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Summary
 3
Indian Journal of Public Health Research & Development, March 2020, Vol. 11, No. 03 2001
1
Input Evaluation (HR, Funds, Method, Facilities and
Infrastructure, and Targets) on the Implementation of Biscuits
as Complementary Foods for Pregnant Women in Parepare
City

Henrick Sampeangin1, Else Theresia2, MartinusJimung1, Agustina Bernadus1, Sherly Horax3, Vidyanto4,
Abd Razak Thaha5
1
Lecturer in Fatima Nursing Academy Pare-pare, City of Pare-pare, Indonesia, 2Doctoral Program Student of
19
Public Health, Faculty of Public Health, UniversitasHasanuddin, City of Makassar, Indonesia, 3Lecturer in Faculty
16
of Dentistry, UniversitasHasanuddin, City of Makassar, Indonesia, 4Lecturer in Public Health Study Program,
Faculty of Public Health, Tadulako University, City of Palu, Indonesia, 5Lecturer in Nutrition Study Program,
Faculty of Public Health, Universitas Hasanuddin, City of Makassar, Indonesia

Abstract
18 1
Context: This study aimed to assess the Inputs (HR, Funds, Method, Facilities and Infrastructure, and
Targets) on the implementation of biscuits as complementary foods for Pregnant Women in Parepare City.
4 1
This study used a descriptive qualitative method to assess the management of the implementation of the
Complementary foods distribution for the Pregnant Women Program in the Parepare City based on Input
aspects. Input consists of Human Resources, Funds, Method, Infrastructure and Targets. The results of
the study showed officers who carry out complemetary foods distribution for pregnant women were TPG
(Nutrition officer) and MCH officers (Midwives). If the Nutrition officer is on duty in the field, the MCH
officer will replace the role of the TPG in the distribution of Biscuits for complementary foods. Funds are
adjusted to the distribution and target, funds are distributed from the Central Government, the Provincial
Government, the City Health Office, the community health center (TPG/Midwife), to the Village (Cadre).
The distribution of biscuits for pregnant women was not in accordance with the initial plan and existing
regulations.Biscuit distribution method for pregnant women based on technical instructions is 150 pieces/
month and carried out for 3 months, with a dose of 5 pieces/day. There were no available facilities and
infrastructure that meet 9 warehouse standards according to technical instructions

Keyword: Input, Biscuit as complementary foods, Pregnant Women, Nutrition Officer and Midwife

Introduction every year by the Health Office. Complementary foods

2 products provided in the form of Biscuits that contain
Complementary foods distribution Program for
pregnant women who suffer chronic energy deficiency
has been implemented in all Regencies/Cities in Indonesia
Corresponding Author:
Henrick Sampeangin
Jl. Ganggawa No. 22,, Kota Pare-Pare, Sulawesi
Selatan, Indonesia,
Phone: +62 852-4058-0171
e-mail: henricksampeangin@yahoo.com
14
Macro and Multi Micro Nutrients. However, there are
still a number of obstacles in the program, including
procurement of goods that only occur in certain periods,
2
the report format from the Ministry of Health is limited to
the implementation of complementary food distribution,
targets cannot be monitored regularly, and report formats
are not uniform among each community health center1.
The effectiveness of a program implementation is also
1
influenced by good management. The implementation
of biscuits as complementary foods begins with the
 9
2002 Indian Journal of Public Health Research & Development, March 2020, Vol. 11, No. 03
stages of Input, Process, Output and Outcome. So that
management really needs to be considered so that it can be
applied in various fields including health to solve public
health problems2. Management is urgently needed to
support a coordinated and integrated system in the fields
20
of health, sustainable human resources, infrastructure
development, and effective data management systems to
overcome current challenges3.
Input is a collection of parts or elements contained
in the system and is needed for the system to function1.
Administrative tools include personnel, funds, facilities
and method, also known as sources, procedures and
capabilities. Input elements can be categorized in 6M,
namely man, money, materials, method, markets and
machinery4.
This study aimed to assess the Input (man, money,
1
materials, method, markets and machinery) on the
implementation of biscuits as complementary foods for
Pregnant Women in the Parepare City.
Method
4
This study used descriptive qualitative method to
1
assess the management of the implementation of the
Complementary foods distribution Program for Pregnant
Women in Pare pare City based on Input aspects. Input
consists of man, money, materials, method, markets and
25
machinery. Data collection through in-depth interviews
with informants and direct observation to the location.
In qualitative research the number of informants
is usually small, so in order to maintain the validity of
the data, several method are needed. The validity test
used in qualitative research was called triagulation. To
establish the validity in this study so: 1) Key Informants
(Head of nutrition section of the City Health Office);
2) Triangulation of Resources (Community Health
Center Nutrition Workers, Village Midwives, Cadres);
3) Triangulation of Method (Interview, Observation,
Document)
Results
Human Resources: Based on the data it can be
known that officers who carry out complementary foods
distribution programs for pregnant women are carried
out by Nutrition Workers (TPG) and MCH officers
(Midwives). If the Nutrition Officer works in the field,
the MCH officer will replace the TPG role in providing
Biscuits as complementary foods for pregnant women.
The number of Nutrition Workers (TPG) involved
in the Pare pare City Health Office was 2 people, and the
number of nutrition workers involved in all community
health centers was 14 people.
“The number of human resources in Parepare
consisted of 2 nutrition workers at the city health office,
17
2 at the Lakassa community health center, 4 at Madising
community health center, 4 at Lapadde community
health center, 2 at Cempae community health center, 3
at Lumpue community health center. people to carry out
complementary foods distribution programs, (EN, 38
years old)
“The village midwife who came only once ... there
were also those who were given nutrition consultations
...”. (AJ, 22 years old)
The number of MCH officers (Midwives) involved
in all community health centers was 63 people. If the
nutrition officer is absent, then it is replaced by another
officer, namely the midwife.
“In the Lakessi Community Health Center,
there were around 6 people who usually carry out
complementary foods distribution programs” (AY, 27
years old)
Funds/Money: Funds are distributed from the
central government, the provincial government, the
26
City Health Office, the community health center (TPG/
Midwife), to the village (cadre).
14
Budget on Biscuit: Based on the results of research
in the field, the distribution of biscuits for pregnant
women is only at the central government level until it
ends at the community health center, and not through
cadres. The main reason is because there is no special
fund for cadres.
Cost: Transportation and warehouse storage costs
should be allocated. Funds are considered insufficient to
cover the costs of building warehouses, transportation
and accommodation as well as staff salaries from the
central level to cadres. These funds also need to be clearly
18
regulated in the technical guidelines and recording still
needs to be improved in terms of neatness and accuracy,
and further checks need to be made to find out the exact
nominal of the budget.
Distribution Method: In general, the distribution
 Indian Journal of Public Health Research & Development, March 2020, Vol. 11, No. 03
time is only when pregnant women do ANC to
23
community health centers so that it is not suitable for the
needs of pregnant women, especially those who do not
routinely do ANC.Some pregnant women with chronic
energy deficiency are not visited after the biscuits run
out because they are from other Community Health
Center areas but always visit other Community Health
Centers as well. Time, energy, and cost limitations to
2
carry out complementary foodsdistribution for pregnant
women with chronic energy deficiency to the home
Dosage: In general, the specified dose is not met
properly because the distribution time is only when
pregnant women do ANC to the public health center. So
that many are not in accordance with the needs of pregnant
women, especially those who do not routinely do ANC.
Pregnant women do not routinely take biscuits because
they do not understand well the dose to be consumed
2
and do not understand well the benefits of biscuits for
pregnant women with chronic energy deficiency. Time,
energy, and cost limitations to complete complementary
2
foods distribution in pregnant women with chronic
energy deficiency. This is the main reason the biscuits
are not distributed directly through the cadres but rather
waiting for pregnant women to come to the community
health center.
Facilities/Materials: There are still many
community health centers that do not carry out standard
storage. Although there are already quite qualified
because 7 of the 9 required standards have been provided
such as the Lapadde community health center. Storage in
many households is not according to standard. The results
of interviews conducted with several informants found
the fact that the storage of biscuits as complementary
foods does not comply with the standards listed in the
technical instructions, some are just put on the cupboard
or in the refrigerator.
Pregnant women do not know the standard of biscuit
storage at home because it is not specifically socialized.
Storage is not prepared a special place. Pregnant women
only pick up the packaging shortly after the biscuits are
eaten. There are also those who store it in jars and invite
any guest who wants to consume because of cultural
factors.
Discussion
Human Resources: Based on the results of an
interview with one of the Coordinating Midwives
(Bikor), it is known that officers who carry out
2003
complementary food distribution in pregnant women
are carried out by TPG (Nutrition Officer) and MCH
officers (Midwife). If the Nutrition officer works in
the field, the MCH officer will replace the TPG role in
providing Biscuits as complementary foods for pregnant
women. A collaborative approach between midwives
and nutrition workers in the service of pregnant women
can be an effective method in overcoming the nutritional
problems of pregnant women5.
The success of the public health center in carrying
out the program is determined by a balanced human
resource between medical staff on the one hand and
promotive and preventive staff on the other. The main
problem in the management of health workers is the
unequal distribution of human resources 6. In addition
there are Over-staffing for non-professional staff (non-
technical) and under-staffing for professional staff
(technical staff) 7A similar study took place in the
Taburia distribution program with an input element in
4
the form of managing the nutritional status of stunting
toddlers in the work area of the Sirampog community
health center which was considered ineffective, because
the health worker coordinator who was midwife not the
Nutrition officer. It was considered incompatible with
competence 8. Midwives should have a management
approach, especially Nutrition management, so that
they can organize all elements involved in their services
properly in order to reduce maternal and child mortality
9
Funds: The funds are adjusted to the distribution and
target, the funds are distributed accordingly starting from
the Central Government, the Provincial Government, the
City Health Office, the community health center (TPG/
Midwife), to the Village (Cadre). The cost depends on
the number of target recipients of the program10.
4
The results of the research in the field showed that
the distribution of biscuits for pregnant women was
not in accordance with the initial plan and existing
regulations. The distribution flow in Parepare city started
from the central government to the community health
center, which should still distribute through the TPG,
Midwives, and Villages/Cadres. From interviews with
officers, the main reason was no special funds intended
for cadres. While the technical instructions are not
regulated in detail about the use of the complementary
foods distribution budget. So that the application of the
program in the field is uneven.
 9
2004 Indian Journal of Public Health Research & Development, March 2020, Vol. 11, No. 03
Complementary Foods Distribution Method:
Complementary Foods Distribution Method for pregnant
women through annual planningand according to the
prescribed dosage. The demand for biscuits is adjusted
to the amount of chronic energy deficiency proposed
from the public health center and the City Health Office
in the previous year, so the number of biscuits available
may not be able to cover pregnant women with chronic
energy deficiency this year because it is not necessarily
the same amount as the previous year. In general, the
specified dose is not met properly because the time of
distribution is only when pregnant women do ANC to
the public health center. So, it is not in accordance with
the needs of pregnant women, especially those who do
not routinely do ANC.
Pregnant women do not routinely take biscuits
because they do not understand well the dose to be
consumed and do not understand well the benefits
2
of biscuits for pregnant women with chronic energy
deficiency. The limited time, energy, and cost to
2
complete complementary foods distribution in pregnant
women with chronic energy deficiency is the main
reason that biscuits are not distributed directly through
cadres but rather waiting for pregnant women to come to
community health center11.
Facilities/Materials: Facilities and infrastructure
are important factors that support the implementation of
complementary foods distribution in pregnant women,
24
including the availability of adequate health services
such as community health centers and the existence
of complementary food storage for pregnant women.
Storage of biscuits as complementary foods should not
be mixed with dangerous goods and are not suitable
for consumption, storage in warehouses according to
standards (pay attention to the taxonomy of inputs for
transportation and storage). Each community health
center has its own warehouse to facilitate distribution
of pregnant women. There are still many community
health centers that do not carry out standard storage.
Inappropriate food storage can cause damage and affect
the nutritional value of the food12.
Target: The target of biscuit distribution is
Pregnant women with chronic energy deficiency.
1
There were 49 pregnant women getting biscuits as
complementary foods (all pregnant women with chronic
1
energy deficiency got biscuits as complementary foods).
Some pregnant women who were stated to have chronic
energy deficiency did not understand well the schedule
for giving biscuits for complementary foods. Pregnant
women were not enthusiastic about visiting health
services, they stated that they got biscuits while doing
ANC, they were also got biscuits even though they were
late or sometimes asked for availability.
In addition to chronic energy deficiency, Gakin
(Poor Family) is also a concern for the improvement of
Nutrition in Parepare, data on pregnant women obtained
from village midwives or cadres about pregnant women
who are below the poverty line are also given biscuits,
although the foods they consume often fall into the
category of less nutritious and unbalanced is certainly a
big hope that the child can still live healthy with the help
of nutrition from these complementary foods.
Chronic energy deficiency as well as Gakin
are the main priority of the biscuits distribution as
complementary foods. This is the first and foremost
goal that must be realized immediately so that it can
be distributed quickly and accurately. Pregnant women
with chronic energy deficiency with a low economy will
find it difficult to meet their nutritional needs through
other foods, because of their economic difficulties13.
Chronic energy deficiency conditions that are not
handled properly will cause fatal for pregnant women14.
Conclusion
The human resources that carry out the
complementary food distribution program for pregnant
women are TPG (Nutrition officer) and MCH officers
(Midwives). Funds are distributed from the Central,
Provincial, City Governments. However, funds were
deemed insufficient to cover warehouse rentals,
transportation to public health centers, and procurement
of technical manuals. Biscuit distribution method for
pregnant women based on technical instructions is 150
pieces/month and carried out for 3 months, with a dose
of 5 pieces/day. There were no available facilities and
infrastructure that meet 9 warehouse standards according
to technical instructions.
13
Ethical Clearance: Taken from Faculty of Public
Health, UniversitasHasanuddin Committee.
Source of Funding: Fatima Nursing Academy
Pare-pare, City of Pare-pare, Indonesia
13
Conflict of Interest: None
 Indian Journal of Public Health Research & Development, March 2020, Vol. 11, No. 03
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