Analisis Implementasi Program Penanggulangan Gizi Buruk Di Puskesmas Wilayah Kerja Dinas Kesehatan Kota Sorong Provinsi Papua Barat

The prevalence of under-five children with severe malnutrition in Sorong city West Papua in 2008, 2009 and 2010 consecutively was 3.59%, 1.1% and 1.9%. Implementation of a program could be influenced by many factors such as communication, resources, disposition and bureaucracy factors. The objective of this study was to know the implementation of severe malnutrition control program at primary healthcare centers (puskesmas) in the working area of Sorong city health office West Papua in 2010. This was a qualitative study with cross sectional approach. Data was collected through in-depth interview using interview guideline. There were 5 primary healthcare centers studied with program executors as main informants. Triangulation informants were family or parents of under-five children with severe malnutrition, head of puskesmas and head of nutrition section of Sorong city health office West Papua province. Results of the study showed implementation of the program had not run according to the standard of implementation from the Ministry of Health. It was caused by not optimal communication that was done by Sorong city health office through program socialization. The availability of resources such as human resource to implement the program was insufficient. Only those who had nutrition educational background implemented the program and other workers were not involved in the program. There was no nutrition care team in all puskesmas. Additionally, the majority of the workers had not received training yet. Management of program funding was not according to the unit cost. Facilities were inappropriate and there was still improper puskesmas. The executor workers were needed for implementing the program; unfortunately due to less transparency and socialization, commitment was also low. No authority or standard operating procedure (SOP) given by Sorong city health office to puskesmas. In addition there was no supervision to the nutrition program workers. It was concluded that the implementation of severe malnutrition control program in Puskesmas in the working area of Sorong city health office West Papua province was not optimal. It was suggested to Sorong city health office to improve socialization about severe malnutrition control program to all program executors including heads of puskesmas in the working area of Sorong city health office; to create nutrition care and training teams. Funding allocation should be given to the right target and facilities should be completed. Supervision, monitoring and evaluation were done continuously.

Download Full-text

Implementation of Home Visit Programs in Improving Nutritional Status of Under-Five Children in Developing Countries: A Scoping Review

Childhood Stunting, Wasting, and Obesity, as the Critical Global Health Issues: Forging Cross-Sectoral Solutions ◽

10.26911/the7thicph.02.11 ◽

2020 ◽

Author(s):

Siti Zakiah Zulfa ◽

◽

Cesa Septiana Pratiwi ◽

Keyword(s):

Developing Countries ◽

Nutritional Status ◽

Scoping Review ◽

Home Visit ◽

Home Visits ◽

Severe Malnutrition ◽

Severe Problem ◽

Under Five ◽

Under Five Children ◽

Review Question

Background: In developing country, malnutrition of under five children was still a severe problem because it may have an impact on the quality of human resources in the future. Various program has been tried in many places to overcome this problem, one of which is through a home visit program, which is very necessary for educational purposes to manage malnutrition. This study aimed to determine how to implement a home visit program to improve the nutritional status of under five children in developing countries. Subjects and Method: A scoping review method was conducted using Arksey and O’malley (2005) framework with five steps: (1) Identify the scoping review question; (2) Identify relevant articles; (3) Article selection; (4) Mapping; (5) Present the results, discussion and conclusion. The search included Pubmed, Wiley, Ebsco, Science Direct, and Google scholar databases. The inclusion criteria were original articles in Indonesian and English from developing countries published from 2010 to 2019. The data were reported by PRISMA flow chart. Results: Five of the 159 articles were selected, and found that five themes were summarized, namely: (1) effective implementation of home visits, (2) types of rehabilitation of nutritional status of under-five children on home visits, (3) home visit officers 4) time and activities for conducting home visits and 5 ) constraints on home visits for malnutrition education purposes. Conclusion: Home visit program is an effective and significant strategy to reduce the incidence of underweight, moderate and severe malnutrition, stunting and wasting in under five children only when combined with other programs. Several knowledge gaps identify which confirm through further research. Keywords: home visit, nutritional status of under-five children, malnutrition, developing countries Correspondence: Siti Zakiah Zulfa. Universitas ‘Aisyiyah Yogyakarta. Jl. Ringroad Barat No.63, Mlangi, Nogotirto, Gamping, Sleman, Yogyakarta. Email: [email protected]. Mobile: 085641349694. DOI: https://doi.org/10.26911/the7thicph.02.11

Download Full-text

Prevalence and Causes of Undernutrition among Under-five Sudanese Children: A Mini-review

Journal of Advances in Medicine and Medical Research ◽

10.9734/jammr/2020/v32i1530602 ◽

2020 ◽

pp. 12-20

Author(s):

Shaza O. H. Kanan ◽

Abd Elmoneim O. Elkhalifa

Keyword(s):

Low Socioeconomic Status ◽

Prevalence Rate ◽

Maternal Education ◽

Severe Malnutrition ◽

Published Data ◽

Childhood Diseases ◽

Severe Stunting ◽

Under Five ◽

Under Five Children ◽

Health Authorities

Background: Malnutrition among under-ﬁve children have significant interest for the health authorities in Sudan. This is considered by the fact that the prevalence of underweight children in Sudan is among the highest in the world and it is essential to determine its prevalence and causes, as this problem affects the future of the under-five children and the community as general. This review aimed to assess the prevalence and causes of undernutrition among under-ﬁve children in Sudan. Methods: Published data such as peer-reviewed articles, published dissertations and official reports on malnutrition and its causes among under-five Sudanese children during the last twenty years, were collected from Science Direct, Google Scholar, PubMed, and others. The information restored was reviewed and analyzed for inconsistency. Results: Data shows that the prevalence of under-nutrition among under-ﬁve children was high and diverse widely, and the majority of the studies were carried out in Khartoum state, which showed the prevalence of wasting (3.3 to 21.1%) stunting (20.3 to 51.0%), severe stunting (12.9 to 25.2%) and underweight and severe underweight represent 24.4 to 35.0% and 6.6 to 48.0%, respectively. The prevalence rate of malnutrition was reported to be 14.1, 23.6, and 10.7% in South Darfur IDP camps, while in North Darfur it was 14.7, 48.9, and 35.6%, for wasting, stunting, and underweight, respectively. In El Fau, Gadarif state the prevalence of moderate and severe malnutrition of the under-five children were 6% and 3.3%. Many causes were reported for malnutrition among the under-five children including bad feeding practices, childhood diseases, hygiene and sanitation, and low socioeconomic status. Conclusion: The prevalence rate of undernutrition among the under-five Sudanese children was very high, and stunting is the main shape of malnutrition. Many causes were contributed to under-five malnutrition and improvement in infant feeding and better maternal education are significant to get a high nutritional status of the children.

Download Full-text

Time to death among HIV-infected under-five children after initiation of anti-retroviral therapy and its predictors in Oromiya liyu zone, Amhara region, Ethiopia: a retrospective cohort study

BMC Pediatrics ◽

10.1186/s12887-021-03072-6 ◽

2022 ◽

Vol 22 (1) ◽

Author(s):

Bereka Tefera Marie ◽

Weldemariam Sintayehu Argaw ◽

Bitewa Yibelu Bazezew

Keyword(s):

Antiretroviral Therapy ◽

Clinical Stage ◽

Severe Malnutrition ◽

Amhara Region ◽

Time To Death ◽

Under Five ◽

Under Five Children ◽

Risk Of Death ◽

Cox Proportional Hazard Regression

Abstract Background Human Immunodeficiency Virus (HIV) is infection which mainly attacks immune system of an individual. Its disease progress is rapid in children and if treatment is not initiated nearly half of infected children will die by the second year of infection. In Ethiopia, nearly twenty four percent of HIV related death is happen to under-five children; however studies done in this specific age group are limited are with poor evidence of predictors. Objectives To determine time to death and identify predictors of death in HIV infected under- five children on antiretroviral therapy in Amhara regional state, Oromia ‘liyu’ zone, Northeast Ethiopia, from 2014 to 2019. Methods Institution based retrospective follow up study was conducted in 376 under-five HIV- infected children on antiretroviral therapy from January 2014 to December 2019 in health institutions in Oromia Liyu Zone, Amhara region, Ethiopia. Multivariable Cox-proportional hazard regression model was used to identify independent predictors of mortality in HIV- infected under-five children on antiretroviral therapy. Result At the end of follow up, 304 (80.85%) of HIV-infected children were alive, 39 (10.95%) were lost to follow up, 12 (3.19%) were transferred out and 21 (5.59%) were reported dead due to HIV/AIDS. The cumulative survival probabilities of children after 3, 6, 12, 24 and 36 months were 0.99, 0.98, 0.97, 0.89 and 0.87 respectively. The overall mean time to death was 19.7 months (95%CI = 18.74–20.67) with incidence of 5.9 deaths per 100 child-months (95%CI: 3.89–9.09). Children with severe malnutrition at baseline (AHR = 4.9; 95 CI: 1.04, 23.50), advanced WHO clinical stage at enrolment (AHR = 3.9; CI: 1.37, 10.88), poor adherence to ART (AHR = 6.56; CI: 3.33, 10.14) and with no history of Isoniazide prophylaxis were significantly associated to higher mortality events (AHR = 3.6; CI: 1.24, 10.18). Conclusion Death of HIV-infected under-five children on ART is high within the first one year after enrolment. The risk of death increased if the child was malnourished at beginning of treatment, had poor ART adherence, with advanced WHO clinical stages and lack of Isoniazide prophylaxis during their age of infancy.

Download Full-text

Nutritional status and its corelates in under five slum children of Kanpur Nagar, India

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20180560 ◽

2018 ◽

Vol 5 (2) ◽

pp. 584 ◽

Cited By ~ 2

Author(s):

S. K. Gautam ◽

Mahesh Verma ◽

S. K. Barman ◽

A. K. Arya

Keyword(s):

Nutritional Status ◽

Nutrition Education ◽

Maternal Education ◽

Standard Technique ◽

Sampling Technique ◽

Severe Malnutrition ◽

Cluster Sampling ◽

Severe Stunting ◽

Under Five ◽

Under Five Children

Background: In Kanpur, overall there were an estimated 43.6% stunted, 24.1% wasted and 41.8% underweight under-five children. There is a critical window of opportunity to prevent undernutrition by taking care of the nutrition of children in the first two years of life. With this background the present study was undertaken with the aim to assess the nutritional status in under five children in the slum area of Kanpur Nagar.Methods: The present study was conducted in 30 slums of Kanpur Nagar selected through 30 cluster sampling technique. The sample size was calculated as 390. From each cluster, approximate 13 study subjects aged 0-60 months were studied. Mothers of study subjects were interviewed to illicit the requisite information, using a predesigned and pretested questionnaire. Anthropometric measurements were taken using standard technique for each study subject. Data collected was analyzed using statistical tool.Results: Based on WHO classification, the prevalence of stunting and severe stunting was observed to be 31.28% and 13.59%. 14.62% study subjects were wasted while 6.15% subjects had severe wasting. 40.51% had mild-moderate malnutrition and 7.95% had severe malnutrition as per the criteria of mid upper arm circumference. Malnutrition was significantly associated with the age of the study subjects (p <0.05). The prevalence of malnutrition decreased significantly with higher maternal education and among those whose mother’s were housewives (p <0.05). Lower birth order and middle socio-economic class was associated with decreased prevalence of malnutrition (p <0.05). Conclusions: The nutritional status of children is dependent on maternal education and occupation and socioeconomic status. Nutrition education can have a significant effect in its reduction.

Download Full-text

Spatial Prevalence and Determinants of Malaria among under-five Children in Ghana

10.1101/2021.03.12.21253436 ◽

2021 ◽

Author(s):

Bedilu Alamirie Ejigu ◽

Eshetu Wencheko

Keyword(s):

Rural Areas ◽

Hot Spot ◽

Control Program ◽

Wealth Index ◽

Household Wealth ◽

Malaria Prevalence ◽

Vulnerable Groups ◽

Eastern Region ◽

Under Five ◽

Under Five Children

AbstractIn Ghana malaria is an endemic disease and the incidence of malaria still accounts for 38.0% of all outpatient attendance with the most vulnerable groups being children under 5 years of age. In order to alleviate this problem, it is essential to design geographically targeted and cost-effective intervention mechanisms guided by up-to-date and reliable data and maps that show the spatial prevalence of the disease. The 2016 Ghana Malaria Indicator Survey data (N = 2,910 under-five children) were analyzed using model-based geostatistical methods with the two objectives to: (1) explore individual-, household-, and community-level determinant variables associated with malaria illness in U5 children, and (2) produce prevalence maps of malaria across the study locations in the country. The overall weighted prevalence of malaria by microscopy blood smear and rapid diagnostic tests were 20.63% (with 95% CI: 18.85% - 22.53%) and 27.82% (with 95% CI: 25.81% - 29.91%), respectively. Across regions of Ghana, the prevalence of malaria ranges from 5% in Greater Accra to 31% in Eastern region. Malaria prevalence was higher in rural areas, increased with child age, and decreased with better household wealth index and higher level of mother’s education. Given the high prevalence of childhood malaria observed in Ghana, there is an urgent need for effective and efficient public health interventions in hot spot areas. The determinant variables of malaria infection that have been identified in this study as well as the maps of parasitaemia risk could be used in malaria control program implementation to define priority intervention areas.

Download Full-text

Time To Death Among HIV-Infected Under-Five Children After Initiation Of Anti-Retroviral Therapy And Its Predictors In Oromiya Liyu Zone, Amhara Region, Ethiopia: A Retrospective Chohort

10.21203/rs.3.rs-234377/v1 ◽

2021 ◽

Author(s):

Weldemariam Sintayehu Arega ◽

Bereka Tefera Marie ◽

Bitewa Yibelu Bazezew

Keyword(s):

Antiretroviral Therapy ◽

Clinical Stage ◽

Severe Malnutrition ◽

Amhara Region ◽

Time To Death ◽

Under Five ◽

Under Five Children ◽

Risk Of Death ◽

Cox Proportional Hazard Regression

Abstract Background: Human Immunodeficiency Virus (HIV) is infection which mainly attacks immune system of an individual. Its disease progress is rapid in children and if treatment is not initiated nearly half of infected children will die by the second year of infection. In Ethiopia, nearly twenty four percent of HIV related death is happen to under-five children; however studies done in this specific age group are limited are with poor evidence of predictors. Objectives: To determine time to death and identify predictors of death in HIV infected under-five children on antiretroviral therapy in Amhara regional state, Oromia ‘liyu’ zone, Northeast Ethiopia, from 2014 to 2019. Methods: Institution based retrospective follow up study was conducted in 376 under-five HIV-infected children on antiretroviral therapy from January 2014 to December 2019 in health institutions in Oromia Liyu Zone, Amhara region, Ethiopia. Multivariable Cox-proportional hazard regression model was used to identify independent predictors of Mortality in HIV-infected under-five children on antiretroviral therapy. Results: At the end of follow up, 285 (80.28%) of HIV-infected children were alive, 39 (10.99%) were lost to follow up, 11 (3.94%) were transferred out and 21 (5.59%) were reported dead due to HIV/AIDS. The cumulative survival probabilities of children after 3, 6, 12, 24 and 36 months were 0.99, 0.98, 0.97, 0.89 and 0.87 respectively. The overall mean time to death was 19.7 months (95%CI= 18.74-20.67) with incidence of 5.9 deaths per 100 child-months (95%CI: 3.89-9.09). Children with severe malnutrition at baseline (AHR=4.9; 95 CI: 1.04, 23.50), advanced WHO clinical stage at enrolment (AHR=3.9; CI: 1.37, 10.88), poor adherence to ART (AHR=6.56; CI: 3.33, 10.14) and with no history of Isoniazide prophylaxis were significantly associated to higher mortality events (AHR=3.6; CI: 1.24, 10.18). Conclusion: Death of HIV-infected under-five children on ART is high within the first one year after enrolment. The risk of death increased if the child was malnourished at begging of treatment, had poor ART adherence, with advanced WHO clinical stages and lack of Isoniazide prophylaxis during their age of infancy.

Download Full-text

Characteristics of severely malnourished under-five children immunized with Bacillus Calmette-Guérin following Expanded Programme on Immunization schedule and their outcomes during hospitalization at an urban diarrheal treatment centre, Bangladesh

PLoS ONE ◽

10.1371/journal.pone.0262391 ◽

2022 ◽

Vol 17 (1) ◽

pp. e0262391

Author(s):

Mst. Mahmuda Ackhter ◽

Abu Sadat Mohammad Sayeem Bin Shahid ◽

Tahmeed Ahmed ◽

Parag Palit ◽

Irin Parvin ◽

...

Keyword(s):

Regression Analysis ◽

Severe Sepsis ◽

Clinical Laboratory ◽

Severe Malnutrition ◽

Bacillus Calmette Guerin ◽

Under Five ◽

Bcg Vaccination ◽

Under Five Children ◽

Binomial Regression ◽

Log Linear

Background Bacillus Calmette-Guérin (BCG) vaccination has recently been found to have beneficial effects among children infected other than Mycobacterium tuberculosis. Due to the paucity of data on the outcomes of children who had successful BCG vaccination following Expanded Programme on Immunization (EPI) schedule, we aimed to investigate the characteristics of such children and their outcomes who were hospitalized for severe malnutrition. Methods A prospective observational study was conducted to determine the viral etiology of pneumonia in severely malnourished children those were admitted to the Dhaka Hospital of International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) between April 2015 and December 2017, constituted the study population. Using a case-control design for the analysis, children having BCG vaccination prior hospital admission were treated as cases (n = 611) and those without vaccination, constituted as controls (n = 83). Bi-variate analysis was conducted using socio-demographic, clinical, laboratory, and treatment characteristics on admission and outcomes during hospitalization. Finally, log-linear binomial regression analysis was done to identify independent impact of BCG vaccination. Results The cases more often presented with older age, have had lower proportion of maternal illiteracy, higher rate of breastfeeding, severe wasting and lower rate of hypoglycemia, compared to the controls. The cases were also found to have lower risk of severe sepsis and deaths, compared to the controls (for all, p<0.05). However, in log-linear binomial regression analysis, after adjusting for potential confounders, BCG vaccination following EPI schedule (RR:0.54; 95%CI = 0.33–0.89; p = 0.015) and breastfeeding (RR:0.53; 95%CI = 0.35–0.81; p = 0.003) were found to be protective for the development of severe sepsis. Conclusion BCG vaccination and breastfeeding were found to be protective for the development of severe sepsis in hospitalized severely malnourished under-five children which underscores the importance of continuation of BCG vaccination at birth and breastfeeding up to two years of age.

Download Full-text

Development of Mother’s Behavior Model in Severe Malnutrition Prevention for Under Five Children

Jurnal NERS ◽

10.20473/jn.v10i22015.195-207 ◽

2015 ◽

Vol 10 (2) ◽

pp. 195

Author(s):

Ika Nur Fauziah ◽

Lilik Djuari ◽

Yuni Sufyanti Arief

Keyword(s):

Health Promotion ◽

Health Belief Model ◽

Health Belief ◽

Severe Malnutrition ◽

Behavior Model ◽

Personal Factors ◽

Health Promotion Model ◽

Under Five ◽

Under Five Children ◽

Belief Model

Introduction: Child malnutrition still a major health problem in the world, including in Indonesia. According to World Health Organization (WHO) African Region and South-East Asia Region data, malnutrition affects nearly 20 million under five children and the main factors that affects about a third of child mortality worldwide. The aims of this study was to analyze and develop mother’s behavior model in severe malnutrition prevention for under five children based on Integration Health Belief Model and Health Promotion Model. Method: Type of this research was an explanatory observational with cross sectional design. Affordable population namely children under five’s years and cadres who visited Posyandu in April 2015 as many as 136 and 20 peoples. This study used proportional random sampling, with sample size 65 mothers; 10 children under five’s mothers and 10 Posyandu Balita’s cadres for FGD. Variables were personal factors, behavioral specific cognitions and affect, individual perceptions, commitment, cues to action and mother's behavior in severe malnutrition prevention. Data were collected by using questionnaires and food recall 24 hours, analyzed by Smart PLS. Result: Mother’s behavior model in severe malnutrition prevention for under five children can be formed by mother's commitment, behavioral specific cognition and affect and personal factors (income and motivation). Discussion: Nurse as a community health care providers have a role in improving community health status through health promotion. High commitment to behave in certain ways according to plan, improving the ability of individuals to maintain health promotion behavior all the timeKeywords: models, mother’s behavior, severe malnutrition prevention, Health Belief Model, Health Promotion Model

Download Full-text

Breastfeeding Practices, Demographic Variables, and Their Association with Morbidities in Children

Advances in Preventive Medicine ◽

10.1155/2015/892825 ◽

2015 ◽

Vol 2015 ◽

pp. 1-9 ◽

Cited By ~ 15

Author(s):

Dipen V. Patel ◽

Satvik C. Bansal ◽

Archana S. Nimbalkar ◽

Ajay G. Phatak ◽

Somashekhar M. Nimbalkar ◽

...

Keyword(s):

Logistic Regression ◽

Exclusive Breastfeeding ◽

Demographic Variables ◽

Severe Malnutrition ◽

Cross Sectional ◽

Under Five ◽

Under Five Children ◽

Early Initiation Of Breastfeeding ◽

Breastfeeding Practices ◽

Initiation Of Breastfeeding

Appropriate feeding practices are the key contributor to reducing morbidities and mortalities in under-five children. A cross-sectional questionnaire based survey of mothers of children aged less than 5years was conducted in 781 mothers. More than half of mothers (57.5%) started feeding within an hour of birth, 55.9% gave exclusive breastfeeding for six months, 89.1% of the mothers stopped breastfeeding before two years of age, 18.2% of the mothers bottle-fed the babies, and 15.6% had problems during breastfeeding in first 6 months. Early initiation of breastfeeding within one hour of birth promoted exclusive breastfeeding, and breastfeeding for longer duration. Exclusive breastfeeding increased frequency of feeds. Multivariable logistic regression showed that initiation of breastfeeding after an hour of birth (p= 0.035), not providing exclusive breastfeeding for 6 months (p< 0.0001), unemployed mothers (p= 0.035), having two or more kids (p= 0.001), and complementary feeds given by person other than mother (p= 0.007) increased hospitalization. Starting breastfeeding after an hour of birth (p= 0.045), severe malnutrition (p= 0.018), and breastfeeding for < two years (p= 0.026) increased rates of diarrhea. Breastfeeding practices were not optimum and interventions to improve these practices need to be strengthened.

Download Full-text

FACTORS ASSOCIATED WITH NUTRITIONAL STATUS OF CHILDREN UNDER FIVE YEARS OF AGE IN GUNUNGSITOLI IDANOI PRIMARY HEALTHCARE CENTER

The Indonesian Journal of Public Health ◽

10.20473/ijph.v15i3.2020.315-324 ◽

2020 ◽

Vol 15 (3) ◽

pp. 315

Author(s):

Novrin Senselia Putri Ziliwu ◽

Lina Dewi Anggraeni ◽

Rosa Nora Lina

Keyword(s):

Nutritional Status ◽

Primary Healthcare ◽

Employment Status ◽

Children Under Five ◽

Under Five ◽

Factors Associated ◽

Healthcare Center ◽

Nutritional Status Of Children ◽

Primary Healthcare Centers ◽

Primary Healthcare Center

The number of children under five years of age suffering from underweight was 28.0% in Gunungsitoli district. Out of six primary Healthcare centers in the district, Gunungsitoli Idanoi Primary Healthcare Center Healthcarewas one of the six primary healthcare centers with the highest malnutrition prevalence. Sixty-four children under five years of age there Healthcaresuffered from malnutrition. This study aimed to identify factors associated with the nutritional status of children under five in Gunungsitoli Idanoi Primary Healthcare Center, Gunungsitoli district. It was an analytical survey with a cross-sectional approach conducted in Gunungsitoli Idanoi Primary Healthcare Center in February 2019. Data were collected using a questionnaire. This study had samples as many as 246 mothers of children under five years of age selected using a purposive random sampling technique. The bivariate analysis indicates the nutritional status of children under five was significantly associated with mother’s employment status (p=0.043) and family size (p=0.015). While the nutritional status of children under five had no significant association with mother’s knowledge of nutrition (p=0.485), mother’s education (p=0.616), family income (p=0.511), infectious disease (p=0.913), and history of breastfeeding (p=0.847). Mother’s employment status and family size affected the nutritional status of children under five. The primary Healthcare center should cooperate with stakeholders across sectors, especially conduct training for improving economic business skills of the people in the village, and promote family planning program for couples of childbearing age. Keywords: Breastfeeding, children under five years of age, underweight, mother’s knowledge, mother’s employment.

Download Full-text