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Harsono Salimo
Department of Pediatrics, Dr. Moewardi Hospital, Surakarta
Medicine & Pharmacology Public Health

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Effects of Maternal Education, Psychosocial Stress, Nutritional Status at Pregnancy, and Family Income, on Birthweight in Nganjuk, East Java Dhewi Nurahmawati; Harsono Salimo; Yulia Lanti Retno Dewi
Journal of Maternal and Child Health Vol. 2 No. 4 (2017)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Abstract

Background: Low birthweight (LBW) is one of the primary causes of infant mortality. It shares 27% of infant mortality rate (IMR). The Indonesian Demographic and Health Survey in 2007 reported that the IMR was 34 deaths per 1,000 live births. As much as 30.3% of this rate was accounted by LBW. As such LBW is an important global public health issue. Countries arround the world have committed to overcome this problem. This study aimed to investigate the effects of maternal education, psychosocial stress, nutritional status at pregnancy, and family income, on birthweight.Subjects and Method: This was an observational analytic study with case control design. The study was conducted in Ngetos community health center, Nganjuk, East Java, from May to June, 2017. A total sample of 120 were selected for this study by fixed disease sampling, compresing 40 infants with low birthweight and 80 infants with normal birthweight. The dependent variable was birthweight. The independent variables were maternal education, psychosocial stress, nutritional status at pregnancy (middle-upper arm circumference, MUAC), maternal anemia, and family income. MUAC was measured by MUAC measuring tape. Hemoglobin concetration was measured by Sahli meter. Psychosocial stress was measured by Holmes and Rahe stress scale. The other variables were measured by a set of questionnaire. Path analysis was used for data analysis.Results: MUAC ?23.5 cm (b= -0.80, SE= 0.57; p=0.064), hemoglobin concetration ?11 g/dL (b= -120.16, SE= 45.14, p=0.008), and low psychosocial stress (b= -0.80, SE= 0.57, p=0.164) directly and negatively affected low birthweight. Maternal education ?Senior High School (b= 1.28, SE = 0.056, p= 0.022), psychosocial stress (b= -0.001, SE<0.001, p=0.097), and family income (b= 0.97, SE= 0.46, p=0.036) positively affected MUAC. MUAC ?23.5 cm positively affected hemoglobin concentration ?11 g/dL (b= 0.19, SE = 20.84, p<0.001).Conclusion: MUAC, hemoglobin concetration, and low psychosocial stress directly and negatively affect low birthweight.Keywords: low birthweight, MUAC, maternal anemia, psychosocial stress, family incomeCorrespondence:
Multilevel Analysis on the Biosocial and Economic Determinants of Exclusive Breastfeeding Prabawati Sinta; Harsono Salimo; Eti Poncorini Pamungkasari
Journal of Maternal and Child Health Vol. 2 No. 4 (2017)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: Exclusive breastfeeding is provided to infants from birth to 6 months of age without supplementary or substitution food and drink. Breastmilk contains nutrients and protective factors that can reduce morbidity and mortality risks of children. This study aimed to determine the effect of maternal nutritional status, parity, employment status, family income, health personnel support, subjective norm, and stratification status of community health center (posyandu), on exclusive breastfeeding in Banjarsari Sub-District, Surakarta.Subjects and Method: This was an analytic observational study with cross sectional design. The study was conducted in Banjarsari sub-district, Surakarta, Central Java, from October 17 to November 7, 2017. Twenty five posyandus were selected by stratified random sampling. Of the posyandus selected, 200 lactating mothers were selected by simple random sampling. The dependent variable was exclusive breastfeeding. The independent variables were maternal nutritional status, parity, employment status, family income, subjective norm, and health personnel support. The data were collected using a set of questionnaire and analyzed by multilevel logistic regression in Stata 13.Results: The likelihood of exclusive breastfeeding increased with better maternal nutritional status (b= 1.65; 95% CI= 0.14 to 3.17; p= 0.032), multi parity (b= 1.72; 95% CI= 0.57 to 2.86; p= 0.003), working outside the house (b= -2.94; 95% CI= -3.99 to -1.88; p= 0.001), higher family income (b= -1.94; 95% CI= -3.13 to -0.76; p= 0.001), strong health personnel support (b= 1.13; 95% CI= 0.02 to 2.25; p= 0.046), and positive subjective norm (b= 1.20; 95% CI= 0.14 to 2.25; p= 0.025). Posyandu showed strong contextual effect on exclusive breastfeeding with intra-class correlation (ICC)= 28.87%.Conclusion: The likelihood of exclusive breastfeeding increases with better maternal nutritional status, multi parity, working outside the house, higher family income, strong health personnel support, and positive subjective norm.Keyword: exclusive breastfeeding, multilevel analysis, maternal nutritional status, parity, employment status, family income, health personnel support, subjective norm, and posyanduCorrespondence:
Biopsychosocial and Economic Determinants of Low Birth Weight in Jambi, South Sumatera: Path Analysis Iga Trisnawati; Harsono Salimo; Bhisma Murti
Journal of Maternal and Child Health Vol. 3 No. 1 (2018)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: Low birth weight (LBW) is one of the main risk factors of neonatal mortality and morbidity. It is an important public health issue particularly in developing countries. Worldwide, LBW shares around 15-20% of birth outcome. In Indonesia, LBW shares about 10.2% of birth outcome. In theory, the risk factors of LBW include not only biological aspect but also psychosocial and economic aspects. This study sought to estimate the biopsychosocial and economic determinants of LBW in Jambi, South Sumatera, using path analysis approach.Subjects and Method: This was an analytic observational study with case-control design. The study was carried out at 20 community health centers in Jambi, South Sumatera, from December 2017 to January 2018. A total sample of 200 newborn infants consisting of 50 LBW and 150 normal birth weight newborn infants were selected for this study by fixed disease sampling. The dependent variable was birth weight. The independent variables were gestational age, infant sex, maternal mid-upper arm circumference (MUAC), maternal gestational stress, maternal education, family income at gestational period, and sanitation. Data on birth weight and MUAC were taken from obstetric record. The other data were collected by questionnaire. The data were analyzed by path analysis.Results: The risk of LBW directly decreased with gestational age ?37 weeks (b= -5.06; 95% CI= -6.49 to -3.62; p<0.001), male sex (b= -0.99; 95% CI= -2.12 to -0.12; p= 0.081), low maternal stress (b= -2.35; 95% CI= 14.01 to -0.70; p= 0.005), and good sanitation (b= -1.04; 95% CI= -2.13 to -0.05; p= 0.062). Gestational age increased with family income (b= 1.74; 95% CI= 0.96 to 2.52; p<0.001). Low maternal stress was positively affected by high family income (b= 1.34; 95% CI= 0.197 to 2.50; p= 0.022). Good sanitation was positively affected by high family income (b= 0.71; 95% CI= 0.01 to 1.41; p= 0.046). High family income was positively affected by high education level (b= 1.37; 95% CI= 0.57 to 2.18; p= 0.001)Conclusion: The risk of LBW directly decreases with gestational age ?37 weeks, male sex, low maternal stress, and good sanitation. LBW is indirectly affected by maternal education and family income.Keywords: biopsychosocial, economic, determinant, LBWCorrespondence:
Biopsychosocial Determinants of Stunting in Children Under Five: A Path Analysis Evidence from the Border Area West Kalimantan Eny Indriyani; Yulia Lanti Retno Dewi; Harsono Salimo
Journal of Maternal and Child Health Vol. 3 No. 2 (2018)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Abstract

Background: Stunting is a form of nutritional deficiency associated with delayed of children growth and development. Stunting is a lack of linear development due to long-term malnutrition. This study aimed to examine factors associated with stunting in children under-five in West Kalimantan, Indonesia.Subjects and Method: This was an analytic observational study with a case-control design. The study was conducted in West Kalimantan, Indonesia. A sample of 200 children under five consisting of 100 stunting children and 100 normal children was selected for this study by fixed disease sampling. The dependent variable was stunting. The independent variables were birth length, maternal education, family income, maternal nutritional intake, maternal middle-upper arm circumference (MUAC), child nutritional intake, and the number of children. The data were collected by questionnaire. The data were analyzed by path analysis.Results: The risk of stunting directly increased with child nutritional intake less than recommended nutritional allowance (b= 1.61; 95% CI= 0.86 to 2.36; p<0.001), birth length <48 cm (b= 2.13; 95% CI= 0.95 to 3.31; p<0.001), and low current maternal education (b= 1.96; 95% CI= 1.21 to 2.72; p<0.001). The risk of stunting was indirectly and significantly influenced by family income during gestation, the number of children, maternal height, maternal MUAC, family support, maternal education during gestation, and maternal nutrient intake during gestation.Conclusion: The risk of stunting directly increases with child nutritional intakes than recommended nutritional allowance, birth length <48 cm, and low current maternal education. The risk of stunting is indirectly and significantly influenced by family income during gestation, the number of children, maternal height, maternal MUAC, family support, maternal education during gestation, and maternal nutrient intake during gestation.Keywords: stunting, biopsikososial factors, gestationCorrespondence:
The Effect of Biological, Social, Economic, and Nutritional Factors on Low Birth Weight: A New Path Analysis Evidence from Madiun Hospital, East Java, Indonesia Novi Paramitasari MS; Harsono Salimo; Bhisma Murti
Journal of Maternal and Child Health Vol. 3 No. 3 (2018)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Abstract

Background: Low birth weight (LBW) remains a major cause of death and illness in infants. This study aimed to analyze the effects of biological, social, economic, and nutritional factors on LBW at Madiun General Hospital, East Java.Subjects and Method: This was an analytic observational study with a case-control design. The study was conducted at Madiun General Hospital, East Java, from January to December 2017. A sample of 200 newborn babies were selected for this study using fixed disease sampling, consisting of 50 babies with low birth weight and 150 control infants with normal birth weight. The dependent variable was birth weight. The independent variables were maternal age, education, parity, maternal nutritional status, maternal employment, family income, anemia, and birth space. Clinical data were taken from medical record. The data of other variables were collected by questionnaire. Path analysis was employed for data analysis.Results: The risk of LBW increased with anemia (b= 1.09; CI 95%= 0.27 to 1.91; p= 0.009), multiparity (b= 1.73; CI 95%= 0.28 to 2.06; p= 0.010), and age <2o or >35 years (b= 1.41; CI 95%= 0.24 to 2.57; p= 0.018). The risk of LBW decreased with good maternal nutritional status (b= -1.49; CI 95%= -2.32 to -0.65; p< 0,001), maternal education ?high school (b= -1.05; CI 95%= -1.88 to -0.21; p= 0.014), and wide birth space (b= -1.06; CI 95%= -2.24 to 0.11 p= 0.076). Maternal employment and family income had indirect effect on the risk of LBW.Conclusion: The risk of LBW is affected by anemia, parity, maternal age <20 years and ?35 years, poor maternal nutritional status, low maternal education, and narrow birth space.Keywords: low birth weight, biological factor, social factor, economic factorCorrespondence:
Multilevel Analysis on the Determinants of Exclusive Breastfeeding at Gunung Anyar Community Health Center, Surabaya, Indonesia Zummatul Atika; Harsono Salimo; Yulia Lanti Retno Dewi
Journal of Maternal and Child Health Vol. 3 No. 3 (2018)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Abstract

Background: Exclusive breastfeeding is provision of breast milk for infants from 0 to 6 months of age with no additional food or drink intake. Provision of medicine, vitamin, and mineral is allowable during the period of exclusive breastfeeding. There is a lack of studies examining factors associated with exclusive breastfeeding in Surabaya using multilevel analysis. This study aimed to examine factors associated with exclusive breastfeeding in Surabaya using multilevel analysis.Subjects and Method: This was an analytic observational study with a cross sectional design. The study was carried out at Gunung Anyar community health center (puskesmas), Surabaya, East Java, Indonesia. A total of 25 puskesmas was selected by stratified random sampling, covering both accredited and non-accredited puskesmas. A total of 8 lactating mothers from each puskesmas were selected by simple random sampling. The dependent variable was exclusive breastfeeding. The independent variables were subjective norm, leisure time for breastfeeding, attitude, husband support, family support, and health personnel support. The data were collected by questionnaire and analyzed by a multilevel logistic regression.Results: Exclusive breastfeeding was positively affected by positive subjective norm (b=4.31; 95% CI= 1.63 to 6.99; p=0.002), leisure time for breastfeeding (b=3.97; 95% CI= 1.12 to 6.81; p=0.006), positive attitude (b=3.01; 95% CI= 0.57 to 5.45; p=0.016), strong husband support (b=2.39; 95% CI= 0.29 to 4.51; p=0.026), strong family support (b=2.71; 95% CI= 0.46 to 4.97; p=0.018), and strong health personnel support (b=4.13; 95% CI= 1.28 to 6.99; p=0.005). Posyandu showed strong contextual effect on exclusive breastfeeding with intra-class correlation (ICC)= 69.47%.Conclusion: Exclusive breastfeeding is positively affected by positive subjective norm, leisure time for breastfeeding, positive attitude, strong husband support, strong family support, and strong health personnel support.Keywords: exclusive breastfeeding, subjective norm, attitude, husband support, health personnel supportCorrespondence:
Factors Associated with the Risk of Autism in Children Under Five Years of Age: A Path Analysis Evidence from Banten Fitriyani Dwi Astuti; Harsono Salimo; Eti Poncorini Pamungkasari
Journal of Maternal and Child Health Vol. 3 No. 4 (2018)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: Autism, now increasingly referred to as autism spectrum disorder (ASD) is a set of clinical phenotypes mirroring an early-onset neurodevelopmental disorder affecting social communication, imagination, and behavior. Children with ASD develop differently from other children. They also have challenges in interacting and communicating with others. These challenges can affect their development and learning. This study aimed to determine factors associated with the risk of autism in children under five.Subjects and Method: This was a case control study carried out at two special schools for children with development problem in Tangerang, Banten, from February to March 2018. A sample of 200 children aged 1-5 years was selected by fixed disease sampling, consisting of 50 children with autism and 150 normal children. The dependent variable was autism. The independent variables were family income, maternal education, maternal age, gestational stress, chemical exposure, nutritional intake, fever at pregnancy, growth and development impairment, and mumps-measles-rubella (MMR) vaccine. Data on immunization status, growth and development were taken from medical record. Data on the other variables were collected by questionnaire.The data were analyzed by path analysis.Results: The risk of autism increased with chemical exposure (b= 2.86; 95%CI= 0.77 to 4.96; p= 0.007), gestational stress (b= 2.45; 95% CI= 0.60 to 4.30; p= 0.010), growth and development impairment (b= 1.69; 95% CI= -0.24 to 3.61; p= 0.086), and maternal age ?35 years (b= 2.82; 95% CI= 0.73 to 4.92; p= 0.008). Autism decreased with good nutritional intake (b= -2.08; 95%CI= -3.88 to -0.28; p= 0.023). The risk of autism was indirectly affected by fever at pregnancy, chemical exposure, family income, and maternal education. MMR vaccine did not affect the incidence of autism (b= 1.12; 95% CI= -2.11 to 4.36; p= 0.500).Conclusion: The risk of autism increases with chemical exposure, gestational stress, growth and development impairment, maternal age ?35 years, and decreases with good nutritional intake. MMR vaccine does not affect the incidence of autism in children.Keywords: autism, chemical exposure, growth and development impairment, MMR vaccine, children under fiveCorrespondence:
Path Analysis on the Biopsychosocial Determinants of Quality of Life among Children with Cerebral Palsy Alinda Nur Ramadhani; Rita Benya Adriani; Harsono Salimo
Journal of Maternal and Child Health Vol. 3 No. 4 (2018)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Co-Authors Alinda Nur Ramadhani Argyo Demartoto Bhisma Murti Bhisma Murti Bhisma Murti Bhisma Murti Desi Ekawati Dhewi Nurahmawati Didik Tamtomo Endang Sutisna Sulaeman Eny Indriyani Eti Poncorini Pamungkasari Eti Poncorini Pamungkasari Fitriyani Dwi Astuti Iga Trisnawati Iin Tri Marlinawati Intan Noor Khalifah Isne Susanti Nining Lestari Novi Paramitasari MS Nur Isniani Ningsih Nurry Ayuningtyas Kusumastuti Prabawati Sinta Putri Andini Muslimah Rita Benya Adriani Setyo Sri Rahardjo Suradi - Wiwen Indita Yulia Lanti Retno Dewi Yulia Lanti Retno Dewi Yulia Lanti Retno Dewi Zummatul Atika