RIWAYAT ASI EKSLUSIF DAN RIWAYAT IMUNISASI DASAR DENGAN KEJADIAN STUNTING PADA BALITA WILAYAH PESISIR PANTAI KABUPATEN BUTON TENGAH PROVINSI SULAWESI TENGGARA

HASAN, Dr. dr. Suryati Kumorowulan, M. Biotech.; Dr. rer. nat. dr. BJ. Istiti Kandarina

2019 | Tesis | S2 Ilmu Kesehatan Masyarakat

Latar Belakang : Prevalensi stunting anak balita di Indonesia periode 2010-2013 menunjukkan trend peningkatan dari 36,8% menjadi 37,2%, dan turun menjadi 30,8% pada tahun 2018 (RISKESDAS, 2018), sedangkan di Provinsi Sulawesi Tenggara sebesar 40,6 (RISKESDAS, 2013). Khusus Kabupaten Buton Tengah prevalensi stunting anak balita sebesar 50,9% pada tahun 2016 dan 49,9% pada tahun 2017 (Dinkes Kab.Buton Tengah, 2018). Intervensi spesifik stunting yang dilakukan diantaranya pemberian ASI ekslusif dan pemberian imunisasi dasar lengkap. Tujuan penelitian: Menganalisis faktor resiko riwayat ASI ekslusif dan riwayat imunisasi dasar terhadap kejadian stunting pada Balita wilayah pesisir pantai Kabupaten Buton Tengah Provinsi Sulawesi Tenggara. Metode Penelitian : Penelitian ini merupakan penelitian observasional dengan rancangan Case Control Study yang dilakukan di Kecamatan Mawasangka Tengah. Sampel penelitian ini adalah balita umur 6-23 bulan., dibagi dalam 2 kelompok yakni kelompok kasus dan kelompok control, yang dipilih secara consecutive sampling, sebanyak 120 orang. Analisis bivariat dilakukan dengan uji chi square dan mengidentifikasi nilai Odds Ratio (OR) dan analisis multivariat dengan uji regresi logistik untuk mengidentifikasi variabel yang paling dominan mempengaruhi kejadian stunting. Hasil Penelitian : Riwayat ASI ekslusif dan imunisasi dasar merupakan faktor resiko kejadian stunting pada balita. Balita yang tidak mendapatkan ASI ekslusif memiliki resiko 2,5 kali lebih besar untuk menderita stunting dibandingkan balita yang diberikan ASI ekslusif (p=0,04, OR : 2,5, CI 95:1,1-5,9. Balita yang tidak mendapatkan imunisasi dasar lengkap memiliki resiko 2,9 kali lebih besar menderita stunting dibanding balita yang mendapatkan imuniasi dasar lengkap (p=0,02, OR=2,9, CI95% : 1,1-9,3). Tingkat pendidikan ibu (p=0,02) ketahanan pangan keluarga (p=0,01) dan pola makan keluarga (p=0,00) berhubungan dengan kejadian stunting, sementara tinggi badan ibu (p=0,17), jumlah anggota keluarga (p=0,65), umur kehamilan saat melahirkan (p=0,83) dan tingkat pendapatan keluarga (0,09) tidak berhubungan dengan kejadian stunting. Pola makan keluarga merupakan variabel confounding yang ikut berinteraksi dengan variabel independent terhadap kejadian stunting. Kesimpulan : Riwayat imunisasi dasar lebih dominan dibanding riwayat ASI ekslusif dalam mempengaruhi kejadian stunting pada balita.

Background: The prevalence of stunting among children under five in Indonesia in 2010 - 2013 period showed an increasing trend from 36.8% to 37.2%, but it decreased to 30.8% in 2018 (RISKESDAS, 2018). Meanwhile, in Southeast Sulawesi Province, the case was 40.6% (RISKESDAS, 2013). In particular, as reported by Dinas Kesehatan (public health office) of Central Buton (2018), the prevalence stunting among toddlers in the regency even higher with 50.9% in 2016 and 49.9% in 2017. Specific interventions such as providing exclusive breastfeeding and complete basic immunization has been done. Objective: This study aimed to analyse the historical risk factors of exclusive breastfeeding and the history of basic immunization to the incidence of stunting among toddlers at the coastal region of Central Buton Regency, Southeast Sulawesi Province. Method: This research is an observational study with a Case-Control Study and conducted in Mawasangka Tengah District. The samples of this study were 120 toddlers of 6 - 23 months old. They were divided into 2 groups, the case and the control groups chosen by using consecutive sampling. The bivariate analysis was applied using the chi-square test; the value of Odds Ratio (OR) was identified, and multivariate analysis with logistic regression test to identify the most dominant variable affecting the incidence of stunting was also applied. Results: History of exclusive breastfeeding and basic immunization are two risk factors for stunting among toddlers. Toddlers who did not get exclusive breastfeeding have a risk for 2,5 times more likely to suffer from stunting than those who were given the exclusive breastfeeding (p = 0.04, OR: 2.5, CI 95: 1.1 - 5, 9). Toddlers who did not complete the basic immunization have 2.9 times greater risk of suffering from stunting compared to those who received a complete basic immunization (p = 0.02, OR = 2.9, CI95%: 1,1- 9, 3). Mothers educational level (p = 0 , 02 ), family food security (p = 0.01) and family diet (p = 0.00) strongly related to stunting events, while mothers height (p = 0.17), number of family members (p = 0.65), gestational age at delivery (p = 0.83) and family income (0.09) was not related to the prevalences. The family diet pattern is a confounding variable that is able to interact with the independent variables on the incidences of stunting. Conclusion: Basic immunization history was found to be more dominant over exclusive breastfeeding history in influencing the incidence of stunting in children under five.

Kata Kunci : Riwayat ASI ekslusif, riwayat imunisasi dasar, stunting, History of exclusive breastfeeding, history of basic immunization, stunting