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Abstrak :
Proporsi BBLR hasil Riskesdas 2018 adalah 6,3% dengan jumlah kasus terbanyak di Provinsi Jawa Barat. Kekurangan zat besi pada ibu hamil dapat menyebabkan pertumbuhan janin terhambat, kelahiran prematur atau BBLR. Program pemberian tablet tambah darah pada ibu hamil diberikan untuk memenuhi kebutuhan zat besi pada ibu hamil. Penelitian ini bertujuan untuk melihat hubungan antara kepatuhan konsumsi suplemen besi selama kehamilan dengan BBLR setelah mengendalikan seluruh variabel confounding. Metode yang digunakan pada penelitian ini adalah kasus kontrol dengan rasio 1:3. Sampel penelitian berasal dari data sekunder Riset Kesehatan Dasar tahun 2018 khusus Provinsi Jawa Barat. Jumlah kasus untuk penelitian ini adalah 180 sampel dan kontrol 540 sampel. Variabel kovariat dalam penelitian ini adalah usia bersalin, tingkat pendidikan, status bekerja, wilayah tempat tinggal, riwayat hipertensi, adanya komplikasi, status merokok, status merokok pasif dan usia gestasi saat melahirkan. Hubungan variabel dinilai dengan analisis bivariat dan multivariat. Hasil penelitian menunjukkan tidak terdapat hubungan bermakna (p>0,05) dengan peluang risiko 1,268 kali lebih besar pada ibu yang tidak patuh mengkonsumsi TTD untuk melahirkan bayi BBLR (OR= 1,268 95%CI 0,87-1,847) setelah dikontrol variabel kovariat. ......Based on Riskesdas 2018, the proportion of LBW in Indonesia is 6.3% with the highest number of cases in West Java Province. Iron deficiency in pregnant women can cause restricted fetal growth, prematur birth or LBW. This study aims to look at the relationship between compliance with iron supplement consumption during pregnancy with LBW after controlling for all confounding variables. The method used in this study is case control with a ratio of 1: 3. The research sample is derived from secondary data used from the 2018 Basic Health Research in West Java Province. The number of cases for this study were 180 samples and 540 controls. The covariate variables in this study were maternal age during pregnancy, education level, work status, area of residence, history of hypertension, complications, smoking status, passive smoking status and gestational age at delivery. The relationship of variables was assessed by bivariate and multivariate analysis. The results showed no significant relationship (p> 0.05) with a 1.268 times greater chance of risk for mothers who consumed less iron supplements than 90 tablets to deliver LBW babies (OR = 1.268 95% CI 0.87-1.847) after covariate controlled variable.

Abstrak :
A study to investigate the effect of iron supplementation program among underfive children in North Central 'Timor, East Nusa Tenggara, Indonesia was conducted. The study was comprised into two parts: a cross-sectional study to investigate the impact of the ongoing government of Indonesia iron supplementation program and a intervention trial aiming to investigate the effect of daily compared to weekly iron supplementation. Hemoglobin, weight, height and compliance assessment were performed. The cross-sectional study involved 127 underfive children from four health centers. The average of age, weight and height of the recruited subjects was 36.6 months, 10.4 kg and 84.5 cm respectively. The result of this study showed that the prevalence of anemia among 127 underfive children where iron supplementation program has been implemented was still high, (81.5%), although 75.6% of the subjects claimed to take all the iron syrup. The intervention study recruited 160 preschool children and were divided into two groups: for 10 week one group received a daily supplement of 30 mg Fe, while the other group received 30 mg Fe per week A complete data set was obtained from 75 children in the group supplemented daily and 73 children in the group supplemented weekly. Th average age, weight and height of the subjects for daily group were 43.7 months, 12.1 kg and 91.0 cm respectively while 41.8 months, 11.7 kg and 90.3 cm for the weekly group. The result of this study showed a significant hemoglobin increase in both groups (p<0.001) which reduced the prevalence of anemia from 42.3 to 7 % in daily group and from 55.9% to 27.9% in weekly group. Although the weekly group had higher compliance (100%) compared to daily group (42.1%), it is concluded that daily group resulted in a better effect in reducing anemia prevalence among the preschool children.

Abstrak :
Anemia defisiensi zat besi pada ibu hamil dapat diatasi melalui program pemberian Tablet Tambah Darah (TTD). Berdasarkan data Riskesdas tahun 2018, ibu hamil yang mengonsumsi TTD sesuai rekomendasi (90+ tablet) hanya sebesar 38,1%. Beberapa penelitian menyebutkan bahwa faktor-faktor yang memengaruhi ibu hamil tidak patuh mengonsumsi TTD adalah ibu hamil memulai kunjungan ANC pada trimester kedua dan ketiga, melakukan kunjungan ANC kurang dari empat kali, dan mendapatkan pelayanan ANC tidak sesuai standar (<10T). Ketiga faktor tersebut merupakan ukuran dari kualitas kunjungan ANC. Penelitian ini bertujuan untuk mengetahui hubungan antara kualitas kunjungan antenatal care terhadap kepatuhan konsumsi TTD ibu hamil di Indonesia tahun 2017. Desain penelitian ini adalah cross sectional menggunakan data SDKI 2017. Sampel penelitian ini adalah Wanita Usia Subur (WUS) 15-49 tahun yang memenuhi kriteria inklusi sebesar 12.230. Analisis data menggunakan complex sample. Hasil analisis multivariat menunjukan terdapat hubungan antara kualitas kunjungan antenatal care terhadap kepatuhan konsumsi TTD ibu hamil di Indonesia setelah dikontrol status ekonomi, tempat tinggal, dan tenaga pemeriksa hamil. Ibu hamil yang memiliki kualitas kunjungan ANC baik dan cukup memiliki kepatuhan mengonsumsi lebih tinggi dibandingkan ibu hamil yang memiliki kualitas kunjungan ANC kurang dengan nilai OR sebesar 4,3 (95% CI: 3,46-5,37) dan 2,7 (95% CI: 2,27-3,25). ......Iron deficiency anemia among pregnant women can be corrected with iron supplementation programs. According to Riskesdas data in 2018, pregnant women who took iron tablets with the recommendation (90+ tablets) were only 38.1%. Several studies state that factors that influence pregnant women not to comply with taking iron tablets are pregnant women starting ANC visits in the second and third trimesters, visiting ANC less than four times, and getting ANC services that are not up to standard. The third factor is a measure of the quality of ANC visits. This study aims to determine the relationship between the quality of antenatal visits and adherence to iron supplements consumption of pregnant women in Indonesia in 2017. The design of this study was cross-sectional using the 2017 IDHS data. The sample of this study was women of childbearing age 15-49 years who met the inclusion criteria of 12,230. Data analysis used complex sample. The results of the multivariate analysis showed the relationship between the quality of antenatal visits and adherence to iron supplements consumption of pregnant women in Indonesia after controlling for economic status, place of residence, and pregnant examiners. Pregnant women who had high and sufficient quality ANC visits had higher adherence to consumption than pregnant women who had less quality ANC visits with OR values of 4.3 (95% CI: 3.46-5.37) and 2.7 (95% CI: 2.27-3.25).

Abstrak :
This two month iron supplementation was a community trial study conducted in Sambelia village in Sambelia subdistrict, East Lombok district, West Nusa Tenggara province during October-December 1996. The main objective of the study was to investigate religious leader or toga as distribution channel of iron tablets for women in child-bearing age. There were 187 women involved in this study, 94 received the tablets through religious leaders (Toga group) and 93 from cadre (Cadre group). Both groups of women received 8 tablets of 60 mg elemental iron (combined with 250 pg folic acid, 2500 IU vitamin A and 60 mg vitamin C) to be taken once weekly for two months. Coverage was defined as percentage of women in child-bearing age who received the tablets. The women's compliance was assessed by interview and stool test. Other methods of assessment included anthropometry measurements (weight, height, MUAC) and biochemical test (hemoglobin test with cyanmethemoglobin method). In addition, Focus Group Discussion on some women and personal interview with the distribution channels (toga and cadre) using Semi Structured Interview were also conducted. The women were comparable in socioeconomic condition and hemoglobin status. The distribution through toga and cadre could cover respectively 87.1% and 86.2% of the women. Compliance was better among women in toga group who in average took 6.8 tablets compared to 5.9 among women in cadre group (p < 0.10). There was however no difference in improvement of hemoglobin (after controlling for some confounders) nor in decrease of anemia prevalence between the two groups after 2 months period The Hb increased by 0.14 g/dL and 0.30 g/dL and anemia prevalence decreased by 13.9 % and 16.2 % respectively in toga group and cadre group. In the cadre group, predictors of non full compliers were social factors (ie. age, family income, education level) and frequency of contact with the cadre, whereas in the toga group, only side effects were predictive of non-full compliers. Combining both groups, 31% of non full compliers were identified by social factors (ie. age less than 20 and living in permanent house) and provider-user dynamics (iefrequency of contact with the distribution channels). Results suggest that toga was a potential channel of iron tablet for women in child-bearing age. With different nature of toga and cadre, their cooperation has potential for better achievement of iron supplementation program.

Abstrak :
Iron deficiency anemia among under live children is highly prevalent in Indonesia and is considered as a public health problem. Iron supplementation seems to be the most appropriate way to control iron deficiency in relatively short period of time. Children consume less food than adult and their diet often consists of foods with little iron content and poor iron bioavailability. Additional iron to food for children is therefore necessary. One possible food chosen as alternative vehicle to prevent iron deficiency among children is bread. This study gave iron supplementation using bread as vehicle which provided 25% of daily iron requirement of preschoolers to address iron deficiency problem in relatively short period of time.

The study report is arranged and divided into three parts- Part I includes the background of the study, problem statement, rationale of the study, literature review, hypotheses, objectives and variable-indicator matrix.

Part 2 is the manuscripts for publication. The manuscript ?The efficacy of iron supplementation using bread as vehicle of preschoolers in Surabaya, East Java? is written for submission to Asia Pasific Journal. This pan consists of abstract, introduction, materials and methods including study and subjects, sample size, study design, data collection, statistical analysis, ethical consideration, results, discussion, conclusion and references.

Part 3 describes the questionnaire used for 'the data collection, detailed methodology and important results that have not been presented in the manuscript, ethical consideration, grant approval, references and curriculum vitae.

Abstrak :
The effect of weekly iron supplementation and deworming on the hemoglobin level was studied among 289 children aged 2 to 5 years in a randomized double-masked placebo controlled community trial. Subjects were allocated into 3 groups which respectively received iron supplements and deworming, iron supplements only and placebos. Iron supplementation for 8 weeks using 30 mg elemental iron as ferrous sulphate syrup once per week, led to a significant reduction in the prevalence of anemia from 37.2%. to 16.2%. Using unsupervised distribution by mothers, hemoglobin concentration increased significantly in both groups which received iron (p<0.001) and also in the placebo group (p<0.05), but the changes in both treatment groups were significantly higher than the placebo group (p<0.001). No significant difference in hemoglobin changes was found between those who received additional deworming and those who received iron supplement only. Positive iron in stool were confirmed in 68.2% of the children who were reported received iron supplements (n=66). It is concluded that weekly iron supplementation is effective to reduce the prevalence of anemia among preschoolers.

Abstrak :
Anemia merupakan salah satu masalah gizi, yang perlu mendapat perhatian khusus. Remaja putri termasuk golongan yang rawan menderita anemia karena mengalami mensturasi setiap bulan dan sedang dalam masa petumbuhan. Tujuan penelitian untuk mengetahui perbedaan efektifitas suplementasi TTD program lama dan baru Kemenkes terhadap perubahan kadar hemoglobin siswi anemia di Kabupaten Bengkulu Utara. Rancangan penelitian randomized control group pretest dan postest. Subyek penelitian dikelompokkan menjadi 2 kelompok perlakuan yaitu kelompok A (19 siswi) diberi suplementasi program lama (satu tablet per minggu dan satu tablet selama haid) dan kelompok B (19 siswi) diberi suplementasi program baru (satu tablet per minggu). Pemberian suplementasi TTD diminum di depan peneliti diberikan selama 8 minggu. Data asupan zat gizi diperoleh dengan kuesioner food recall, lama haid, lama menarche, kebiasaan minum teh atau kopi, pengetahuan tentang anemia dan TTD diperoleh melalui kuesioner berstruktur, kadar Hb awal dan akhir dengan cyanmethemoglobin. Hasil penelitian menunjukkan tidak terdapat perbedaan efektifitas perubahan kadar Hb pada kedua kelompok intervensi (p=0.402) dan tidak ada hubungan bermakna antara variabel internal dan eksternal terhadap perubahan kadar hemoglobin siswi kecuali Hb awal (p=0.001) dengan rata-rata perubahan Hb siswi kelompok A sebesar 1.77 g/dl sedangkan kelompok B sebesar 1.44 g/dl.

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Anemia is one of the nutritional problems, which needs to be highly concerned. Adolescent girls are included to a group which is susceptible to anaemia because of their monthly menstruation and gowth periods. This study aims to investigate difference effectiveness between old and new programs of the ministry iron supplementation in changes hemoglobin level among anemic students in Kabupaten Bengkulu Utara. Design of this study is randomized control group pretest dan posttest.Subjects were randomized into two groups, group A (19 subjects) old program supplementation ( once per week and once per day in menstrual period) and group (B) new program supplementation (once per week). Supplementation of iron tablet was given for a consecutive 8 weeks. Nutrient intake obtained with the food recall questionnaire, days menstruation, menarche, drinking tea or kopi, knowledge anemia and iron tablet through structured questionnaire and level of hemoglobin by cymenthemoglobin. The study shows no difference found in the change of hemoglobin level of the two groups (p=0.402) and internal and external variable were not significantly in the change of hemoglobin level except early hemoglobin with mean hemoglobin change in old program supplementation was 1.77 g/dl while in new program supplementation the change was 1.44 g/dl.