STUNTING DAN KERAGAMAN PANGAN PADA BALITA USIA 24-59 BULAN DI INDONESIA (ANALISIS DATA INDONESIAN FAMILY LIFE SURVEY TAHUN 2014-2015)

MUHAMMAD HAFIZH H, Dr. dr. Mubasysyir Hasan Basri, M.A; Tony Arjuna, M.Nut.Diet., APD, Ph.D.

2020 | Tesis | MAGISTER ILMU KESEHATAN MASYARAKAT

Latar Belakang: Stunting merupakan gangguan pertumbuhan linear dan perkembangan kognitif yang dapat berdampak pada penurunan kemampuan belajar dan produktifitas, serta peningkatan morbiditas dan mortalitas di masa mendatang. Pada tahun 2018, sebanyak 30.8% balita di Indonesia masih menderita stunting sehingga prevalensi stunting di Indonesia masuk dalam kategori tinggi berdasarkan standar WHO. Stunting disebabkan oleh malnutrisi secara kronis yang terjadi pada anak dalam masa pertumbuhan. Kurangnya asupan gizi secara kronis sebagai penyebab stunting memang sudah umum diketahui. Namun jenis makanan yang menyebabkan adanya perbedaan kondisi antara anak yang stunting dan tidak stunting masih perlu diteliti lebih lanjut. Keragaman pangan adalah salah satu indikator yang dapat digunakan untuk melihat jenis dan kualitas dari makanan yang dikonsumsi. Tujuan: Menganalisis hubungan antara keragaman pangan dengan kejadian stunting pada anak balita usia 24-59 bulan di Indonesia. Metode: Penelitian ini adalah penelitian observasional yang menggunakan data sekunder Indonesia Family Life Survey (IFLS) periode ke-5 tahun 2014, dengan rancangan penelitian cross-sectional. Hasil: Hasil analisis bivariat diketahui bahwa keragaman pangan memiliki hubungan signifikan dengan kejadian stunting (p=0.0048, OR=1.50; CI 95%=1.12-2.02). Jenis makanan yang memiliki hubungan signifikan dengan kejadian stunting adalah daging (p=0.0410, OR=1.2; CI 95%=1.00-1.43), telur (p=0.0002, OR=1.67; CI 95%=1.26-2.20), susu dan olahannya nilai (p=0.0004, OR=1.43; CI 95%=1.16-1.74), serta sayur sumber vitamin A (p=0.0000, OR=1.54; CI 95%=1.28-1.86). Pada jenis makanan lainnya (serealia, umbi, ikan, sayuran hijau, buah vitamin A, buah lain) tidak ditemukan hubungan signifikan dengan kejadian stunting. Hasil analisis multivariat keragaman pangan dengan kejadian stunting yang mengikutsertakan variabel luar didapatkan hasil bahwa BBLR (p=0.0000, OR=2.342; CI 95%=1.743-3.163), status ekonomi (p=0.0000, OR=1.461; CI 95%=1.219-1.752), wilayah tinggal (p=0.002, OR=1.329; CI 95%=1.109-1.593), serta pendidikan ibu (p=0.0000, OR=1.616; CI 95%=1.344-1.943) merupakan prediktor dari kejadian stunting. Kesimpulan: Konsumsi pangan beragam terutama sumber protein hewani seperti telur, daging, ikan, dan susu merupakan salah satu upaya yang dapat dilakukan untuk menurunkan resiko kejadian stunting. Selain itu dalam memberikan makanan kepada anak perlu memerhatikan kuantitas dan kualitas dari makanan yang diberikan. Faktor-faktor yang dapat meningkatkan keragaman pangan adalah kemudahan akses dalam meraih makanan dan pengetahuan dalam menentukan jenis makanan yang baik bagi anak. Untuk itu diperlukan upaya dan strategi untuk meningkatkan aksesibilitas terhadap bahan makanan serta pengetahuan gizi. Kata kunci: stunting, keragaman pangan, IFLS 5

Background: Stunting is the impaired growth and cognitive development that can have an impact on decreased learning ability and productivity, as well as increased morbidity and mortality in the future. In 2018, as many as 30.8% of children under five in Indonesia still suffer from stunting, so the prevalence of stunting in Indonesia is included in the high category based on WHO standards. Stunting is caused by chronic malnutrition that occurs in childhood. Chronic lack of nutrition as a cause of stunting is well known. However, the type of food that causes differences in the conditions between stunting and non-stunting children still needs further investigation. Food diversity is one indicator that can be used to see the type and quality of food consumed. Objective: To analyze the relationship between food diversity and the incidence of stunting in children aged 24-59 months in Indonesia. Method: This study was an observational study using secondary data from the Indonesia Family Life Survey (IFLS) for the 5th period of 2014, with cross-sectional study design. Results: Bivariate analysis showed that food diversity had a significant relationship with stunting (p = 0.0048, OR = 1.50; 95% CI = 1.12-2.02). The types of food that have a significant relationship with the incidence of stunting are meat (p = 0.0410, OR = 1.2; 95% CI = 1.00-1.43), eggs (p = 0.0002, OR = 1.67; 95% CI = 1.26- 2.20), milk and dairy product (p = 0.0004, OR = 1.43; 95% CI = 1.16-1.74), and vegetables sources of vitamin A (p = 0.0000, OR = 1.54; 95% CI = 1.28-1.86). In other types of food (cereals, tubers, fish, green vegetables, vitamin A fruits, other fruits) no significant relationship was found with stunting. The results of multivariate analysis of food diversity with the incidence of stunting that included external variables showed that LBW (p = 0.0000, OR = 2.334; 95% CI = 1,743-3,163), economic status (p = 0.0000, OR = 1,461; 95 % CI 1,219-1,752), living area (p = 0.002, OR = 1,329; 95% CI = 1,109-1,593), and maternal education (p = 0.0000, OR = 1,616; 95% CI = 1,344-1,943) are predictors of stunting. Conclusion: Dietary diversity and the consumption of protein sources such as eggs, meat, fish, and milk is one of the efforts that can be done to reduce the risk of stunting. While parents need to pay attention to the quality and the quantity of food provided to their children. Factors that can increase food diversity are access to food and knowledge in determining the type of food that is good for children. For this reason, assistance and strategies are needed to improve the accessibility of food ingredients and nutritional knowledge. Keywords: stunting, dietary diversity, IFLS 5

Kata Kunci : stunting, keragaman pangan, IFLS 5