sectional with a quantitative
approach. Samples were taken by purposive sampling
technique and found 15 mothers who have babies aged
0-6 months. The independent variable is maternal
behavior in breastfeeding, and the dependent variable is
the nutritional status of infants aged 0-6 months. Data
collected through questionnaires and observation
sheets. Data analysis using Spearman’s Rho test with a
significance level of 0.05. This study shows that there is
a significant relationship between knowledge (p=0.004)
and attitude (p=0.000) with the nutritional status of
infants aged 0-6 months, and there is no meaningful
relationship between the actions (p=0.462) of mothers in
breastfeeding with nutritional status babies aged 0-6
months. The mothers’ behavior in giving good milk can
well. Mothers are expected to provide exclusive
breastfeeding to babies to optimize growth and
development in infants aged 0-6 months.
MATERIALS AND METHODS
This research is quantitative research with a cross-
sectional approach. The sampling technique in this
study used purposive sampling and obtained a total
sample of 15 respondents consisting of mothers who
have babies aged 0-6 months. The variable studied in
this study was maternal behavior in breastfeeding as an
independent variable with the nutritional status of infants
aged 0-6 months as the dependent variable. Data
collected through questionnaires and observation
sheets. Data analysis using the Spearman’s Rho test
with a significance level α <0.05. this study has received
a research ethics-worthy permit from the research ethics
and community service committee.
Received: November 2019
Accepted: April 2020
Printed: July 2020

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Table 1. Frequency Distribution Based on General Table 3. The relationship of knowledge, attitudes, and
Characteristics of Respondents actions of mothers in breastfeeding with the nutritional
Characteristics of Respondents n % status of children aged 0-6 months
Mother’s age (years) Baby’s nutritional status
23-30 6 40 Possible
31-40 9 60 Severely total Spearman’s
Variable Wasted Normal risk of
Total 15 100 wasted Rho
overweight
Mother’s education n % n % n % n % n %
Elementary school 3 20 Knowledge
Middle School 6 40 Less 2 13 4 27 1 7 0 0 7 47
High school 3 20 Enough 0 0 0 0 2 13 2 13 4 27 p=0.004
College 3 20 Good 0 0 0 0 4 27 0 0 4 27 r=0.695
Total 15 100 Total 2 13 4 27 7 47 2 13 15 100
Mother’s occupation Attitude
Housewife 5 33 Negative 2 13 4 27 0 0 0 0 6 40
Civil servants 0 0 p=0.000
Positive 0 0 0 0 7 47 2 13 9 60
Private 10 67 r=0.907
total 2 13 4 27 7 47 2 13 15 100
Total 15 100 Action
Child number- Less 0 0 2 13 1 7 0 0 3 20
1 4 27 Enough 2 13 0 0 6 40 2 13 12 80 p=0.462
2 8 53 Good 0 0 0 0 0 0 0 0 0 0 r=0.206
3 1 7 Total 2 13 2 13 7 47 2 13 15 100
>3 2 13
Total 15 100
Breastfeeding Complaints breastfeeding, which is equal to 79%. The breastfeeding
None 12 79
Baby confused nipples 1 7
frequency mostly gives breast milk with a rate of > 5
Babies don’t want breast milk 1 7 times/day, which is 60%.
feeling dizzy after breastfeeding 1 7 Table 2 indicates that most of the nutritional status of
Total 15 100
Frequency of Breastfeeding infants is in the normal value of 7 (46.67%). The majority
1-3 / day 4 27 of mothers’ knowledge at fewer levels were seven
3-5 / day 2 13 respondents (46.67%). The more negative attitude of
> 5 / day 9 60
Total 15 100 mothers is eight respondents (53.33%). The majority of
mothers’ actions are sufficient, with 12 respondents
Table 2. Distribution of Infant Nutrition Status, Knowledge, (80%).
Attitudes, and Actions of Mother in breastfeeding for infants Table 3 shows that the results of the analysis of the
aged 0-6 months relationship using Spearman Rho, between the mother’s
Amount knowledge in breastfeeding and the nutritional status of
Variable
n %
Nutritional status the baby, obtained p=0.004. It means there is a
Severely wasted 2 13.33 relationship between the mother’s expertise in
Wasted 4 26.67
Normal 7 46.67
breastfeeding and the baby’s nutritional status. The
Possible risk of overweight 2 13.33 results of the analysis of maternal attitudes in
Total 15 100 breastfeeding with the nutritional status of infants
Knowledge
Less 7 46.67
obtained p=0.000. It means that there is a relationship
Enough 4 26.67 between maternal attitudes in breastfeeding with the
Good 4 26.67 nutritional status of infants. In the action variable, p-
Total 15 100
Attitude value=0.462 indicates there is no relationship between
Positive 7 46.67 maternal actions in breastfeeding and the nutritional
Negative 8 53.33
Total 15 100
status of infants.
Action
Less 3 20 DISCUSSION
Enough 12 80
Good 0 0 Mother’s knowledge about exclusive breastfeeding is
Total 15 100
closely related to nutritional status in infants. Based on
the results of research on education, it is found that most
mothers with insufficient knowledge of having babies
RESULTS with underweight dietary status (Shah et al., 2016). Two
Based on Table 1, most respondents have age 31- factors affect the nutritional status of infants, namely
40, more than half the number of respondents, which is extrinsic and intrinsic, including external factors, namely
60%. The majority of respondents, 67% have private breastfeeding, disease, and social and economic
jobs. The level of education is a high school education condition (Khotimah & Kuswandi, 2015; Kurniawati,
as many as 40%. The number of respondent children 2012; Nilakesuma et al., 2015; Septikasari, 2018). One
mostly had the second child as much as 53%. Most of factor that affects the nutritional status of infants is
the respondents did not have complaints when breastfeeding (Haseeb & Azam, 2020), where breast
milk is a natural drink for all term babies during the first

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month of age (Giri, 2013; Kuchenbecker et al., 2015;
Meshram, Laxmaiah, Venkaiah, & Brahmam, 2012;
Muchina & Waithaka, 2010). Besides, breast milk is the
primary source of nutrition for babies (Mahdiah et al.,
2018). Nutritional deficiencies in infants can cause
various health problems, both short and long term, such
as growth and stunting failure (Ariati, 2019; Hidayati et
al., 2010; Kusudaryati, 2013; Nurbaiti et al., 2014;
Scheffler et al., 2019). Providing nutrients other than
breast milk to infants aged 0-6 months can cause babies
to experience health problems, especially in the
digestive system (Astuti, 2015; Jayanti & Utomo, 2014;
Larasati, 2011; Puspita, 2011). Errors in breastfeeding
can occur when the level of knowledge in the mother is
still lacking.
The attitude of mothers in breastfeeding infants aged
0-6 months has a relationship with nutritional status in
infants. The mother’s opinion in giving milk to her baby
reflects how the mother meets the baby’s dietary needs
(Hidayati, 2016; Raharjo et al., 2012; Sari & Ernawati,
2018). The mother’s attitude determines how the
fulfillment of nutrition in infants can be fulfilled (Aris et al.,
2018; Hargi, 2013; Idris & Palutturi, 2019; Widiyanto,
2012; Asoodeh,& Motlagh, 2015). In this case, the
satisfaction of the specified nutrients can affect the
nutritional status of infants. Infants who are exclusively
breastfed have a tendency not to experience obstacles
in growth and development (Bakar et al., 2018;
Lumbanraja, 2017). A positive attitude has implications
for the fulfillment of nutrition in babies. Babies whose
nutrition is fulfilled with a balanced diet can make growth
and development optimal for infants following the stages
(Anggraini & Septira, 2016; Febriani et al., 2019; Fitri et
al., 2014). In the first 1000 days of human life, mothers
must play an active role in this period’s success (Yusuf
et al., 2020). Errors in fulfilling nutrients in this period can
cause long-term health problems in infants. Infants who
fail in the first 1000 days of life due to issues of poor
nutritional status will usually show physical growth
problems that are not appropriate for their age (Priyatna
& Sos, 2014; Rahmawati et al., 2016; Ruaida, 2018;
Sudargo & Aristasari, 2018). Besides, the lack of
nutritional status in infants can inhibit mental
development in infants so that they cannot develop
optimally according to their age stages.
ACKNOWLEDGEMENTS
Knowledge and attitude of mothers in breastfeeding
infants have a relationship with nutritional status in
infants. The behavior of mothers in giving good milk can
make the nutritional status of infants aged 0-6 months
well. Mothers are expected to provide exclusive
breastfeeding to babies to optimize growth and
development in infants aged 0-6 months.

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