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Star Shine Medical Journal
Journal of Health Research
Vol. 2, No. 1, January 2022: 71-77
ISSN (print): 2774-1974, ISSN (online): 2797-1502
Available online at https://starshinemedicaljournal.com
THE EFFECT OF NUTRITIONAL EDUCATION
WITH BRAINSTORMING ON FEEDING PRACTICE
KNOWLEDGE OF STUNTING MOTHERS
1 2 3
Sri Yanniarti , Afrina Mizawati ,Ayu Pravita Sari
1,2 3
Department of Midwifery, Poltekkes Kemenkes Bengkulu, Indonesia; Department of
Nutrition Poltekkes Kemenkes Bengkulu, Indonesia
Corresponding email: afrinamizawati@poltekkesbengkulu.ac.id
Abstract
The incidence of stunting in Bengkulu Province is still quite high. Stunting is one of the
nutritional problems that impact on children's health problems in the future. It is associated
with the risk of morbidity and mortality, suboptimal brain development, resulting delayed
motor development and retarded mental growth. One of the causes of stunting is feeding
practice. Education to mothers of stunting children about feeding practice is expected to
increase mother's knowledge. The purpose of this study was to determine the effect of
nutrition education with brainstorming on knowledge of stunting mother aged 6-24 months.
This research used quantitative methods with a quasi-experimental two group pretest-
posttest design with a control group. The population in this study were 38 mothers who had
stunting children aged 6-24 months in Seluma Regency, Province Bengkulu. Data was
collected by questionnaires, then analyzed by using Willocoxontest and Mann Whitney,
because the data distribution was not normal. The results of the study showed there was an
effect of nutrition education with brainstorming on mother’s knowledge about feeding
practice. It is expected to health services can provide information about the importance of
conduct education about nutrition using barainstorming and monitor children's weight and
height in preventing stunting.
Key words: Nutritional education, knowledge, stunting, brainstorming, stunting mothers
INTRODUCTION
Stunting became chronic nutritional problem in under-fives characterized by
shorter height compared to children of their age. Children who suffer from
stunting will be more susceptible to disease and as adults are at risk for
degenerative diseases. The impact of stunting is not only in terms of
health but also affects the level of intelligence of children (Ministry of Health,
2018). Stunting is a nutritional problem faced by the world, especially in poor
and developing countries. Stunting is a health problem because it is
associated with the risk of morbidity and mortality, suboptimal brain
development, resulting in delayed motor development and stunted mental
growth.
Star Shine Medical Journal, Vol 2(1), 2022 71
Sri Yanniarti, Afrina Mizawati, Ayu Pravita Sari
Globally, around 150.8 million children under the age of five suffer from
stunting. Data show that 55% mother with children aged 6-24 months in
Asia experiencing stunting (WHO StuntingInfographic). The data collected
stunting prevalence children aged 6-24 months. World Health
Organization (WHO), Indonesia is among the three countries with the
highest prevalence in Southeast Asia. The average prevalence of stunting
under two children in Indonesia in 2005-2017 was 36.4%. Data from
Riskesdas (Basic Health Research) 2018 recorded the national stunting
prevalence reached 30.8% and in 2019 it became 27.67% (Survey on
Nutritional Status of Indonesian aged 6-24 months, 2019).
There were 60 villages that became stunting loci in Bengkulu Province
in 2020. They were spread in Bengkulu Kaur Regency (10 villages), South
Bengkulu Regency (10 villages), North Bengkulu Regency (20 villages) and
Seluma Regency (20 villages). In 2019 stunting cases in Seluma Regency
reached more than 1000 children aged 6-24 months, and in 2020
stunting cases fell to 933. Although it has decreased, the figure is still high.
Studies showed the child of a mother who is stunted is at risk of giving
birth to a child who is also stunted. According to research, several factors
related to stunting in Nepal, including socioeconomic status, environmental
factors, exclusive breastfeeding, additional food intake, food diversity,
infectious diseases. Exclusive breastfeeding, socio-economic and low birth
weight babies are factors associated with stunting in Nepal. Research
conducted by Wulan Angraini in 2019 in North Bengkulu Regency showed
that birth weight was associated with stunting in children aged 24-36
months (Paudel et al, 2012; Hafidet al, 2016; Aryastami et al, 2017;
Hossain et al, 2017; & Abeway et al, 2018).
The impact of stunting is divided into two, namely there is a long-
term impact and also a short-term. In short, the incidence of stunting is
disruption of brain development, physical growth, intelligence, and
metabolic disorders in the body. Meanwhile, in the long term, it is easy to
get sick, the emergence of diabetes, heart and blood vessel disease,
obesity, cancer, stroke, disability in old age, and poor quality of work so
that productivity is low (Kemenkes RI, 2016).
The feeding practice applied by parents to children aims to control healthy
eating behavior for children. The feeding practice is carried out by controlling
the food consumed by children, setting an example for children to eat healthy
foods, teaching children to consume nutritious foods so that they can
encourage them to regulate their nutritional intake independently, helping
Star Shine Medical Journal, Vol 2(1), 2022 72
The eEfect of Nutritional Education with Brainstorming on Feeding Practice…
them recognize and accept new types of food, and promote the
development of eating behavior healthy children (Dev et al., 2014). Feeding
practice can also be interpreted as a description of what parents do to
influence their children's eating behavior, for example, such as parents limiting
their children to consume sweet foods (Braden et al., 2014).
The research was conducted byMusher-Eizenman & Holub, 2017) explains
the practice of feeding children can be seen from 12 aspects, namely pressure
to eat, restriction for weight, food as a reward, emotion regulation,
restriction for health, child control, teaching nutrition, encourage balance and
variety, healthy environment, involvement, monitoring and modeling.
Children's health is the most important thing that must be considered by
parents. If the practice of feeding given is carried out properly and in a
balanced manner, it can affect the health status of children. The child's health
can be achieved by providing nutritional needs.
Parenting styles and eating styles are often described as two dimensions that
underlie demand and responsiveness. Parents who have authoritarian
characteristics in implementing child feeding usually do not consider the
needs of their children much but tend to apply strict rules regarding food to
their children. Parents who have these characteristics often impose a reward
and punishment system on their child's eating style (Ip et al., 2017). Research
by Subarkah et al (2016) showed parents who provide appropriate feeding
patterns based on the type of food, amount of food, and meal schedule
means that the parent has succeeded in paying close attention to the feeding
pattern of the child.
The role of parents in meeting children's nutritional needs is the
background for feeding practice. The desire to carry out this role can
lead to different practices in its application. Parents who are less precise
in implementing feeding practices in children usually always fulfill the child's
desire to consume various kinds of food that the child wants, there are even
parents who force the child so that the child wants to consume certain foods
(Musher-Eizenman & Holub, 2007). Research conducted by Perdani and
Hasan (2016) shows that most parents are less than optimal in carrying out
feeding practices for their children. Parents who feed their children by trying
to control their children, try to involve children in the selection and provision
of food, and provide food knowledge information to their children can
support the nutritional status of children.
Star Shine Medical Journal, Vol 2(1), 2022 73
Sri Yanniarti, Afrina Mizawati, Ayu Pravita Sari
METHODS
Research Design and Subject
The design used was quasi-experimental using pre-test and post-test non-
equivalent control group. This study aimed to determine the difference
in knowledge about the feeding practice of stunting aged 6-24 months
were given education with counseling with education with counseling and
brainstorming. The population in this study were all mothers who
had stunting children aged 6-24 months in Seluma Regency. Sampling is
done by means of total sampling. The samples obtained were 38 mothers
who had children aged 6-24 months where 19 mothers were given
education with counseling and 19 mothers were given education with
counseling and brainstorming.
Instruments and Data Analysis Procedures
Data collection in this study is primary data taken directly from
questionnaires, namely data on knowledge of mothers who have stunting
children about Feeding Practice. The data analysis used was two types of data
analysis, namely univariate and bivariate. Univariate analysis aimed to
determine the characteristics of mothers under two years old aged 6-24
months as seen from age, education and occupation with a frequency
distribution and the average knowledge of mothers who have stunting
children aged 6-24 months about Feeding Practice in Seluma District and
bivariate analysis was used to see the effect of the independent variable with
the dependent variable. The analysis in this study used the Willocoxontest
and Mann Whitney because the data distribution was not normal.
RESULTS
1. Univariate Analysis
The intervention group showed the average knowledge of feeding practice
before being given nutrition education by brainstorming is 12.32, while
the average knowledge of feeding practice after being given nutrition
education by brainstorming is 14.74 with adifference mean of 2.42. In
the control group the average knowledge of feeding practice before being
given nutrition education with counseling was 7.68, while the average
knowledge of feeding practice after being given nutrition education with
counseling was 10.00 with adifference mean of 2.32.
Star Shine Medical Journal, Vol 2(1), 2022 74
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