PREGNANCY WOMEN'S KNOWLEDGE REGARDING PREVENTING

STUNTING IN PREGNANCY
Elizabet C. Jusuf1, Mardiah Tahir1, Umar Malinta1, Nasrudin A.M. 1, Abdul Rahman1, Eddy
Hartono1, Nadya K. Wardani1, Mirah Avisha 1, Gledies Gosal1
1
Division of Social Obstetrics and Gynecology Department of Obstetrics and
Gynecology Faculty of Medicine Hasanuddin University, Indonesia
Corresponding Autor. Elizabet C. Jusuf
E-mail : obginsosikuh email com
ABSTRACT
Malnutrition is an impact of nutritional status both in the short and long term. Stunting is one
of the conditions of malnutrition associated with past nutritional inadequacies so that it is
included in chronic nutritional problems. Stunting is measured as nutritional status by taking
into account height or length, age, and gender of children under five. Scaling Up Nutrition
(SUN) is a global push for action and investment to improve maternal and child nutrition. Facts
show that proper nutrition during the 1000 days between the beginning of a woman's pregnancy
and her child's age of two years gives children a healthy start in life. The goal of the Global
SUN Movement is to reduce malnutrition, with a focus on the first 1000 days of life (270 days
during pregnancy and 730 days from birth to 2 years of age) in pregnant women, breastfeeding
mothers and children aged 0-23 months. In an effort to reduce the stunting rate in the first 1000
days of life, health counseling is conducted at the Puskesmas, which is expected to increase the
level of knowledge and attitude of the community, especially pregnant women, and posyandu
cadres towards the importance of preventing stunting. An initial questionnaire was filled out
before counseling and a questionnaire was filled out after counseling. The data from the
questionnaire was processed with the SPSS program. The results of this activity were that the
activities were well organized, the participants came on time and were active in the question-
and-answer session activities. Statistically, there was an increase in the value of the
questionnaire before and after counseling with a p value of 0.000. In conclusion, there is an
increase in community knowledge in the Makassau Health Center area about preventing
stunting in 1000 days of life which can be seen based on the statistical results of filling out the
questionnaire.
Keywords: Stunting, 1000 HPK, Counseling.
INTRODUCTION nutrition during the critical 1000-day
window, from the beginning of a woman's
Indonesia faces a severe nutritional
pregnancy until her child reaches two years
problem characterized by numerous cases
of age, establishes a foundation for a
of undernutrition among children under the
healthy life. The overarching objective of
age of five, as well as among school-age
the Global SUN Movement is to combat
boys and girls. Nutritional issues during
malnutrition, with a specific focus on the
school age can result in a low quality of
initial 1000 days of life (comprising 270
education, high absenteeism, and elevated
days during pregnancy and 730 days from
dropout rates.1 Malnutrition has both short-
birth to 2 years of age). This emphasis
term and long-term impacts on nutritional
targets pregnant women, breastfeeding
status. Stunting is one manifestation of
mothers, and children aged 0-23 months.
malnutrition associated with past
(Himmawan LS, 2020)
nutritional deficiencies, which fall under
Healthcare workers play a pivotal
the category of chronic nutritional
role in enhancing the quality of
problems. Stunting is assessed as a measure
comprehensive health services within the
of nutritional status, taking into account the
community. This serves to elevate
height or length, age, and gender of children
community awareness, willingness, and
under the age of five. (UNICEF, 2013;
capacity to adopt healthy lifestyles,
Stewart, C. P. et al., 2013).
ultimately contributing to the realization of
Community health workers play a
optimal health as an investment in the
strategic role in enhancing the quality of
development of socially and economically
life, particularly in the prevention of
productive human resources. In the context
stunting during the first 1000 days of life
of health development, community health
(HPK). In Indonesia, this initiative is
workers assume a highly significant role in
referred to as the National Movement for
raising awareness about promotive and
the Acceleration of Nutrition Improvement
preventive health services. (Himmawan LS,
in the First 1000 Days of Life (1000 HPK
2020)
Movement). (Himmawan LS, 2020)
The Resident Obstetrics and
Scaling Up Nutrition (SUN)
Gynecology team at Hasanuddin
represents a global initiative aimed at
University's Faculty of Medicine represents
driving action and investment to enhance
a cohort of Obstetrics and Gynecology
maternal and child nutrition. The evidence
specialists who are deeply committed to the
underscores that providing adequate
nation's well-being and hold responsibility
for future generations, encompassing (Puskesmas) in Makassar City. The event
community health. The attainment of public took place on Saturday, August 29, 2023,
health goals hinges on collaborative support commencing at 10:00 am and concluding
from all sectors of society and relevant upon completion. The program
agencies in endorsing health programs encompassed counseling employing lecture
spearheaded by healthcare workers, methodology, followed by a question-and-
including Obstetrics and Gynecology answer session. Participants were
residents. In line with this, a collaborative administered a questionnaire featuring
community service initiative was closed-ended questions both before and
conducted in partnership with the Health after the event. The data collected during
Office, the Department of Obstetrics and this event were recorded and subsequently
Gynecology, the Faculty of Medicine, processed utilizing SPSS software.
Hasanuddin University, specifically the
Obstetrics and Social Gynecology division, RESULTS AND DISCUSSION
Makasseu Health Center, and all
This counseling session was attended
stakeholders, including pregnant women,
by 112 female participants. The
midwives, and posyandu cadres in the
characteristics of the counseling
Makassau Health Center's operational area.
participants are presented in Table 1.
This community service activity targeted
Table 1. Characteristics of counseling
pregnant women, midwives, and posyandu
participants
cadres in the Makassau neighborhood, with
the primary aim of augmenting knowledge
and attitudes regarding stunting and the
imperative of stunting prevention within the
context of the 1000 HPK initiative.
(Himmawan LS, 2020)

METHODS
This activity entails an interactive
lecture aimed at enhancing public
awareness regarding stunting, with the The majority of participants were aged
overarching goal of preventing stunting between 20 and 35 years (76.78%), had
during the initial 1000 days of life, held at been married for 3-9 years (39.28%), had an
the Makasseu Public Health Center
education level of ≥ 9 years (87.50%), were increase in scores, indicating an
not employed (53.57%), and had 1-4 enhancement in the knowledge of
children (83.93%). counseling participants regarding the
The session commenced with the counseling material (Table 3).
completion of a pre-counseling Figure 1. Counseling Activity on
questionnaire, followed by introductory Preventing Stunting in the First 1000
remarks from representatives of the Days of Life
Makassau Health Center and the
supervising doctor for the counseling. The
counseling content was presented through
an audio-visual presentation, which was
followed by a question-and-answer session,
as depicted in Figure 1. During the question After counseling, the scores of the
and answer session, four participants raised questionnaire answers ranged from a
questions. These questions pertained to minimum of 6 to a maximum of 10. The
topics such as discontinuing breastfeeding average score of the questionnaire
for a 22-month-old child, recommended responses before counseling was 6.85,
foods to prevent anemia, the effects of which increased to 8.52 after counseling.
consuming ice water on pregnant women, These results were subsequently subjected
and ways to manage weight gain during the to statistical testing using the SPSS
6th month of pregnancy. The speaker and program, as illustrated in Table 3. Table 3.
supervising doctor addressed these Differences in knowledge level about
questions. Participants appeared to preventing stunting in the first 1000 years
comprehend and express satisfaction with of life
the provided explanations. The counseling
session concluded with participants sharing
their impressions and messages. They
expressed the hope that such counseling
activities would be conducted regularly, *p-value <0.05 (Wilcoxon test)

and this was followed by a group photo 1000 HPK signifies the life phase

session. Subsequently, participants beginning from fetus formation during

completed a post-counseling questionnaire. pregnancy (270 days) and continuing until

Analysis of the pre and post-counseling the child reaches 2 years old (730 days).

questionnaires revealed a significant This period is crucial as it witnesses the

development of vital organs such as the Insufficient or detrimental health-related
brain, liver, heart, kidneys, bones, arms, knowledge must be reshaped into a health-
legs, and other bodily structures. The 1000 promoting direction. This is because
HPK stage is often referred to as the golden knowledge affects attitudes, subsequently
period due to the rapid development of influencing behaviors. A mother's
brain cells and nerve fiber growth, leading awareness of balanced nutrition for children
to the formation of intricate nerve and brain holds paramount importance. Such
networks. This phase sees nearly 80% of awareness guides mothers in monitoring the
optimal brain development, thereby growth and development of children under
significantly influencing the future quality five by providing them with a well-rounded
of human beings. Several key diet meeting their nutritional requirements.
considerations must be taken into account Adequate nutritional fulfillment ensures
for the optimal development of children toddlers' normal nutritional status. Mothers
during this golden period. (Likhar A and equipped with diverse information sources
Patil MS,2022) tend to possess more comprehensive
Stunting is a result of multidimensional knowledge about toddler nutrition
factors, not solely attributed to malnutrition compared to those with limited sources of
experienced by pregnant women and information. Consequently, they are
toddlers. Hence, the most impactful deemed better-equipped to manage health
intervention to diminish stunting problems, particularly nutritional
prevalence should be executed within the challenges within their families. (Likhar A
initial 1000 days of a child's life. (Bappenas and Patil MS,2022; Augsburg B and
and UNICEF, 2017) Rodríguez-Lesmes PA, 2018)
Familial knowledge about nutrition can One way to enhance knowledge,
offer various alternative solutions to tackle attitudes, and behavior is through health
toddler nutrition-related issues. education. Health counseling proves to be
Furthermore, the mother's attitude holds an intensive and effective method of
immense significance; if a mother imparting information to improve facets of
demonstrates inadequate concern for her health that might still be lacking in a
toddler's nutrition, it can lead to insufficient particular setting. Health counseling itself
nutritional intake. Given that mothers can be executed through diverse methods,
interact most with toddlers, they play a tailored to the specific targets of the
pivotal role in averting nutritional problems intended counseling. Furthermore, it can
and preventing malnutrition and stunting. involve provisions of nutritious foods,
supplementary diets for underweight/very The community service initiative has been
thin pregnant women, administration of effectively executed and has garnered
blood supplement tablets (90 tablets), significant community enthusiasm,
maintenance of maternal health, utilization particularly among pregnant women,
of healthcare facilities for childbirth, and midwives, and posyandu cadres operating
facilitation by health professionals, along within the Makassau Health Center vicinity.
with IMD (early breastfeeding initiation).
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