PENGARUH PENDIDIKAN GIZI DALAM UPAYA MENINGKATKAN KEPATUHAN KONSUMSI ZAT BESI MELALUI KELAS IBU HAMIL DI KECAMATAN GATAK KABUPATEN SUKOHARJO

SITI SULASTIJAH, Dr. Dra Sumarni, M. Kes; Siti Helmiyati, DCN, M. Kes

2015 | Tesis | S2 Ilmu Kesehatan Masyarakat

Latar Belakang : Anemia defisiensi besi menyumbang kejadian anemia sebesar 50% dan menimbulkan kematian sekitar 841.000 per tahun di seluruh dunia. Prevalensi anemia pada ibu hamil di daerah perkotaan Indonesia sebesar 24,5%. Pendidikan gizi sebelum suplementasi besi perlu diberikan disebabkan kepatuhan ibu hamil masih rendah. Kecamatan Gatak merupakan salah satu wilayah kecamatan di Kabupaten Sukoharjo yang memiliki ibu hamil dengan faktor resiko tertinggi (20,02%). Tujuan : Penelitian ini bertujuan untuk mengetahui pengaruh pendidikan gizi dalam upaya meningkatkan kepatuhan konsumsi zat besi melalui kelas ibu hamil di Kecamatan Gatak Kabupaten Sukoharjo. Metode : Jenis penelitian berupa kuasi eksperimental yang menggunakan rancangan pre test-post test dengan non equivalent control group. Dilaksanakan pada Juni-Agustus 2014 di Kecamatan Gatak. Sampel penelitian yakni ibu hamil yang memenuhi kriteria inklusi (bersedia mengikuti penelitian, usia kehamilan 12- 24 minggu, kehamilan tunggal, kooperatif) dan eksklusi (memiliki penyakit kronis dan riwayat penyakit perdarahan). Sampel sejumlah 33 ibu hamil pada kelompok perlakuan dan 37 ibu hamil pada kelompok kontrol. Kelompok perlakuan mendapat pendidikan gizi melalui buklet anemia dan suplementasi zat besi yang berisi 60 mg sulfas ferosus dan 400 μg asam folat secara harian di kelas ibu hamil selama tiga bulan. Kelompok kontrol tidak mendapatkan pendidikan gizi namun masih mendapatkan suplementasi zat besi harian selama 3 tiga bulan. Variabelvariabel yang diukur adalah tingkat pengetahuan yang dinilai berdasarkan kuesioner, kepatuhan konsumsi zat besi bedasarkan wawancara, asupan makanan (energi, protein dan Fe) secara recall 2x24 jam dan kadar hemoglobin dengan metode cyanmet Hb pada awal dan akhir penelitian. Independent t-test dan paired t-test dipergunakan untuk meneliti pengaruh pendidikan gizi terhadap tingkat pengetahuan, kepatuhan konsumsi zat besi, asupan makanan (energi, protein, dan Fe), dan kadar hemoglobin pada kelompok perlakuan dan kontrol. Hasil : Tingkat pengetahuan (lebih tinggi 12,59), kepatuhan (lebih tinggi 15,16%), asupan makanan yang meliputi energi (lebih tinggi 9,24%), protein (lebih tinggi 10,98%), dan Fe (lebih tinggi 6,68%), walaupun semuanya masih berada di bawah AKG, dan kadar hemoglobin (lebih tinggi 0,44 g/dl) pada kelompok perlakuan dibandingkan kelompok kontrol (p<0,05). Faktor-faktor umur, tingkat pendidikan, jumlah pengeluaran, paritas, ANC, status gizi, dan jarak kelahiran terakhir tidak mempengaruhi kepatuhan meminum suplementasi zat besi (p>0,05). Kesimpulan : Pendidikan gizi berpengaruh meningkatkan kepatuhan konsumsi zat besi melalui kelas ibu hamil di Kecamatan Gatak Kabupaten Sukoharjo.

Background : Iron deficiency anemia contributed to a number of 50% in anemia and caused mortality of 841,000 every year in the world. Prevalence of anemia in pregnant women in Indonesian urban was appoximately 24.5%. Nutrition education before iron supplementation is needed because of low compliance in pregnant women. Gatak Sub District that is located in Sukoharjo Regency had the highest risk in pregnant women by 20.02%. Objective : This research aimed to know the effect of nutrition education in an effort to increase compliance of iron consumption through prenatal classes in Gatak Sub district Sukoharjo Regency. Method : The method of this research was quasi experiment with pre test-post test with non equivalent control group design. This study researched on June-August 2014 in Gatak Sub District. The samples of this research were 70 pregnant women who fulfilled inclusion (willing to follow the research, gestation age was 12-24 weeks, single pregnancy and cooperative) and exclusion criteria (had cronic diseases and hematologic abnormalities history). A number of 33 pregnant women were in treatment group and 37 pregnant women were in control group. Treatment group received a nutrition education through anemia booklet and iron supplementation which contained 60 mg sulfas ferosus and 400 μg folic acid on a daily basis in prenatal classes for 3 months. Control group did not receive a nutrition education, but still received a daily iron supplementation for 3 months. Variables measured were knowledge level through questionnaires, compliance based on interviews, food intakes (energy, protein, and Fe) with 2x24 hours recall, and hemoglobin level with cyanmet Hb method at the beginning and end of this study. Independent t-test and paired t-test were used to analyze the effect of nutrition education on knowledge level, compliance of iron consumption, food intakes (energy, protein, and Fe) and hemoglobin level in treatment and control groups. Results : The knowledge level (higher 12.59), compliance of iron consumption (15.16%), food intakes including energy (higher 9.24%), protein (higher 10.98%), and Fe (higher 6.68%), although those food intakes were still below the RDA, and hemoglobin level (higher 0.44 g/dl), in treatment group compared with control (p<0.05). The factors of age, education level, household expenditure, parity, ANC, nutritional status, and last birth spacing did not affect the compliance of iron consumption (p>0.05). Conclusion : The nutrition education affected the increase in compliance of iron consumption through prenatal classes in Gatak Sub District Sukoharjo Regency.

Kata Kunci : Pendidikan gizi berpengaruh meningkatkan kepatuhan konsumsi zat besi melalui kelas ibu hamil di Kecamatan Gatak Kabupaten Sukoharjo; The nutrition education affected the increase in compliance of iron consumption through prenatal classes in Gatak Sub Dist