Inisiasi Menyusu Dini (IMD) dan ASI Eksklusif sebagai Determinan Masalah Perkembangan Anak Usia 12-24 Bulan: Studi Kasus Kontrol di Kabupaten Kendal

LINDRA ANGGOROWATI, Prof. Dr. dr. E. Siti Herini Sp.A(K); Dr. rer. nat. dr. BJ. Istiti Kandarina

2016 | Tesis | S2 Ilmu Kesehatan Masyarakat

Latar Belakang: Pada tahun 2014 cakupan pelaksanaan Stimulasi Deteksi Intervensi Dini Tumbuh Kembang (SDIDTK) di Kabupaten Kendal tidak dilaporkan secara spesifik, sehingga balita yang mengalami gangguan perkembangan dan yang mendapatkan penanganan dini tidak diketahui. Oleh karena itu, diperlukan deteksi dini perkembangan anak dan identifikasi determinan yang mempengaruhinya. Tujuan: Untuk mengetahui apakah pemberian inisiasi menyusu dini (IMD) dan ASI eksklusif merupakan determinan masalah perkembangan anak usia 12-24 bulan di Kabupaten Kendal. Metode: Desain studi penelitian ini adalah observasional analitik dengan pendekatan unmatched case-control. Kasus adalah anak berusia 12-24 bulan yang tercatat di laporan posyandu Dinas Kesehatan Kabupaten Kendal tahun 2014 dan 2015, yang mengalami gangguan perkembangan berdasarkan Denver II. Kontrol adalah anak berusia 12-24 bulan yang tercatat di laporan posyandu Dinas Kesehatan Kabupaten Kendal tahun 2014 dan 2015, yang tidak mengalami gangguan perkembangan berdasarkan Denver II. Cara pengambilan sampel menggunakan teknik multistage random sampling dengan besar sampel sebanyak 46 kasus dan 46 kontrol. Analisis data dilakukan secara bivariabel, dengan uji Chi-square dan multivariabel, dengan uji regresi logistik. Hasil: Pemberian IMD dan ASI eksklusif berhubungan secara signifikan dengan masalah perkembangan anak (OR: 2,65, CI 95%: 1,05-6,72). Bahkan setelah mempertimbangkan variabel status gizi, hubungan masih tetap signifikan (AdjOR 2,71, CI 95%: 1,14-6,47). Kesimpulan: Pemberian IMD dan ASI eksklusif merupakan determinan masalah perkembangan anak usia 12-24 bulan di Kabupaten Kendal. Rekomendasi yang diberikan adalah meningkatkan pengetahuan ibu dan cakupan pemberian IMD dan ASI eksklusif, serta deteksi dini perkembangan anak secara berkala sesuai usia.

Introduction: In 2014, coverage of early stimulation, detection, and intervention of growth and development in Kendal District was not completely reported, so that children under 5 years who suffered from developmental disorder and early treated were unknown. Therefore, it was necessary early detection and identification of affecting determinants among children. Objective: Research objective was to know whether early initiation of breastfeeding and exclusive breastfeeding were determinants of developmental disorder among 12-24 months old children in Kendal District. Method: Study design of this research was analytic observational with unmatched case-control approach. Cases were defined as children aged 12-24 months who were recorded in the report of integrated health service of Kendal District Health Office 2014 and 2015 and suffered from developmental disorder based on Denver II. Controls were defined as children aged 12-24 months who were recorded in the report of integrated health service of Kendal District Health Office 2014 and 2015 and did not suffer from developmental disorder based on Denver II. Sampling technique used was multistage random sampling until 46 cases and 46 controls were enrolled in the study. Chi-square tests and logistic regression were done. Results: Early initiation of breastfeeding and exclusive breastfeeding were significantly associated with children developmental disorder (OR: 2.65, 95% CI: 1.05-6.72). Even after adjusting for nutritional status variable, the association was still statistically significant (AdjOR: 2.71, 95% CI: 1.14-6.47). Conclusion: Early initiation of breastfeeding and exclusive breastfeeding were determinants of developmental disorder among 12-24 months old children in Kendal District. We recommended to increase mother knowledge and coverage of early initiation of breastfeeding and exclusive breastfeeding, and implement early detection of development periodically by children’s age

Kata Kunci : IMD, ASI eksklusif, perkembangan anak, kasus kontrol, Early initiation of breastfeeding, exclusive breastfeeding, child development, case control