HALAMAN JUDUL KARAKTERISTIK IBU DAN ANAK PADA PERIODE 1000 HARI PERTAMA KEHIDUPAN TERHADAP KEJADIAN STUNTING DI DAERAH PROGRAM KESEHATAN DAN GIZI BERBASIS MASYARAKAT KABUPATEN KATINGAN

SALAHUDDIN AL AYUBI, Dr. Toto Sudargo, SKM. M.Kes.; Dr. Ir. I Made Alit Gunawan, M.Si

2018 | Tesis | MAGISTER ILMU KESEHATAN MASYARAKAT

Latar Belakang: Upaya penurunan prevalensi stunting harus terus dilakukan terutama pada 1000 hari pertama kehidupan untuk mencegah munculnya dampak stunting pada periode kehidupan selanjutnya. Ibu hamil, ibu menyusui, bayi baru lahir dan anak usia di bawah dua tahun (baduta) merupakan kelompok sasaran untuk meningkatkan kualitas kehidupan pada 1000 hari pertama kehidupan. Tujuan Penelitian: Mengetahui hubungan karakteristik ibu dan anak pada periode 1000 hari pertama kehidupan terhadap kejadian stunting di daerah program kesehatan dan gizi berbasis masyarakat Kabupaten Katingan. Metode Penelitian: Penelitian ini merupakan penelitian observasional dengan desain Unmatched Case Control Study melalui pendekatan retrospektif. Subjek penelitian yaitu anak usia 6-24 bulan yang memenuhi kriteria inklusi dengan jumlah 100 baduta stunting (TB/U <-2 SD) dan 100 baduta normal (TB/U >=-2 SD). Hasil Penelitian: Berdasar hasil analisis bivariat karakteristik ibu dan anak yang merupakan faktor risiko stunting adalah status gizi awal kehamilan (p=0.047; OR=1.95), status KEK (p=0.018; OR=2.15); kenaikan berat badan selama hamil (p=0.56; OR=1.18); frekuensi pemantauan pertumbuhan (p=0.637; OR=1.24); penanganan persalinan (p=0.825; OR=1.1); IMD (p=0.159; OR=1.55); ASI Eksklusif (p=0.145; OR=1.53) dan frekuensi pemantauan pertumbuhan (p=0.08; OR=1.66). Analisis multivariat dengan regresi logistik memperlihatkan bahwa tidak ada variabel bebas yang paling dominan pengaruhnya terhadap kejadian stunting. Kesimpulan: Karakteristik ibu dan anak yang berhubungan dengan kejadian stunting adalah status gizi awal kehamilan dan kekurangan energi kronis, walaupun hubungannya tidak independen.

Background: Attempts to minimalize stunting prevalence must be continuouslyconducted especially during the 1,000 days of life to prevent any stunting effectoccurring in the later period of life. Pregnant women, breastfeeding women, newborn babies, and children under age of two years-old are the attempt targets toincrease life quality during the first 1,000 days. The Indonesian government, supported by the US through its Millennium Challenge Corporation, implemented Program Kesehatan dan Gizi Berbasis Masyarakat (PKGBM, Community-based Health and Nutrition Program) that aimed to minimalize and prevent occurrences of low birth weight infants and stunted children and nutrient deficiency ofchildren. Objectives: This research aimed to analyze the relation between characteristics ofmothers and children during the first 1,000 days of life and stunting occurrencesin the community-based health and nutrition program area of Katingan. Methods: This research was observational research applying the unmatched casecontrol study design through a retrospective approach. Research subjects werechildren aged 6-24 months-old meeting inclusion criteria. Furthermore, the chosenchildren consisted of 100 stunted (BH/A < -2SD) and 100 normal (BH/A >= -2SD)children. Results: Based on results of bivariate analysis of the characteristics of mothersand children, risk factors of stunting were nutritional status during earlypregnancy (p = 0.047, OR = 1.95), status of chronic energy deficiency (p = 0.018, OR = 2.15), body weight gain during pregnancy (p = 0.56, OR = 1.18), frequencyof antenatal care (p = 0.637, OR = 1.24), labor and delivery care (p = 0.825, OR =1.1), Initiations of Early Breastfeeding (p = 0.159, OR = 1.55), exclusive breast milk (p =1.145, OR = 1.53), and frequency of antenatal care (p= 0.08, OR = 1.66). Results of multivariate analysis with logistic-regression analysis implied that therewere no independent variables directly affecting stunting occurrences. Furthermore, results of path analysis indicated there was no significant relationbetween pregnancy period and age period of children under two years-old and the stunting occurrences. Conclusion: Maternal and child characteristics associated with stunting incidenceof children aged 6-24 months is the prenatal nutritional status and chronic energydeficiency status although the relationship is not independent.

Kata Kunci : Stunting, periode 1000 HPK (periode kehamilan, periode persalinan, dan periode usia baduta, stunting, periods of the first 1,000 days of life (periods of pregnancy, birthing, and under two years-old)