The influence of intensive nutritional counseling in Posyandu towards the growth 4-18 month old children
Abstract
Introduction Under 5 years is a critical period for child growth,when growth faltering often occurs. Periodical growth monitoring
and nutritional counseling can detect growth faltering earlier, de-
termine the cause, and find alternatives to solve such problems.
Objective To determine the benefit of nutritional counseling on
knowledge, attitude, practice of mothers, and child growth.
Methods A randomized controlled trial was conducted in
Sendangguwo, Semarang on 143 children of the treatment group
and 135 children of the control group. Nutritional counseling was
given to mothers in the treatment group by trained health volun-
teers. Changes of weight for age Z-score (WAZ), height for age Z-
score (HAZ), and weight for height Z-score (WHZ) were analyzed
repeatedly by using ANOVA. The differences of ΔWAZ, ΔHAZ, and
ΔWHZ between groups were compared by student t-test. GEE (gen-
eralized estimating equation) analysis was used to analyze the
effect of confounding variables on the changes of WAZ.
Results After 6 months of counseling, knowledge, attitude, and
practice of nutrition in the treatment group significantly increased
compared to that of the control group (P<0.001). The WAZ, HAZ,
and WHZ curves in the control group decreased. However, in the
treatment group, WHZ increased and there was stabilization of
WAZ. At the end of the study, treatment group had significantly
improved their WAZ (P<0.001), HAZ (P=0.004), and WHZ
(P<0.001) compared to that of the control group.
Conclusion Nutritional counseling can improve knowledge, atti-
tude, and practice of mothers, and has beneficial effects on child
growth by WAZ, HAZ, and WHZ
References
saraf pusat pada janin dan bayi. In: Tarjoto BH, Kosim
MS, Deliana E, Muarif YS, editors. Naskah lengkap
KONAS VII Perinasia dan Symposium on International
Adolescent Reproductive and Perinatal Health Toward
3rd Milenium. Semarang: Perinasia Jawa Tengah; 2001.
p. 154-62.
2. Susanto JC. KMS sebagai alat deteksi dini hambatan
pertumbuhan pengalaman dari Semarang. In: Kumpulan
makalah diskusi pakar bidang gizi tentang ASI-MP ASI
antropometri dan BBLR. Cipanas: Persatuan Ahli Gizi
Indonesia. LIPI, UNICEF, 2000.
3. Departemen Kesehatan RI Direktorat Jenderal Bina
Kesehatan Masyarakat-Direktorat Gizi Masyarakat.
Pemantauan pertumbuhan balita. Jakarta: Departemen
Kesehatan; 2002.
4. Corrales KM, Utter SL. Failure to thrive. In: Samour
PQ, Helm KK, Lang CE, editors. Handbook of pediat-
ric nutrition. 2nd ed. Maryland: Aspen Publishers;
1999. p. 395-412.
5. King FS, Burgess A. Nutrition for developing countries.
Oxford: Oxford University Press; 1996. p. 209-21.
6. Akademi Gizi Surabaya. Growth monitoring field ex-
perience in Mojokerto district East Java province 2002.
7. Satoto, Djahari AB. Growth data from Posyandu in
Indonesia: Precision, accuracy, reliability, and utiliza-
tion. Presented at International experts’ seminar on
child growth and poverty, Jakarta; 2002 November.
8. Sub Bagian Gizi Ilmu Kesehatan Anak RSUP Dr.
Kariadi Semarang. Laporan pengamatan pertumbuhan
anak di 6 Posyandu sekitar RSUP Dr. Kariadi Semarang
(Januari-Juni 2002). Unpublished data.
9. Sub Bagian Gizi Ilmu Kesehatan Anak RSUP Dr.
Kariadi Semarang. Laporan bulanan BKIA RSUP Dr.
Kariadi Semarang tahun 2002. Unpublished data.
10. Hendrickson JL, Dearden K, Pachon H, An NH,
Schroeder DG, Marsh DR. Empowerment in rural Viet-
nam: Exploring changes in mothers and health volun-
teers in the context of an integrated nutrition project.
Food and Nutrition Bulletin 2002;23:83-91.
11. Guldan GS, Fan HC, Ma X, Ni ZZ, Xiang X, Tang MZ.
Culturally appropriate nutrition education improves
infant feeding and growth in rural Sichuan, China. J
Nutr 2000;130:1204-11.
12. Notoatmojo S. Ilmu kesehatan masyarakat. Jakarta:
Rineka Cipta, 1997.
13. Black MM, Krishnakumar A. Predicting longitudinal
growth curves of height and weight using ecological
factors for children with and without early growth de-
ficiency. J Nutr 1999;129:539-43.
14. Brown LV. Evaluation of the impact of weaning food
messages on infant feeding practices and child growth
in rural Bangladesh. Am J Clin Nutr 1992;56:994-
1003.
15. Bhandari N, Bahl R, Nayyar B, Khokhar P, Rohde JE,
Bhan MK. Food supplementation with encouragement
to feed it to infants from 4 to 12 months of age has a
small impact on weight gain. J Nutr 2001;131:1946-
51.
16. Bhandari N, Mazumder S, Bahl R, Martines J, Black
RE, Bhan MK, et al. An educational intervention to
promote complementary feeding practices and physi-
cal growth in infants and young children in rural
Haryana, India. J Nutr 2004;134:2342-8.
17. English RM, Badcock JC, Giay T, Ngu T, Waters AM,
Bennett SA. Effect of nutrition improvement project
on morbidity from infectious diseases in preschool chil-
dren in Vietnam: Comparison with control commune.
BMJ 1997;315:1122-5.
18. Sripaipan T, Schroeder DG, Marsh DR, Pachon H,
Dearden KA, Ha TT, et al. Effect of an integrated nu-
trition program on child morbidity due to respiratory
infection and diarrhea in northern Vietnam. Food and
Nutrition Bulletin 2002;23:67-75.
19. Wright CM. Identification and management of failure
to thrive: A community perspective. Arch Dis Child
2000;82:5-9.
20. Kendrick D, Elkan R, Hewitt M, Dewey M, Blair M,
Robinson J, et al. Does home visiting improve parenting
and the quality of the home environment? A system-
atic review and meta-analysis. Arch Dis Child
2000;82:443-51.
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Accepted 2016-10-13
Published 2016-10-18