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All Journal Journal of Epidemiology and Public Health Journal of Health Policy and Management Journal of Health Promotion and Behavior Journal of Maternal and Child Health
Yulia Lanti Retno Dewi
Faculty of Medicine, Universitas Sebelas Maret
Medicine & Pharmacology Public Health

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Multilevel Analysis on the Determinants of Overweight among Children Under Five in Kediri, East Java Alfadefi Khalifatunisak; Harsono Salimo; Yulia Lanti Retno Dewi
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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Abstract

Background: Child overweight and obesity are an important public health issue worldwide. Overweight and obese children are likely to stay obese into adulthood and more likely to develop non-communicable diseases like diabetes and cardiovascular diseases. This study aimed to determine factors associated with overweight among children under five in Kediri, East Java, using a multilevel analysis model.Subjects and Method: This was a case control study conducted at 25 posyandus (integrated family health posts) in Kediri, East Java, from April to May 2018. A sample of 200 children under five was selected by fixed disease sampling. Posyandu was selected by stratified random sampling. Children were located at level 1 and posyandu at level 2 in the multilevel analysis model. The dependent variable was overweight. The independent variables were maternal body mass index (BMI), exclusive breastfeeding, calorie intake, feeding pattern, and nutritional status monitoring. Overweight status was measured by weight for height z-score. The data were collected by questionnaire and analyzed by a multilevel logistic regression model run in Stata 13.Results: Maternal BMI ?25 (b= 0.72; 95% CI= -0.98 to 1.54; p= 0.085) and calorie intake exceeding the recommended allowance (b= 1.45; 95% CI= 0.59 to 2.31; p= 0.001) increased the risk of overweight in children under five. Good feeding pattern (b= -1.11; 95% CI= -2.15 to -0.08; p= 0.034), exclusive breastfeeding (b= -0.97; 95% CI= -1.98 to 0.02; p= 0.057), and regular nutritional status monitoring (b= -4.34; 95% CI= -6.42 to -2.21; p<0.001) decreased the risk of overweight. Posyandu showed negligible contextual effect on the incidence of child overweight with ICC= 0.98%.Conclusion: Maternal BMI ?25 and calorie intake exceeding the recommended allowance increase the risk of overweight in children under five. Good feeding pattern, exclusive breastfeeding, and regular nutritional status monitoring decrease the risk of overweight in children under five. Posyandu has a negligible contextual effect on child overweight.Keywords: overweight, children under five, exclusive breastfeeding, maternal body mass index, multilevel analysisCorrespondence:
Path Analysis on the Life-Course Biopsychosocial Determinants of Stunting in Children Under Five Years of Age in Karawang, West Java Rona Luthfi Fauziyyah; Yulia Lanti Retno Dewi; CSP Wekadigunawan; Rita Benya Adriani
Journal of Maternal and Child Health Vol. 4 No. 1 (2019)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: Studies have shown that stunted children are more likely to start school later, perform more poorly on cognitive functioning tests, and are more likely to drop out of school. In future, adults who are stunted as children earn 20% less than comparable adults who were not stunted and are 30% more likely to live in poverty and less likely to work in skilled labor. This study aimed to examine the life-course biopsychosocial determinantsof stunting in children under five years of agein Karawang, West Java, using a path analysis model.Subjects and Method: This was a case control study carried out inTunggakjati, Rengasdengklok, Kutawaluya, Pedes, and Medangasem community health centers, Karawang, West Java, from April to May 2018. A sample of 225 children under five was selected for this study by fixed disease sampling, consisting of 75 stunted children and 150 normal children. The dependent variable was stunting. The independent variables were maternal height, maternal middle upper arm circumference (MUAC), low birthweight (LBW), history of infection illness, maternal education, exclusive breastfeeding, complementary feeding, and family support. Child height was measured by infantometer or microtoice. The other variables were measured by questionnaire. The data were analyzed by path analysis run on Stata 13.Results: Stunting increased with LBW (b=1.64; 95% CI=0.69 to 2.59; p=0.001) and history of infection illness (b=1.80; 95% CI=0.94 to 2.67; p<0.001). Stunting decreased with maternal height ?150 cm (b=-1.57; 95% CI=-2.43 to -0.71; p<0.001) and appropriate complementary feeding (b=-1.80; 95% CI=-2.53 to -1.08; p<0.001). Stunting was indirectly affected by maternal MUAC, maternal education, exclusive breastfeeding, and family support.Conclusion: Stunting increases with LBW and history of infection illness, but decreases with maternal height ?150 cm and appropriate complementary feeding. Stunting is indirectly affected by maternal MUAC, maternal education, exclusive breastfeeding, and family support.Keywords: stunting, life-course, biopsychosocial, children under fiveCorrespondence:
Logistic Regression Analysis on the Determinants of Stunting among Children Aged 6-24 Months in Purworejo Regency, Central Java Atika Rakhmahayu; Yulia Lanti Retno Dewi; Bhisma Murti
Journal of Maternal and Child Health Vol. 4 No. 3 (2019)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: Stunting is a representation of the state of chronic malnutrition in the first 1000 days of life that occurred in the world at an incidence of 22.2% in 2017. Stunting in children has impact on morbidity and mortality, resulting in a long-term decline socio-economic productivity of the community. The purpose of this study was to analyze the determinants of stunting in children aged 6-24 months in Purworejo, Central Java.Subjects and Method: This was an analytic observational study with a case control design. It was conducted in 25 integrated community health posts (posyandu) in Purworejo, from October to December 2018. A sample 200 children under five was selected using by simple random sampling. The dependent variable was stunting. The independent variables were maternal mid-upper arm circumference (MUAC) at pregnancy, maternal education, paternal education, family income, family food allocation, infant birth weight, exclusive breastfeeding, complementary feeding (CF), posyandu strata, stunting monitoring at posyandu, and posyandu stunting intervention. The data was collected by questionnaire and analyzed by a multiple logistic regression.Results: Maternal MUAC at pregnancy ?23.5 cm (b= -1.56; 95% CI= 0.06 to 0.67; p = 0.009), high maternal education (b= -1.70; CI95% = 0.06 to 0.57; p = 0.003), high paternal education (b= -1.90; 95% CI= 0.05 to 0.51; p= 0.002), high family income (b= -1.85; 95% CI= 0.05 to 0.50; p = 0.002), family food allocation (b= -2.26; 95% CI= 0.03 to 0.37; p<0.001), birth weight ?2,500 g (b= -1.39; 95% CI= 0.08 to 0.83; p= 0.024), exclusive breastfeeding (b = -2.04; 95% CI= 0.04 to 0.48; p= 0.002), and adequate complementary feeding (b= -1.61; 95% CI= 0.06 to 0.65; p= 0.007) reduced the risk of stunting in children aged 6-24 months.Conclusions: Maternal MUAC at pregnancy ?23.5 cm, high maternal education, high paternal education, high family income, family food allocation, birth weight ?2,500 g, exclusive breastfeeding, and adequate complementary feeding reduce the risk of stunting in children aged 6-24 months.Keywords: stunting, determinants, children aged 6-24 monthsCorrespondence:
Co-Authors Agustina Utii Alfadefi Khalifatunisak Atika Rakhmahayu Bhisma Murti Bhisma Murti Bhisma Murti C.S.P. Wekadigunawan CSP Wekadigunawan Dewi Mustika Ratih Dyah Ayu Saputri Eti Kuswandari Eti Poncorini Pamungkasari Firman Pardosi Hanung Prasetya Harsono Salimo Harsono Salimo Harsono Salimo Harsono Salimo Joko Sugiyanto Mario Febrianus Helan Sani Mayasari Kurnianingsih Ninik Hartini Priscilla Jessica Pihahey Prita Yuliana Irnawati Putri Andini Muslimah Riski Anisa Rita Adriani Benya Adriani Rita Benya Adriani Rita Setiyaningsih Rona Luthfi Fauziyyah Ruth Apriyanti Salwa Annisaa Samara Rahma Dania Setyo Sri Rahardjo Setyo Sri Raharjo Stevani Rambu Kudu Sumardiyono Yayang Kharistik A Yuli Astuti