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Indonesia has targeted a reduction in stunting prevalence to 14,2% in 2029. However, this effort still faces major challenges such as the complexity of the double burden of malnutrition and suboptimal feeding practices during the first 1000 days of life. At individual level, a child can experience more than one malnutrition problem at once, which called the double burden of malnutrition. Limited studies have examined the double burden of malnutrition at individual level in Indonesia. Therefore, this study was conducted to identify the association of complementary feeding practices and the double burden of malnutrition among children aged 6-23 months in Indonesia. This was a cross-sectional study using secondary data from the 2022 Indonesia Nutritional Status Survey. The double burden of malnutrition was assessed in forms of coexisting stunting-wasting and stunting-overweight, while complementary feeding practices was measured based on WHO and UNICEF IYCF indicators. A total of 69.884 children were analyzed for stunting-wasting and 72.158 children for stunting-overweight after meeting data completeness and no extreme values. Multiple logistic regression analysis was conducted to estimated asjusted prevalence odds ratio (aPOR). This study found the prevalence of stunting-wasting and stunting-overweight was 2.7% and 0.7%, respectively. Among the children, 50.9% met the minimum dietary diversity (MDD), 83.5% met the minimum meal frequency (MMF), 45.3% met the minimum acceptable diet (MAD), 72.5% consumed eggs and flesh foods (EFF), 24.9% consumed sweet beverages (SwB), and 21.6% had zero consumption of fruits and vegetables (ZVF). SwB and ZVF indicators were significantly associated with both forms of the double burden of malnutrition. Children who did not consume sweet beverages had a 10% lower risk of stunting-wasting (aPOR: 0.90; 95% CI: 0.81–0.996) and a 31% lower risk of stunting-overweight (aPOR: 0.69; 95% CI: 0.57–0.84) compared to children who consume sweet beverages. Meanwhile, children who consumed fruits and vegetables had a 20% lower risk of stunting-wasting (aPOR: 0.80; 95% CI: 0.71–0.90) and a 29% lower risk of stunting-overweight (aPOR: 0.71; 95% CI: 0.57–0.89) than those with zero intake of fruits and vegetables. These findings highlight the importance of improving the diversity and quality of foods provided in government programs, along with strengthening nutrition education and sweet beverages nutrition labeling policies to prevent the double burden of malnutrition among children.
Latar belakang: Masalah gizi stunting masih menjadi isu kesehatan masyarakat yang utama. Prevalensi stunting di Indonesia khususnya, pada bayi di bawah dua tahun (baduta) masih tergolong tinggi yakni 18.50%. Angka laju penurunan stunting pada baduta cenderung lamban dalam periode 10 tahun terakhir. Diperlukannya optimalisasi intervensi stunting terutama pada 1000 Hari Pertama Kehidupan (HPK) salah satunya, melalui pemeriksaan kehamilan (antenatal care).
Tujuan: Penelitian ini bertujuan untuk menganalisis hubungan antara kualitas pemeriksaan kehamilan terhadap kejadian stunting pada anak usia 6-23 bulan di Indonesia setelah di kontrol oleh variable lainnya pada ibu yakni; faktor sosiodemografi, kesehatan kehamilan dan kesehatan anak.
Metode: Studi ini berdesain cross-sectional, dimana faktor paparan dan outcome diukur pada satu waktu. Data yang digunakan adalah data Survei Kesehatan Indonesia (SKI) tahun 2023. Mengikutsertakan sebanyak 18.898 anak berusia 6-23 bulan yang ibunya sedang tidak hamil dan memiliki data pemeriksaan kehamilan lengkap pada instrumen SKI tahun 2023. Analisis hubungan menggunakan cog regression sedangkan, pada pengontrolan hubungan variable menggunakan metode time-dependent dan backward-elimination.
Hasil: Anak berusia 6-23 bulan di Indonesia yang ibunya tidak melakukan pemeriksaan kehamilan berkualitas berisiko 1.23 kali (aPR = 1.230, 95%CI: 1.111-1.361, p-value = 0,000) mengalami stunting setelah di kontrol oleh variabel kovariat lainnya.
Kesimpulan: Melakukan ANC minimal 4 kali dan menerima pelayanan ANC yang berkualitas dapat menurunkan resiko stunting pada baduta di Indoensia.
Bayi umur 4 - 6 bulan mulai mendapatkan makanan pendamping ASI (MP-AS1) secara bertahap, disamping masih tetap mendapat ASI. Pada masa ini kekebalan anak yang didapat secara pasif dari ibunya mulai menurun, sementara bayi mulai mendapatkan makanan yang kurang mencukupi dari kebutuhannya. Beberapa basil penelitian menunjukkan bahwa prevalensi KEP pada bayi lebib dari 15% berdasarkan indeks status gizi (BB/U). Hal ini menunjukkan bahwa masalah gizi pada bayi merupakan hal yang serius yang perlu segera ditangani.Penelitian ini menganalisis data sekunder dari Penelitian " Pola menyusui, Usia penyapihan dan Pemberian MP-ASI dalam Kaitannya dengan Status Gizi Batita (6 - 36 bulan) Di Kecamatan Pedamaran Kabupaten Ogan Komering Mir Sumatera Selatan Tabun 2001". Tujuan penelitian ini adalah untuk memperoleh tentang kekuatan hubungan umur pertama kali pemberian MP-ASI dengan status gizi bayi. Pada penelitian ini desain yang digunakan adalah cross sectional (potong lintang). Sampel adalah bayi umur 6 - 12 bulan yang mendapatkan ASI. Analisis yang digunakan adalah univariat, bivariat dan multivariat_Hasil penelitian didapatkan bahwa prevalensi KEP sebesar 20,7%, rata-rata umur pemberian MP-ASI 3,8 bulan, sedangakan bayi yang diberi MP-ASI < 4 bulan sebesar 31,0%. Asupan energi dari rata-rata 764 kkal sedangkan asupan protein 16 gr. Dari basil analisis multivari.at didapatkan adanya hubungan yang bermakna antara umur pertama kali pemberian MP-ASI dengan status gizi bayi umur 6 - 12 bulan. Bayi yang mendapatkan MP-ASI pada umur < 4 bulan kemungkinan akan mengalami risiko gizi kurang 5,2251 kali dibandingkan dengan bayi yang mendapatkan MP-ASI pads mnur 4 - 6 bulan setelah dikontrol oleh asupan energi. Ternyata asupan energi berperan sebagai confounder, atau mempunyai pengaruh dalam meningkatkan hubungan umur pertama kali pemberian MP-ASI dengan status gizi bayi.Untuk meningkatkan status gizi bayi maka perlu dilakukan peningkatan pelaksanaan monitoring pertumbuhan melalui kegiatan UPGK di posyandu, selain itu kepada ibu menyusui hams diupayakan untuk tidak memberikan makanan prelakteal dan memberikan MP-ASI dini, karena bila sudah mendapat makanan prelakteal dan IvfP-ASI yang diberikan pada umur < 4 bulan bisa merugikan bayi. Petugas kesehatan berperan penting dalam memberikan pendidikan/konseling terhadap ibu hamil tentang manajemen laktasi. Agar bayi dapat memenuhi kebutuhan gizinya perlu dikembangkan makanan lokal melalui pelatihan pembuatan makanan lokal yang memenuhi syarat gizi dan cita rasa.
The Relationship between the First Age of Introducing Complementary Feeding with Nutritional Status of Babies aged 6 - 12 Months at Pedamaran Subdistrict Ogan Komering Ilir District South Sumatera in 2001Babies aged 6 -12 months begins to get complemernary feeding gradually while still breast feeded. In this age, baby immunity which was received passively from his mother decreases, while he begins to receive an inadequate food. Several researches show that protein energy malnutrition (PEM) prevalence to babies is more than 15% based on nutritional status index (Weight/Age). This shows that baby nutrition remains serious matter to overcome.The research analyzes secondary data obtained from the previous research titled "Breast feeding pattern, weaning age and complementary feeding in relation to the nutrition status of baby under three years ( 6 - 36 months) at Pedamaran Subdistrict, Ogan Komering Ilir District, South Sumatera in 2001". This research purpose is to obtain the relational strength between the first age of introducing complementary feeding and nutritional status of babies 6 - 12 months. This research uses cross sectional design, through univariat, bivariat, and multivariate analyses. Samples are baby aged 6 - 12 months who received Breast milkThe research result shows that Protein Energy Malnutrition (PEM) prevalence is 20,7%, mean of ages introducing complementary feeding is 3,8 months, mean of babies of age of introducing complementary feeding < 4 months is 31,0%, mean of energy intake is 764 kkal, and mean of protein intake is 16 gr. Multivariate analysis shows that there is significant relationship between first age of introducing complementary feeding and nutritional status of infant age 6 -12 months. Babies who received complementary feeding <4 months possible might experience with under nutrition (Weight/Age) risk more than 5,2251 than babies who received complementary feeding at 4 - 6 months of age after controlled by energy intake. Apparently, energy intake plays as confounder role, or has influence to increase the relationship between first age of complementary feeding and nutritional status of infants.In order to improve baby nutritional status, there should be monitoring improvement through UPGK program at Posyandu. In addition, mother is expected not to administer prelacteal food and able to administer exclusive breast-feeding, because babies given prelacteal and administered of introducing complementary feeding at the age <4 months, they will be harmful. On the other hand there should be information given both to health officers and pregnant mothers about lactation management . In order to baby nutrient necessity, there should be it needs local/ordinary foods development through the training of local food production which fulfills nutrition condition and flavor.