The effect of Augmented-Reality media-based health education on healthy lifestyle knowledge, attitude, and healthy lifestyle behaviors among pregnant women during COVID-19 pandemic in Jakarta, Indonesia.

Pregnancy is a critical period. Pregnant women need to perform healthy lifestyle behavior in order to ensure good fetal development. During COVID-19 pandemic, Augmented-Reality (AR) media may be used in pregnant women health education. However, there is a lack of research that investigated the effect of AR media use in pregnant women health education. Therefore, this research aimed to investigate the impact of AR media use on healthy lifestyle knowledge, attitude, and behaviors among pregnant women during COVID-19 pandemic. This cohort-longitudinal study involved 86 pregnant women aged 18-45 years. The subjects who participated in this research received health education interventions using AR media for 5 months. The data collection was performed at the pre-post-intervention through a survey with questionnaire. Changes in subjects' healthy lifestyle knowledge, attitude, and behaviors were analyzed by using t-test. The research results show that the AR media use in health education significantly improved the subjects' scores for healthy lifestyle knowledge (5.0 ± 10.9; p < .05) and behaviors (9.7 ± 17.5; p < .05). However, the subject score for attitude was not significantly improved (0.3 ± 7.1; p ≥ .05). This research results provide evidence of the importance of using AR media in health education for pregnant women during COVID-19 pandemic.

Effect of dehydration during pregnancy on birth weight and length in West Jakarta.

Nutrition and maternal behavior are critical factors in fetal development. Maternal water intake is necessary to regulate metabolism and may influence fetal growth. This study aims to determine the effect of dehydration during pregnancy on birth weight and length. This cohort-prospective study took place in the area of Kebon Jeruk District Health Centre. A total of 38 subjects of pregnant women in their second trimester were examined. Subject characteristics were collected through direct measurements and interviews. Urine and blood samples were collected at the sixth trimester (32-34 and 35-37 weeks) to determine hydration status. Nutritional status was collected through food recall, while birth weight and length were obtained from the anthropometric measurements 30 min after birth. From a total of 38 subjects, 20 were dehydrated, and 18 were well hydrated. There was a significant relationship between hydration status and water intake, birth weight and length, head circumference, and chest circumference. After being corrected to the level of water intake, the difference in birth weight and length between the two groups were 500⋅6 g and 0⋅4 cm, and 0⋅8 cm and 1⋅4 cm for the head circumference and chest circumference (P < 0⋅05). It is recommended for mothers to monitor their weight and ensure fluid intake of 3⋅0 l per day. Further research requires more subjects to observe the effects of chronic maternal dehydration on pregnancy output and a cohort study that monitors infant development in the first six months of life.

Nutritional anemia: Limitations and consequences of Indonesian intervention policy restricted to iron and folic acid.

BACKGROUND AND OBJECTIVE: Currently, anemia is a severe public health issue in Indonesia. The aim of this review was to examine policy measures and program implementation to reduce anemia attributed to iron deficiency in Indonesia. METHODS AND STUDY DESIGN: A literature search was conducted using Google Search, Sciencedirect.com, and PubMed to retrieve relevant studies in the last three decades. Qualitative data were also obtained from service providers. The search yielded 141 articles, of which 32 were excluded, and further screening was conducted based on the type and scale of the intervention program. RESULTS: In the iron-folic acid (IFA) supplementation programs studied, antenatal care and health personnel capacity information were limited. Implementation often did not correspond to standard operating procedures. Analysis, follow-up, and feedback on IFA tablet programs were lacking. Moreover, the IFA tablet supply was inadequate, facilities and infrastructure were insufficient, and counseling guidance, relevant material, and information media were lacking. In the national fortification program, wheat flour was used as a vehicle for anemia prevention. However, evidence from the Total Diet Study indicated that wheat noodles have limited value across the Indonesian archipelago. CONCLUSION: Programs to reduce the likelihood of anemia will be more successful if they are less dependent on nutrient-specific strategies and focus more on the pathogenetic complexity arising from personal behavior, sociocultural factors, dietary and health patterns, local community, and ecology. Partnerships between the community and government reflected in evidence-based policy will always be of value, but continued research is required to examine the factors contributing to the successful outcomes of such programs.

Vitamin A-fortified cooking oil reduces vitamin A deficiency in infants, young children and women: results from a programme evaluation in Indonesia.

OBJECTIVE: To assess oil consumption, vitamin A intake and retinol status before and a year after the fortification of unbranded palm oil with retinyl palmitate. DESIGN: Pre-post evaluation between two surveys. SETTING: Twenty-four villages in West Java. SUBJECTS: Poor households were randomly sampled. Serum retinol (adjusted for subclinical infection) was analysed in cross-sectional samples of lactating mothers (baseline n 324/endline n 349), their infants aged 6-11 months (n 318/n 335) and children aged 12-59 months (n 469/477), and cohorts of children aged 5-9 years (n 186) and women aged 15-29 years (n 171), alongside food and oil consumption from dietary recall. RESULTS: Fortified oil improved vitamin A intakes, contributing on average 26 %, 40 %, 38 %, 29 % and 35 % of the daily Recommended Nutrient Intake for children aged 12-23 months, 24-59 months, 5-9 years, lactating and non-lactating women, respectively. Serum retinol was 2-19 % higher at endline than baseline (P<0·001 in infants aged 6-11 months, children aged 5-9 years, lactating and non-lactating women; non-significant in children aged 12-23 months; P=0·057 in children aged 24-59 months). Retinol in breast milk averaged 20·5 µg/dl at baseline and 32·5 µg/dl at endline (P<0·01). Deficiency prevalence (serum retinol <20 µg/dl) was 6·5-18 % across groups at baseline, and 0·6-6 % at endline (P≤0·011). In multivariate regressions adjusting for socio-economic differences, vitamin A intake from fortified oil predicted improved retinol status for children aged 6-59 months (P=0·003) and 5-9 years (P=0·03). CONCLUSIONS: Although this evaluation without a comparison group cannot prove causality, retinyl contents in oil, Recommended Nutrient Intake contributions and relationships between vitamin intake and serum retinol provide strong plausibility of oil fortification impacting vitamin A status in Indonesian women and children.

Expert meeting on Child Growth and Micronutrient Deficiencies--New Initiatives for Developing Countries to Achieve Millennium Development Goals: executive summary report.

Undernutrition in early childhood has long-term physical and intellectual consequences. Improving child growth should start before the age of two years and be an integrated effort between all sectors, covering all aspects such as diet and nutrient intake, disease reduction, optimum child care, and improved environmental sanitation. To discuss these issues, the Indonesian Danone Institute Foundation organized an expert meeting on Child Growth and Micronutrient Deficiencies: New Initiatives for Developing Countries to Achieve Millennium Development Goals. The objective of the meeting was to have a retrospective view on child growth: lessons learned from programs to overcome under-nutrition in the developed countries and to relate the situation to the Indonesian context, as well as to discuss implications for future programs. Recommendations derived from the meeting include focus intervention on the window of opportunity group, re-activation of the Integrated Health Post at the village level, improvement of infant and young child feeding, expand food fortification intervention programs, strengthen supplementation programs with multi-micronutrient, and strengthening public and private partnership on food related programs.

Regional study of nutritional status of urban primary schoolchildren. 2. West Jakarta and Bogor, Indonesia.

The study provides information on the nutritional status of 8- to 10-year-old primary schoolchildren in urban areas of Jakarta and Bogor, Indonesia, based on anthropometric indicators. It compares the use of the anthropometric indicators weight-for-age Z score, height-for-age Z score, weight-for-height Z score, and body mass index (BMI) to assess thinness (underweight and wasted) and overweight in children. A total of 1,367 children were examined. The nutritional status of the 8- to 10-year urban schoolchildren was better than that of urban children under 5 years old. The prevalence of underweight among urban schoolchildren ranged from 7.4% (girls) to 12.95% (boys), while underweight among urban children under 5 years old in 1998 was 29.7%. Meanwhile, the prevalence of overweight (BMI > 85th percentile) ranged from 15.3% (girls) to 17.8% (boys). There were more overweight children in the private schools than in the public schools. On average, private schoolchildren, of all ages and both sexes, were heavier and taller than public schoolchildren. The BMI indicator for "thinness" and "wasting", using the NHANES reference, indicates a false positive result. For detecting overweight in children aged 8 to 10 years, BMI is comparable to the other indices, weight-for-age, height-for-age, and weight-for-height.