Prevalensi stunting pada balita di Indonesia, khususnya Kabupaten Bogor masih tergolong tinggi. Minimum Acceptable Diet (MAD), salah satu penilaian pada praktik pemberian makanan pendamping ASI, merupakan salah satu determinan utama dalam kejadian stunting. Penelitian ini bertujuan melihat hubungan MAD dan faktor lainnya dengan kejadian stunting pada anak umur 6-23 bulan. Metode penelitian ini menggunakan desain studi kohor prospektif data penelitian Kohor Tumbuh Kembang Anak (TKA) yang dilaksanakan sejak tahun 2012 di Kota Bogor. Sampel penelitian ini adalah anak umur 6-23 bulan pada studi kohor TKA yang dilakukan pengukuran berulang secara lengkap. Anak yang lahir pada pada tahun 2012-2017 dan diikuti hingga umur 23 bulan (pada tahun 2014-2019).

Variabel dependen pada penelitian ini ialah anak stunting yang diamati pada saaat usia 12, 18 dan 24 bulan. Variabel independen utama pada penelitian ini ialah MAD yang diamati pada rentang umur 6-11, 12-17 dan 18-23 bulan.

Hasil: Prevalensi stunting dalam penelitian ini masih cukup tinggi yaitu anak umur 12 bulan (23,8%), 18 bulan (33,2%) dan 24 bulan (24,6%). Capaian MAD tidak adekuat paling banyak terjadi pada anak umur 6-11 bulan (77,9%). Analisis bivariat menunjukkan bahwa MAD umur 6-11, 12-17 dan 18-23 tidak berhubungan terhadap kejadian stunting pada anak umur 12,18 dan 24 bulan.. Analisis Multivariat Regresi Cox menunjukkan stunted usia sebelumnya dan asupan protein mempengaruhi terjadinya stunting.

Kesimpulan: Upaya lebih lanjut perlu dilakukan untuk capaian MAD yang direkomendasikan pada anak usia 6-23 bulan untuk mencegah stunting. Studi skala besar untuk mengeksplorasi peran MAD dalam mengurangi stunting dan studi kualitatif untuk mengidentifikasi kendala dan faktor yang mempengaruhi praktik pemberian makan bayi dan anak yang lebih baik sangat penting untuk perbaikan program.

The prevalence of stunting among children under-fives in Indonesia, particularly in Bogor, West Java, is still relatively high. Minimum Acceptable Diet (MAD), one of the  assesments on the practice of complementary feeding is one of the main determinants of stunting. This study aims to examine the relationship between MAD and other factors with the incidennce of stunting in children aged 6-23 months. Methods: This research method uses a prospective cohort study design from the Cohort of Growth and Development  of children (TKA) research data which has been carried out since 2012 in Bogor City.

The sample of this study was children aged 6-23 months in the TKA cohort study whio underwent complete repeated measurements. Children born in 2012-2017 and followed up to 23 months of age (in 2014-2019).

The dependent variables were stunted children at ages 6-11, 12-17. 18-23 and 24 months. The main independent variable was Minimum Acceptable Diet at the age interval of 6-11, 12-17, and 18-23 months. The data collection on the MDD, the MMF, and the MAD used twenty-four-hour dietary recall. Result: Prevalence of stunting was higher for child aged 12 months (41,7%) than for those in 18 months (8,1%) and 24 months (4,0%) category. Inadequate MAD achievement was most common in children aged 6-11 months (41.7%). Bivariate analysis showed that fulfilment MAD aged 6-11, 12-17 and 18-23 were not associated with stunting. Multivariate analysis Cox Regression indicated that stunted early age and protein intake were significantly associated with stunting.

Conclusion: More efforts need to be done to achieve the recommended MAD for all children aged between 6-23 months and to prevent stunting. Large scale studies to explore the role of MAD in reducing stunting and qualitative studies to identify the constraints and promoting factors to better infant and young child feeding practices are imperative for programme improvement.

Stunting merupakan salah satu masalah gizi yang banyak dialami anak diseluruh dunia, terutama
dialami oleh negara berkembang.). Indonesia sebagai salah satu Negara berkembang di kawasan
Asia juga mengalami masalah tersebut. Tujuan penelitian adalah untuk mengetahui determinan
stunting anak 1-2 tahun dan perubahan anak yang awalnya stunting menjadi tidak stunting
(tinggi badan normal) pada umur berikutnya Penelitian ini melakukan analisis data sekunder
dengan memanfaatkan ketersediaan data survei IFLS (Indonesian Family Life Survey). Populasi
dalam penelitian ini adalah anak usia balita yang ada dalam data IFLS 1993. Sampel dalam
penelitian ini adalah anak yang usia 1-2 tahun pada IFLS 1993. Analisis data dilakukan dengan
menggunakan regresi logistic.Hasil penelitian menunjukkan bahwa ada 47,1 % anak 1-2 tahun
mengalami stunting dan pada usia berikutnya 8-9 tahun 31,3 % tinggi badannya dapat menjadi
normal. .Hasil analisis multivariate ternyata ada 5 variabel yang berhubungan dengan kejadian
stunting anak 1-2 tahun yaitu variabel Tinggi badan ibu, tempat tinggal, Berat lahir, kondisi
ekonomi keluarga dan kondisi kesehatan lingkungan Selanjutnya dari hasil analisis multivariate
ternyata ada 5 variabel yang berhubungan dengan perubahan anak stunting umur 1-2 tahun
menjadi anak dengan tinggi badan normal (tidak stunting) pada umur 8-9 tahun yaitu variabel
tinggi badan ibu, tinggi badan bapak, tempat tinggal, jenis kelamin dan perubahan kondisi
ekonomi keluarga menjadi lebih baik. Kementerian Kesehatan perlu merumuskan kebijakan
untuk program perbaikan gizi kronis (stunting) yang biasanya mulai terjadi selama periode seribu
hari kehidupan yaitu sejak masa janin dalam kandungan sampai usia anak 2 tahun. Intervensi gizi
difokuskan pada perbaikan status gizi sebelum kehamilan dan selama hamil, bahkan lebih baik
intervensi gizi dilakukan jauh sebelum menikah, yaitu pada usia sekolah dan usia remaja

Kata Kunci: stunting, perubahan tinggi badan normal

Falls are the leading cause of unintentional injuries in preschool-aged children, and prinarily occur in the home environment. Injuries from falls at an early age have the potential to cause long-term effects on a child's physical, cognitive, and neurological development. Previous research has focused more on identifying risk factors and the occurrence of injuries, while this study aims to model the success of fall prevention in children based on a household-based risk management framework. This approach integrates the Safety I–III and the Theory of Graceful Extensibility (TGE) to evaluate the protective and adaptive capacity of family systems in sustaining child safety. The study used a cross-sectional design with 167 primary caregivers of preschool-aged children in Depok, who care for children in household settings. Data was collected through a questionnaire developed based on four main factors: the child, the home, the agent, and the companion's knowledge. The analysis was conducted in stages using Rasch measurement to test the validity and reliability of the instrument, Principal Component Analysis (PCA) to determine factor scores, Receiver Operating Characteristic (ROC) to establish the cut-off point for protective categories, and Bayesian Network and Bayesian Logistic Regression to map the probabilistic relationships between factors.
The results show that 65.3% of children experienced at least one fall in the past six months. The developed instrument proved to be valid and reliable in measuring the protective capacity of families against falls in children. Based on modeling results, the baseline probability of successful fall prevention for children, at 42%, reflects the limitations of the family system's protective capacity in actual conditions. Through sensitivity analysis, home factors and child factors were identified as the main protective factors against the success of fall prevention. Protective home and child conditions triple the system's chances of success (OR = 3.14). Furthermore, the what-if scenario simulation shows that strengthening home and child factors are the main leverage points in the system that can increase the probability of success in prevention by 53% and 52% respectively. Companion knowledge and agent factors play a role as adaptive enhancers in the next layer of protection.
The implication of these findings is the need to develop a household-based fall prevention program in the form of a layered protection system (barrier-based approach). The first barrier prioritizes strengthening home and child factors in parallel and interactively through improving the physical environment of the home and increasing knowledge and shaping basic child safety behaviors according to the developmental stage. The second barrier focuses on strengthening caregivers' knowledge, while the third barrier concentrates on controlling agent factors through arranging furniture and children's toys.
The success of fall prevention in preschool-aged children at home is the result of the adaptive and dynamic performance of the family system. Integrating risk management, Safety I–III, and the Theory of Graceful Extensibility allows fall prevention to be understood as a positive safety outcome resulting from the family system's capacity.