Masalah stunting pada anak masih menjadi tantangan serius di Indonesia, termasuk di Kabupaten Pohuwato, Gorontalo. Penelitian ini bertujuan untuk menganalisis pengaruh edukasi Panduan Gizi Seimbang Berbasis Pangan Lokal terhadap perubahan praktik pemberian makan, asupan gizi, status besi, dan status gizi anak baduta. Desain penelitian yang digunakan adalah mixed methods exploratory sequential design, diawali dengan riset formatif kualitatif untuk pengembangan media edukasi, kemudian dilanjutkan dengan kuasi eksperimen dengan pendekatan non-randomized pretest-posttest control group design. Intervensi edukasi dilakukan selama 12 bulan dengan pendekatan komunikasi perubahan perilaku sosial (SBCC) menggunakan modul PGS-PL yang disesuaikan dengan kondisi lokal melalui edukasi intensif, peer educator dan juga demo masak.
Hasil penelitian menunjukkan bahwa edukasi PGS-PL berpengaruh signifikan terhadap peningkatan skor keragaman makanan (DDS) (OR = 1,89; p = 0,048) dan Konsumsi sumber pangan hewani (OR=1,55, p = 0,037), serta peningkatan asupan energi, protein, karbohidrat, lemak, vitamin A, asam folat, zat besi, dan seng (p < 0,05). Namun, tidak ditemukan pengaruh signifikan terhadap kadar serum ferritin dan serum transferrin receptor. Status gizi anak mengalami peningkatan signifikan pada indeks tinggi badan menurut umur (TB/U) sebesar 0,60 z-score (p = 0,007), tetapi tidak signifikan pada indeks berat badan menurut umur (BB/U), dan terdapat penurunan signifikan pada indeks berat badan menurut tinggi badan (BB/TB) (p = 0,034).
Penelitian ini menegaskan bahwa edukasi gizi berbasis pgs-pl dengan pendekatan kombinasi edukasi intensif, peer educator dan demo masak dapat menjadi strategi efektif dalam meningkatkan praktik pemberian makan dan status gizi anak balita di wilayah dengan potensi pangan lokal.

Stunting in children remains a serious public health challenge in Indonesia, including in Pohuwato District, Gorontalo. This study aimed to analyze the effect of nutrition education based on the Local Food-Based Balanced Nutrition Guidelines (PGS-PL) on changes in feeding practices, nutrient intake, besi status, and nutritional status of children aged 6–14 months. The research employed a mixed methods exploratory sequential design, starting with formative qualitative research for the development of educational media, followed by a quasi-experimental study using a non-randomized pretest-posttest control group design. The education intervention was conducted over 12 months using a social and behavior change communication (SBCC) approach, incorporating the PGS-PL module adapted to local conditions through intensive education, peer educators, and cooking demonstrations.
The results showed that PGS-PL education had a significant effect on increasing Dietary Diversity Scores (DDS) (OR = 1.89; p = 0.048) and Egg and/or flesh food (EFF) (OR=1,55, p=0,037), as well as improving the intake of energy, protein, carbohydrates, fat, vitamin A, folic acid, besi, and seng (p < 0.05). However, no significant effect was found on serum ferritin and serum transferrin receptor levels. Children's nutritional status showed a significant improvement in the height-for-age index (HAZ) by 0.60 z-score (p = 0.007), but no significant change was observed in the weight-for-age index (WAZ), and there was a significant decrease in the weight-for-height index (WHZ) (p = 0.034).
This study confirms that nutrition education based on PGS-PL using a combination of intensive education, peer educators, and cooking demonstrations can be an effective strategy for improving feeding practices and the nutritional status of toddlers in areas with local food potential.

Latar belakang : Keberhasilan pembangunan suatu bangsa ditentukan olch ketcrsediaan Sumber Daya Manusia (SDM) yang berkualitas. Unioef tahun 2000, mcnyatakan adanya bukti empiris yang menunjukkan bahwa hal tezsebut sangat ditentukan oleh status gizi. Semakin muda usia seozang anak untulc rnenderita gizi kurang, maka semakin bel-at akibat yang ditimbulkan. Dimana kemunduran mental yang diakibatkan oleh keadaan gizi kurang yang berat dapat bersifat pennanen, akan tetapi pada keadaan gizi kurang yang ringan maupun sedang kecenderungan kemunduran mental dapat dipulihkan, semenjak dengan bertambah baiknya keadaan gizi danlingklumgan anak dibesarkan. (I-lusaini, 1986, Jalal, 1998 dan Azwar, Azrul. 2004). Metodologi : Penelitian ini merupakan studi analitik dengan desain kohort retrospektifi Jumlah sampel kesehuuhan adalah 1200 anak. Analisis kandidat model menggunakan chi-kwadrat, dan analisis untuk variabel independen yang masuk ke dalam model menggunakan uji regxesi logistik dan Mantel-Haenzel. Hasil dan Pembahasan : Hasil penelitian di pcngaruhi olch bias obsen/asi bersifat misklasiiikasi non dejizrensial yang under estimate, confounding, interaksi multipikatif positif dan chane variazion. Alcan tetapi penelitian ini sangat konsisten karena mendulcung beberapa penelitian yang dilakukan sebelumnya., seperti: Burd L., Hames (1988), Cook Jr (1993) dan Halterman (2001), serta tidak dimungkinkan untuk texjadinya temporal ambiguity, sehingga dapat diaplikasikan pada populasi yang eligible dan populasi sumber. Dampak poterisial yang timbul pada populasi untuk tcxjadinya prestasi belajar verbal yang rendah dapat dicegah sebesar 44% pada saat anak usia baduta dan 30% pada saat anak usia setelah baduta apabila dalam status gizi balk pada usia tersebut. Dan dampalc potensial yang timbul pada populasi untuk terjadinya prestasi belajar numerik yang rendah dapat dioegah sebesar 80% pada saat anak usia baduta dan 63% pada saat anak usia setelah baduta apabila dalam status gizi baik pada usia tersebut. Kesimpulan: Semakin dini seomng anak menderita gizl kurang, maka semakin berisiko untuk mengalami prestasi belajar yang rendah, seperti besamya risiko prestasi verbal yang rendah dapat texjadi pada anak yang memiliki gizi kurang pada saat usia baduta sebesar 6,5 kali, dan pada saat usia setelah baduta 5 kali dibanclingkan dengan anak yang memiliki gizi baik pada saat usia texsebut. Demikian pula besarnya risiko prestasi numerik yang rendah dapat teljadi pada anak yang memilil-Li gizi kumng pada saat usia baduta sebesar 25 kali, dan pada saat usia setelah baduta I5 kali dibandingkan dcngan anak yang memiliki gizi baik pada saat usia tersebut. Prestasi verbal sangat dipengaruhi oleh kodisi (iluktuasi) status glzi individu sepanjang hayatnya. Suatu hal yang agak berbeda te1jadi pada prestasi numerik, dimana status gizi pada saat usia balita saja yang telihat berpengaruh.

 Background : The successful development of one’s nation is determined by availability of qualified human resources. UNICEF in 2000 said that there was empirical proof that those qualifications are detemained by nutritional status. The younger children get malnutrition, the heavier impact will be gotten by the children. The condition will be much heavier if the malnutrition starting to occur in fetus in the pregnancy. Mental retardation caused by severe malnutrition could be permanent, but if it happens in mild or moderate malnutrition it could be cured, as the nutritional status and environment where the children grow is getting better. (Husaini, 1986, Jalal, 1998 and Azwar, Azml. 2004). Methodology : This study was an analytical study with retrospective cohort design. Total sample in this study was 1200 children. Model candidate analysis used Chi Square, and analysis for independent variables to enter the model used logistic regression and Mantel-Haenzel. Result and Discussion : The result of the study was influenced by observational bias, which is non deferential rnisclassiiication that could be underestimated the result, positive multiplicative interaction, and chance variation. Thus, the result of this study was very consistent; because it supports prior study conducted by Burd L. Harnes (1988), Cook Jr (1993) and I-laltennan (2001), and also it is not by any chance temporal ambiguity could be happened, so the result of this study could be generalized to eligible population and source population. Potential impact that occurs in the population to have low verbal accomplishment which could be prevent was 44% if the nutritional status constantly good in children age less than 2 years and 30% if the nutritional status is good in children aged more than 2 years. Moreover, potential impact that occurs in population to prevent low numeric accomplishment which could be prevent is 80% if the nutritional status constantly good in children age less than 2 years and 63% if the nutritional status is good in children age more than 2 years. Conclusion : The younger a child get nutritional deiiciency, the bigger risk he will have low study accomplishment, such as the risk to have low verbal accomplishment could be happen in children age less than 2 years who has malnutrition is 6.5 times, and in children age more than 2 years the risk is 5 times than children in the same age 'with good nutritional status. Moreover, the risk to have low numeric accomplishment in children age less than 2 years is 25 times, and in children age more than years, the risk is I5 times than the children in the same age with good nutritional status. Verbal score was very influenced by condition or fluctuation of nutritional status of a person all his life. A little difference &om that, numeric score only being influenced by a person's nutritional status in his first five years of life

ABSTRAK Nama : Januar Tree Kencana Program Studi: Epidemiologi Judul : Hubungan Status Imunisasi dan Status Gizi dengan Kejadian Difteri Pada Kejadian Luar Biasa (KLB) di Kabupaten Serang Propinsi Banten Tahun 2017-2018 Pembimbing : Dr. dr. Tri Yunis Miko Wahyono, M.Sc Penyakit difteri disebabkan oleh infeksi corynebacterium diphteriae merupakan salah satu penyakit menular yang dapat dicegah dengan imunisasi, penyakit ini masih menjadi masalah kesehatan yang serius karena seringkali menimbulkan kejadian luar biasa (KLB) di berbagai negara maupun belahan dunia. Berdasarkan data Kementerian Kesehatan pada tahun 2017 telah terjadi KLB difteri di 20 propinsi dan 95 kabupaten / kota di Indonesia, termasuk Propinsi Banten dan salah satunya adalah di Kabupaten Serang. Di kabupaten Serang Status imunisasi dan statu gizi masyarakat masih menjadi masalah kesehatan, Cakupan imunisasi yang masih rendah di beberapa Desa dalam kecamatan dan status gizi buruk masih ditemukan, oleh karenanya penelitian ini dilakukan untuk mengetahui hubungan status imunisasi dan status gizi dengan kejadian difteri pada KLB di kabupaten Serang Propinsi Banten Tahun 2017-2018. Desain penelitian yang digunakan adalah kasus kontrol dimana variabel penelitiannya adalah status imunisasi dan status gizi serta variabel kovariat yaitu lingkungan fisik tempat tinggal, pengetahuan dan riwayat bepergian. Berdasarkan hasil penelitian secara multivariat dengan menggunakan regresi logistik di dapatkan hasil bahwa status imunisasi mempunyai OR : 3,777 95% CI = 1.48 -9.60 P Value 0.005 sedangkan Status Gizi memiliki OR : 1,23 90% CI = 0.44 – 3,41 P Value 0,680 setelah dikontrol dengan Variabel  Umur, Jenis Kelamin, Pengetahuan, Riwayat Bepergian, lingkungan fisik Rumah, pencahayaan alami, Kelembaban dan kepadatan Hunian. Kata Kunci : Difteri, Kasus Kontrol, Kejadian Luar Biasa

ABSTRACT Nama : Januar Tree Kencana Study Program: Epidemiology Title                 : The Relationship between Immunization and Nutritional Status with Diphtheria Outbreaks in Serang Regency, Banten Province 2017-2018. Background: Diphtheria as a one of the most contagious diseases that can be prevented by immunization (VPD) is still a serious health problem because it often causes outbreak in various countries including Indonesia. Based on data from the Ministry of Health of the Republic of Indonesia, during 2017 there have been diphtheria outbreaks in 20 provinces and 95 regency/cities including Serang Regency.This study aims to determine the relationship between immunization and nutritional status with the diphtheria outbreaks in Serang Regency of Banten Province in 2017-2018. Methods: This study was an analytic study using case control design with 172 respondents consisting of 43 cases and 129 controls. Logistic regression analysis was performed to obtain an estimate of the relationship between immunization and nutritional status with diphtheria after controlled covariate variables. Result: Proportion of immunization and good nutrition in the case is lower than in control. Immunization and nutrition in both cases were 51.2% and 76.7% while in controls were 77.5% and 81.4%. The association (OR) between immunization status and diphtheria was 3.78 (95% CI: 1.48-9.60) after controlling to age, room density and natural house lighting while the association (OR) between nutritional status and diphtheria was 1.23 (95% CI: 0.44-3.41) after controlling to age, knowledge, humidity, and immunization status. Conclusions: The proportion of immunization in diphtheria cases is still low. Nonimmunization status are at risk for diphtheria 3.78 times. The Health Office is expected to conduct routine monitoring and evaluation of basic immunization programs, especially in areas with low coverage and provide information to the community about diphtheria, including factors such as immunization, nutrition, and the physical environment of the house. Keywords: Diphtheria, Case Control, Outbreak.