<![CDATA[ABSTRACT Severe wasted among children under five is still a public health problem. Treatment of severe wasted at the health center follows the management recommended by the Ministry of Health and WHO. The improvement of nutrition and health status has not been maximized during treatment and it was suspected related to childcare. Therefore it will be studied how caring practice had been done at household. The purpose of this study was to examine caring practice level and their constraints as well. This research was a mix-method with cross-sectional design, located in four provinces. Then in each province, the two highest regencies of severe wasted were selected, and purposively from each district one health center was taken which had a lot of severe wasted cases. Sample were parents whose children suffered from severe wasted and informants were nutritionist of health center and integrated post cadre. Data collected were data of characteristics children and their families, feeding and care for sick children habit and caring parctice level of parents. Data was analyzed descriptively. Results levels of good caring practice were highest in West Java Province (60%), while the other three provinces were lower. The constraints faced were the low mothers education, father’s main job as laborers, the habit of giving prelacteal food and formula milk from birth, solid food given at the beginning children suffered from severe wasted and complaints of some infectious diseases. There needs to be an increase in caring practice level with parenting programs both expected to be at health center or at integrated post. Keywords: caring practice, childcare, parenting, severe wasted, treatment ABSTRAK Status gizi sangat kurus pada balita masih menjadi masalah kesehatan masyarakat dengan prevalensi nasional sekitar 5,3 persen. Penanganannya di puskesmas mengikuti tatalaksana direkomendasikan Kementerian Kesehatan dan WHO. Saat ini peningkatan gizi dan kesehatan belum maksimal melalui pemulihan gizi sangat kurus, diduga masalahnya berkaitan dengan pengasuhan anak. Tujuan penelitian ini mengkaji pengasuhan anak dalam praktik pemberian makan, perawatan anak sakit di rumah tangga dan kendalanya. Penelitian ini merupakan penelitian mix-method dengan desain kros-seksional, berlokasi di empat provinsi dengan prevalensi gizi sangat kurus yang tinggi. Dari tiap provinsi dipilih dua kabupaten yang tinggi prevalensinya, kemudian secara purposive dari tiap kabupaten diambil satu puskesmas yang merupakan kantong gizi sangat kurus. Sampel adalah orang tua yang mempunyai balita gizi sangat kurus yang mengikuti pemulihan gizi di puskesmas. Informan adalah TPG Puskesmas dan kader posyandu. Data yang dikumpulkan adalah data karakteristik balita dan keluarga, kebiasaan pemberian makan dan perawatan anak, dan tingkat pengasuhan anak yang meliputi praktik pemberian makan, perawatan dan perkembangan anak. Data dianalisis secara deskriptif. Hasil tingkat pengasuhan anak yang baik tertinggi di Provinsi Jabar (60%), sedangkan tiga provinsi lainnya lebih rendah dan yang terendah di Provinsi NTT (26%). Kendala yang dihadapi adalah pendidikan ibu yang kurang (banyak yang hanya sampai sekolah dasar), pendidikan ayah terbanyak sebagai buruh, kebiasaan ibu yang memberikan makanan prelakteal, susu formula sejak lahir, kebiasaan memberikan makanan padat ketika anak mengalami gizi sangat kurus dan keluhan timbulnya beberapa penyakit infeksi. Perlu adanya peningkatan pengasuhan anak melalui program parenting untuk ibu balita gizi sangat kurus yang bisa dilakukan di Puskesmas atau posyandu. [Penel Gizi Makan 2018, 41(2):101-112] Kata kunci: pengasuhan anak, parenting, gizi sangat kurus, pemulihan]]>
