Evaluasi penanggulangan gizi buruk pada anak bawah lima tahun di Puskesmas Kabupaten Belu NTT :: Studi kasus Puskesmas dengan kaus gizi buruk tertinggi

SERAN, Agustina Abuk, dr. Siswanto Agus W, SU., MSc.,ScD

2008 | Tesis | S2 Ilmu Kesehatan Masyarakat

Latar Belakang: Angka kematian anak balita di dunia ada hubungan dengan masalah gizi dan penyakit infeksi. Penyebab kematian anak bawah lima tahun (balita) di seluruh dunia antara tahun 2000-2003 yaitu 60 persen disebabkan karena kurang gizi. Kurang gizi di Indonesia masih tinggi. Kematian anak balita di Provinsi Nusa Tenggara Timur (NTT) pada bulan Januari sampai dengan Juni 2008 yang berhubungan dengan kurang gizi sebanyak 31 anak. Sedangkan di Kabupaten Belu terjadi peningkatan balita gizi buruk dari 2,8 persen pada tahun 2005 menjadi 6,4 persen pada tahun 2007. Depkes RI berupaya meningkatkan kegiatan pemantauan kasus gizi buruk di sarana kesehatan dasar (Puskesmas dan Posyandu). Pemberian ASI dan revitalisasi Posyandu serta intervensi gizi dan kesehatan merupakan beberapa cara untuk menurunkan prevalensi gizi kurang dan gizi buruk. Tujuan penelitian: Evaluasi pelaksanaan penanggulangan gizi buruk pada anak balita usia 6-59 bulan di Puskesmas. Metode penelitian: Penelitian ini adalah penelitian studi kasus, yang bersifat evaluasi dengan rancangan cross sectional. Subjek penelitian sebanyak 200 anak usia 6-59 bulan di Puskesmas, diambil berdasarkan Simple random sampling. Analisis data univariabel menggunakan distribusi frekuensi, bivariabel menggunakan uji statistik Chi-square dan analisis multivariabel menggunakan logistic regression dengan menggunakan paket program stata versi 8. Hasil penelitian: Dari 200 anak dalam penelitian ini, gizi kurang 41,5 persen dan gizi buruk 26 persen dan yang mendapat ASI eksklusif 21,5 persen. Kejadian gizi kurang lebih besar pada anak yang tidak mendapat ASI eksklusif dibandingkan dengan anak yang mendapat ASI eksklusif dan penyakit infeksi (RP=3,5; IK 95%=1,58-8,13 dan RP=2,1; IK 95%=1,00-4,06). Variabel pengetahuan ibu dan tingkat pendidikan ibu bermakna secara statistik dan praktis. Kesimpulan: Gizi kurang dan gizi buruk di Kabupaten Belu NTT masih tinggi dari target yang telah ditetapkan. Pemberian ASI, penyakit infeksi, berpengaruh terhadap gizi kurang dan gizi buruk.

Background: The mortality rate of under-five children in the world is related with nutritional problems and infectious disease. Sixty percent of the under-five mortality globally from 2000 to 2003 was due to nutritional deficiency. In fact, the incidence of nutritional deficiency in Indonesia is still high. In addition, the under-five deaths in Nusa Tenggara Timur (NTT) Province from January to June 2008 that were related with nutritional deficiency were 31 children. Meanwhile, in Belu District there was an increased number of under-five with malnutrition from 2.8% in 2005 to 6.4% in 2007. Indonesian Health Office is in effort to improve the monitoring of malnutrition cases in basic health facilities (Community Health Center or CHC and Posyandu or Integrated Services). Breastfeeding and posyandu revitalization as well as nutrient and health intervention are some of methods to reduce the prevalence of nutritional deficiency and malnutrition. Objective: Evaluation the implementation of malnutrition eradication among children 6-59 months of age in Community Health Centers. Method: This was a case-study and evaluative study with a cross-sectional study design. Subjects were 200 children 6-59 months of age in CHCs selected with simple random sampling. Data were analyzed with univariable analysis using frequency distribution, bivariable analysis using chi-square test and multivariable analysis using logistic regression with Stata version 8. Results: Of 200 children in this study, 41.5% was included in nutritional deficiency, 26% was included in malnutrition, and 21.5% received exclusive breastfeeding. The incidence of nutritional deficiency was greater in children who did not receive exclusive breastfeeding and who presented infectious disease than in children who received exclusive breastfeeding and who did not present infectious disease (RP=3.5; CI 95%=1.58-8.13 and RP=2.1; CI 95%=1.00-4.06 respectively). Variables of mother’s knowledge and education were significant statistically and practically. Conclusion: The incidence of nutritional deficiency and malnutrition in Belu District, NTT Province, was still high compared to the determined target. Breastfeeding and infectious disease affected nutritional deficiency and malnutrition

Kata Kunci : Evaluasi gizi buruk,Anak balita,Puskesmas, evaluation, malnutrition, under-five children, community health center