Air Susu Ibu (ASI) eksklusif merupakan makanan alamiah yang pertama dan utama bagi bayi yang lahir karena ASI dapat memenuhi kebutuhan bayi akan energi dan zat gizi bayi di masa pertumbuhan selama 6 bulan pertama kehidupannya. Kementerian Kesehatan pada tahun 2015 menargetkan cakupan ASI eksklusif sebesar 80%. Namun, cakupan ASI eksklusif di Kepulauan Bangka Belitung masih cukup rendah yaitu (59,4%) di wilayah Kota Pangkalpinang. Penelitian ini bertujuan untuk menilai perbedaan antara status pemberian ASI eksklusif terhadap perubahan panjang badan bayi neonatus di RSUD Depati Hamzah Pangkalpinang. Desain penelitian adalah penelitian cohort dengan jumlah sampel 34 orang ibu yang melahirkan di RSUD Depati Hamzah Pangkalpinang pada bulan Juni-Juli 2015. Instrumen penelitian yang digunakan adalah kuesioner dan pengukur tinggi badan bayi. Uji t-independent digunakan untuk melihat perbedaan hasil pengukuran panjang badan bayi neonatus pada masing-masing kelompok observasi setiap 7 hari berturut-turut selama 28 hari. Hasil penelitian menunjukan bahwa kelompok ASI non eksklusif sebesar 55,9% (19 orang), sedangkan ASI eksklusif sebesar 44,1% (15 orang). Rata-rata perubahan panjang badan neonatus yang diberikan ASI eksklusif selama 1 bulan lebih besar yaitu 10,87 cm dibandingkan ASI non eksklusif yang hanya 8,53 cm. Hasil ini menunjukan ada perbedaan rata-rata perubahan panjang badan antara neonatus yang diberikan ASI eksklusif dan neonatus yang diberikan ASI non eksklusif.
The proportion of stunting above 20 percent indicates that there are still public health problems in Indonesia. The impact of stunting not only affects the stature but also affects the economic productivity of a country. The purpose of this study was to develop index models that are responsive stunting in children under-5 years in Indonesia. Development of the index model used mathematical formulations using the SDGs indicator and other relevant indicators. Aggregate data from 16-time series were selected from 34 provinces in Indonesia in the span of 4 years (2015 - 2018). Furthermore, the method of developing a stunting index in this study was carried out through the stages of standardization, weighting, aggregation and validation. The results showed that the stunting index model is an evaluation measure that is responsive to stunting interventions in infants (0-56 months) in Indonesia. The national stunting index from 2015 to 2018 increased although it was still in the medium category with index values of 69.77, 70.29, 70.30 and 72.74, respectively. This study recommended an increase in efforts to achieve dimension index values in the development pillars of environmental and economical, especially in the eastern regions of Indonesia and the divided provinces.ABSTRAK Proporsi stunting lebih dari 20 persen menunjukkan bahwa masih terdapat masalah kesehatan masyarakat di Indonesia. Dampak stunting tidak hanya mempengaruhi perawakan tetapi juga mempengaruhi produktifitas ekonomi suatu negara. Sebuah model sederhana dan responsif dalam bentuk indeks stunting dapat menjadi bagian dari pilar rencana aksi intervensi stunting tersebut di atas. Model indeks stunting pun diharapkan dapat membantu pengambil keputusan (decision maker) menyusun formulasi, implementasi dan evaluasi kebijakan dalam penanggulangan stunting untuk masa yang akan datang. Tujuan penelitian ini adalah untuk mengembangkan model indeks stunting responsif pada anak balita di Indonesia. Pengembangan model indeks menggunakan formulasi matematis dengan menggunakan indikator Sustainable Development Goals (SDGs) dan indikator terkait lainnya. Data agregat dari 16 time series dipilih dari 34 provinsi di Indonesia dalam kurun waktu 4 tahun (2015 - 2018). Selanjutnya metode pengembangan indeks stunting pada penelitian ini dilakukan melalui tahapan standardisasi, pembobotan, agregasi dan validasi. Hasil penelitian menunjukkan bahwa model indeks stunting pada penilitian ini merupakan ukuran evaluasi yang tanggap terhadap intervensi stunting pada bayi (0-56 bulan) di Indonesia. Indeks stunting nasional dari tahun 2015 sampai 2018 mengalami peningkatan meskipun masih dalam kategori sedang dengan nilai indeks masing-masing 69,77, 70,29, 70,30 dan 72,74. Studi ini merekomendasikan peningkatan upaya pencapaian nilai indeks dimensi pada pilar pembangunan lingkungan dan ekonomi khususnya di wilayah timur Indonesia dan daerah provinsi pemekaran.Kata kunci: Indeks stunting, evaluasi kebijakan, anak balita
Stunting affects stature with all the consequences of disruption of growth and development and also affects economic productivity. In Indonesia, which is mostly archipelago, stunting interventions require a multi-sectoral convergence strategy. Difficulties often occur in coordinating multi-sectoral cooperation in the policy process. It is even more challenging to formulate and define intervention strategies at different administrative levels. The Multi-Criteria Decision Making (MCDM) approach, such as Analytic Network Process (ANP), is one of the multi-criteria measurement approaches used to obtain the relative priority scale of individual evaluations relative dependence between elements. This approach is possible for use in the public sector,such as stunting interventions, with a high amount of information, interactions, and complexity levels. Therefore, this research aimed to develop an institutional strategy model for stunting intervention in the archipelago. The studywaslocated at Institut Pertanian Bogor (IPB)University,Bogor and Bangka Belitung Island Province (Bangka and West Bangka Regency). The research method used pairwise comparison techniques with the ANP approachof15 expert informants selected purposively based on their expertise, position and work. The framework model's construction in this study was carried out through a literature review of strategic issues consisting of criteria and indicators in decision-making for stunting reduction. Data analysis utilized Superdecisionsversion 2.8software. The study results emphasized the priority strategies for nutrition-specific interventions in the initial phase of the first 1000 days of life, namely the conception period, pregnancy,and children under two years. Also, priority strategies for nutrition-sensitive interventions emphasized the importance of integrative holistic care patterns with access to safe water and improved sanitation. Based on this research, it can be concluded that the priority strategy model for stunting reduction in Indonesia, especially the archipelago, requires simultaneous multi-sectoral convergence. Recommendations for further research are to develop an intervention model in the practice of nutritious feeding with integrated, holistic, clean water, and improved sanitation access by the characteristics of the research location.
Proporsi stunting baduta berada diatas 20%, mengindikasikan bahwa masih terjadinya masalah gizi kronis dan masalah kesehatan masyarakat di Indonesia. Dampak stunting bukan saja berpengaruh terhadap perawakan dengan segala konsekuensi gangguan tumbuh kembang, akan tetapi berpengaruh terhadap produktifitas ekonomi suatu negara. Penelitian ini bertujuan mengembangkan model prediksi responsif stunting pada baduta di Indonesia. Desain pengembangan model menggunakan formulasi matematis menggunakan data aggregate dari metadata indikator TPB/SDGs dan indikator harga pangan (beras dan telur). Data deret waktu dipilih sebanyak 16 variabel dari 34 provinsi di Indonesia dalam rentang waktu 4 tahun (2015–2018). Analisis data menggunakan metode regresi backward dengan perangkat lunak IBM SPSS Statistics version 22. Hasil penelitian menunjukkan rumah tangga yang memiliki akses terhadap layanan sanitasi layak (X9), kebiasaan merokok penduduk umur ≥15 tahun (X14) dan Annual Parasite Incidence (API) malaria per 1000 penduduk (X12) merupakan prediktor yang responsif terhadap stunting baduta di Indonesia. Model prediksi dinyatakan dengan persamaan dengan nilai R2 sebesar 49,9% dan nilai Radj sebesar 44,9%, yang berarti akses sanitasi, merokok dan API malaria cukup baik digunakan untuk menduga prevalensi stunting baduta di Indonesia. Penelitian ini merekomendasikan pemenuhan akses fasilitas sanitasi rumah tangga, terutama pada wilayah endemis malaria dan rumah tangga memiliki anggota keluarga perokok.
Jaminan Kesehatan Sepintu Sedulang (JKSS) is a form of public policy in improving basic services as mandatory government affairs to public in the regional autonomy era financing from local budget (APBD). This policy was approved by the Decree of Bangka District No. 188.45/236/Kes/2005. There are many obstacles in implementing this policy. Then these obstacles become the research focus to see the implementation process base on the policy content and implementation context in basic health services and referral.To improve the implementation of this policy more effective and efficienct, some suggestions can be considered such as implementation of an appropriate capitation system, strengthening human resources and organization or the implementing agency (Bapel) it self separately as legal basis in implementing this policy to be local regulation (Perda).
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