Journal of Maternal and Child Health (JMCH)
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Contextual Effect of “Posyandu” in the Incidence of Anemia in Children under Five
Get PDFBackground: Iron deficiency can cause anemia which adversely affects children's growth, especially in terms of achievement, quality of life, and performance as human resources in the future. Birth weight, exclusive breastfeeding complementary feeding (EBF-CF) have a direct relationship with the incidence of anemia in infants. The purpose of this study is to examine the factors that influence anemia in children under five at the Banguntapan II Bantul Health Center, Yogyakarta.Subjects and Method: The cross sectional study was conducted at 25 posyandu in the working area of Banguntapan II Bantul Health Center, Yogyakarta, Indonesia. A sample of 200 children aged 24–60 months was selected by simple random sampling. The dependent variable is anemia in infants. Independent variables are exclusive breastfeeding, breastfeeding, birth weight, nutritional status (BB / TB), mother's education, and mother's work. Anemia data was measured by Hb meter, other variable data were collected using questionnaires. The data were analyzed using a multiple logistic regression with a multilevel approach.Results: The risk of anemia in infants is reduced by exclusive breastfeeding (b = –5.77; 95% CI = -11.30 to -0.24; p = 0.041), EBF-CF administration is appropriate (b = –12.24; 95% CI = -22.47 to -2.00 , p = 0.019), birth weight 2500–4000 g (b = –5.04; CI 95% = -9.87 to 0.21; p = 0.040), good nutritional status (-2SD - + 2SD) (b = –9.11; CI 95% = -17.99 to 0.23; p = 0.044), high maternal education (high school) (b = -10.96; 95% CI = -20.61 to 1.31; p = 0.026), and mothers who work at home (b = -5.98; 95% CI = -11.27 to -0.68; p = 0.026). Posyandu strata showed that there was a contextual influence of posyandu on variations in anemia incidence (ICC = 62.62%).Conclusions: Exclusive breastfeeding, proper EBF-CF, normal birth weight, good nutritional status, high maternal education, and mothers working at home reduce the risk of anemia in infants.Keywords: anemia, children under five, exclusive breastfeeding, multilevelCorrespondence: Rokhayati. Public Health Master’s Program, Universitas Sebelas Maret, Surakarta, Jl. Ir. Sutami No. 36 A, 57126, Surakarta, Jawa Tengah.Email: [email protected]. Mobile +6285328014414Journal of Maternal and Child Health (2019), 4(6): 1-10https://doi.org/10.26911/thejmch.2019.04.06.0
Factors Affecting Maternal Birth Preparedness: Evidence from Salatiga, Cental Java
Get PDFBackground: Maternal unpreparedness in facing childbirth is one of the factors causing the high maternal mortality rate (AKI). To support efforts to accelerate the reduction of MMR, preparation of childbirth is an important matter that must be improved. Pregnant women class is an activity to prepare the mother physically and psychologically in facing the delivery. The purpose of this study was to determine the factors that influence preparation for childbirth in pregnant women, including: the role of midwives, motivation of pregnant women and utilization of pregnant classes.Subjects and Method: This was an analytic observational study with a cross sectional design. The study was conducted in 6 community health centers in Salatiga, from June to July 2018. A sample of 120 mothers was selected by total sampling. The dependent variable was birth preparation. The independent variables were motivation, midwife role, and utilization of pregnant class. The data were collected by questionnaire and analyzed by a multiple linear regression.Results: Birth preparedness was increased with strong midwife role (b= 2.82; 95% CI= -0.45 to 5.68; p= o.054), strong motivation (b= 4.12; 95% CI= 0.97 to 7.27; p= 0.011), and utilization of pregnant class (b= 3.90; 95% CI= 0.66 to 7.13; p= 0.019).Conclusions: Birth preparedness is increased with strong midwife role, strong motivation, and utilization of pregnant class.Keywords: birth preparedness, motivation, midwife role, pregnancy class, pregnant womenCorrespondence
The Effect of Stimulation, Detection, and Early Intervention Development Training Based on Group Dynamics on Motivation and Skill among Cadre
Get PDFBackground: Early childhood development monitoring by cadre was an effort to detect delayed development among children. Knowledge of child growth and development was highlighted as important for all cadres. Based on the survey in Surakarta, Central Java, in 2017, many cadres did not know about stimulation detection and early interventions development (SDEID). The purpose of this study was to analyze the effect of SDEID training based on group dynamics on cadre’s motivation and skill.Subjects and Method: This study was a quasy experiment conducted in Kadipiro, Surakarta, Central Java, from February to September 2018. A sample of 21 cadres was selected for this study by total sampling. The dependent variable was motivation and skill. The independent variables were SDEID training. The data were collected by questionnaire and analyzed by paired t-test.Results: There was no difference motivation before (mean= 64.62; SD= 4.95) and after (mean= 63.62; SD= 5.17) training, but it was statistically non-significant (p= 0.526). Cadre’s skill after (mean= 29.71; SD= 6.52) was higher than before training (mean= 11.00; SD= 5.24) and it was statistically significant (p<0.001).Conclusion: SDEID training based on group dynamics is effective to improve cadre’s skill.Keywords: SDEID training, group dynamics, motivation, skill, cadresCorrespondence: Rusiana Sri Haryanti. Jl. Tulang Bawang Selatan No. 26, Kadipiro, Banjarsari, Surakarta, Central Java. Mobile: 085702162126, 082225297203. Email: [email protected], rusianamolyn@gmail.com. Journal of Maternal and Child Health (2019), 4(5): 351-357https://doi.org/10.26911/thejmch.2019.04.05.0
“Women’s Three Bodies”: An Anthropological Perspective on Barriers to Safe Abortion Services in Kibera Informal Settlements, Nairobi, Kenya
Get PDFBackground: Abortion remains a critical determinant of maternal morbidity and mortality in Kenya. Recent studies on induced abortion estimated an annual abortion incidence of 48 abortions per 1,000 women of reproductive age, which is higher than other East African countries. In 2010, the Kenyan Constitution widened the provisions under which women qualified for safe abortions. However, majority of women still seek abortion services from unqualified providers. Using an interpretive, meaning-centered approach, this study aims to explore the barriers to safe abortion services in Kibera informal settlements, Nairobi Kenya.Subjects and Method: This was a cross-sectional study encompassing both qualitative and quantitative research methods. We used different sampling techniques (convenient, purposive and snow ball methods) to recruit our study participants (n=55). Quantitative data was collected using a survey questionnaire and data was analyzed by SPSS version 21. Qualitatively, data was collected using Focus Group Discussions (FGDs), Key Informant interviews and case study narratives. This involved note taking and audio recordings, which were transcribed verbatim and thematically analyzed using QSR Nvivo 21 software.Results: This study revealed that women’s decisions to procure abortion are influenced by a myriad of complex factors: a multiplicity of meanings regarding abortion, as provided by the law or as dictated by cultures or religion. Women’s access to safe abortion services were also determined by their ability to afford the procedure and to identify and reach a health care provider who offered the services.Conclusions: Legal access to abortion does not simultaneously ensure access to safe abortion services. Policy makers and health promoters need to work towards changing the socio-economic and religious forces that hamper access to safe abortions. Safe and affordable abortion services to women in Kenya including post abortion care need also be ensured.Keywords: barriers, access, safe abortion, KenyaCorrespondence: Edna Nyanchama Bosire, MRC/Wits Developmental Pathways for Health Research Unit (DPHRU), School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. 27 St Andrews Road, Parktown, Johannesburg, South Africa. Email: [email protected]. Telephone: 011 717 2383.Journal of Maternal and Child Health (2019), 4(2): 97-109https://doi.org/10.26911/thejmch.2019.04.02.0
Understanding Pregnant Women with Opioid Use Disorder
Get PDFBackground: Pregnant women with opioid use disorder are a major concern to the healthcare industry. They are not only one of the most stigmatized groups but are in need of outreach. Women who are afflicted by opioid addiction are a highly vulnerable group who are at risk of adverse pregnancy outcomes and perinatal complications. The purpose of this study was to do a meta-synthesis of the literature to gain a better understanding of the women’s perspective who are addicted to opioid during pregnancy.Subjects and Method: We conducted an exhaustive literature search for qualitative studies that focused on women with opioid used disorder during pregnancy and postpartum. After conducting a rigorous methodological protocol for meta-synthesis described by Joanna Briggs Institute, ten studies met the criteria for inclusion into this study. We used the Qualitative Assessment and Review Instrument (QARI) from the Joanna Briggs Institute to assist with data management. We extracted the representative quotations and categorized them into like themes.Results: There were three themes formulated from this meta-synthesis: overarching fear, trust, and educational deficits. This meta-synthesis of qualitative studies leads to a greater understanding of how pregnant women with opioid use disorder perceive the consequences of their actions.Conclusion: Implications from this meta-synthesis will inform those working with opioid-addicted pregnant women and aid in establishing best practices for them and their infants by revealing their addiction experiences and narratives.Keywords: opioid use disorder, pregnancy, stigmaCorrespondence: Deborah Stiffler. Indiana University School of Nursing, Indianapolis, IN, USA. Email: dstiffle@iu.edu.Journal of Maternal and Child Health (2019), 4(6): 461-474https://doi.org/10.26911/thejmch.2019.04.06.07
Risk Factors for Acute Respiratory Infection in Children Under Five in Padang, Indonesia
Get PDFBackground: Acute Respiratory Infection (ARI) is a major cause of acute diseases and death in infants worldwide. Percentage of ARI (year 2017) in children aged 12-59 months in Padang was 26.5% and Andalas health center was 33.2%. ARI is influenced by many factors such as environmental condition. This study aimed to analyze risk factors for ARI in children under five in Padang, Indonesia.Subjects and Method: This was a case control study conducted at Andalas community health center, Padang, Indonesia. A sample of 90 children aged 12-59 months was selected for this study. The dependent variable was ARI. The independent variables were humidity, house ventilation, dwelling density, indoor smoke cigarette. Data on ARI status were taken from medical record. The other variables were measured by questionnaire and observation sheet. The data were analyzed by a multiple logistic regression.Results: Poor ventilation (OR = 11.73; 95% CI = 2.16 to 63.86; p = 0.004), high dwelling density (OR = 21.99; 95% CI = 3.75 to 129.04; p = 0.001), indoor cigarette smoke (OR = 5.09; 95 % CI = 1.06 to 24.34; p = 0.042), and high air humidity (OR = 5.00; 95% CI = 0.79 to 31.51; p = 0.086) increased the risk of ARI in children under five and they were statistically significant.Conclusions: Poor ventilation, high dwelling density, indoor cigarette smoke, and high air humidity increase the risk of ARI in children under five.Keywords: Acute respiratory infection, dwelling density, air humidity, children under fiveCorrespondence
Logistic Regression Analysis on the Determinants of Stunting among Children Aged 6-24 Months in Purworejo Regency, Central Java
Get PDFBackground: Stunting is a representation of the state of chronic malnutrition in the first 1000 days of life that occurred in the world at an incidence of 22.2% in 2017. Stunting in children has impact on morbidity and mortality, resulting in a long-term decline socio-economic productivity of the community. The purpose of this study was to analyze the determinants of stunting in children aged 6-24 months in Purworejo, Central Java.Subjects and Method: This was an analytic observational study with a case control design. It was conducted in 25 integrated community health posts (posyandu) in Purworejo, from October to December 2018. A sample 200 children under five was selected using by simple random sampling. The dependent variable was stunting. The independent variables were maternal mid-upper arm circumference (MUAC) at pregnancy, maternal education, paternal education, family income, family food allocation, infant birth weight, exclusive breastfeeding, complementary feeding (CF), posyandu strata, stunting monitoring at posyandu, and posyandu stunting intervention. The data was collected by questionnaire and analyzed by a multiple logistic regression.Results: Maternal MUAC at pregnancy ≥23.5 cm (b= -1.56; 95% CI= 0.06 to 0.67; p = 0.009), high maternal education (b= -1.70; CI95% = 0.06 to 0.57; p = 0.003), high paternal education (b= -1.90; 95% CI= 0.05 to 0.51; p= 0.002), high family income (b= -1.85; 95% CI= 0.05 to 0.50; p = 0.002), family food allocation (b= -2.26; 95% CI= 0.03 to 0.37; p<0.001), birth weight ≥2,500 g (b= -1.39; 95% CI= 0.08 to 0.83; p= 0.024), exclusive breastfeeding (b = -2.04; 95% CI= 0.04 to 0.48; p= 0.002), and adequate complementary feeding (b= -1.61; 95% CI= 0.06 to 0.65; p= 0.007) reduced the risk of stunting in children aged 6-24 months.Conclusions: Maternal MUAC at pregnancy ≥23.5 cm, high maternal education, high paternal education, high family income, family food allocation, birth weight ≥2,500 g, exclusive breastfeeding, and adequate complementary feeding reduce the risk of stunting in children aged 6-24 months.Keywords: stunting, determinants, children aged 6-24 monthsCorrespondence: Atika Rakhmahayu. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami No. 36 A, Surakarta, Indonesia. Email: [email protected]. Mobile: 083124386960.Journal of Maternal and Child Health 4(3): 158-169https://doi.org/10.26911/thejmch.2019.04.03.0
Multilevel Analysis on the Determinants of Antenatal Care Visit at Community Health Center in Madiun, East Java
Get PDFBackground: Antenatal care (ANC) is an important determinant of high maternal mortality rate and one of the basic components of maternal care. However, some pregnant women still had low awareness about the importance of ANC. The purpose of this study was to examine determinants of ANC visit in community health center, Madiun, East Java, and to determine the contextual effect of the community health center on the ANC visit.Subjects and Method: This was a case-control study conducted in Madiun, East Java, from November to December 2018. A sample of 200 pregnant women was selected by simple random sampling. The dependent variable was ANC visit. The independent variables were knowledge, occupation, number of children, attitude, income, and husband support. The data were collected by questionnaires and analyzed by a multilevel linear regression.Results: The likelihood of ANC visit increased with employment status (b= 1.97; 95% CI= 0.81 to 3.13; p= 0.001), good knowledge (b= 1.56; 95% CI= 0.41 to 2.72; p= 0.008), positive attitude (b= 1.74; 95% CI= 0.52 to 2.96; p= 0.005), higher family income (b= 1.42; 95% CI= 0.29 to 2.55; p= 0.014), and stronger husband support (b= 1.29; 95% CI= 0.16 to 2.43; p= 0.260). ANC visit decreased with larger number of children (b= -1.05; 95% CI= -2.17 to 0.07; p= 0.067). Community health center had strong contextual effect on ANC visit in pregnant women with ICC= 41.85%.Conclusion: ANC visit increases with employment status, good knowledge, positive attitude, high family income, and strong husband support. ANC visit decreases with large number of children. Community health center has strong contextual effect on ANC visit in pregnant women.Keywords: antenatal care, determinants, pregnant womenCorrespondence: Sinta Ayu Purbaningrum, Masters Program in Public Health, Universitas Sebelas Maret, Surakarta, Jl. Ir. Sutami No. 36A, 57126, Surakarta, Central Java. Email: [email protected]. Mobile: +6282220100192. Journal of Maternal and Child Health 2019, 4(3), 180-189https://doi.org/10.26911/thejmch.2019.04.03.05
Multilevel Analysis on Factors Associated with Occurrence Chronic Energy Deficiency among Pregnant Women
Get PDFBackground: One of the nutritional problems experienced by pregnant women is chronic energy deficiency (CED). Chronic energy deficiency is a condition in which women of childbearing age experience a lack of energy and protein intake and take place continuously resulting in health problems. This study aims to analyze chronic energy deficiency factors in pregnant women in Gunungkidul Regency.Subjects and Method: This study implemented a case control design. It was conducted in 25 community health centers, Gunungkidul, Yogyakarta, from April to May 2019. A sample of 200 pregnant women was selected by fixed disease sampling. The dependent variable was chronic energy deficiency in pregnant women. The independent variables included food intake, education level, occupation, knowledge, family income, age, parity, utilization of antenatal care services (ANC), and food availability. The data were collected using the MUAC tape and questionnaire. The data were analyzed by a multilevel multiple logistic regression.Results: The risk of protein energy deficiency decreased with high energy and protein intake (b = -2.74; 95% CI = -7.74 to -1.28; p = 0.006), more education level than high school (b = -2.16; 95% CI = -4.54 up to -0.22; p = 0.030), working mothers (b = -2.75; CI 95% = -9.48 to -1.59; p = 0.006), sufficient knowledge (b = -2.32; CI 95% = -6.27 to -0.52; p = 0.020), high family income (b = -2.38; CI 95% = -6.27 to -0.60; p = 0.017), age ≥20 years to 35 years (b = -2.17; 95% CI = -5.16 to - 0.26; p = 0.030), parity> 2 (b = -2.57; CI 95% = -8.42 to -1.13; p = 0.010), using high ANC services (b = -2.72; 95% CI = -9.20 to -1.49 ; p = 0.007), and food availability is fulfilled (b = -2.54; CI 95% = -7.63 to -0.98; p = 0.011). Public health centers had a large contextual influence on chronic energy shortages with an ICC of 51.25%.Conclusion: There is a significant influence between food intake, education level, occupation, knowledge, family income, age, parity, utilization of ANC services, and food availability for chronic energy shortages in pregnant women. The variations at the public health centers level show that there is a contextual influence on chronic energy shortages in pregnant women.Keywords: chronic energy deficiency (CED), multilevel analysis, pregnant womenCorrespondence: Nur Cahya Rachmawati. Master’s Program in Public Health, Universitas Sebelas Maret, Surakarta, Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: [email protected]. Mobile: +6287838992205.Journal of Maternal and Child Health (2019), 4(6): 474-485https://doi.org/10.26911/thejmch.2019.04.06.0
Multilevel Analysis on the Contextual Effect of Posyandu on Healthy Prenatal Behavior Among Pregnant Women in Bengkayang, West Kalimantan
Get PDFBackground: Evidence suggests that prenatal care, healthy behaviors such as exercise and nutrition, general stress level, and routine blood pressure examination, are associated with fetal and maternal health. However, there is a lack of studies on factors affecting these healthy prenatal behaviors in Indonesia. This study aimed to determine the contextual effect of posyandu on healthy prenatal behavior among pregnant women in Bengkayang, West KalimantanSubjects and Method: A cross-sectional study was conducted at 25 integrated health posts (posyandu) in Bengkayang, West Kalimantan, from November to December 2018. A sample of 200 pregnant women was selected by simple random sampling. The dependent variable was healthy prenatal behavior. The independent variables were maternal education, family income, knowledge, health personnel support, family support, community leader support, and distance to posyandu. The data were collected by questionnaire and analyzed by multilevel logistic regression.Results: Healthy prenatal behavior was affected by maternal education (b= 4.64; 95% CI= 2.05 to 7.23; p<0.001), family income (b= 3.26; 95% CI= 1.15 to 5.37; p= 0.002), knowledge (b= 2.83; 95% CI= 0.90 to 4.47; p= 0.004), family support (b= 2.69; 95% CI= 0.70 to 4.69; p= 0.008), community leader support (b= 3.01; 95% CI= 1.05 to 4.96; p= 0.003), health personnel support (b=3.74; 95% CI= 1.44 to 6.04; p= 0.001), and distance to posyandu (b= -3.51; 95% CI= -5.50 to -1.52; p= 0.001). Posyandu had strong contextual effect on healthy prenatal behavior with ICC= 74%.Conclusion: Healthy prenatal behavior is affected by maternal education, family income, knowledge, family support, community leader support, health personnel support, and distance to posyandu. Posyandu has strong contextual effect on healthy prenatal behavior. Keywords: healthy prenatal behavior, prenatal, path analysisCorrespondence: Dayang Fitri Murdikawati. Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: [email protected]. Mobile: 08999988880.Journal of Maternal and Child Health, 2019, 4(4); 242-249https://doi.org/10.26911/thejmch.2019.04.04.0