Leersia Yusi Ratnawati
Bagian Gizi Kesehatan Masyarakat, Fakultas Kesehatan Masyarakat, Universitas Jember Jln. Kalimantan 37, Jember 68121

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IMPLEMENTASI WATER, SANITATION, AND HYGIENE (WASH) KELUARGA BADUTA STUNTING DI WILAYAH PERTANIAN KABUPATEN JEMBER Ratnawati, Leersia Yusi; Nafikadini, Iken; Ningtyias, Farida Wahyu; Prasetyowati, Irma; Bumi, Candra
Jurnal Ilmu Kesehatan Masyarakat Vol 20 No 2 (2024)
Publisher : Fakultas Kesehatan Masyarakat, Universitas Jember

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19184/ikesma.v20i2.43772

Abstract

Intervensi Water, Sanitation and Hygiene (WASH) terbukti dapat menurunkan 860.000 kematian anak akibat kekurangan gizi salah satunya stunting. Karakteristik wilayah pertanian memiliki korelasi dengan kejadian stunting baik dari aspek sosio ekonomi maupun cemaran lingkungan dan penggunaan pestisida maupun pupuk. Kabupaten Jember dengan angka stunting tertinggi di Jawa Timur juga memiliki beberapa wilayah pertanian dengan stunting yang tinggi. Tujuan dari penelitian adalah untuk menganalisis impelementasi WASH pada keluarga baduta stunting di wilayah Pertanian Kabupaten Jember. Penelitian ini merupakan penelitian obervasional analitik dengan pendekatan cross sectional. Populasi penelitian adalah anak usia 6 – 23 bulan kriteria utama orang tua memiliki mata pencaharian sebagai petani. Teknik pengumpulan data dengan Proportionate Stratified Random Sampling dan dianalisis menggunakan chi square. Hasil penelitian menunjukkan bahwa indikator WASH yang berkaitan dengan akses sumber air minum, pengolahan air, serta kebiasaan cuci tangan pada saat sebelum dan sesudah beraktivitas pada keluarga baduta stunting di wilayah pertanian sudah baik. Namun, indikator pengolahan sampah menunjukkan implementasi yang masih rendah karena kondisi tempat sampah yang tidak saniter, pengolahan secara dibakar serta tumpukan sampah yang menjadi tempat perkembang biakan rodent. Selain itu, akses jamban sehat juga masih rendah yang dibuktikan dengan masih adanya masyarakat yang melakukan praktik BABS ke sungai. Hasil statistik menunjukkan indikator WASH tidak secara signifikan berhubungan dengan stunting. Satu indikator yang berkorelasi dengan kejadian stunting adalah banyaknya tikus yang berada di lokasi sampah. Implementasi WASH perlu dilakukan terutama intervensi program pengolahan sampah untuk mengurangi tempat perindukan rodent yang dapat berkorelasi dengan penyakit infeksi sebagai determinan stunting.
RELATIONSHIP BETWEEN LONG-SUFFERING AND DIABETES DISTRESS WITH DIETARY ADHERENCE AMONG DIABETES MELLITUS PATIENTS: A CROSS-SECTIONAL STUDY Purwanti, Aisyah Tri; Ratnawati, Leersia Yusi; Rohmawati, Ninna
Journal of Public Health Research and Community Health Development Vol. 7 No. 2 (2024): March
Publisher : Fakultas Ilmu Kesehatan, Kedokteran dan Ilmu Alam (FIKKIA), Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jphrecode.v7i2.36975

Abstract

Background: The prevalence of diabetes melitus is increasing significantly. Dietary adherence in people with diabetes mellitus is difficult to achieve because it requires regular long-term changes throughout their lives. It also has an impact on the psychology of people with diabetes mellitus to experience distress. Purpose: Analyze the relationship of long suffering and diabetes distress with dietary adherence in diabetes mellitus patients. Methods: This research uses analytical methods with a cross-sectional design. There were 71 respondents who were taken from 1320 diabetes mellitus patientin Puskesmas Talango by simple random sampling method. Data collection was using the Diabetes Distress Scale and Perceived Dietary Adherence Questionare Questionnaires. chi square was used for bivariate analysis. Results: The results showed that dietary adherence had a significant relationship with diabetes distress (p=0.001) but had no relationship with long-suffering (p=0.100). Conclusion: There is a significant relationship between education, income, and diabetes distress with dietary adherence.
Soil-Transmitted Helminth Infection and Macronutrient Intake among Stunted Toddlers in Panti Sub-district, Jember Ghaiska Najma Amnur; Yunita Armiyanti; Irawan Fajar Kusuma; Leersia Yusi Ratnawati; Wiwien Sugih Utami; Bagus Hermansyah
Media Gizi Indonesia Vol. 20 No. 1 (2025): MEDIA GIZI INDONESIA (NATIONAL NUTRITION JOURNAL)
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/mgi.v20i1.74-80

Abstract

Soil-transmitted helminth (STH) infections are one of the most common infectious diseases in the developing world, with prevalence rates as high as 65%. STH infections generally affect the digestive system, which can reduce appetite and nutrient absorption. This study aimed to determine the association between STH infection and macronutrient intake in stunted toddlers aged 12-36 months in Panti Sub-district, Jember Regency. This study used observational analysis method with cross-sectional approach. The total number of subjects was 83 stunted toddlers. Data on STH infection were collected through fecal examination and 2x24 hour food recall questionnaire to assess their macronutrient intake. The results of the study showed that the prevalence of STH was 4.8% with species identified in the examinations such as Ascaris lumbricoides (2.4%) and hookworm (2.4%). The majority of macronutrient intake was considered sufficient for protein (77.1%), deficit for carbohydrate (94%) and fat (77.1%). Bivariate analysis using the contingency coefficient correlation test showed that there was no significant correlation between STH infection and macronutrient intake. Based on the results of this study, macronutrient intake may be influenced by other factors such as the role of parents in preparing nutritious food, economic status, and mild degree of infection. However, the underlying mechanism remains unclear and should be further investigated.
Bibiliometrics Menggunakan Analisis R-Bibiloshiny Resistensi Insulin pada Obesitas Kelompok Dewasa Database Scopus (2019-2025) Krish Naufal Anugrah Robby; Rachmad Gusti Irwansyah; Leersia Yusi Ratnawati; Candra Bumi; Irma Prasetyowati; Isa Ma’rufi; Dedek Sutinbuk; Farida Wahyu Ningtyias; Anita Dewi Prahastuti Sujoso; Dewi Rokhmah; Ida Srisurani Wiji Astuti
Jurnal Kesehatan Amanah Vol. 8 No. 2 (2024): Jurnal Kesehatan Amanah
Publisher : Universitas Muhammadiyah Manado

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.57214/jka.v8i2.678

Abstract

contributing to the global burden of type 2 diabetes, cardiovascular diseases, and other metabolic complications. This bibliometric study aims to analyze trends, thematic focuses, and collaborations in scientific publications related to insulin resistance in adult obesity, utilizing data from the Scopus database covering the period from 2019 to 2025. Bibliometric tools such as RStudio, Biblioshiny, and VoS Viewer were employed to extract and visualize findings from 8,037 publications. The results reveal that research activity peaked in 2021, followed by a decline in subsequent years. Dominant keywords, such as "insulin resistance," "obesity," and "metabolic syndrome," highlight the clinical and metabolic focus of current research. Biomolecular markers, such as "glycated hemoglobin" and the "triglyceride-glucose index," reflect a growing interest in more precise diagnostic tools. The United States, China, and Italy emerged as major contributors, with journals like Nutrients and Frontiers in Endocrinology leading in publications. Despite significant progress, there remains a considerable gap, particularly in exploring the role of epigenetics and the microbiota in insulin resistance. Additionally, cross-disciplinary collaboration and participation from institutions in developing countries remain limited. This study emphasizes the importance of global, interdisciplinary efforts to address these gaps and drive innovation in interventions, providing a foundation for future research aimed at reducing the impact of insulin resistance in adult obesity.
The Lifestyle of Health and Sustainability Framework in Agricultural Community Fibriansari, Rizeki Dwi; Astuti, Anggia; Ratnawati, Leersia Yusi
Jurnal Promosi Kesehatan Indonesia Vol 20 No 3: July 2025
Publisher : Master Program of Health Promotion Faculty of Public Health Diponegoro University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jpki.20.3.156-162

Abstract

Background: The Lifestyle of Health and Sustainability (LOHAS) concept encourages life choices and adopting behaviors that prioritize both environmental sustainability and personal well-being. Lifestyle shifts and food consumption patterns are significant factors that often hinder the pursuit of a healthy and sustainable way of living. The purpose of this research is to explore the concept of LOHAS and its role in addressing the fundamental health needs of agricultural communities.Method: This study employs a descriptive-analytic method with a cross-sectional design. A sample of 138 fish cage farmers was selected. Primary data were collected through interviews using questionnaires and direct observations, focusing on aspects such as physical fitness, mental and emotional health, spiritual well-being, environmental awareness, and social responsibility. The data were analyzed descriptively.Result: The majority of fish cage farmers are males over the age of 50 years old. Aging farmers face physical and health challenges that can impact their productivity and long-term sustainability. Optimal physical health in agricultural communities can be supported through a balanced diet and regular exercise. Moreover, mental and emotional well-being can be enhanced through stress-relief activities, meditation, and fostering positive relationships. Adopting a holistic health approach enables communities to address physical, mental, emotional, and environmental aspects in alignment with the LOHAS framework.
Behaviour of Using Personal Protective Equipment by Midwives During Normal Childbirth Based on Health Belief Model and Social Capital at Maternity Clinics Framudella, Azarine Dwinta; Asmaningrum, Nurfika; Ratnawati, Leersia Yusi
Indonesian Journal of Global Health Research Vol 7 No 1 (2025): Indonesian Journal of Global Health Research
Publisher : GLOBAL HEALTH SCIENCE GROUP

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37287/ijghr.v7i1.3997

Abstract

The implementation mechanism of normal childbirth care is inseparable from the potential risks to midwifery health disorders. One of the efforts to prevent health problems due to work is to use Personal Protective Equipment (PPE). The behavior of using PPE by midwives is important to prevent work accidents or occupational diseases during normal childbirth assistance which can be reviewed from a person's health behavior. Theories that can describe health behaviors are the Health Belief Model and Social Capital. The purpose of this study is to analyze the influence of the theory of Health Belief Model and Social Capital on the behavior of using PPE in midwives in normal childbirth care at the Surabaya City maternity clinic. The research design uses clinical observation with a cross sectional approach. The population consists of 80 midwives and the sample consisted of 66 respondents. All aspects of HBM and social capital have a sig > 0.05 which means that these aspects are related to the behavior of using PPE in midwives in normal childbirth care at the Surabaya City maternity clinic. All aspects of HBM and social capital have a sig of < 0.05 which means that these aspects affect the behavior of using PPE in midwives in normal childbirth care at the Surabaya City maternity clinic. The vulnerability aspect of HBM theory and the proactive action aspect of Social Capital theory significantly affect normal childbirth care.
Faktor predisposisi dan dukungan suami dalam praktik pemberian makanan pendamping ASI (MP-ASI) pada bayi usia 6-12 bulan Lailiyah, Eka Nur; Ningtyias, Farida Wahyu; Ratnawati, Leersia Yusi
Jurnal Gizi Klinik Indonesia Vol 21, No 3 (2025): Januari
Publisher : Minat S2 Gizi dan Kesehatan, Prodi S2 IKM, FK-KMK UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/ijcn.84840

Abstract

Predisposing factors and husband’s support in the practice of feeding weaning food infants aged 6-12 monthsBackground: Nutritional problems are caused by several factors, one of which is weaning food feeding. Objective: This research aims to analyze the predisposing factors and the husband's support for feeding weaning food to infants aged 6-12 months. Methods: This observational analytic study, using a cross-sectional approach, was conducted in the working area of Kemuningsari Kidul Public Health Center in Jember Regency. Eighty mothers of infants aged 6-12 months were chosen as the sample, and the sample selection was done using a simple random sampling technique. Meanwhile, the Chi-Square test and multiple logistic regression were used for the statistical analysis. Results: The research showed that most respondents were 26-35 years old, and their latest education was junior high school/equivalent. They were unemployed, had good knowledge, a positive attitude, family support, and no cultural influence. Fifty-four people (67,5%) had appropriate behavior in feeding weaning food, while the other 26 people (32.5%) had not. Besides, based on the results of the bivariate analysis, there was a relationship between occupation (p=0.007), knowledge (p=0.023), attitude (p=0.004), culture (p=0.000), and husband's support (p=0.008) with the practice of feeding weaning food. The results of the multivariate analysis indicated that culture was the dominant factor in feeding weaning food. Conclusions: Factors related to feeding weaning food to infants aged 6-12 months include work, knowledge, attitudes, culture, and husband's support. Culture is the most dominant factor.
The Analysis of Protein Content, Iron Content, and Acceptability of Crackers Substituted with Edamame (Glycine max L. Merrill) Flour and Mackerel Tuna (Euthynnus affinis) Protein Hydrolysate Rachmawati, Septi Nur; Astuti, Maulina Sefi; Ratnawati, Leersia Yusi
Window of Health : Jurnal Kesehatan Vol 8 No 4 (October 2025)
Publisher : Fakultas Kesehatan Masyarakat Universitas Muslim Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33096/woh.vi.1598

Abstract

Crackers are a snack often favored by toddlers. Commercially available crackers predominantly use wheat flour, which is high in carbohydrates but low in nutritional value, particularly in protein content. Therefore, innovative formulations are needed to enrich the nutrition, notably protein and iron, by substituting edamame flour and mackerel tuna protein hydrolysate into crackers to help address stunting. This study aims to analyze the protein content, iron content, and acceptability of crackers made with a substitution of edamame flour and tuna protein hydrolysate. This research was conducted at the University of Jember from February to April 2024 using a completely randomized design at four levels. Protein analysis used the Kjeldahl method, and iron content was examined by atomic absorption spectrometry. The acceptability was tested using the hedonic scale test on 30 semi-trained panelists. The results were analyzed using SPSSv24. Results showed statistically significant differences in protein content, iron content, color acceptability, aroma, and taste. The highest protein content is found in A3, while the highest iron content is found in A1. The best formulation, determined by the exponential comparison method, was treatment A2. In conclusion, substitution with edamame flour and tuna protein hydrolysate in all treatment variations significantly affected protein content, iron content, and acceptability in terms of color, aroma, and taste; however, it did not substantially impact texture or overall acceptability. Substitution of edamame flour and mackerel tuna protein hydrolysate in crackers can increase protein content and therefore could be an effective measure in preventing stunting.
The correlation of antenatal care and nutrition parenting with stunting incidence in toddlers age 24-59 months Ummah, Khoiroh; Ningtyias, Farida Wahyu; Ratnawati, Leersia Yusi
Jurnal Gizi dan Dietetik Indonesia (Indonesian Journal of Nutrition and Dietetics) VOLUME 13 ISSUE 2, 2025
Publisher : Alma Ata University Press

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21927/ijnd.2025.13(2).88-98

Abstract

ABSTRAKLatar Belakang: Prevalensi balita stunting di Indonesia sebesar 21,6%. Faktor penyebab stunting antara lain karena kurangnya pemahaman orangtua dalam pemenuhan gizi sebelum dan saat hamil terutama pada masa 1000 HPK. Salah satu upaya meminimalisir terjadinya stunting adalah melakukan pemeriksaan Antenatal Care (ANC) pada masa kehamilan. Rangkaian kegiatan pemeriksaan ANC yang berpengaruh terhadap stunting adalah kelengkapan frekuensi kunjungan dan layanan 10T. Pola asuh orangtua terutama ibu dianggap penting dalam penentuan status gizi dan tumbuh kembang anak. Aspek pola asuh ibu yang berpengaruh terhadap kejadian stunting adalah praktik pemberian makan yang meliputi pemberian ASI Eksklusif dan MP-ASI.Tujuan: Menganalisis hubungan antara ANC dan pola asuh gizi dengan kejadian stunting pada balita usia 24-59 bulan.Metode: Penelitian analitik observasional dengan desain cross-sectional. Penelitian ini dilakukan pada 111 balita usia 24-59 bulan yang dipilih melalui Simple Random Sampling, selama kurun waktu Januari-Maret 2023 di wilayah kerja Puskesmas Jelbuk Kabupaten Jember yang prevalensi balita stunting mencapai angka 34,4%. Penelitian ini dilakukan dengan observasi metode wawancara, pengukuran berat badan dan tinggi badan secara langsung, kuesioner, formular dan food recall 2x24 jam. Hasil penelitian dianalisis menggunakan uji chi-square. Penelitian ini telah lolos uji etik penelitian kesehatan dengan nomor sertifikat No.63/KEPK/FKM-UNEJ/VI/2021.Hasil: Sebagian besar balita dalam penelitian ini memiliki status gizi (TB/U) dalam kategori stunting (66.7%). Balita stunting banyak terjadi pada balita perempuan dengan rentang usia 21-30 bulan. Balita stunting banyak terjadi pada ibu dengan usia 21-25 tahun, berpendidikan dasar, tingkat pengetahuan gizi kurang, tidak bekerja, jumlah anggota keluarga kecil, dan pendapatan keluarga > UMK. Tidak terdapat hubungan bermakna (p>0,05) antara ANC (p=0,544) dan pola asuh gizi (p=1,000) dengan kejadian stunting balita usia 24-59 bulan di wilayah kerja Puskesmas Jelbuk Kabupaten Jember.Kesimpulan: Tidak terdapat hubungan bermakna antara ANC dan pola asuh gizi dengan kejadian stunting balita usia 24-59 bulan di wilayah kerja Puskesmas Jelbuk Kabupaten Jember. KATA KUNCI: stunting; ANC; pola asuh gizi  ABSTRACTBackground: The prevalence of stunting under five in Indonesia is 21,6%. Factors causing stunting include malnutrition before and during pregnancy, especially at 1000 HPK. One of the efforts to minimize stunting is to carry out pregnancy ANC. The series of ANC examinations that affect stunting is the completeness of the frequency of visits and 10T services. Parenting style is important in determining the nutritional status of children. Aspects of maternal parenting that influence stunting are the practice of exclusive breastfeeding and complementary breastfeeding.Objective: To analyze the relationship between the completeness of the frequency of visits and ANC 10T services and nutritional care patterns with the incidence of stunting in children aged 24-59 months.Methods: Observational analytic study with cross-sectional design. A sample of 111 toddlers aged 24-59 months were selected by Simple Random Sampling, starting from January to March 2023 in the working area of the Jelbuk Health Center, Jember Regency, where the stunting prevalence was 34.4%. Data were collected by observation of interview methods, direct measurement of weight and height, questionnaires, formulas and 2x24-hour food recalls. The results were analyzed using the chi-square test. This research has passed the health research ethics test with certificate number No.63/KEPK/FKM-UNEJ/VI/2021.Results: Most of the toddlers in this study had nutritional status (Height/Age) in the stunting category (66.7%) occurs in female infants aged 21-30 months, mothers aged 21-25 years, basic education, lack of nutrition knowledge, not working, small number of family members, and income family > UMK. There was no significant relationship (p>0.05) between ANC (p=0.544) and nutritional care (p=1.000) with the incidence of stunting in children aged 24-59 months in the working area of the Jelbuk Health Center, Jember Regency.Conclusions: There is no significant relationship between ANC and nutritional care with the incidence of stunting in children aged 24-59 months in the working area of the Jelbuk Health Center, Jember Regency. KEYWORDS: stunting; ANC; nutritional parentingReceived: 30 Dec 2024; Revised: 27 Aug 2024; Accepted: 22 Jan 2025; Available online: 30 Mar 2025; Published: 30 Mar 2025.
Effect of micronutrient deficiency on protozoal infection in stunting toddler Utami, Wiwien Sugih; Ramadanti, Novi Awalia; Rachmawati, Dwita Aryadina; Ratnawati, Leersia Yusi; Armiyanti, Yunita; Hermansyah, Bagus
Jurnal Gizi dan Dietetik Indonesia (Indonesian Journal of Nutrition and Dietetics) VOLUME 12 ISSUE 4, 2024
Publisher : Alma Ata University Press

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21927/ijnd.2024.12(4).233-241

Abstract

Background: Stunting is a developmental disorder caused by chronic inadequate nutritional intake in toddlers, leading to deficiencies in various nutrients, including iron and zinc. This can weaken toddlers' immunity, making them more vulnerable to infectious diseases, such as intestinal protozoa. An infected digestive tract can interfere with absorbing nutrients and reduce appetite, causing the infection to persist and become chronic. Chronic infection triggers the formation of pro-inflammatory cytokines that affect bone growth, hindering growth and causing stunting.Objectives: This study confidently investigates the correlation between iron and zinc micronutrient intake and intestinal protozoan infection in stunting toddlers in Jember District.Methods: The research is observational and cross-sectional, with 568 stunting toddlers aged 0-59 months in Jember District, East Java as study subjects. Iron and zinc intake were collected through 2x24-hour food-recall questionnaire interview and processed using the Nutrisurvey software. Protozoan infection status in toddler feces samples was identified using direct smear and modified Ziehl-Neelsen methods. The data analysis method chosen was the Spearman correlation test.Results: The study found that stunted toddlers in Jember District had mostly deficient micronutrient intake. The average iron intake is 2.56±3.06 mg and the average zinc intake is 1.8±1.47 mg. Protozoan infection was found in this study has a prevalence of 15.7%, with identified species including Entamoeba histolytica (3.3%), Giardia lamblia (2.6%), Cryptosporidium parvum (3.2%), Blastocystis hominis (5.3%), and mixed infections (1.2%). The statistical analysis confirms that there is no significant correlation between the intake of micronutrients iron (p=0.91;r=0.005) and zinc (p=0.76;r=0.013) and intestinal protozoan infection in stunting toddlers in Jember District.Conclusions: Based on the data, protozoan infection may be caused by multiple factors, such as parenting practices and family socioeconomics. However, improving nutrition by education and giving additional supplementation are crucial to reduce the prevalence of malnutrition in toddlers.