The coverage of indicators of sensitive and specific intervention programs and prevalence of stunting under-five children: A cross-sectional study in Aceh Province, Indonesia.

Background: The prevalence of stunting children under-five in Aceh Province is still high due to multiple factors, including the sub-optimal coverage of intervention programs. Aim: This study aimed at finding out the correlation between the coverage of indicators of sensitive and specific intervention programs with prevalence of stunting in Aceh. Methods: A cross-sectional design analyzed secondary data from the Indonesia nutritional status survey and program coverage data in 13 regencies/cities in Aceh Province. The dependent variable was the prevalence of stunting. Meanwhile, the independent variable covered 20 sensitive and specific intervention program indicators. We apply STATA 16 to analyze the correlation between sensitive and specific coverage and stunting prevalence. Results: The coverage of indicators of pregnant women with chronic energy deficiency (CED) receiving supplementary feeding, young children with diarrhea receiving zinc supplementation, parents taking parenting classes, and participation in the health insurance program had a significant correlation with prevalence stunting in Aceh (r = -0.57; r = -0.50; r = -0.65; and r = -0.60). Conclusion: Intervention measures to avert childhood stunting in Aceh should include strengthening supplementary feeding programs for mothers and toddlers, supplementation to prevent toddler diarrhea, and counseling parents on parenting and health insurance.

Prevalence of, and factors associated with anaemia in children aged 1-3 years in Aceh, Indonesia: A cross-sectional study.

Background: Child anaemia continues to represent a major public health challenge in lower-and-middle income countries. It has serious long-term consequences for child growth and development. In Indonesia, there was a 10% increase in the national prevalence of child anaemia between 2013 and 2018. Aim: This study aims to assess the prevalence of, and factors associated with anaemia among children aged one to three years in eight districts in Aceh Province, Indonesia. Methods: A cross-sectional study was conducted on a sample of 1148 mother-child dyads aged one to three years between November and December 2018. The sampling process involved a three-stage cluster sampling design using the probability proportionate to size methodology. Anaemia status was determined using haemoglobin level (Hb < 11.0 g/dL). Data were analysed using multivariable logistic regression to estimate adjusted odds ratios (aOR) and their 95% confidence intervals (95% CI) for associated factors. Results: The overall prevalence of anaemia was 76.1% (869/1142). 44.7% (510/1142) and 28.6% (327/1142) had moderate and mild anaemia, respectively. Child aged 12-24 months (aOR: 2.00, 95% CI: 1.26-3.17), not receiving routine immunisation (aOR: 2.62, 95% CI: 1.34-5.10), and maternal anaemia (aOR: 2.15, 95% CI: 1.59-2.90) were significantly associated with anaemia. Conclusion: The prevalence of anaemia among the children in this study was high, and was associated with child age, immunisation status, and maternal anaemia. These findings provide further insight into anaemia as a public health issue at a sub-national level in Indonesia and for development of targeted programmes to address associated risk factors of child anaemia.

Assessment of Anemia Status on Physical Development Skills of Children Under Two Years Old in Aceh, Indonesia.

Anemia and iron deficiency can cause detrimental effects on brain development, and continued iron deficiency anemia is known to interfere with development which results in a permanent delay in mental and Motor development. This study investigated the impact of anemia on physical development skills of under two years children in aceh besar district. A cross-sectional study design was applied to 102 under-two years children selected using cluster random sampling technique using village as cluster. A structured questionnaire to determine general characteristics such as maternal age, maternal education, maternal occupational, family income, number of family members and toddlers. Anemia status was assessed by Hemocue 201+ tool, and physical motor development such as gross and fine motor development skills were determined using Denver II instrument. Almost two- thirds of children were anemia, as assessed by blood hemoglobin levels of <11 g/dL, while 34.3% of them were experienced delay in either fine development or gross development skills. The prevalence of children with fine and gross motor development delay was higher in children with suffering from anemia (27.1% and 17.1%) than non-anemia, respectively (3.2% and 9.4%). There was significant association anemia status on fine motor development (r=0.291; p=0.003), while not significant to gross motor development (r=0.092; p=0.357). The prevalence of anemia in children 12-24 mo old was very high, and has an impact on motor development delays, so anemia prevention programs and motor stimulation intervention for under two years children are needed.

Determinant Factors of Maternal Knowledge on Appropriate Complementary Feeding of Children Aged 6-23 Months in Aceh.

The aim of this study was determine mothers knowladge on appropriate complementary feeding of children aged 6-23 mo. A cross-sectional design was applied on 392 mothers of children aged 6-23 mo selected through a cluster sampling in Aceh Besar District Aceh Province Indonesia. Data on mothers knowledge and determinant factors included socio-demographic of mothers were collected using valid and reliable structured questionnaire. The data was analyzed using binary logistic regression at 95% confident interval. Overall, there was less than one-fourth (20.2%) of the mothers have good knowledge on appropriate Complementary feeding. Education level of mothers were significantly associated with mothers knowledge, mothers who have education level elementary school, junior high school and senior high school higher risk of having low knowledge on appropriate complementary feeding (OR=3.11, OR=5.22 and OR=10.20) than those have graduted level. Therefore, an effort and a research to developing nutrition education model is warranted to improving knowledge and skill of mothers is important.

Effect of Nutrition Education and Multi-Nutrient Biscuit Interventions on Nutritional and Iron Status: A Cluster Randomized Control Trial on Undernourished Children Aged 6-23 Months in Aceh, Indonesia.

Undernutrition and iron deficiencies on under-five children in Indonesia remain high and very closely related to inadequate complementary feeding. This study investigated the effect of weekly nutrition education by home visite using the food monitoring card (FMC) models and daily provision multi-nutrient biscuits and combination on growth and reduction of iron deficiency and anemia among underweight children aged 6-23 mo in Aceh Indonesia. A 6-mo, cluster randomized, control trial was conducted on 121 children received nutrition education (NE), multi-nutrient biscuit (MNB), combination both nutrition education and biscuits (NE+MNB), and control group. The outcome weight gain and prevalence of underweight (weight for age z-score <-2SD) were collected by anthropometric and iron deficiency were serum ferritin measuring with ELISA method. After the 6-mo intervention, the rate of weight gain was higher in combination intervention group 1.51±0.68 kg than multi-biscuit group 1.40±0.72 kg, NE group 1.34±0.66 kg and control group 1.21±0.42 kg, and the rate increase of serum ferritin was higher in combination NE+MNB and biscuit group (2.54 µg/L and 2,17 µg/L). At the end of study there were a significant decrease in prevalence of underweight (p=0.003), the incidence of underweight in NE+MNB (45.2%) lower than NE group (63.3%), MNB group (64.5%) and control group (69,0%) and significant decrease of iron deficiency (p=0.02), the incidence lower in MNB group (6.5%) than NE+MNB (22.6%), NE group (23.3%) and control group (24.1%). The combination of nutritional education and multi-nutrient biscuits intervention improving nutritional and iron deficiency status on undernourished children. These risearch highlight the need integration of nutrition education and food base intervention to prevent underweight and iron deficiency on children 6-23 mo old.

Complementary feeding practices and nutritional status of children 6-23 months old: formative study in Aceh, Indonesia.

BACKGROUND/OBJECTIVES: The 6-23 months for infants is the longest period in the "first 1,000 days" of life. This period is very important for child development, so complementary feeding (CF) practices should be optimized to maximize children's potential for growth and development. The aim of this study was to analyze the CF practices and nutritional status of children aged 6-23 months. SUBJECTS/METHODS: For this cross-sectional study, 392 children aged 6-23 months were selected using stratified random sampling. Socio-demographic data were collected through interviews. CF practices, collected by interviews and repeated 24-hour food recall method, were the timely introduction of CF, minimum meal frequency, dietary diversity and minimum acceptable diet, consumption food rich in proteins and vitamin A. Nutritional status was assessed using the indicators of underweight, wasting and stunting. To analyze the association between socio-demographic indicators and CF with nutritional status, the chi-square test with a confidence interval of 95% was used. RESULTS: Results showed that 39% were exclusively breastfed, only 61% received prolonged breastfeeding and 50% received timely introduction of CF. Minimum meal frequency was met by 74% of subjects, but dietary diversity and minimum acceptable diet were only realized in 50% and 40% of the children, respectively. The prevalence of underweight, wasting, and stunting were 26%, 23%, and 28%, respectively. Age of the child, birth order, birth weight, parents' education level, family size and incidence of fever and diarrhea during the previous two weeks were associated with underweight, while child's birth order, fathers' education level, mother's age, family size, completion of the age-appropriate vaccination and fish consumption frequency were associated with wasting. Age of the child, incidence of fever and acute respiratory infection, and fortified food consumption were associated with stunting. CONCLUSIONS: Suboptimal CF practices and high prevalence of underweight, wasting and stunting were found among children aged 6-23 months old in Aceh. These results highlight the need to improve CF and nutritional status.