EMPOWERMENT COMMUNITY DEVELOPMENT MODEL WITH STUDENTS ACCOMPANYING IN MALNUTRITION EARLY DETECTION (Study in Sub District Kandri, Gunung Pati Semarang).

ISBN :

978-602-98fi7-2:fr

PROCEED}

"9ffiffi'ff'www_ffiw

NATIOilAilCULTURE

AND

CHATACTER EDUCATIO

r.i

t,.:

PO5T

GRADUATE I)ROG

Proceedings of lnternational Seminar PPs Unnes 2010

Published

by

Post

Graduate

Program Semarang State

University

Gd.4

PPs UNNES,

Semarang 50233

lndonesia

Tel. +6224

844

9jfi

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

Production by Swadaya Manunggal Offset & Press

Jl. Kelud Raya No.78, Semarang

Tel.

+6224

8411 006

Fax.+6224 8505723

Proceedinqs of International Seminar PPs Unnes 2010

13. IMPLEMENTATION IN CULTURE PHYSICAL EDUCATION

14'FRoMcoVERINGTHEWRoNGDoINGSToCHARACTERBUILDING

15. CULTURE-BASED CHARACTER EDUCATION IN SCHOOL Rediana SetiYani ...

I.6.DEVELoPINGoFcoNCEPTMAPPINGASSESSMENTFoRMEASURINGSTUDENT,S ABILITYINCoNSTRUCTINGcoNCEPToFELEKTRoNIKADASARII

Ani Rusilowati, Achmad SoPYan

IT.EMPoWERMENTcoMMUNITYDEVELOPMENTMoDELWITHSTUDENTS

ACCOMPANYING IN MALNUTRITION EARLY DETECTION

I"8.oPTIMIZETHEROLEoFTHETEACHERSASTHEIMPLEMENTATORSoFETHICAL

EDUCATION AT SCHOOL

Titi Prihatin

]-g.PENGEMBANGANKARAKTERBANGSAMELALUIBIMBINGANDANKoNSELING

PERKEMBANGAN DALAM SETTING KELUARGA (SUATU TINJAUAN PSIKOLOGIS-rSLAMl)

Anwar SutoYo

20. PENDIDIKAN KARAKTER DALAM PENDIDIKAN INFORMAL

Maman Rachman

2I..MENGGAGASPEMBEWARANKARAKTERBERBASISBUDAYADISEKoLAHDASAR

Masrukhi

22. MEMBANGUN KARAKTER PESERTA DIDIK MELALUI PEMBELAJARAN MATEMATIKA BERBASIS BUDAYA LOKAL

Scolastika Mariani

23.MEMBANGUNKARAKTERDANBUDAYABANGSAINDoNESIAMELALUIPMRI Wardono

24.PENDIDIKANKARAKTERBERBASISPoTENSIDIRIMENDoNGKRAKKUALITAS

PENDIDIKAN

D. YahYa Khan ...

88

94

99

1t

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

wht-compared

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

:'

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 under}

five who

became

the

_sample'

lf

for

_{some reason}

the

mother can

not

be

a

respondent, the

respondent can be _{replaced ny peopte}

*ho

.r.

_responsible

for preparing _{the family meal/ toddlers.}

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

the

KMS

(KartuMenuiuSehot)toddlers.Thevariablelevelsofenergyconsumptionwasobtainedwith

3x24-hour 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 :}

Early detection

by surevy consumption)

Nutritional status

<-2SD _>-2SD

<99%

Energv RDA

Positif A

False Positif

B

>100

% Energy RDA

False Negatif c Negatif D A+C _B+D

A+B

C+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 status of} g0%. _Chi

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:

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

malnutritic-events

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%.

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

;iilfiffiiX'5rirl]],!"''Jl,o'"

occurred, then the ralse positive varue win increase _as

wer.

(r

Closing

1. Conclusion

a'

Most toddrers this sampre has a good rever _{of energy consumption (g2.5%).}

b'

Most toddrers this sampre has a _tood nutritionar

,tlriu,

(soz").

c'

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).

d'

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'

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.

b'

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}

Rakyat

Ahmad Djaeni Sedia Oetama. 1999.

Rakyat

Azrul Azwar. 20O2. pangan dan _Gizi

Bogor: Dpp pergizi pangan

Hasanudin References

Ahmad Djaeni Sedia _{Oetama. 2000. ilmu Gizi Untuk Mahasiswa}

dan profesi

jilid

l. Jakarta

:

Dian

llmu _{Gizi Untuk Mahasiswa dan profesi}

jilid

'.

Jakarta

:

Dian

di

Era Desentralisasi: _{Masalah dan Strategi pemecahannya.}

lndonesia Bekerjasama pusat pangan, _Gizi

dan

Kesehatan

Badan Penelitian

dan

_{Pengembangan Pertanian Deptan.2o06. pengawascm}

Ketahanan pangan.

Bogor: http//www.pse.litbang.deptan.go. _id

Budioro. 19g7. pengantar _{Administrasi Kesehatan}

Masyarakat. semarang : FKM Undip.

Buckle K'A' Edward R'A, Fleet G.H, wootton _M. 1985. tlmu pangan.Terjemahan

Hari purnomo, dkk.

Jakarta : Ul press

Budiono'

lrwan'

_2007'

studi

Pendahuluan Keragaman pangan Keluarga petani

di

_Kecamatan

Limbangan. Semarang : _{Jurusan IKM FIK UNNES.}

ototo*nrr.,i,2?!;.^,,,1:1,or1:.-,,

"'T^---Pensembangan Konsumsi

pangan

rdngan

:

http:

'rtek'a.piii'or'id

rtikel

'nean

_TPTAN.

6iunduh"pada tanggal 1 Desember 2007.

Direktorat _{Bina Gizi Masyarakat oepkes nL}

r99g. pedoman _{Ilmrrm Gizi (aimh-^^}

rdsydrdKar uepKes Kt. _{1999. pedoman Umum Gizi Seimbang.}

Dinas

Pertanian.

2006.

pedoman Umum

Heooman

umum

pensemhans:n

pengembangan Knncrrm-i

Konsumsi

pangan.

(HIlp://

i pte k. a p ij i. o r.i d _{/ artiket /} pa nga n/D E pTA N _). Dinkes

^i_T_Jil,1?l;,iol,r;,,^l:ir1.

-lJ,iornsunan

.Kesehatan

2001_200s. _semarang:

http://www.iatene.eo.idldinkes. _Diunduh

pada tanggar 1 Desembe

r

2007.

I _{Dewa Nyoman supariasa' 2001. Penilaian}

status cizi. rakarta: penerbit Buku Kedokteran ECG

117

Proceedings of lnternational Seminar pps lJnnes 201A

Kantor

Kecamatan Limbangan. _{2007. Monografi Kecamatan Limbangan}

Tahun

_{zOO7. Kantor}

Kecamatan Limbangan Kabupaten Kendal.

Lisdiana'1998. Waspada terhadap Kelebihan dan Kekurangan Gizi. Ungaran: Trubus Agriwidya

Moh. Agus Krisno Budiyanto. 2004. Dasar-Dasar ilmu Gizi. Malang: UMM press

RSCM Bagian Gizi. 1986. Penuntun diit. Jakarta: Gramedia pustaka Utama

Sajogyo dkk. _{1994. Menuju gizi baik yang merata}

di

pedesaan dan kota. yogjakarta: Gajahmada

University Press

sjahmien Moehji. 2003. llmu Gizijilid 2. Jakarta:

pr

Bhatara karya Aksara

Soetjiningsih.1995. Tumbuh KembangAnak. Jakarta: ECG

soegeng santoso dkk. 1999. Kesehatan dan Gizi. Jakarta: Rineka cipta

soekidjo Notoatmodjo. 1997.llmu Kesehatan Masyarakat. Jakarta: Rineka cipta

qoe _{kidjo Notoatmodj}

o. 2002. Metodologi Pene litia n Kese hata n. Ja ka rta : Rineka Cipta

Suhardjo dkk. 1986. Pangan, Gizi _{dan pertanian. Jakarta: Ul} press

suhardjo dkk . 2003. Berbagai cara pendidikan Gizi. Jakarta: Bumi Aksara

sunita Almatsier.. 2004. Penuntun Diet. Jakarta: Gramedia pustaka Utama

Sunyoto Usman. 2004. Politik Pangan. Yogjakarta: (Cired) Center

for

lndonesian Research and

Development

Syamsul Bakhri, dkk.2001. Teknologi Peningkatan intensitas Pertanaman Sawah _{tadah hujan} di

Sulawesi Tenga h. Sulteng: http://bp2tp.litbang.deptan.go.id

Tri _{Bastuti Purwantini dkk. 2006. Analisis Ketahanan Pangan Regional dan Tingkat Rumah Tangga}

(studi Kasus di propinsi _{sulawesi Utara. Bogor : http//www.deptan.go.id}

Widyakarya Nasional Pangan dan Gizi.

Vl.

1998. Prosiding Widyakarya Nasional pangan dan Gizi.

Jakarta: LlPl.

Yayuk Farida Baliwati. 2004. Pengantar Pangan dan Gin. Jakarta: Penebar Swadaya.