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Proceedings of lnternational Seminar PPs Unnes 2010
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Post Graduate Program Semarang State University Gd.4 PPs UNNES, Semarang 50233 lndonesia Tel. +6224 844
Published
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EDITOR
Wasino Samsudi S.B. Waluya LAY OUT
Adhi Setyanto Rohmadi DESIGN
Mundzir Copyright @ Post Graduate Program Semarang State University @ 2010 All rights reserved. No part of this publication may be reproduced, stored in a retriecval System or transmitted in any form or by means, electronis, mechanical, photocopying, Recording, or otherwise, without permission of the copyright holder. ISBN
: 978 -
602
-
98777
- 2- O
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2010 Proceedinqs of International Seminar PPs Unnes
13. IMPLEMENTATION IN CULTURE
PHYSICAL EDUCATION
88
14'FRoMcoVERINGTHEWRoNGDoINGSToCHARACTERBUILDING
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SCHOOL 15. CULTURE-BASED CHARACTER EDUCATION IN
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Rediana SetiYani ........ I.6.DEVELoPINGoFcoNCEPTMAPPINGASSESSMENTFoRMEASURINGSTUDENT,S ABILITYINCoNSTRUCTINGcoNCEPToFELEKTRoNIKADASARII Ani Rusilowati, Achmad SoPYan
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(SUATU TINJAUAN PSIKOLOGISPERKEMBANGAN DALAM SETTING KELUARGA rSLAMl) Anwar SutoYo
INFORMAL 20. PENDIDIKAN KARAKTER DALAM PENDIDIKAN Maman Rachman
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Masrukhi MELALUI PEMBELAJARAN MATEMATIKA 22. MEMBANGUN KARAKTER PESERTA DIDIK BERBASIS BUDAYA LOKAL
Scolastika Mariani
23.MEMBANGUNKARAKTERDANBUDAYABANGSAINDoNESIAMELALUIPMRI Wardono 24.PENDIDIKANKARAKTERBERBASISPoTENSIDIRIMENDoNGKRAKKUALITAS PENDIDIKAN D. YahYa Khan ..........
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Proceedings of lnternational Seminar PPs Unnes 201 0 EMPOWERMENT COMMUNITY DEVELOPMENT MODEL WITH STUDENTS ACCOMPANYING IN MALNUTRITION EARLY DETECTION (Study in Sub District Kandri, Gunungpati, Semarang)
By: IRWAN BUDIONO ABSTRACT
Health and nutrition in children is an important factor in the development of qualified individuals. But unfortunately, the incidence of malnutrition is still a lot happening. One of them in in The Village Kandri, ie 7.8% of children under five are underweight. Magnitude of the incidence of malnutrition is indicated the possibility of the presence of nutritional status of infants with levels of "mild" big enough, which, if not immediately found, it can be developed into a toddler nutrition and subsequently become less malnutrition. Therefore, research must be done to develop early detection systems.
This research is an observational analytical survey with cross sectional design. The population in this study are listed in posyandu toddler Kandri (N=398). Samples taken some 40 children under five are obtained by using non random. The instrument used in this study is a questionnaire and 24-hour recall form. The data obtained were processed using the chi-square statistic with degree of significance of 5%, and calculated the sensitivity and positive predictive value. Results showed the majority of children under five samples of this study have a good level of energy consumption (82.5%),80% had good nutritional status. Chi square test results show There is a relationship between energy consumption levels and nutritional
status (p = O.OOO1). Sensitivity value of the consumption survey method for early detection of malnutrition incidence rate of 0.75. And positive predictive value of the consumption survey method for early detection of malnutrition incidence of 0.8. Suggested to the health center to further improve nutritional surveillance activities, and training of health cadres. Next to the village health cadres are expected to support surveillance activities nutrition consumption surveys conducted continuously and periodically. Keywords : nutritional status, earlv detection Background
The quality of human resources (HR) is one of the main factors required in implementing national development. HR quality improvement needs to be done with mutual efforts sustainable Determinant factor of quality human resource is the health and nutritional status, especially sinct the time of the child / children (Depkes Rl, 2004). Children under five years old (toddlers) is an age group with the rapid body growth, which i. the most vulnerable groups suffer from disorders of nutrition and nutrition easy. Nutrients neede: by children under five in number and relatively large (Achmad Djaeni S, 1999). lmproved nutriticr status of children is part of the increase in the nutritional status of the community. Although ever' effort has been in power and try both in national and international scale, malnutrition remains ' fundamental cause for the occurrence of disease and reduction in life expectancy. To improve tl^= nutrition status and living conditions in the community or the discovery of early detection of cases :' nutritional needs to be done quickly and then get the right treatment. Noting the facts about the importance of preparing children to have good nutritional statu: there is a n ironic situation. ln Centra I Java the re are 1..SI% ca rrying child ren with severe ma lnutritic and 13.8% children undernourished in 2002. These circumstances tend to be even worse whtcompared to 2006 data, where there incidence of malnutrition and nutrition as much as 1.55% le:: 15.1%. Almost the same situation is also found at Kelurahan Kandri, 78% of children under five a'= underweight. Magnitude of the incidence of malnutrition in Kandri, This indicated the possibility :'
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Proceedings of rnternationar seminar pps unnes 2010
the presence of infants with low nutrient status level of mild big enough, which, if not immediately found it to deverop into an infant marnutrition and further into marnutrition. Follow-up of the treatment of malnutrition
/ poor children under five have done well. Department of Health through the Health Center has established procedures for handling child malnutrition / bad (DinkesJawa Tengah, 2006). The problem faced was an early effort to find children with malnutrition is not maximal' Efforts undertaken so far is with undernourished children crawl through IHC' But the scope of the discovery of undernourished children with this method is certainly not maximal, due to the invention rely on passive surveillance. Based on the background of these problems will want to do survey research to test whether consumption can be the moder in earry detection of nutritionar probrems. Research Metodology This research is a type of research with cross sectional survey. The population in this study are all under five in IHC Kandri contained in The Village, District Gunungpati semarang. rn this case there are four neighborhood health center with a totar of 39g infants. Sampres taken as many as 40 infants with non-random techniques. ln this study the respondents were mothers of children
lf for some reason the mother can not be a respondent,under the ny peopte *ho .r. responsible for preparing the family meal/ toddlers.
five who became the sample' respondent can be replaced
The variable in this research is the nutritional status and level of energy consumption. Variable nutritional status measured by anthropometric Z-scores of weight / age for the current measure of nutritional status. This variable data obtained through secondary data from (KartuMenuiuSehot)toddlers.Thevariablelevelsofenergyconsumptionwasobtainedwiththe KMS
3x24hour recall and compared with the recommended daily allowance {RDA) is recommended. Energy consumption levels are grouped in the criteria, namely whether the level of consumption, when > 80% RDA, and less if < gO% RDA (Supariasa,2o02:L14). ln this study, a questionnaire instrument for recording the weight and age of children included in the KMS, and rormulir recall 24 hours to get the data rate of energy consumption Data were analyzed by calculating univariate measures of central tendency (mean, median, minimum and maximum values, and standard deviation) and frequency distribution for the variable of nutritional status and level of energy consumption. And bivariate analysis was done by calculating the sensitivity and positive predictive value sensitivity and positive predictive value of early detection system (in this case through consumer surveys to determine levels of energy consumption) is calculated with the formula : Nutritional status
Early detection
by
surevy consumption)
<-2SD
>-2SD
<99%
Positif
False Positif
Energv RDA
A
B
>100
%
Energy RDA
False Negatif
c A+C
Negatif
A+B C+D
D
B+D
Sensitivity=A/(n+C) predictive positif value A/ (A+A) = Result And Discussion Results showed the majority of children under five samples of this study have a good level of energy consumption, amountin g lo 82.5%. The toddler who had a good nutritional g0%. Chi status of square test results show There is a relationship between energy consumption levels and nutritional status (p
= o'ooot)' sensitivity value of the consumption strrvey method for early detection of malnutrition incidence rate of 0'75. And positive predictive value of the consumption survey method for early detection of malnutrition incidence of 0.g. Here is the translation of research results and discussion:
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Proceedings of lnternational Seminar PPs Unnes 2A10 1. The relationship between energy consumption levels
with nutritional status Based on the results of research indicate that there is a relationship between energy consumption with the nutritional status of children. The results of this study is strengthened by earlier research conducted by the Rahmi M (2000), Early Rosita (2001) and Dewi Firdauz (2003)which states that the same results ie there is a correlation between the level of energy consumption with nutritionalstatus. Based on the results of this study indicated that children with good energy consumption largely shows that good nutritional status, children who otherwise lack or deficit of energy consumption shows a lack of nutritional status. This is reinforced by existing theories. When the consumption of energy through food is less than energy expenditure then the body will lack energy. Consequences are the body will experience the energy imbalance, so the weight is less than the weight it should be. Conversely, if the consumption of energy derived from food exceeds energy expenditure then the excess energy will be stored as body fat, weight loss will occur as a result that exceeds ideal body weight (Sunita Almastier, 2003:150). Energy is the ability to do the job. Body obtain energy from food eaten, which means there is energy in food as chemical energy that can be converted into other forms of energy (Agoes Krisno Budiyanto, 2004:77l'. Humans need energy for survival, growth and physical activity. Energy consumption is a factor directly related to nutritional status. This statement is in accordance with the theory Djaeni Achmad S. (2000:25) stating that the nutritional situation depends on the level of consumption. Consumption level is determined by the quality of dishes and a comparison with one another. When the consumption of energy through food is less than energy expenditure, the body will lack energy. The impact of energy shortage is the body will experience an imbalance so that the weight is less than ideal body weight. Lack of one of the nutrients in food consumed daily can cause disturbances in the process of digestion and absorption of nutrients and can lead to malnutrition. ln people who lack the nutrients, the nutrients in the body will be used to meet the needs of the body. lf this goes on continuously and in the long term there will be a deterioration of the network and malnutrition (Djiteng Roedjito, 1989:31) From the above research findings are consistent with many conclusions from previous research, the energy consumption can be used as one variable that can be used for early detection of malnutrition incidence. 2. Sensitivity of consumption survey method for early detection of malnutrition events The results showed six of the eight children who experience malnutrition can be detected
by the level of energy consumption is less (sensitivity 0.75). Sensitivity value of 0.75 indicates that the level of energy consumption can be used as variables for incidence of early detection of malnutrition. From the calculation is also known from eight infants who have poor nutrition status o' children who have six, including as a false negative. Sensitivity value of 0.75 This also means that the ability of survey methods to estimate th: consumption of the undernourished children as toddlers who are also less energy consumption bi 75%.fhere are several reasons why the sensitivity value of 0.75. First, probably due to small sample size. Sample size will significantly influence the calculation of sensitivity (Grandson Murti, 1997i Second, the possibility of other variables that directly affects the occurrence of malnutrition that are not controlled. ln this infectious disease is the variable that most directly impact on the incidence c' malnutrition (Soekirman,2OOT). Third, the ability interviewer in conducting the recall of food is als: an important factor. Recal bias can occur because of the lack of interviewer skills. lf this recall bia: occurred, then the sensitivity of consumption survey method in early detection of malnutrition eve:: also willgo down (l Dewa Nyoman Supariasa, 2001).
3. Positive predictive value of the consumption survey method for early detection of malnutriticevents Results showed a positive predictive value of 0.85. This shows that the level of ener= consumption can detect early occurrence of malnutrition at 85%.
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Proceedings of lnternational Seminar pps IJnnes 2010
ln this research revealed that there was one of seven children included in the criteria of a false positive' This means that a toddler who does not actuaily have any experience marnutrition detected through the survey as subjects who consumed ress carorie intake. The existence of these false positive rates can be influenced by several possibilities. The first possibiiity is the lack of large sample sizes. This is because the sample size will be related to the normality of a data (Grandson Murti, 1gg7). second, as with the sensitivity, the possibility of another variable that directly affects the occurrence of malnutrition that are not controiled can arso cause a false positive' ln this infectious disease is the variable that most directly impact on the incidence of malnutrition (soekirman, 2oo7)- Third, the same as the sensitivity, the ability interviewer in conducting the recall of food is also an important factor. Recal bias can occur because of the lack of occurred, then the ralse positive varue win increase as wer. (r
;iilfiffiiX'5rirl]],!"''Jl,o'" Closing 1. Conclusion
a' b' c' d'
Most toddrers this sampre has a good rever of energy consumption (g2.5%). Most toddrers this sampre has a nutritionar tood ,tlriu, (soz"). There is a relationship between the level of energy consumption with the nutritional status of children in Sub District Kandri Gunungpati Semarang (p = O.OOOf). survey of energy consumption in infants as instrumen"ts sensitive enough for early detection of malnutrition incidence (sensitivity 0.75, positive predictive value = 0.g). =
B. Sugestion
a'
b'
To the health center, given the level of energy consumption has been found to significantly associated with nutritional status, and consumption surveys will be sensitive enough to predict the occurrence of malnutrition, it is recommended to the Health center to further improve nutritionar surveiilance activities, and training of hearth cadres. To the village health cadres, to support surveillance activities of nutrition, it is recommended that the vilrage hearth cadres to carry out surveys of consumption
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