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Abstrak :
Kualitas sumber daya manusia salah satunya ditentukan oleh keadaan gizi masyarakat, terutama status gizi anak balita. Prevalensi gizi kurang anak balita di wilayah I kabupaten Pandeglang sebesar 21,4%. Pemantauan pertumbuhan dan perkembangan anak balita dapat dilakukan di posyandu. Cakupan penimbangan balita (D/S) di posyandu wilayah I kabupaten Pandeglang tahun 2003 masih rendah 51,40%. Tujuan penelitian ini adalah untuk mendapatkan gambaran, faktor-faktor yang berhubungan, dan melihat faktor paling dominan terhadap cakupan penimbangan balita di posyandu wilayah I kabupaten Pandeglang tahun 2004. Rancangan penelitian cross-sectional, dilaksanakan di wilayah I kabupaten Pandeglang. Sampel posyandu sebagai unit analisis sebanyak 64 posyandu. Untuk mendapatkan data karakteristik posyandu, setiap posyandu diambil sampel ibu balita sebanyak 7 responden dan semua kader aktif sesuai kriteria. Sehingga jumlah sampel keseluruhan 448 responden ibu balita dan 160 responden kader posyandu aktif. Pengambilan sampel dilakukan secara acak sederhana, kecuali kader aktif diambil seluruhnya. Data karakteristik posyandu merupakan agregat dari seluruh responden (ibu balita dan kader) tiap posyandu. Data yang dikumpulkan adalah cakupan penimbangan posyandu, faktor kader (umur, pendidikan, rasa kerja, pengetahuan, penghargaan, proses penunjukkan dan pelatihan), supervisi petugas kesehatan, pembinaan desa, faktor ibu balita (pengetahuan, pendidikan, jumlah anak balita), dukungan tokoh masyarakat dan faktor posyandu (jangkauan, jadwal dan PMTPenyuluhan). Analisis dilakukan secara deskriptif, uji Chi-Square dan Regresi Logistik. Rata-rata cakupan penimbangan balita di posyandu wilayah I kabupaten Pandeglang 57,6%. Hasil uji Chi-Square didapatkan 6 variabel babas yang berhubungan bermakna yaitu faktor kader (masa kerja, pengetahuan dan pelatihan), pengetahuan ibu balita, dukungan tokoh masyarakat dan PMT-penyuluhan. Dengan uji regresi logistik terdapat 5 variabel yang berhubungan secara bermakna yaitu masa kerja kader, pelatihan kader, pengetahuan ibu balita, dukungan tokoh masyarakat dan PMT-Penyuluhan, sedangkan faktor paling dominan adalah variabel pelatihan kader. Untuk meningkatkan cakupan penimbangan balita di posyandu perlu dibuat kebijakan dari kepala daerah tentang pelaksanaan pelatihan kader yang dilaksanakan bersamaan dengan pembinaan desa. Pelatihan kader dilaksanakan 3 bulan sekali di tingkat desa, yang sebelumnya belum pernah diselenggarakan secara berkala di tingkat desa. Pelaksanaannya bersamaan dengan pertemuan desa dengan materi yang disesuaikan kebutuhan dan waktu pelaksanaan hanya dalam sehari. PMT-Penyuluhan diadakan setiap bulan, dikelola oleh masyarakat dan sumber dana dari masyarakat yang potensial sebagai donatur, dengan dukungan yang baik dari tokoh masyarakat yang ada di wilayah posyandu.

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Factors Related To Coverage Of Weighing Of Underfive Children In Posyandus In Area I Of Pandeglang District Year 2004The quality of human resources is determined by, among others, the situation of community nutrition status, particularly of the underfives. Prevalence of undernourished children in Area I Pandeglang District was quite high, i.e. 21.4%. Monitoring of growth and development of underfives could be conducted in posyandu (integrated health post). Coverage of weighing (DIS) in posyandus in Area I Pandeglang District year 2003 was considered low, i.e. 51.40%. This study aimed to describe factors related to the coverage of underfives weighing in Posyandus in Area I Pandeglang District year 2004. Design of the study was cross-sectional, study conducted in Area I of Pandeglang District with number of samples (posyandu) as unit of analysis of 64 posyandus. To obtain data on posyandu characteristics, 7 mothers for each posyandu were randomly selected as respondents as well as all active cadres. Thus, there were 448 mother respondents and 160 cadres respondents in total. Data on posyandu characteristics was aggregate of all respondents including coverage of weighing, cadres factors (age, education, length of work, knowledge, rewards, recruitment process, and training), supervision from health worker, support from village, mother factors (knowledge, education, number of underfive children), support from informal leader, and posyandu factors (distance, schedule, and food supplementation program). Analyses were conducted descriptively, chi-square test, and logistic regression. The average coverage of weighing was 57.6%. The Chi-Square test found six independent variables with statistically significant association, i.e. cadre factors (length of work, knowledge, and training), mother's knowledge, informal leader support, and food supplementation program. Logistic regression test showed 5 significant variables, i.e. cadre's length of work, cadre's training, mother's knowledge, informal leader's support, and food supplementation program, with cadre's training as the most dominant factor. To improve the .weighing coverage in posyandu, it is recommended to develop policy from local government on cadre's training which could be implemented simultaneously with village meeting. It is suggested to conduct short cadre's training once in three month at village level with various adjustable substances. Food supplementation program is suggested to be implemented monthly, organized by community, funded by economically potential community members, supported by community informal leader.

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 :
Salah satu masalah kesehatan yang masih menjadi beban di negara-negara berkembang, seperti di Indonesia adalah masalah gizi buruk dan gizi kurang pada anak balita. Hal ini berkaitan dengan kualitas sumber daya manusia yang rendah dengan timbulnya berbagai masalah kesehatan. Bila hal itu dibiarkan di masa yang akan datang, akan semakin banyak anak yang tidak dapat menyelesaikan program wajib belajar sebab IQ nya rendah. Anak balita gizi buruk memiliki IQ 13 poin lebih rendah dibandingkan anak normal. Hasil penimbangan balita di kota Bogor pada tahun 2004, menunjukkan bahwa balita gizi buruk sebesar 0,4% dan gizi kurang 8,9%. Pengalaman di Laboratorium Pusat Penelitian Pengembangan Gizi dan Makanan (Lab P3GM) menunjukkan bahwa untuk perbaikan status gizi balita gizi buruk dengan tanda klinis (DTK) lebih lama dibanding tanpa tanda Minis (TTK). Status gizi buruk DTK adalah apabila gizi buruk tipe marasmus, kwashiorkor, dan marasmik kwashiorkor. Sedangkan status gizi buruk TTK adalah bila secara antropometri BBILI - 3 SD atau BB/TB - 2 SD, maka dikategorikan gizi buruk. Selama ini belum diketahui faktor yang mempengaruhi status gizi buruk balita DTK. Penelitian ini bertujuan untuk mengetahui hubungan pemberian makanan dan ASI serta faktor lain terhadap status gizi buruk balita DTK yang datang le Lab P3GM tersebut. Juga diketahuinya faktor dominan yang berpengaruh pada status gizi buruk anak balita DTK. Penelitian ini menggunakan data sekunder, dengan disain penelitian Cross Sectional. Data yang digunakan berasal dari data anak balita gizi buruk yang mengikuti rawat jalan di Lab P3GM. Seluruh balita yang berkunjung pada tahun 2004-2005 yang datanya lengkap untuk analisis ink dan sesuai dengan kriteria inklusi dan eksklusi dijadikan sampel dalam penelitian ini, yaitu sebanyak 74 anak. Analisis data yang dilakukan meliptiti analisis kai kuadrat dan analisis multivariat dengan nienggimakan analisis Regresi Logistik Ganda. Hasil analisis menunjukkan bahwa persentase jumlah gizi buruk balita DTK lebih besar (67,6%) dibanding balita GB= TTK (32,4%). Di antara anal( balita gizi buruk DTK, ternyata lebih banyak anak gizi buruk dengan tipe marasmus (56,S%), disusul marasrnik kwashiorkor. (8,1%) don kwashiorkor (2,7%). Pembezian ASI berhubungan bermakna dengan status gizi buruk anak balita DTK. Hasil analisis multivariat menunjukkan bahwa pemberian ASI merupakan faktor yang paling dominan berhubungan dengan kejadian status gizi buruk anak balita ILK setelah dikontrol oleh faktor umur balita dan status anemia. Anak balita yang tEdak mendapat ASI mempunyai peluang untuk menderita gizi buruk DTK 7,616 kali (OR= 7,616; 95% CI: 1,578-36,750) dibandingkan balita yang masih mendapat ASI setelah dikontrol variabel umur balita. Promosi pemberian ASI secara benar pada ibu-ibu dari balita gizi buruk perlu diprioritaskan Promosi. ASI tersebut di antaranya, menyusui eksklusif selama 6 bulan dan meneruskan pemberian ASI hingga usia 2 tahun.

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One of the health problem which is still being a burden in developing countries, including Indonesia, is malnutrition in underfive children. It related to the low quality of human resources with the occurrence of many health problems and if it is occurred, in the future will be many children not being able to graduate from their compulsory education program caused of their low IQ. Severe malnutrition children are 13 pains lower than normal children in IQ level. Children weighing result in Bogor 2004, showed that underfive children with severe malnutrition were 0,4% and moderate malnutrition were 8,9%. The experience in Food and Nutrition Development Research Center Laboratory (Lab P3GM) result is to improve the nutrition status of severe malnutrition in under five children with clinical sign (WCS) is longer than without clinical sign (WoCS). The WCS severe malnutrition are severe malnutritions with marasmus, kwashiorkor and marasmic kwashiorkor types. Whereas the severe malnutrition WoCS is if in antropomically WIA - 3 SD or WIH - 2 SD, therefore categorized as severe malnutrition. Until now, the factors that influence the WCS children with severe malnutrition are still undetectable. Research that aims to find the relationship between food and breast feeding gift along with other factors of WCS chidren with severe malnutrion status that came to the Lab P3GM. Also known the dominant factor which influenced the WCS children with severe malnutrition. This research uses secondary data of cross sectional research design. The children's data which suffered severe malnutrition and took the away treatment at Lab P3GIvL The amount of all underfive years chidren visited in 2004-2005 and had the complete data for this analysis and also suitable with the inclusive and exclusive criteria that made as examples in this research were 74 children. The data analysis that done, the chi square analysis and multivariate analysis. Analysis result describes the some of WCS children with severe malnutrition are bigger (67,6%) than severe malnutrition WoCS (32,4%). Between severe malnutrition WCS children, apparently, there were more severe malnutrition children in marasmus type (56,8%), followed by marasmik kwashiorkor (8,3%) and kwashiorkor (2,7%). Breast feeding gift is related to the WCS children status of severe malnutrition. The result of multivariate analysis described that breast feeding gift to children was the most dominant factor related to the WCS children status case of severe malnutrition after having been controlled by the children age and anaemic status factors. Underfive children that do not get breast feeding gift, having risk of suffering WCS severe malnutrition 7,616 times (OR = 7,616; 95% Cl : 1,578 -- 36,750) compared with children that still having the breast feeding after controlled according to children's age variables. Promotion of breast feeding gift correctly, to all mothers of underfive children with severe malnutrition, needs to be given priority. The promotion is an exclusive breast feeding for 6 months and until 2 years old.

Abstrak :
The high prevalence of anemia and vitamin A deficiency among underfive children is related to their food intake and health status. The situation appeared worst after multiple crisis hit Indonesia in 1997/1998. To obtain factors affecting the nutritional status of children aged 1-5 years, a baseline study was conducted in DKI Jakarta, Bogor, and Tangerang in collaboration with UN-WFP. The sample size was 1337 underfive children consisting of 666 boys and 666 girls. The study showed that malnutrition among underfive children was still high which indicated the high prevalence of underweight and stunting, especially in Bogor District and Tangerang District. The micronutrient intake of vitamin A, iron, and zinc among underfive children were certainly below the Indonesian RDA. The level of poverty and the education of woman as well as husbands were two conditions that were obvious from all areas, mainly Tangerang District.

Abstrak :
Salah satu titik berat pembangunan jangka panjang adalah pembangunan kualitas sumber daya manusia (SDM). Salah satu faktor yang mempengaruhi kualitas SDM adalah tingkat kesehatan yang dipengaruhi oleh status gizi khususnya usia balita (0 - 5 tahun). Kekurangan gizi merupakan salah satu manifestasi dari kemiskinan. Hal ini karena keluarga miskin (gakin) tidak memiliki cukup uang untuk membeli kebutuhannya yang merupakan penyebab rendahnya tingkat konsumsi pangan. Untuk mengatasi masalah gizi khususnya pada balita yang muncul sebagai dampak krisis ekonomi telah dilakukan intervensi perbaikan gizi balita diantaranya melalui pemberian makanan tambahan (PMT). karena dana yang ada dirasakan kurang, sehingga PMT yang diberikan belum mampu menjangkau semua balita gakin dengan gizi buruk. Penelitian ini dilakukan di Dinas Kesehatan Kabupaten Tangerang dengan fokus pada pembiayaan PMT balita gakin gizi buruk. Desain penielitian adalah operasional riset dengan mengumpulkan data alokasi anggaran untuk PMT balita gakin gizi buruk, perhitungan biaya PMT balita gakin gizi buruk, meghitung kesenjangan dan kerugian ekonomi akibat balita gakin gizi buruk dirawat di rumah sakit. Penelitian hanya menghitung biaya yang sifatnya langsung, sedangkan biaya investasi yang besar (seperti gaji, pembangunan gedung) serta biaya pemeliharaan (pemeliharaan gedung) tidak dihitung, karena biaya tersebut sudah selayaknya menjadi beban pemerintah. Dari hasil analisis didapatkan bahwa dana yang tersedia untuk PMT balita gakin gizi buruk yang dikelola oleh Dinas Kesehatan Kabupaten Tangerang tahun 2004 dari berbagai sumber sebesar Rp. 365.908.148,-. Sebagian besar (95%) dari APED Kabupaten Tangerang. Perkiraan biaya yang dibutuhkan sebesar Rp.960.841.337,-, jadi ada kesenjangan pembiayaan sebesar Rp.594.933.189,-. Ditemukan Pula kesenjangan kegiatan sebagai akibat dari kesenjangan pembiayaan. Kesenjangan yang besar adalah pada perencanaan yaitu tidak ada orientasi petugas dan kader serta pemenuhan sarana posyandu berupa timbangan gakin. Kesenjangan pelaksanaan adalah tidak semua gakin gizi buruk mendapatkan PMT, PMT yang diberikan komposisinya masih di bawah kecukupan gizi yang dianjurkan Depkes, tidak ada tranport distribusi dan transport/ insentif kunjungan rumah oleh kader yang diperlukan untuk memastikan bahwa PMT dikonsumsi oleh sasaran serta memberikan konseling kepada keluarga balita. Selain itu monitoring tidak dilaksanakan di semua desa yang ditemukan kasus gizi buruk. Kerugian ekonomi akibat balita gakin gizi buruk dirawat di RS sebesar Rp. 3.954.900,- terdiri dari biaya langsung 77,77%, biaya tidak langsung untuk makan dan transport penunggu balita serta biaya kesempatan 22,23%. Biaya tidak langsung menghabiskan semua penghasilan gakin yang relatif kecil. Selain kerugian terhitung juga ada kerugian yang tidak bisa dihitung dalam nilai uang yaitu rasa sakit, penderitaan dan berkurangnya kemampuan serta kecerdasan balita di masa depan. Melihat besarnya proporsi APBD dalam pembiayaan PMT balita gakin gizi buruk, maka perlu mobilisasi dana dari sumber lain. Memperhatikan kerugian akibat balita gakin gizi buruk dirawat di RS perlu dilakukan berbagai upaya pencegahan munculnya gizi buruk dan perlu ada dana tambahan lain untuk mensubsidi biaya tidak langsung rumah sakit agar gakin tidak menjadi semakin miskin. Daftar Bacaan : 43 (1985 - 2004)

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Cost Need Analysis of Food Supplementation Program for Underfive Children of Poor Families in Tangerang District Year 2004One emphasis of long run development is the development of human resource quality. Important factor that influence the human resource quality is health status which in turn is influenced by nutritional status, especially during the first five years of life. Under nutrition is a manifestation of poverty. This is mainly caused by insufficient amount of money owned by poor families to afford their needs and thus causing low food consumption level. To overcome under nutrition problem among underfives that was caused by economic crises, several nutrition interventions have been implemented including food supplementation. Due to lack of funding, this program could not reach all severely malnourished underfives from poor families . This study was conducted in Tangerang District Health Office focused on costing of Food Supplementation Program. Design of this study was operational research by collecting data on budget allocation for food supplementation program, calculating the cost of food supplementation program, calculating the gap between cost need and real allocation as well as the economic loss as implication of hospital care of severely malnourished children. This study only calculated direct cost, and did not calculate large investment such as salaries, building, and maintenance costs considering those as to be fully funded by government. The analysis showed that available fund for food supplementation program in the year 2004 from various sources was Rp. 365.908.148,-. Most of the funding (95%) came from Local Development Budget (APED) Tangerang District. Predicted cost need was Rp.960.841.337,-, therefore there was Rp.594.933.189,- gap. Gap in activity due to this funding gap was also found. One particular large gap was found in planning where no clear orientation among health workers and cadres and insufficient amount of necessary equipment such as weighing scales to be located in integrated health post (posyandu). Gap in program implementation was reflected by the facts that not all target children received food supplement, insufficient nutrients contained in food supplement, no money for transport, distribution, and home visits by cadres. Monitoring was not conducted in all villages. The economic loss due to hospital care of severely malnourished children was Rp. 3.954.900,- consisted of 77,77% direct cost, 22,23% indirect costs for food and transport of person who accompanied the child in hospital, and opportunity cost. This indirect costs absorbed the whole income of poor families. There were also losses which could not be valued by money including pain, suffers, and decreasing ability and intelligence of the children. Considering the large proportion of APBD in the costing of food supplementation program, there was a need to mobilize other sources of funding. To prevent unnecessary cost to be spent by poor families of hospitalized child, there wish an urgent need to prevent severely malnourished cases by various means and interventions, as well as extra fund to subsidize indirect cost to prevent further impoverishment of the poor. References: 43 (1985-2004)

Abstrak :
Latar Belakang. Rotavirus merupakan penyebab terbesar dari penyakit diare akut pada anak balita. Gejala klinis yang ditimbulkan yaitu diare, demam, muntah, nyeri perut, dan dehidrasi. Berdasarkan hasil penelitian di dua kota tahun 2007, ditemukan 47% Rotavirus sebagai penyebab diare akut di RS Hasan Sadikin, Bandung, sedangkan di RS Dr Sardjito, Yogyakarta ditemukan 32%. Biaya pemeriksaan laboratorium untuk mendeteksi adanya Rotavirus sangat mahal pada laboratorium tertentu saja. Belum diketahui kemampuan mendeteksi diare yang disebabkan Rotavirus berdasarkan beberapa gejala klinis dan karakteristik anak balita dengan diare akut. Objektif. Mengeksplorasi model prediksi untuk diagnosis diare yang disebabkan infeksi Rotavirus pada anak balita dengan diare akut dengan berdasarkan informasi gejala klinis dan karakteristik anak. Metode. Analisis dilakukan dengan menggunakan subsampel data penelitian utama Badan Penelitian dan Pengembangan Kesehatan Kementrian Kesehatan RI yang berjudul "Identifikasi dan Uji Resistensi Mikroorganisme Penyebab Diare Pada Anak Balita di Indonesia tahun 2011". Data anak balita dengan diare yang dirawat di Rumah Sakit Umum Serang selama tahun 2012 dikumpulkan melalui kuesioner. Selain gejala klinis dan karakteristik anak, dikumpulkan juga sampel tinja untuk dilakukan pemeriksaan adanya Rotavirus dengan metode Real-Time PCR. Hasil. Hasil penelitian menunjukkan bahwa gejala demam, kondisi tinja cair dan karakteristik anak (meliputi umur balita dan tidak diberi ASI) dapat digunakan untuk memprediksi adanya infeksi Rotavirus pada anak balita dengan diare akut. Model prediksi untuk nilai duga positif terjadinya infeksi Rotavirus pada anak diare akut sebesar 71,43%, berdasarkan gejala klinis (meliputi demam dan kondisi tinja cair) dan karakteristik anak (umur balita dan tidak diberi ASI). Pada anak diare akut yang mengalami gejala demam, kondisi tinja cair, umur 1-12 bulan, dan tidak diberi ASI, dugaan penyebab diare akut adalah rotavirus dengan peluang sebesar 82,1%. Simpulan dan Saran. Karakteristik anak dan beberapa gejala klinis dapat digunakan untuk menduga penyebab diare akut yang disebabkan Rotavirus. Mendasari hasil penelitian disarankan agar anak diare yang diikuti dengan demam dan kondisi tinja cair, perlu mendapat penanganan segera dengan diawali rehidrasi dan dapat dijadikan masukan bagi kebijakan dalam tatalaksana diare akut yang disebabkan Rotavirus. ...... Background. Rotavirus is the common cause of acute diarrheal disease in children under five years old with the several clinical symptoms such as watery stool, fever, vomiting, abdominal pain and dehydration. Based on the previous studies, the prevalence rotavirus among underfive children between 32% and 47% at two hospital in the two cities in the year 2007. Laboratory cost for examining Rotavirus is very expensive. Until now, we don?t know how accurate to predict Rotavirus as a cause of acute diarrhea among underfive children based on the information of clinical symptoms and children?s characteristics. Objectives. The aim of this study is to explore the prediction model for diagnosing Rotavirus diarrhea among underfive children by clinical symptoms and other characteristics. Methods. Using data from the main study of ?Identification and resistance analysis of microorganism causing diarrhea among children under five years old in Indonesia? was analyzed?. The study collected data from the questionnaire and also specimens in Serang Hospital in 2012. The analyses were completed by laboratory data from the specimens by Real-Time PCR. Results. The results of the study found that fever, watery stools and age under 12 months without having breastfeeding can be used as prediction model of Rotavirus infections among children with acute diarrhea. The prediction model of positive predictive value of Rotavirus infection of acute diarrhea is 71,43%. The positive predictive value is fulfilled from clinical symptoms including fever and watery stools and toddlers without having breastfeeding. Children presenting acute diarrhea with fever, watery stools, age under 12 months and no breast feeding had the prediction value 82,1%. Conclusion and recommendation. Characteristics and clinical symptoms of children underfive might be used to predict diarrhea caused by Rotavirus. Rehydration of acute diarrhea of Rotavirus infection is important step in management of acute diarrhea among underfive children.