A Multi-'Approach
In terven tion
TO EMPO WER
PROGRAM
to combat
A MULTI-APPROACH INTERVENTION
TO EMPOWER
POSYANDU NUTRITION
PROGRAM
A
MULTI-APPROACH INTERVENTION
TO EMPOWER
POSYANDU NUTRITION
PROGRAM
TO COMBAT MALNUTRITION
PROBLEM IN RURAL AREAS
Ali Khomsan
Dadang Sukandar
Faisal Anwar
Hadi Riyadi
Tin Herawari
Anna Farchiya
Mira Dewi
_
ｾ｟＠ Ｎ＠
/ 1... , I
_
' . , _ I .
Sur
A Multi-Approach Intervention
to Empower
Posyandu
Nutrition Program
to Combat Malnutrition Problem
in Rural Areas
Ali Kbomsan Dadang 5ukandar Faisal Anwar H adi Riyadj Tin Herawati Anna Farchiya Mira Dewi
Copyrigh r © 2014 Ali Khomsa n Dadang Sukandar Faisal Allwar Hadi Riyadi
Tin Hera\vari
An na Fatchiya
J\I1 ira De\vi
Penyunting : N ia Januatini
Desain Samplil & Penara lsi : Ardhya Praram a
PT Penerbir IPB Press
Karnplis IPB Tama n Kencana Bogor
Cerakan Penall1a: ,1uni 2014
Dicerak oleh Perccrakan I PB
Hak cipra dilindungi oleh undang-lindang, ' , ' '
Di larang mempcrbanya k buku ini tanpa ,%,n tertli los da" Pene rblt
ISBN: 978-979-493-651-1
Posyandu is a communiry-ba e
managed and held by [he co mr in carrying our [he healch
d
｜ｃＧｾ＠ :co provid e [hem an easy ｡｣｣･｟ ｾ＠ order co accelerate the d ecreas;" mortality rate.
Home garden is an area aro . _ vegetables, and fruits can gro". .,. household needs. Home gard en -through an integrated approa ch, avaiJability of various food m :': _ household nutrition.
The objectives of the study we re: participation in the Posyandu pr _ plant/animal diversity of ru ral ｾ＠ attitude and practise of nutritio r.
to revitalize Posyandu
s
activiti -ｬｾＧ［＠training, and facili tating Posy Ｑｊ ｟ ｾＢ＠ Ｌ＠
participation in the Posyandu
through home gardening for in
-r
The research was conducted by gi' - _ extension and home gardening . ｾ＠five and were active as Pos)'tlJltl ,
having children under five were _. _ｾ＠ 31 households having children I ::-•.:.
- -0 :-_
Program
Summary
Posyandu is a community-based health effort which is from the community,
managed and held by the community, and inrended for the community in carrying out the health development to empower the community and
to provide them an easy access to obtaining basic health/social services in order to accelerate the decrease of the maternal mortality rate and the infant • mortality rate.
Home garden is an area around the house where spices, herbal plants, vegetables, and fr!fits can grow in season or along the year in order to meet household needs. Home garden utilization is a home garden which is managed through an inregrated approach so it is expected to be able to guaranree the availability of various food materials continuously in order to fulfill the household nutrition.
The objectives of the study were: (1) to identify factors affecting community participation in the Posyandu program, (2) to idenrify land ownership and pl ant/animal diversity of rural community, (3) to identify knowledge, attitude and prac tise of nutrition among mothers and Posyandu's cadres, (4)
Ｎ＠
VI
SummaryThis research was started by collecting baseline data of 124 households of mothers of children under five and 18 cadres of Posyandus selected before the intervention was done. The baseline data was used to get a preliminary information on the socio-economic characteristics of the households, the condition of ho.me environment. land ownership. nutrition knowledge. attitude to nutrition and nutrition practice of the mothers of children under five, as well as food consumption of the children under five.
The in terven tion implemen tation incl uded two main activi ties, that is, n utri tion education and a home-gardening program. Prior to the implementation of this program , the research team socialized the program and conducted a focus group discussion (FGD) to three villages getting the intervention. The socialization included presentation of the purposes and goals of the program in general. the schedule, and the forms of activities that will be performed. The socialization was not only directed to the mothers of children under five and cadres being the research respondents but al so to the midwives. leaders of the villages, heads of RTs/RWs (subparts of a village) and the local government (Sub-District ofTamansa ri). The objectives of the socialization was to describe the programs to be conducted within two years so that the stakeholders were able to support the program accomplishment.
The data analyses of the baseline and endline included parameter estimation. that is, mean, standard dev'lation, for the quant"ltati:\l e var"la'o\es as we\\ as the proportion for the categorical variables, and quantitative variable which were able to be categorized. The t-student for twO dependent populations and two independent populations was performed.
Participation of the community in the Posyandu activities is very important as an effort for the improvement of the basic health and nutritional status, particularly among the children under five. Almost all of the mothers of children under five (97.6%) stated that the existence of Posyandu was very important for them. The factors inBuencing the community participation are internal and external factors. Internally. the condition, situation and motivation of the mothers of children under five inBuenced the frequency of their visit to Posyandu. Not all of the mothers of children under five routinely visined Posyandu every month. The reasons, among others, are: being occupied , laziness, the children did not want to be taken to Posyandu or they were sick, being afraid that their children got fever after immunization, and being ashame if their children's body weight decreased. The main motivation
of the mothers of children under children grow healthily, get lmm body weight is monitored.
The activities of the Posyandu if
supplementary foods,' preparation problems etc., which were done b· cadres have carried out the proces ｾ＠ up to evaluation of the Posyandu <
The external factors which are i: stakeholders, the availability ofｐ ｯ Ｌ＠ ｾ..
also very important in encouraain- .
1) ｾ＠
The cadres are the most essenri dl of children under five to visit
Po.-performamce were still limited_ 111
-the mo-thers of children under £11 -<: (
and invited them to come to Po_._:
Posyandu equipments, weighed ｲｬ Ｚ ｾ＠
all connected with the Posyandl! ac.:
role in the Posyandu activities, am o ' (the smallest subvillage) , fam il - -I
r--(the community health center·. ｾＺＺ ＮＬ｟＠
from the husbands or parents al 0 n
children under five to visit ｰ ＨＱ ｟［ｾＢＧ ｟＠ ＺＮ＠
PMT (Supplementary Feeding ｰ ｾ＠
'-is able to increase the comm L:-;_::-"
at Posyandu. However, the P_ ｾ＠
that the budget allocated bv [he ＮＺ ｾ＠
the supplementary foods r;uti nt"_
system from the mothers of ch il ｾ Ｎ｟＠
supplementary foods in the reS e,! f - ,
The presence of extension acril-ir1, _ l
under five to visit Posyandu. The r
i
-:
nutrition and health better is of pa_
reliable counsellors at their P05) _7
during the intervention program i:_
-d ine data of 124 households of
__rues of Posyandus selected before
. .: : :,;. was used [0 get a preliminary
--: n er istiCS of the households, the -n ership, nutrition knowledge,
:::: ｾＱ Ｇ＠ the mothers of children under
'r : ｾ Ｚｾｮ＠ under five.
.lain activities, that is, nutrition
_ : ior [0 the implementation of
· -...:.:. :h ,-'" program and conducted a
ｾ Ｚ［＠ ＺＧＢ＠ ge ning the intervention. The
Ｍ ＬＭＭ ［ ｾＬＬ ｻＧｓ＠ and goals of the program . rr-·, ::es thar will be performed. The
:' '
ii".t'r5 of children under five and
:0 [he midwives, leaders of the
｟ｾ ･Ｉ＠ and the local government he socialization was to describe
ｾ ,0 that the stakeholders were
-<e nci uded parameter estimation,
ｾ＠ ＬＫＭｾ ｲ ｪ＠ ｴ ､ｲｩｶ･＠ variables as well as the
JCla nt i rative variable which were c.wendent populations and two
; -:r!!! activities is very important • ｾ｟ Ｍ ｩ ｛＠ he alth and nutritional status,
_ C:, ,:!. ,-\lmost all of the mothers of
· , -- ex istence of Posyandu was very
.' , :lg rhe community participation
Ｇ ｾ ...l - rhe condition, situation and
ｌＮＭＺ ｾ＠ !1 \'e inA.uenced the frequency of
Ｎｾ＠ :-rs of children under five
routineh-｟ ｾｯ ｮｳＬ＠ among others, are: being
a nt to be taken to Pos)landu or they
Ｎ［＠ ｾＮＬ＠ go r fever after immunization, and
｟ Ｎ ｾｨＨ＠ decreased. The main motivation
Summary
VII
of the mothers of children under five visiting Posyandu is in order that their
children grow healthily, get immunization/vitamin A, and their children's body weight is moni[Ored.
The acrivities of the Posyandu implementation are such as provIsion of
supplementary foods,' preparation of the place, discussion on the Posyandu
problems etc., which were done by the Posyandu cadres. Thus, basically the
cadres have carried out the process ofpreparation or planning, implementation
up to evaluation of the Posyandu activities.
The external factors which are in forms of supports from the Posyandu
stakeholders, the availability ofPosyandu facilities, and counselling activities are
also very important in encouraging the community [0 participate in Pos)Jandu .
The cadres are the most essential stakeholders in encouraging the mothers
of children under five to visit Posyandu, however their number and their
performamce were still limited. The cadres have actively given information [0
rhe mothers of children under five on the schedule of the Posyandu activities
and invited them to come to Posyandu, prepared supplementary foods and
Posyandu ･ｱｵｩｰｭ･ｾｴｳＬ＠ weighed the children/pregnant mothers, and recorded
dll connected with the Posyandu activities. The other stakeholders who playa
ｾ ｯ ｬ･＠ in the Posyandu activities, among others, are: midwives, the RT leaders :11e smallest subvillage), family planning counsellors, officers from puskesmas : ne community health center), religious figures, and Village leaders. Supports ':"om the husbands or parents also played a role in encouraging the mothers of
Ｚ ｾ Ｚ ｪｊ ､ ｲ･ｮ＠ under five to visit Posyandu.
. . IT (Supplementary Feeding Program) is one of powers of amaction which
-Oo le to increase the community interest [0 have their children weighed
Posyandu. However, the PMT was not routinely held with the reason
'.: rhe budget allocated by the government was not sufficient to provide
=
rupplementary foods routinely every month. A collective contribution［ｾ ｾ from the mothers of children under five was not available to provide
ＧＧＺ Ｇ ｾ＠ｾ ｭ ･ｮｴ｡ｲｹ＠ foods in the research villages.
:: -:-ese nce of extension activities also motivated the mothers of children
ｾ Ｌ ＭＺＬ Ｍ :-= vc to visit Posyandu. Therefore, empowering the cadres to understand
,..:::
.;:. - n and health better is of paramount importance, so they can become
.counsellors at their Posyandu. The nutritional training conducted
ｾ＠ :.'-te intervention program in this action research is a real step to the
VIII
SummaryThe adequacy and completeness of the Posyandu facilities/infrastructure also
motivated the mothers of children under five to visit Posyandu, because they
improved the comfort and promptness in service. However, almost all of the
Posyandus still faced problems of the avalabiliry for the facilities. Some of
them were permanent Posyandu buildings were not available and therefore
most of the Posyandus used the house of one of the cadres; the availabiliry of
weighing scales, microtoise, tables, chairs, as well as divan and manress for the examination of the pregnant mothers was also limited.
111e villages which became this research site had a relatively fertilized land
texture so the activity of yard utilization was potential to develop. On average
the control and intervention groups possessed a narrow yard (<120 m2
).
The average of the land area under control in the intervention group was
approximately 32 m2 per household, in details Sukaresmi Village 44.1 m2
,
Sukaluyu Village 23.6 m2 , and Sukajaya Village 11.9 m2 .
Based on the baseline data it is known that the yards in the research site had not been maximally utilized, most of the land around the house had not been utilized or left empry. In the three intervention villages ,the number of
the households which utilized the yards to cultivate vegetables was 30.1 %,
tubers 25.8%, and decorative plants 23.7%. Whereas, in the control village the number of the households which utilized their yards for decorative plants 25.8%, vegetables 19.4%, and tubers 12.9%. This low utilization was because the households did not have plant seeds/seedlings, did not have time and were occupied taking care of their house as well as their children, did not know how to plant, and other various reasons.
The intervention in a form of nutritional extension resul ted in a positive impact in the case of nutritional knowledge. The trend of the nutritional knowledge increase was observed in the intervention group, where the number of the mothers who gained nutritional knowledge categorized as 'good' increased. In the intervention group the score of the momers' nutritional knowledge increased as many as 12.4 on average, while in the control group the in increase was JUSt 1.8 . The increase of the nutritional knowledge score in the intervention group was significantly higher than that in the control group (p<0.05).
In regard to the nutritional knowledge of the cadres, the number of the cadres in the intervention group whose nutritional knowledge was categorized as
'good' increased from 14.3% to 78.6%. Statistically the nutritional knowledge
increase of the cadres in the interv that in the control group (p<0.05).
Concerning with the nutritional arr ir
.:"':'. ,_
ｾ＠
L"::' ..
as many as 6.9. The result of the ｴＭ｛Ｈ Ｎ＾ｾｴ＠ ＭＧ＠
(p<0.05) berween the nutritional a:-: the intervention group and that of : ._ , the mothers in the intervention gro•
attitude. On the other hand, amO f1f ＢＭＮｾ＠
a significant difference berween the
group and that in the interventi on g.
Nutritional ani tude was relecte
habits. In the intervention grou p Ｎ Ｍｾ＠ >
-who consumed vegetables in the h five reached 11.0%, while in th e c The majoriry of the mothers, ei dlci"
-one provided tofu/tempeh for cl-..:-.; j
the control group and in the in: c:T!'
in the intervention group. The .. .ｾ＠
who stated that their children ｜ Ｇ Ｚ ･ ｾ＠ Ｇ＠
approximately 9.3%, while in
U"::-15.8%. The significant increase 5 :; the households of the cadres in :
The action-research activiry whi..
to improve the nutritional kn O\\
and also of the Posyandu cadres. T
in a long term is to improve ch<:, ;::-_.
the nutritional status of the ch ilwe-, nutritional service at the commu!",i, '
the spread of nutrition deficien
.
-five. Therefore, the empowern rnc
education, and training on ｯｰｲ ｪ ｭ ｾＮｕＴ .._
The increasingly good qualifY or
T
elements, that is, the increase of i-'":::'"
program service for children ｵｮ ､ ｾ Ｚ＠ •.
-increasingly skillful will be able to
3:
-Posyandu nutritional program COij,l
'oW fa cilities/infrastructure also
- ｾ＠ ,i:O -: isi t Posycmdu, because they
-- ｾ Ｚ ＮＺＭｾ｟＠ However, almost all of the :- - for the facilities. Some of
_i;! not available and therefore
I;" ｾ ｨ ･＠ cadres; the availabiliry of
ｾｉ＠ as divan and mattress for the
j m ited,
' ,<ld a relatively fertilized land
- - [e ntial to develop. On average
a narrow yard (<120 m 2).
n the intervention group was
;;ills Sukaresmi Village 44.1 m 2,
ce 11.9 m 2.
.i: rh e yards in the research site
,-.b·'
land around the house had not=-- :
t"[w ntion villages the number of '.:u ltivate vegetables was 30.1 %, - - _ Wnereas, in the control village --:: [heir yards for decorative plants . Th is low utilization was because lugs, did not have time and wereJ5 their children, did not know
__..ｾＨｽｳ ｩ ｯｮ＠ resulted in a positive impact
ＬＮ｣ｾ＠ crcn d of the nutritional knowledge - - g-ro up, where the number of the
...:ge categorized as 'good' increased. -Ｎ＠ ｾ ＺＭ｣Ｚ＠ mothers' nutritional knowledge
iil e
in the control group the inＭ Ｍｾ＠ n u tr itional knowledge score in the
-'f:1e r than that in the control group
: ' !)e cadres, the number of the cadres
Ｍ Ｚｾ ｯｮ ｡ ｬ＠ knowledge was categorized as :-: -.J[ istically the nutritional knowledge
Summary
IX
increase of the cadres in the intervention group was significantly higher than that in the control group (p<0.05).
Concerning with the nutritional attitude, in the intervention group it increased as many as 6.9. The result of the t-test showed that there is a significant different (p<0.05) between the nutritional attitude score increase of the mothers in the intervention group and that of the mothers in the control group, where the mothers in the intervention group gained higher scores of the nutritional attitude. On the other hand, among the cadres it was not found that there was a significant difference between the nutritional attitude score in the control group and that in the intervention group (p>0.05).
Nutritional attitude was relected in several things connected with eating habits. In the intervention group the increase in the number of the children • who consumed vegetables in the households of the mothers of children under
five reached 11.0%, while in the control group the increase was less than 9% . The majority of the mothers, either in the control group or in the intervention
one provided ｴｯｦｾＡｴ･ｭｰ･ｨ＠ for their children. The increase occured both in
the control group and in the intervention one, but the increase was higher in the intervention group. The number of the mothers in the control group who stated that their children were accustomed to having breakfast increased approximately 9.3%, while in the intervention group the increase reached 15.8%. The significant increase (35.8%) in having breakfast also occurred in the households of the cadres in the intervention group.
The action-research activiry which is a nutritional education has been able to improve the nutritional knowledge of the mothers of children under five
and also of the Posycmdu cadres. The importance of the nutritional education
in a long term is to improve the eating habit which at the end can improve
the nutritional status of the children. Posycmdu cadres as the spearhead of the
nutritional service at the communiry level play an important role in preventing the spread of nutrition deficiency particularly among the children under five. Therefore, the empowernment of the cadres in a form of nutritional
education, and training on optimizing the Posyandu services need to be done.
The increasingly good qualiry of Posyandu is reflected in one of its qualiry
elements, that is, the increase of the cadres' abiliry in giving a nutritional
program service for children under five. It is expected that the cadres who are
increasingly skillful will be able to attract the communiry to participate in the
Posyandu nutritional program constantly so the nutrition deficiency among
x
SummaryThe equipments possessed by the
Posyandus
to operate the nutritional serviceprogram were still limited . In this action research the
Posyandus
in theresearch site which have been facilitated by a collaborative project, the Nestle Foundation-Bogor Agricultural University, with various kinds of facilities
to support the
Posyandu
operation, such as media for nutritional extension(poster, flipch art, module, and leaflet), tables, chairs, divan , mattress, weighing scale, microtoise etc. It is expected, with the equipments/facilities which are
more complete, the
Posyandus
are able to provide better nutritional services.Increasing the community participation in the
Posyandu
activities can be doneby solving the
Posyandu
problems which are rooted from the internal andexternal factors as have been explained in point 1. Internally, in this action
research some efforts to motivate the mothers of children under five to come
to
Posyandu
routinely have been done. Therefore, the resea rch team togetherwith the
Posyandu
cadres in the activities of the nutritional extension haveemphasized the importance of
Posyandu
for the growth and development ofchildren and the need of the community to utilize
Posyandu
as nutritional andhealth services for children.
The performance of the
Posyandu
cadres was still limited, therefore theresearch team held trainings on health, nutrition, an'd optimizing
Posyandu
services. With th e trainings it is expected that th e
Posyandu
services get betterso this is able to encourage the community to be willing to participate in the
Posyandu
ac tivities.The role of the community figures is very crucial in increasing the community
participation in
Posyandu.
Therefore, it has been conducted socialization onthe programs connected with the development of
Posyandu
to the communityfigures, and improvement of their understanding on the importance of
Posyandu
for the community. Thus, their concerns will emmerge todevelop
Posyandu
and they also pay attention to the health and quality ofthe community life, particularly among children under five. It is expected
that with high understanding and concerns, the formal and informal figures are able to convince the community members on the importance of their
participation in the
Posyandu
which is held once a month in each village.The community participation in the
Posyandu
activities is also influ encedby the ava ilability and completeness of the
Posyandu
facilities. The facilitieswhich are complete and of good quality improve the comfort and promptness
in giving services to the mothers at the
Posyandu.
However, in fact the>"
ｾ＠ -I e period o f ＮＬｾＧｾｮ＠ Ｍ Ｇ＠Ｎｾ＠-］ ｾ ﾷ ､｢Ａ ･ｳ＠ in rh e ｾ ＮＧ ｡ｲ､＠ •.!:
-::-· 0 in Suka lu\ll \ '
illa£::-';'t- ) . Other
［Ｇ･ｧ･
ｴ ｡ ｢ｬｾ＠
ｾＮｾ＠ spinach, cucum be.
- ｾｾ＠ \egeta bles whose proc
_:.. : ble ro be planted in rilL _:..; _
-. 5cholds w plant. •
.;, trend of the wral q"'C'eLo
-ｾ＠
nC:1 rl y similar patrern.ｊｾ＠
: :l i'.J 'reased, then in ｏ｣ｲｏ｢ ｾ ｦ＠ ｛ ｏｾﾭ
and in January w June 201_'
-The role of the cadres in Lhe '
-' 0 o perate the nutritional service
.. ｾ ･ ［［ ･ ｡ｲ｣ｨ＠ the Posyandus in the • co ll aborative project, the Nestle
·...: th
various kinds of facilities"' aIrs , divan, mattress, weighing :: eq u ipments/facilities which are e better nutritional services.
Po.'wwdu activities can be done
-e roo ted from the internal and
_ ...:J ;,:--ccDt. 1. Internally, in this action
Ｎｴ ｾ［ ＾Ｚ＠
or
ch i ldren under five to come- !"do rt . the research team together
;- th e nutritional extension have
- ｾＬ･＠ g rowth and development of
:ilize Posyandu as nutritional and
,..as still limited, therefore the
. ' on , and optimizing Posyandu
Ｎ［Ｎｾ＠ th e Posyandu services get better
: 0 b e willing to parricipate in the
ucial in increasing the community
. c ｢ｾ ･ｮ＠ conducted socialization on
ＭＭ ｾ･ｭ＠ of Posyandu to the community uliders randing on the imporrance
0 0 - lhe i r concerns will emmerge to
ｾＬＭ［Ｎ･＠ ﾷＬ ｈ ｩ ｯ ｮ＠ to the health and quality of
ＮＬ Ｍ ｾ＠ chi ldren under five. It is expected
. '. :':'. 0 ) . the formal and informal figures
'-em bers on the imporrance of their
d d once a month in each village.
?O_:i'tlildu activities is also influenced ;- [he Posyandu facilities. The faciliries - - im p rove the comforr and promptness : -h e Posyandu. However, in fact the
Summa ry
Posyandus in the research site still possessed limited facilities. The research
team made an endeavour to overcome the problems by giving facilities as have been mentioned in point 4 so it is expected that the Posyandu services can be better.
In the activity of the yard utilization (home gardening) in the research site there were 15 kinds of vegetables which were planted, namely, small-sized chilli,
katuk, spinach, kangkung, string bean etc. The kinds of vegetables which were
easily planted were spinach, kangkung, and raisin. Most of the respondents felt pleased with the yard-utilization (home gardening) program because they got guidance, direction, and enough facilities to develop their yard, as well as their harvest can be used to fulfill their household needs without spending any money to buy vegetables.
., During the period of April 2012 to June 2013 the highest productions of vegetables in the yard were raisin in Sukaresmi Village (aboutl50 kgs) , wmato in Sukaluyu Village (about 155 kgs) and in Sukajaya Village (about 100 kgs). Other vegetables whose production was also caterogized as 'high' ',-ere spinach, ｣ｵｾｵｭ｢･ｲＬ＠ bitter melon, kangkung, chilli, and eggplant. These vegetables whose production was high indicate that the vegetables are uirable to be planted in the yard and are potential be recommended to other
useholds to plant.
'=he trend of the total vegetable harvest in the three intervention Villages has _ nearly similar pattern. In the period of April to September 2012 the harvest ' .Teased, then in October to December 2012 d ec reased due to the dry season,
:1Q in January to June 2013 the harvest increased again .
ｾｾ＠ role of the cadres in the yard utilization program helped very much in
<..':-:-i.ield; this was connected with an efforr to maintain/build the respondents ' - ｾ＠ ::'.-a rion. Most of the cadres in the three villages were enthusiastic to the :- . am sustainability, even though in the course there were some of the
- 5 who were less active in the field because of their business or other
ｾ＠ -<" . Interest and motivation were (wo of the factors which affect the yard
ｾ :Io n. Strong interest and motivation will make the community easy to
=
rheir yard optimally because the yard need to be taken care so that it :o nr inual production.Acknowledgment
The authors would like to thank the Nestle Foundation for funding the study.
Gratitude is also expressed to the head ofTamansari Subdistrict, Bogor, West
Java, Indonesia, the village heads, all community who had participated in the study and to the cadres of Posyandus at the study sites for their support, Tisna Prasetyo SP, MSi (IPB) and agricultural extension workers (Ir Kobarsih • Daeny Afif, Ir Yeti Sumiyati, Dewi Lestari STP, Sukandar SST, and Towapa Miharja, SST) for their participation and valuable inputs and commitments
to improve the home garden program. Appreciation to Dean of Faculty of
Human Ecology and Chairman of Department of Community Nutrition,
Bogor Agricultural University for their supports. Many thanks to Catur Dwi
List of Content
SUMMARy ... ... ... ... .. v
·LIST OF PICTURES ... .... .... ... ... ... ... ... ... ... . xxv
LIST OF APPENDICES ... .. ... ... ... ... ... ... xxvii
ACKNOWLEDGMENT .... .. ... ... .. ... ... .. ... xiii
LIST OF CONTENT ... ... .. ... ... ... ... xv
LIST OF TABLES ... .... .. xix
INTRODUCTION ... ... ... ... ... ... ... ... 1
1.1 Background ... ... ... .... ... 1
1.2 Goals and Objecrives ... .. ... . 5
1.3 Research Hypotheses ... .... ... ... ... 5
2 LITERATURE REVIEW ... .. ... 7
3 METHOD ... ... .... ... ... ... ... 23
3.1 Research Design ... ... ... .... ... ... .. 23
3.2 Research Sites and Time ... .. ... .... ... ... ... 23
3.3 Sampling Technique ... .... ... .. ... 24
3.4 Resea rch Procedures ... .... ... ... ... .... ... .... 24
3.4.1 Focus Group Discussion (FGD) ... : ... 25
3.4.2 Nutritional Extension ... .. ... 29
3.4.3 Implementation of Home Gardening ... 32
3.4.4 Workshop of
Posyandu
Management and Cadre Training ... 403.5 Kinds and Methods of Data Collection ... 41
XVI
Li sl of Con lentDESCRIPTION OF THE STUDY SITES ... ... ... ... ... ... 47
4
4.1 Geography .. .... .. ... .... ... ... .. ... ... ... .. .... ... .. .... .... .... .. .... ... 474 .2 Governmental Matters ... .. ... .. .. .. ... ... ... .. .... .. .. .. ... 47
4.3 ｓｯ｣ｩｯｾｐｯｰｵｬ｡ｴｩｯｮ＠ Affairs .. .. .... ... .. .. ... .. .... ... .. .... .. .... .. ... 48
4.4 Agriculture ... .. ... .... ... ... .. ... .. ... .. ... 49
5 SOCIO-ECONOMIC AND DEMOGRAPHIC CHARACTERIST ICS OF HOUSEHOLDS .. .. ... 51
5.1 Socio-Demographic Characteristics of the Households ... .... 51
5.2 Household Incomes and Expenditures ... .. ... 52
6 EMPOWERING POSYANDU. .. .... ... .... ... ... ... .. .. .. ... .. ... .. .... .. ... .. . 63
6.1 Characteristics of the Cadres .. .. ... .. ... .. ... .. ... .. .. .... .. 63
6.2 C adre Participation in the Posyandu Implementation... .. ... 65
6. 3 Perce ption of the Cadres on Posyandu ... .. ... 75
6.4 Participation on th e Mothers of Children under Five in the Posyandu Implemenration ... ... ... ... .. ... : ... ... .. .... 77
6.5 Roles of the Stakeholders in Improving the Participati o n of the Mothers of Children under Five to Posyandu .. .. ... .. ... .. .... 91
6.6 Perception of the Formal and Informal Village Leaders on Posyandu ... .... ... ... .. .. ... ... ... .. 94
6. 7 Facilitating Posyandu ... .. ... .. .. .. ... .. .... .. ... ... .... .. .... . 97
7 HOME GARDENING ... .. ... .. ... ... ... .. ... .. ... .. ... 99
7.1 O wnership and Utilization of the Yard ... .. ... .. ... .. ... . 99
7. 2 Impl ementation of the Home Gardening Program .. .. .. ... .. ... 101
8 NUTRITIONAL KNOWLEDG E, ATTITUDE, AND BEHAVIOUR OF T HE CADRES AND THE MOTHERS O F CHILDREN UNDER FIVE ... .. .. .. ... ... .. .. .. .. .... .. ... .. .... 115
8.1 Nutritional Knowledge ... .. .... .. ... .. .. ... .. .... .. . 115
8.2 Nutrition al Attitud e .... .. ... ... .. ... 118
8. 3 Nutritional Behaviour .. .. .. ... .. ... .. ... 124
EATING HABITS OF .
9.1 Feeding Pattern ...
9.2 Th e Habir ofC ofl.> l!1'
9.3 Th e Habit of H a\ ir. _
9.4 The ｈｩｳｲｾｲ ｹ＠ of Fo rm
9.5 The History of \ tiL
.0 FOOD CONSUMP TI O_
10. 1 Food Frequen cL ... _
10.2 Food Preference .. .... .
10.3 Food Taboo .. .. .. ... ...
10.4 Nutrition Adeq u::.=:- . 10.5 Nutritional Adeq_..: :" _
11 NUTRIT IONAL A::\D .. ｾ ｟＠
11 . 1 Characteristi cs 0" - ..:
1l.2 Nutritiona l Sran15 .. . ..
11.3 H ealth Srarus.. .. ... .
12 SUSTAINABILI TY O F T'
. ..
- - ...13 CONCLUSIONS
A,."< D
ｾ＠13.1 Conclusions .... ... ... .
13.2 Recommendario n
14 BIBLIOGRAPHY ... ... .. .. .. _
-·... ... .. ... .. .. .. ... .. 47
... .. ... .
... . 47
.. ... 47
... ... 48
... ... ... ... ... ... 49
or- [he Households ... 51
reo ... 52
.. .. ... 63
_ _... ... 63
--_ . l mplementation ... 65
.rA:! ...·75
. Childre n under Five in the
... 77
- '?""'l ng the Participation of ＭＭ ｾ＠ Five to
Posyandu
.. .... ... .. ....
91d hro rmal Village Leaders on _.... ... ... .. ... ... ... 94
... ... .. .. ... .. .... ... ... .. ... ... .... ... 97
.. .. ... ... 99
:' lhe Yard .. ... ... 99
:',e Gardeni ng Program ... .. .. ... 101
:; E.
ATTITUDE, AND .ES .-\.t"'JD THE MOTHERS OF ... .. ... ... ... ... .. ... 11 5 ... .. .... ... .. ... .. .. ... ... .... ... ... 11 5 .. .. ... ... ... 11 8 .. .. .. ... .... .. .... .. .. .. .... ... ... ... .... .. 124XVII
Li sr of Conlenl 9 EATING HABITS OF CHILDREN UNDER FIVE ... ... ... 1299.1 Feeding Pattern ... ... ... ... 129
9.2 The Habit of Consuming Fruit and Vegetable ... 132
9.3 The Habit of Having Streerfood ... .. ... 133
9.4 The History ofFormulated Milk Consumption ... .... 134
9.5 The History of Milk Consumption ... 136
10 FOOD CONSUMPTION ... .. . 139
10.1 Food Frequency ... ... ... ... .. .. ... .. .... .... .. 139
10.2 Food Preference ... ... ... .... ... 144
10. 3 Food Taboo ... .. ... ... ... ... .. ... .. ... 150
10.4 N utrition Adequacy Level ... 151
10. 5 N utritional Adequacy Level of the Households ... 152
NUTRITIONAL AND HEALTH STATUS ... ... 15 9 11.1 Characteristics of Children under Five ... ... 159
11. 2 Nutritional Starus ... 161
11.3 H ealth Status ... 165
Ｇ ｾ＠ SUSTAI N ABILITY OF THE PROGRAM ... ... 169
.-' CONCLUSIONS AND RECOMMENDATIONS ... 175
13.1 Conclusions.. ... .... .. ... ... .. .. ... .. .... 175
13.2 Recommendations ... .. .. ... ... ... ... ... .. ... ... 180
"" IBLIOGRAPHY.... .. .. .. ... .. .. .. ... ... ... ... ... ... .. ... .. ... . 183
Table 2.1
Table 3.1
Table 3.2
Table
5.1
Table
5.2
Table
5.3
Table 5.4
Table
5.5
Table 5.6
Table 5.7
Table
5.8
Table
5.9
Table
5.10
Table 6.1
Table 6.2
Table 6.3
Table 6.4
Table 6.5
Table 6.6
List of
Tables
Clasificarion of
Posyandus
and rhe implemenrarionindicarors ... .... ... ... .. ... .. ... ... ... ... ... ... ... 11
The selecred
Posyandus,
number of respondenrs, and cadres by village ... ... ... ... ... ... ... .. .... ... .. ..24
Merhods of measuremenr and merhods of dara collection .... .
42
Characrerisrics of rhe household socio-demogra phy ...
52
Srarisrics of household income and expendirure Ｈｉｄｾ｣｡ｰＯｭｯｮｲｨＩ＠ ... .... ... ... .. .... ... ...
53
Sraristics of household food expenditure (IDRIcap/monrh) ..
54
Srarisrics of household nonfood expenditure (IDRIcap/monrh) ... .... .. .. ... ... .. ... ... ...
55
Disrriburion of lirerare husbands and wives .... ... ... ... . 56
Distriburion of husband's and wife's occuparions ... .... ... 57
Disrriburion of houses by rheir sratus and characrerisrics ...
58
Disrriburion of household lighring and fuel .... .... ... ... .. .... .
59
Distribution of wa rer resources ... ... ... ... ... ... ... 60
Disrriburion of household sanirarion ... .. ... .. ... 61
Srarisrics of rhe cadres' socio-demographic characrerisrics ... 63
Paniciparion of rhe cadres ar
Posyandu
... .. ...
66Disrriburion of rhe cadres by incenrive received .... ...
68
Disrribution of rhe cadres by rask in rhe
Posyandu
implemenrarion ... ... .. .... ... ... ... ... ... 69Disuiburion of rhe cadres by nurrirional counselling ar
Posyandu
... .. ...
70xx
Lisl of TablesTable 6.7 Posyandu Problems and a condirion-change rrend in rhe lasr
rhree years in Village Sukal uyu .... ... ... ... ... ... ... -; _
Table 6.8 Posyandu problems and a condirion-change rrend in rhe lasr
rhree years in Village Sukaresmi ... ... .. .. ... ... ... ...
r
Table 6.9 Perceprions of rhe cadres on rhe Posyandu acriviri es necessary
ro be improved .... ... ... .... .. ... 76
Table 6 . 10 Disuiburion of visir frequencies of rhe morhers of children
under five ro rhe Posyandus during rhe lasr one yeaL ... 78
Table 6.11 Disrriburion of visir frequencie of rhe morhers of children
Table 6.12
Table 6.13
Table 6.14
Table 6 . 15
Table 6.16 Table 6.17 Table 6.18 Table 6.19 Table 6.20 Table 6.21 Table 6.22 Table 6.23
under five ro Posyandu wirhin rhe lasr rhree months ... 79
Disrriburion of rhe morhers of children under five ro join
Posyandu unril rheir children reach 5 years old... ... 80
Household supporrs ro rhe visir of rhe morhers of children
under five ro Posyandu ... .. ... ... .... .... ... ... ... .. ... 81
Disuiburion of rhe reasons for rhe morhers of children
under five visiring Posyandu ....... ... ... 82
Disrriburion of rhe morhers of children under five by KMS
(children growrh charr) ownership ...
83
Parriciparion of rhe morhers of children under fi ve
in rhe Posyandu implementarion ... ... ... .... ... ... .... .
84
Perceprion of rhe morhers on rhe service of supplemenrary food provision ar Posyandu .... ... ... .... .... ... .... ... ... ...
85
Perceprion of rhe morhers on rhe counselling program
ar rhe Posyandus ... .. ... ...... ... ... ... ... ... ... ... .. ... .. .
85
Perceprion of rhe morhers on rhe roles and services of rhe
Posyandu ... 86
Perceprion of rhe morhers on rhe adequacy of
rhe Posyandu faciliries ... ... 86
Perceprion of rhe morhers on rhe programs requiring
improvemenr ar rh e Posyandu ... ... .. ... ... .. 87
Componenrs, problems , and suggesrions for overcoming rhe problems ar rh e Posyandu .. ... .. .. ... .... ... ... ... ... ... 88
Perceprion of rhe morhers on the performance of
rh e Posyandu cadres .... .. ... ... ... ... .. ... .. ... ... .... .. 91
- - - .6
Ｎ ｾ＠ .3
.e 8.4
ｾ ｾ ｢Ａ｣＠ 8.5
.able 8. 6
-':-;Jb le 8.7 ｾ ｬ｢ ｬ･＠ 8.8
Ta ble 9.1
Table 9.2
Table 9.3
Table 9.4
Table 9.5
Table 9.6
Table 9.7
Per cp rio n of rll.:
i
-ligu res on Po, . . m.a"Eq uipments O\\- :-'CL
ｾ＠ w ri sri.:s o f
-h:.' .-'- .. _
L rilizarion 0 " C::
TIle widrh 0 -ｨｯＺｾ Ｍ Ｎ＠ _
lendlin c) .. .. ... _ .••..
in Suka! m"l!
D ara of rhe
ha.
in Sukaresm i
Dara of rhe ｨｾＧ＠ :: .
"-in Sukaja. ·;1 \ 'H .. j ::
Ca regories or" n,,:
-Caregori e-
of :< __
Ca regories
Dis rribur io n 0 - - ｾ＠
arriwde ... ... _ .... _
Caregori es o r-lr.;; _ - "_
Disrriburio . ｯ ｾ Ｍ Ｇ＠ :: _ ani rud e ... ... _ .. _ _
Disrribu ri on o r- . - :"
Distriburio n ｯ ｾ Ｍ Ｚ Ｍｴ＠ - ｾ＠
The distrib lHion
The distribu ri on of children un Ｇ ･ ｾ＠ :.
Fruirs consu med
.--DisrriblHion o r 11...;. under fi ve ... .. ...
_=Disrri blHion of :h .-Disuiburion of [.'-e
consumprion .... ...•.
[11:-ｉ ｾＺＺＺｮ Ｇ ﾷｮ ＮＺＧＡｵ ｮｧ･＠ trend in the last
. ... 74
..,. ·cllange trend in the laSt ... ... ... ... 75
I • • • .• ,'.ii/au aC(IvlCleS necessary ... .. ... ... 76
;' ;he mothers of children _ _ i;-f : he last one year. ... 78
.
ｾ Ｎ＠we
mothers of children ｾ Ｇ ＭＭ ｾＮ ＡＧ＠ las t three monrhs ... 79- : children under five co join ' ·21 ＧＧＺｾＲ ［Ｚｨ＠
5
vears old ... .. .... 80.: : of ;:he mothers of children ... ... .. . 81
.
ｾ ｢ ･＠ mothers of children ... 82:::b il dren under five by KMS ｌＮＢｃ ﾷ ｾｮｩ ｰ＠ ... ... ... .... 83
ｾ ＧＡＭ［Ｚ［＠ (li' ch ildren under five ｾﾷ Ｇ Ｂﾷ ｾｮ＠ ... .. ... 84
.. we service of supplementary .... ... ... ... ... 85
ｾ＠ rh e counselling program ... ... 85
(La [h e roles and services of the ... 86
. on th e adequacy of .... ... ... .. ... ... ... 86
"'> o n the programs requiring
· .. ·i l'
... ... ...
87;Lad ｾ ｵｧｧ･ｳｴｩｯｮｳ＠ for overcoming ··;du ... ... ... .... ... 88
.. ｾ＠ o n the performance of .... ... 91
Table 6.24 Table 6.25 Table 7.1 Table 7.2 Table 7.3 Table 7.4 Table 7.5 Table 7.6 Table 8.1 Table 8.2 Table 8.3 Table 8.4 Table 8.5 Table 8.6 Table 8.7 Table 8.8 Ta ble 9.1 Table 9.2 Table 9.3 Ta ble 9.4 Table 9 .5 Ta ble 9.6 ｾ＼ ｬ ｢ｬ･＠ 9.7 List of Tables Perception of the formal and informal village community figures on Posyandu ... .. ... 94
Equipmenrs owned by the Posyandu's ... 98
Statistics of the land width (m2 ) ... .. ... 99
Utilization of the yard areas (baseline) ... .... ... 100
The width of home gardening areas through the IPB Program (endline) ... .... ... ... 102
Data of the harvest in the period of April 2012 co June 2013 in Sukaluyu Village ... 105
Data of the harvests in the period of April 20 12-June 2013 in Sukaresmi Village ... ... 107
Data of the harvest in the period of April 2012 co June 2013 in Sukajaya Village ... 108
Categories of nutritional knowledge of the mothers ... 116
Categories of the cadres nutritional knowledge ... 117
Categories of the mothers' nutritional attitude ... ... 118
Distribution of the mothers by statemenr of the nutritional attitude ... .. ... .. ... .... ... 119
Categories of the cadres' nutritional attitude ... 122
Distribution of the cadres by statemenr of nutritional attitude ... ... ... 123
Distribution of the mothers by nutritional behaviour ... 125
Distribution of the cadres by nutritional behaviour ... ... 127
The distribution of feeding patterns of children under five .. 130
The distribution of vegetable and fruit consuming habits of children under five ... 132
Fruits consumed frequen rly by children under five ... 132
Distribution of having-streetfood habits among the children under five ... ... ... 133
Distribution of the most frequenrly bought streetfoods ... 134
Distribution of the history of formulated milk consumption ... 136
Distribution of the history of milk consumption .... .. ... 137
XXII
Lisl of TablesTable 10.1 The frequency and amoum of cereal consumed by
the children under ... 141
Table 10.2 The freq uency and amoum of animal-sourced food
consumed by the children under five .. .. ... .... ... 141
Table 10.3 The frequency and number of beans consumed by
the children under five .. .. ... .... ... .. 141
Table 10.4 The frequency and amoum of vegetable and fruit consumed
by the children under five ... 143
Table 10.5 The frequensy and amount of street food consumed by
the children under five ... 143
Table 10.6 Distribution of children under five by kinds of vegetables
preferred ... ... ... .. ... ... .... ... .... .... ... 145
Table 10.7 Distribution of the children under five by kinds offruits
they preferred ... .... ... ... .. 146
Table 10.8 Distribution of the children under five by kinds of
sidedishes they liked ... .. ... 147
Table 10.9 Distribution of the children under five by kinds of snacks
they preferred ... ... ... .. ... . ; ... .. ... ... ... ... .... 147
Table 10.10 Distribution of the children under five by the kinds of
sidedishes they disliked ... 148
Table 10.11 Distribution of the children under five by snacks they
disliked ... ... ... .... 149
Table 10.12 Distribution of the respondents by kinds of vegetables
and fruits they dislike ... 150
Table 10.13 Taboo foods for the children under five ... 151
Table 10.14 Imakes and the nutrient adequacy level among the children under five .. ... .. ... ... ... 154
Table 10.15 The percentage of children under five by classification
of the nutrition adequacy level .. .. ... ... .... .... .. ... ... .. 155
Tabl e 10.16 The households' imake and nutrient adequacy level ... .. .... 156
Table 10.17 The percemage of the households by classification of
nutritional adequacy level .... ... .. ... .... ... . 157
Table 11.1 Distribution of the children under five by sex ... 159
Table 11.2 Characteristics of the children under five ... .. ... .. ... 160
Table 11 .3 Distriburion 0 ' :.b:- _
and trearmen g: .... .
Table 11.4 Linear regre5sio
by the srep\\ ise ;ut'
Table 11.5
and trea tmen! ｾ［Ｍ ｾ＠
Table 11.6 Distriburion ,' , ｾ＠
and rreatm e . ｲｾ ＺＭ ｾ｟＠
Table 11.7 Distribution 0 :' ｾ＠ ｾ＠
from since bon: . __
Table 11.8 Distribution ch . ｾ Ｍ
-from in the L -r
:-Table 11.9 Distriburio n or' : . . - ,
children un ･ ｾ ＮＭ _ ::
one momh .. ... .. . _,_
[image:19.595.50.392.55.638.2].;;.., consumed by
... ... 141
- " consumed by
... ... 141
｟ ］Ｍ ＧＭＭ ｾ｢ｬ ･＠ and fruit consumed ... .... .... ... ... .... .... 143
... ... ... .. ... .... 143
: " j " b\ kinds of vegetables
... ... 145
Ｎｾｾ＠ ｾＮｩＦ ﾷ ＲＺＧ＼ｾ＠ fi \e by kinds of fruits __ .. ... ... .... 146
-
Ｍﾷ Ｍ Ｎ｣ＬＬ ｾ＠ fi ve by kinds of... 147
...
Ｍ ｏＢ Ｇ､ｾ ｲ＠ fi ve by kinds of snacks ... 147
.... ::: er fi ve by the kinds of
... ... ... ... 148
.u ... , de r fi ve by snacks they
... 149
",::.0. '...0: bv kinds of vegetables
... ... 150
_0_'"
u od er five... ... ... .. ... .. ... 151. gu.J.cy level among the children
, .... ... ... ... 154
_
.1. '.lnder five by classification
-. e··d ... 1 5 5
ｾ｣＠ u u trienr adequacy level ... 156
ｾ･ ｨ ｯｬ､ｳ＠ by classification of
, . .. ... ... ... ... .. ... 157
-en u nder five by sex ... ... ... 159
ren under five ... 160
Lisl of Tables
XXIII
Table 11.3 Disrribution of the children by the weight for age (WAZ)
and treatment group ... ... ... .. ... 161
Table 11.4 Linear regression analysis of the nutritional status (WAZ) by the stepwise method ... ... . 162
Table 11.5 Distribution of the children by the height for age (HAZ)
and treatment group ... ... ... .... 163
Table 11.6 Distribution of the children by the weight for height (WHZ)
and treatment group ... 163
Table 11.7 Di stribution of the diseases the children under five suffered
from since born ... ... ... 165
Table 11.8 Distribution the diseases the children under five suffered
from in the last month ... ... ... ... ... 166
Table 11.9 Distribution of the lengths (day) of the diseases of the
children under five by kind of diseases in the last
one month ... .. ... ... .... ... 166
[image:20.595.47.380.49.619.2]List of Pictu res
Picture 3.1 Focus group discussion among ｐｯｳｹ｡ｮ､ｵｾＧ＠ cadres ... ... 27
Picture 3.2 Focus group discussion among communiry leaders ... ... 28
Picture 3.3 Nuuitional extension ... ... ... ... ... ... ... 31
Picture 3.4 Cooking demonstration ... ... ... ... ... ... ... 31
'picture 3.5 Preparing nursery for home garden ... .. ... ... ... 35
Picture 3.6 Preparing verticulture for home garden ... ... 37
Picture 3. 7 The use of bamboo for fences ... .. ... .... ... 37
Picture 3.8 Preparing liquid fertilizer ... ... ... ... 39
Picture 3.9 Monitoring home garden ... ... ... ... 39
Picture 3.10 Workshop of Posyandu management ... .... .. ... ... ... 41
Picture 6.1 PRA technique (trend timeline) ... ... ... ... ... 72
Picture 6.2 KMS (children growth chart) ... ... ... .... . 82
Picture 6.3 An example of diagram Venn created by the cadres ... 92
Picture 6.4 A reporting system flowchart ... ... ... ... ... ... .. 96
Picture 7 .1 Verticulture technique ... ... ... ... ... 103
Picture 7. 2 Housing of seeds ... .. ... .. ... .. ... 104
Picture 7.3 Vegetable harvests ... .. ... .. ... 106
Picture 7. 4 The harvests of the yard crops .... .. ... .. ... .. . 109
Picture 7.5 Home gardening .. .... ... .. ... .. ... 110
Picture 11.1 The trend of the children's nutritional status (W AZ) ... 164
-List of Appendices
Appendix 1 The percemage of [he mo[hers of children under five
answering [he nmri[ional knowledge i[ems correcdy ... 196
Appendix 2 The perceIHage of [he cadres answering [he nuui[ional knowledge i [ems correcdy ... 201
Appendix 3 Pos[ers for Posyandu ... ... .. ... ... 206
Appendix 4 Banners for Posyandu ... ... 207
Appendix 5 Home garden in villages ... ... ... ... .... 208
Appendix 6 Nu[ri[ion ex[ension anivi[ies ... ... .. .. .. ... .... 209
Appendix 7 Reseac hers, Posyandu's cadres, and research assis[ams ... ... 210
-A
Multi - Approach
Interven tion
TO EMPOWER
I
PRO GRAM
to
Combat
Malnutrition Problem
in Rura l Area s
- - -
---Ali f(homsa!1_, ｄ｡ Ｎ､｡ｮｧ ﾷｓ ＮｵｾｮＹｾｲ＠ :
I .Faisal Anwar . ｾ､ｬ＠ ｒｬｾ Ｎ ､ｲＮ＠ Tin ｈｾｲ｡ｷ｡ｴｬ＠
-:.
Anna Fatchiya. Mira Dewl I_ _ _ __ _ _ _ _ ·2 _ .ｾｾ｟ｾｾ＠
PT Penerbit IPB Press
Kampu s IPB Taman Kencana
JI. Taman Kencana No . 3, Bogor 16128
Telp. 0251 - 8355158 E-mail : ipbpress@ymail.com
Penerbit IPB Press @IPBpress
S{H. I.ll
ISBN 978·979-4 93-651-1
