scholarly journals Key Informants’ Perceptions on the Implementation of a National Program for Improving Nutritional Status of Children in Iran

2016 ◽  
Vol 38 (1) ◽  
pp. 78-91 ◽  
Author(s):  
Delaram Ghodsi ◽  
Nasrin Omidvar ◽  
Arash Rashidian ◽  
Hossein Raghfar ◽  
Hassan Eini-Zinab ◽  
...  

Introduction: Childhood malnutrition is a major public health issue. Multidisciplinary approach for Improvement of Nutritional Status of Children in Iran was implemented in order to reduce malnutrition among children. Objective: This study aimed to evaluate the implementation aspect of the program and to explore key informants’ perceptions and experience regarding the factors affected its implementation. Methods: Data were collected through the review of secondary data and semistructured interviews at national, province, and local levels. Four layers of key informants were selected purposefully for interviewing, including policymakers, senior nutrition officers, head of Hygiene, Remedy and Insurance Affairs in Imam Khomeini Relief Foundation, and community health workers. Qualitative content analysis was carried out based on Supporting the Use of Research Evidence framework and Tailored Implementation for Chronic Diseases’ checklist to interpret the viewpoints of the study participants. Results: Results showed that the program had successes in improving mother’s knowledge on health, nutrition, and child care through health system and increased families’ access to food, but there were some aspects that affected program’s implementation. Some of these factors are the lack of clarity in the program’s protocol and indicators, human shortage and inadequate financial resources, poor facilities, inattention to staff motivation, insufficient commitment among different sections, poor communication and supervision among different executive sections, and program protocols designing regardless of practical condition. Conclusion: Based on the results, top-down approach in policymaking and inadequate financial and human resources were responsible for most of the challenges encountered in the implementation.

2021 ◽  
Vol 12 (1) ◽  
pp. 127-134
Author(s):  
Nurulfuadi Nurulfuadi ◽  
Ariani Ariani ◽  
Diah Ayu Hartini ◽  
Ummu Aiman ◽  
Devi Nadila ◽  
...  

Palu, Sigi, and Donggala districts experienced a 7,7 magnitude earthquake on September 28 2018. This incident was declared a national disaster. The impact of the disaster is a decrease in the nutritional status of children under five. Nutritional problems in children under five after the earthquake can be caused by paralysis of health service, lack of availability of clean water, poor environmental sanitation, infectious diseases, and lack of consumption of nutritious food. This research is a descriptive study wich to identify nutritional problems in children under five after the earthquake in Palu, Sigi, and Donggala districts. The type of data used is secondary data, including height, weight, and age. The results showed that the nutritional status of under five children based on the weight for age index were underweight 32,1% and very underweight 16,6%. Nutritional status based on the weight for height index, were malnutrition 13,7% and poor nutrition 4,9%. The nutritional status based on the height for age index were stunting 55,7%. The conclusion that the stunting is a nutritional problem with the highest prevalence after the earthquake. The health of children under five is easily influenced by food security, the environment, and the economy. The high prevalence stunting post-earthquake can be caused by job losses, damage to agricultural land and plantations, disruption of the economic system and development in the area which has an impact on low access to food for families.


Author(s):  
Natasha Shaukat ◽  
Meesha Iqbal ◽  
Muhammad Arslan Khan

Background: Endemicity of intimate partner violence (IPV) against women is established globally. Children are directly dependent on mothers for care and nourishment. Literature has shown inconsistent association between IPV and nutritional status of children, and no nationwide study has been conducted in Pakistan to test this association. Thus, we aimed to do a secondary data analysis on Pakistan Demographic Health Survey (PDHS 2012-13) to explore the association of IPV and the nutritional status of children.Methods: This secondary data analysis was conducted on nationally representative data of PDHS 2012-13. All four provinces, including Islamabad Capital Territory and Gilgit Baltistan districts were taken, and two stage stratified random sampling was performed. The conflict tactics scale (CTS) was used to quantify Intimate Partner Violence (IPV), and its emotional and physical dimensions.Results: This study included mother-child dyads (n=1851) who completed the domestic violence module in PDHS. The lifetime prevalence of intimate partner violence was almost 40% among married women of reproductive age group. About 20% of women reported emotional violence and 2.5% women reported physical violence only. However, 16% of the women reported having suffered from both emotional and physical violence. Women who suffered from emotional violence had children with significantly higher odds of being underweight (OR, 95% CI: 1.57, 1.04-2.36) and stunted (OR, 95% CI: 1.54, 1.05-2.24) respectively. IPV was not found to be significantly associated with occurrence of wasting in children.Conclusions: Policy implications towards this issue call for establishing programmes and laws to protect women and children from the detrimental effects of violence. Provision of initiatives which focus on women autonomy and empowerment via increased access to education and economic opportunities.


2021 ◽  
Vol 1 ◽  
pp. 1120-1127
Author(s):  
Neti Mustikawati ◽  
Dian Kartikasari

AbstractThe nutritional status of children is one of the important indicators in assessing the health status of children. Assessment of the nutritional status of children is done by monitoring the growth of children. Growth monitoring can be carried out by measuring weight (BB), body length (PB) for children under 24 months of age or height (TB) for children aged 24 months and over, and measuring head circumference (LK), added to the measurement of the upper arm circumference (LLA/LILA). Growth monitoring is carried out every 3 months for children aged 0 to 24 months, and every 6 months for children aged 30 to 72 months. TK ‘Aisyiyah Batik Pekajangan is an early childhood education school (PAUD) which has a total number of students around 71 children. The school has carried out weighing and measuring height and measuring the circumference of the child's upper arm at the end of each semester (6 months) which are carried out independently by the teacher. The school also has equipment facilities in the form of weight scales and height measurements as well as measuring tapes. However, what has been done is limited to measurements that are documented in a reporting record. This monitoring was not followed up with conclusions from the measurement results to determine the nutritional status of children, because the assistance provided by health workers from the health centers was not optimal. The purpose of this community service activity is to identify the nutritional status of children. The community service method is carried out by direct detection through the measurement of BB, TB, LK, and LILA. This activity was carried out for 2 days and was attended by 59 children. The results of the activity showed that most of the children (78%) were in the category of good nutritional status, 10% were undernourished, 7% were obese, and 5% were overnourished. LILA data obtained 100% of children in the normal category and for LK data it was found that most (90%) children were in the normal category and 10% of children were microcephaly. There is still a need for a re-assessment to ensure the child's condition and follow-up in the form of collaboration between the school, parents, and also related health facilities to carry out management for children who are still experiencing problems in growth.Keywords: growth detection, nutritional status,kindergartner AbstrakStatus gizi anak merupakan salah satu indikator penting dalam penilaian status kesehatan anak. Penilaian status gizi anak dilakukan dengan cara memantau pertumbuhan anak. Pemantauan pertumbuhan dapat dilakukan dengan cara melakukan pengukuran berat badan (BB), panjang badan (PB) bagi anak usia di bawah 24 bulan atau tinggi badan (TB) bagi anak usia 24 bulan keatas, dan pengukuran lingkar kepala (LK) serta bisa pula ditambahkan dengan pengukuranl ingkar lengan atas (LLA/LILA). Pemantuan pertumbuhan dilakukan setiap 3 bulan sekali bagi anak yang berusia 0 sampai 24 bulan, dan setiap 6 bulan sekali bagi anak yang berusia 30 sampai 72 bulan. TK ‘Aisyiyah Batik Pekajangan merupakan sebuah sekolah pendidikan anak usia dini (PAUD) yang memiliki jumlah total siswa 71 anak. Selama ini pihak sekolah sudah melakukan penimbangan berat badan dan pengukuran tinggi badan serta pengukuran lingkar lenganatas anak pada setiap akhir semester (6 bulan) yang dilakukan secara mandiri oleh guru. Sekolah juga telah memiliki fasilitas alat berupa timbangan berat badan dan pengukur tinggi badan serta pita ukur. Namun yang dilakukan baru sebatas pengukuran saja yang didokumentasikan dalam sebuah catatan pelaporan. Pemantauan ini tidak ditindak lanjuti dengan kesimpulan dari hasil pengukuran untuk menentukan status gizi anak, karena belum optimalnya pendampingan yang dilakukan oleh petugas kesehatan dari pihak Puskesmas terkait. Tujuan dari kegiatan pengabdian masyarakat ini adalah untuk mengidentifikasi status gizianak. Metode pengabdian masyarakat dilakukan dengan deteksi secara langsung melalui kegiatan pengukuran BB, TB, LK, dan LILA. Kegiatan ini dilakukan selama 2 hari dan diikuti oleh 59 anak. Hasil kegiatan didapatkan data bahwa sebagian besar (78%) anak termasuk dalam kategori status gizi baik, 10% anak gizi kurang, 7% anak obesitas, dan 5% gizi lebih. Data LILA didapatkan 100% anak dalam kategori normal dan untuk data LK didapatkan bahwa sebagian besar (90%) anak masuk dalam kategori normal dan 10% anak microcephaly. Masih diperlukan adanya assessment ulang untuk memastikan kondisi anak dan tindak lanjut berupa kerjasama antara pihak sekolah, orang tua, dan juga fasilitas Kesehatan terkait guna melakukan tata laksana bagi anak-anak yang masih mengalami masalah dalam pertumbuhan.Kata kunci: deteksi pertumbuhan, status gizi, anak TK


2017 ◽  
Vol 1 (1) ◽  
pp. 1
Author(s):  
Ika Tristanti ◽  
Indah Risnawati

AbstrakBadan kesehatan dunia (WHO, 2011) memperkirakan bahwa 54% kematian anak disebabkan oleh keadaan gizi yang buruk. Di Indonesia, saat ini tercatat 4,5% dari 22 juta balita atau 900 ribu balita di Indonesia mengalami gizi kurang atau gizi buruk dan mengakibatkan lebih dari 80% kematian anak (Kemenkes,2012). Status gizi balita di Jawa Tengah tahun 2012 menunjukkan status gizi kurang sebesar 4,88% dan gizi buruk sebesar 0,06% (Dinkes Provinsi Jawa Tengah, 2012). Kabupaten Kudus tahun 2013 terdapat 3,74% balita menderita gizi kurang dan 0,76% gizi buruk. Penggunaan Kartu Menuju Sehat(KMS) untuk memantau pertumbuhan balita sangat efektif dan bermanfaat untuk mendeteksi adanya gangguan pertumbuhan seperti gizi kurang ataupun gizi buruk. Pengisian KMS dilakukan oleh kader kesehatan. Hasil survei pendahuluan dengan wawancara yang mendalam kepada 10 kader posyandu pada bulan Desember 2016 di Kabupaten Kudus, diperoleh 4 kader (40%) lengkap dalam pengisian KMS dan 6 kader (60%) tidak lengkap dalam pengisian KMS. Tujuan penelitian ini adalah untuk mengetahui pengaruh motivasi kader terhadap kelengkapan pengisian Kartu Menuju Sehat di Kabupaten Kudus. Jenis penelitian adalah observasional analitik dengan rancangan cross sectional. Tempat penelitian ini di Posyandu Kabupaten Kudus pada bulan Januari 2017. Populasi dalam penelitian ini sebanyak 39 kader yang bertugas mengisi KMS. Teknik pengambilan sampel dengan accidental sampling.Selanjutnya data yang diperoleh dianalisis dengan uji univariat dan bivariat dengan menggunakan SPSS versi 20. Hasil penelitian ini adalah ada pengaruh motivasi kader dengan kelengkapan pengisian Kartu Menuju Sehat. Hendaknya kader kesehatan lebih diberikan kesempatan untuk mengikuti pelatihan tentang posyandu dan pengisian KMS. Selain itu, insentif yang diberikan kepada kader lebih ditingkatkan lagi. Kata kunci : Motivasi, Kader,Kartu Menuju Sehat AbstractThe World Health Organization (WHO, 2011) estimates that 54% of child deaths are caused by poor nutritional status. In Indonesia, there are 4.5% from 22 million children less than 5 years or 900 thousand children less than 5 years in Indonesia suffered malnutrition or poor nutrition, and there are resulted more than 80% from childhood deaths (MoH, 2012). Nutritional status of children in Central Java in 2012 showed that malnutrition status is 4.88% and malnutrition is 0.06%  (Central Java Provincial Health Office, 2012). Kudus Regency in 2013 has 3.74% toodler under five suffer from malnutrition and 0.76% severe malnutrition. The use of Kartu Menuju Sehat (KMS) to monitor the growth of children is very effective and useful for detecting the presence of growth disorders such as malnutrition or poor nutrition. Charging KMS is done by health workers/ health cadre. The results of  preliminary survey with in-depth interviews to 10 cadres Posyandu in December 2016 in Kudus,is there are four cadres (40%) complete in charging  KMS and 6 (60%) did not complete in charging KMS. The purpose of this study was to determine the effect of the motivation of cadres in completeing Kartu Menuju Sehat in Kudus. The study was observational analytic with cross sectional design. This study place at Kudus District in January 2017. The population in this study is the  total 39 cadres and their duty to fill KMS.  The sampling technique is accidental sampling. Furthermore, the data obtained were analyzed by univariate and bivariate using SPSS version 20.  The results of this study are there is no motivational effect cadre completeness Kartu Menuju Sehat. Health workers should be given the opportunity to attend training on posyandu and charging KMS. In addition, the incentives for the cadres can be added and developed.  Key words: Motivation, cadres, KMS


2021 ◽  
Author(s):  
Michelle D. S. Boakye ◽  
Collins J. Owek ◽  
Elizabeth Oluoch ◽  
Sefa Bonsu Atakora ◽  
Juddy Wachira ◽  
...  

Abstract BackgroundMalaria continues to be the leading cause of morbidity and mortality in Africa. Community Case Management of malaria (CCMm) through engaging Community Health Workers (CHWs) to effectively address management of malaria cases in some endemic communities was explored in this study. We assessed the needs of CHWs that would help sustain and retain their services to enhance the efficient delivery of CCMm. MethodsData on the needs of CHWs was gathered through a qualitative study consisting of in-depth interviews and focus group discussions (FGDs) conducted among study participants in five districts in western Kenya using a semi-structured questionnaire. The study participants comprised of 100 CHWs, 100 mothers of children under five years and 25 key informants made up of public health officers and clinicians involved in the CCMm. The interviews were conducted in English and Swahili or Dholuo, the local language. The recorded audio interviews were transcribed later. The analysis was done using NVivo version 7 software and transcripts were coded after which themes related to the objectives of the study were identified.ResultsAll the study participants recognized the need to train and update CHWs on their work as well as remunerating them for their services to enhance efficient delivery of services. The CHWs on their part perceived the provision of gloves, RDTs, lancets, cotton wool and ethanol, bins (to dispose of RDTs and lancets), together with drugs for treating clients as their essential needs to undertake CCMm in the communities. Other logistical needs and incentives mentioned by CHWs and key informants for the successful delivery of CCMm included: gumboots, raincoats, torch lights, mobile phones, means of transportation (bicycles and motorbikes), uniforms and ID cards for identification. ConclusionCHWs would perform tasks better and their services retained for a sustainable CCMm if properly incentivized, offered refresher trainings (and updates) on malaria and equipped with the requisite tools identified in this study.


2020 ◽  
Author(s):  
Bandar Noory ◽  
Sara A Hasssanein ◽  
Asma Elsony ◽  
Gunnar Bjune

Abstract Background: The health system of Sudan has experienced several forms of decentralization, as well as, a radical reform. Authority and governance of secondary and tertiary health facilities have been shifted from federal to state levels. Moreover, the provision of health care services have been moved from large federal tertiary level hospitals such as Khartoum Teaching Hospital (KTH) and Jafaar Ibnaouf Hospital (JIH), located in the center of Khartoum, to smaller district secondary hospitals like Ibrahim Malik (IBMH), which is located in the southern part of Khartoum. Exploring stakeholders’ perceptions on this decentralisation implementation and the relevant consequences is vital in building an empirical benchmark for the improvement of health systems. Methods: This study utilizes a qualitative design which is comprised of an in-depth interviews and qualitative content analysis with an inductive approach. The study was conducted between July and December 2015, and aimed at understanding the personal experiences and perceptions of stakeholders towards decentralization enforcement and the implications on public health services, with a particular focus on the Khartoum locality. It involves community members residing in the Khartoum Locality, specifically in catchments area where hospital decentralization was implemented, as well as, affiliated health workers and policymakers. Results: The major finding suggests that the privatization of health services occurs after decentralization. The study participants also highlighted that scrutiny and reduction of budgets allocated to health services led to an instantaneous enforcement of cost recovery user fee. Devolving KTH Khartoum Teaching and Jafaar Ibnaouf Hospitals into peripherals with less capacity is considered to be a plan to outsource services to the private sector. Another theme that was highlighted in hospitals included the profit-making aspect of the governmental sector in the form of drug supplying and profit-making retail. Conclusions: A change in health services after the enforcement of decentralization was illustrated. Moreover, the empowerment of the privatization concept was the prevailing perception among stakeholders. Having in-depth studies and policy analysis in line with the global liberalization and adjustment programs is crucial for any health sector reform in Sudan. Keywords: decentralization, privatization, stakeholders, global liberalization, profit-making.


2018 ◽  
Vol 2 (3) ◽  
pp. 65-71
Author(s):  
Kadek Tresna Adhi ◽  
Ni Wayan Arya Utami ◽  
Putu Ayu Swandewi Astuti ◽  
I Gusti Ngurah Edi Putra

The discrepancies between the numbers of children suffering from severe malnutrition and/or wasting and children being detected was likely owing to the low socio-economic background of the children and distance needing to be traveled to access integrated health service location. These children did not undergo regular weight for age screening, thus became disengaged with integrated health services and were not sufficiently observed by health workers. This situation provided impetus to conduct a study into the validation of collected weighing coverage data from integrated health services with the reality in the field (D/S). This case study was conducted in Dusun Jumenang, Bukit village, Karangasem Regency. The study compared weighing coverage and nutritional secondary data on those children who have undergone screening at the integrated health service with the number of children identified through active case finding in the field. Five village health workers were trained in mobile measuring skills with a focus on nutritional status and were asked to actively search and find all under-five children living in the village. Nutritional status data were collected through weighing scales and the nutritional status table.


2020 ◽  
Vol 1 (2) ◽  
pp. 38
Author(s):  
Marniati Marniati ◽  
Enda Silvia Putri ◽  
Susy Sriwahyuni ◽  
Khairunnas Khairunnas ◽  
Maiza Duana

Toddler Nutrition Status Is a state of balance or manifestation of nutrition in the form of certain variables. The high incidence of malnutrition in Suka Makmue Subdistrict is centered as the main target in improving nutrition. The objective is to analyze the Knowledge Study of Income and Social Culture Level of Toddler Nutrition status in Blang Muling Village, Suka Makmue Subdistrict, Nagan Raya Regency. This type of research is Analytical Surveys with cross-sectional approach. The total number of samples is 33 mothers of toddlers. Univariate and Bivariate analyzes were further tested with Chi Square. The results after a deeper study of the three variables have an influence on the nutritional status of children under five namely Knowledge (Pvalue 0,000 <α 0.05), income level (Pvalue 0.001 <α 0.05), and socio-cultural (Pvalue 0.003 <α 0.05) . Suggestion Health workers should be more active in delivering information about the importance of the nutritional status of children under five.


2020 ◽  
Author(s):  
Michelle Danny Stampley Boakye ◽  
Collins J. Owek ◽  
Elizabeth Oluoch ◽  
Sefa Bonsu Atakora ◽  
Juddy Wachira ◽  
...  

Abstract Background Malaria continues to be the leading cause of morbidity and mortality in Africa. Community Case Management of malaria (CCMm) through engaging Community Health Workers (CHWs) to effectively address management of malaria cases in some endemic communities was explored in this study. We assessed the needs of CHWs that would help sustain and retain their services to enhance the efficient delivery of CCMm.Methods Data on the needs of CHWs was gathered through a qualitative cross-sectional study consisting of in-depth interviews and focus group discussions (FGDs) conducted among study participants in five districts in western Kenya using a semi-structured questionnaire. The study participants comprised of 100 CHWs, 100 mothers of children under five years and 25 key informants made up of public health officers and clinicians involved in the CCMm. The interviews were conducted in English and Swahili or Dholuo, the local language. The recorded audio interviews were transcribed later. The analysis was done using NVivo version 7 software and transcripts were coded after which themes related to the objectives of the study were identified.Results All the study participants recognized the need to train and update CHWs on their work as well as remunerating them for their services to enhance efficient delivery of services. The CHWs on their part perceived the provision of gloves, RDTs, lancets, cotton wool and ethanol, bins (to dispose of RDTs and lancets), together with drugs for treating clients as their essential needs to undertake CCMm in the communities. Other logistical needs and incentives mentioned by CHWs and key informants for the successful delivery of CCMm included: gumboots, raincoats, torch lights, mobile phones, means of transportation (bicycles and motorbikes), uniforms and ID cards for identification.Conclusion CHWs would perform tasks better and their services retained for a sustainable CCMm if properly incentivized, offered refresher trainings (and updates) on malaria and equipped with the requisite tools identified in this study.


1998 ◽  
Vol 19 (1) ◽  
pp. 42-45 ◽  
Author(s):  
Kesitegile Gobotswang

Variations in interdistrict nutritional status have puzzled both social policy makers and health workers in Botswana. A total of 643 households and 898 pre-school children were surveyed to determine factors that are associated with the nutritional status of children below the age of five years in the north-western District of Chobe. Except for those in remote and difficult-to-reach places, all households with a pre-school child were selected for the study. The results showed that the nutritioneal status of the pre-school children had a strong positive correlation with access to a latrine ( r = 0.52) and ownership of cattle ( r = 0.27). Age was negatively correlated with the child's nutritional status ( r = −0.02).


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