Dietary Diversity, Stunting, and the Impact of an Education Program on Parents’ Knowledge and Attitudes in West Sumba, Indonesia
Article Sidebar
Issue
Vol. 18 No. 2 (2023)
Accepted
3 April 2023
Published
31 July 2023
Keywords:
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attitude, dietary diversity, education, stunting, West Sumba
Abstract
This pre- and post-test quasi-experimental study aimed to assess dietary diversity and its association with stunting among toddlers (13–60 months), examine the levels of knowledge and attitudes towards balanced and diverse diets among parents or caregivers, and evaluate the impact of customized flashcards and meal boxes as educational tools on parents’/caregivers’ knowledge and attitudes in three selected villages in West Sumba, Indonesia. A total of 59 parents/caregivers were recruited, 30% of whom had stunted toddlers. The levels of parents’/caregivers’ knowledge and attitudes were moderate. The results from the pre-test study show that Dietary Diversity Score (DDS) did not correlate with stunting status. Furthermore, neither knowledge nor attitudes was discovered to be related to DDS. The use of flashcards and meal boxes in the educational program improved the scores of knowledge (p<0.05) and attitudes (p<0.05) from the pre-test scores. There was a positive correlation between knowledge and attitudes, either before or after the education program (r=0.362, p<0.05 and r=0.562, p<0.05, respectively). To summarize, this study has the potential to be applied in other rural and remote areas.
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Spronk I, Kullen C, Burdon C, O'Connor H. 2014. Relationship between nutrition knowledge and dietary intake. Br J Nutr 111(10):1713–1726. https://doi.org/10.1017/S0007114514000087
[UNICEF] United Nations Children's Fund. 2012. Programming Guide: Infant and Young Child Feeding. New York (USA): UNICEF.
[WHO] World Health Organization. 2006. Physical Status and the use and Interpretation of Anthropometry. Reports of WHO Expert Committee. Technical Report Series: No. 854. Switzerland (CH): WHO.
[WHO] World Health Organization. 2010. Indicators for Assessing Infant and Young Child Feeding Practices: Part 2 Measurement. Switzerland (CH): WHO.
Wali N, Agho KE, Renzaho AM. 2020. Factors associated with stunting among children under 5 years in five South Asian countries (2014–2018): Analysis of demographic health surveys. Nutrients 12(12):3875. https://doi.org/10.3390/nu12123875
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Yue A, Marsh L, Zhou H, Medina A, Luo R, Shi Y, Zhang L, Kenny K, Rozelle S. 2016. Nutritional deficiencies, the absence of information and caregiver shortcomings: A qualitative analysis of infant feeding practices in rural China. PLoS One 11:e0153385. https://doi.org/10.1371/journal.pone.0153385
Yuwanti Y, Mulyaningrum FM, Susanti MM.2021. Faktor-Faktor yang mempengaruhi
stunting pada balita di Kabupaten Grobogan. J Kesehat Masy Cendikia Utama 10(1):74. https://doi.org/10.31596/jcu.v10i1.704
Barbosa EY. 2021. A neurodidactic model for teaching elementary EFL students in a college context. English Language Teaching 14(3):42–58. https://doi.org/10.5539/elt.v14n3p42
Beer SS, Juarez MD, Vega MW, Canada NL. 2015. Pediatric malnutrition. Nutr Clin Pract 30(5):609–624. https://doi.org/10.1177/0884533615600423
De Silva I, Sumarto S. 2018. Child malnutrition in Indonesia: Can education, sanitation and healthcare augment the role of income? J Int Dev 30(5):837–864. https://doi.org/10.1002/jid.3365
Hadi AJ, Antoni A, Dongoran IM, Ahmad H. 2022. Analysis model of toddlers Ffactoras stunting risk predisposition factordue to covid 19 in stunting locus village area of Indonesia. J Pharm Negat Results14(1):6–10. https://doi.org/10.47750/pnr.2022.14.01.002
Khaliq A, Wraith D, Miller Y, Nambiar S. 2022. Association of infant feeding indicators and infant feeding practices with coexisting forms of malnutrition in children under six months of age. Nutrients 14(20):4242. https://doi.org/10.3390/nu14204242
Khamis AG, Mwanri AW, Ntwenya JE, Kreppel K. 2019. The influence of dietary diversity on the nutritional status of children between 6 and 23 months of age in Tanzania. BMC Pediatr 19(1):1–9. https://doi.org/10.1186/s12887-019-1897-5
[MoH RI] Ministry of Health Republic of Indonesia. 2014. Balanced Nutrition Guidelines - Indonesia. Jakarta (ID): MoH RI.
Mahmudiono T, Nindya TS, Andrias DR, Megatsari H, Rosenkranz, RR. 2016. Theeffectiveness of nutrition education for overweight/obese mothers with stunted children (NEO-MOM) in reducing the double burden of malnutrition in Indonesia: study protocol for a randomized controlled trial. BMC Public Health 16(1):1–11. https://doi.org/10.1186/s12889-016-3155-1
Mehta NM, Corkins MR, Lyman B, Malone A, Goday PS, Carney L (Nieman), Monczka JL, Plogsted SW, Schwenk WF, The American Society for Parental and Enteral Nutrition. 2013. Defining pediatric malnutrition: A paradigm shift toward etiology-related definitions. J Parenter Enter Nutr 37(4):460–481. https://doi.org/10.1177/0148607113479972
Mitra M, Susmaneli H, Septiani W, Nurlisis N. 2020. Effect of nutritional education on improving mother's knowledge and nutritional status of malnourished toddlers in Pekanbaru City Indonesia. Int J Sci Basic Appl Res 53(2):244–253.
Nachvak SM, Abdollahzad H, Mostafai R, Moradi S, Pasdar Y, Rezaei M, Esksndari S. 2017.Dietary diversity score and its related factors among employees of Kermanshah University of Medical Sciences. Clin Nutr Res 6(4):247–255. https://doi.org/10.7762/cnr.2017.6.4.247
Obilor EI, Amadi EC. 2018. Test for significance of pearson's correlation coefficient. Int. J. Innov Math Stat Energy Policy 6(1):11–23
Ong RHS, Chow WL, Cheong M, Lim GH, Xie W, Baggs G, Huynh DTT, Oh HC, How CH, Tan NC et al. 2021. Associations between socio-demographics, nutrition knowledge, nutrition competencies and attitudes in community-dwelling healthy older adults in Singapore: Findings from the SHIELD study. J Health Popul Nutr 40:52. https://doi.org/10.1186/s41043-021-00277-4
Putra AIYD, Setiawan NBW, Sanjiwani MID, Wahyuniari IAI, Indrayani AW. 2021. Nutrigenomic and biomolecular aspect of Moringa oleifera leaf powder as supplementation for stunting children. J Trop Biodivers Biotechnol 6:60113. https://doi.org/10.22146/jtbb.60113
Rah JH, Akhter N, Semba RD, Pee S de, Bloem MW, Campbell AA, Moench-Pfanner R, Sun K, Badham J, Kraemer K. 2010. Low dietary diversity is a predictor of child stunting in rural Bangladesh. Eur J Clin Nutr 64:1393–1398. https://doi.org/10.1038/ejcn.2010.171
Raiten DJ, Bremer AA. 2020. Exploring the nutritional ecology of stunting: New approaches to an old problem. Nutrients 12(2):371. https://doi.org/10.3390/nu12020371
Ruel MT. 2003. Operationalizing dietary: A review of measurement issues and research priorities. J Nutr 133:11. https://doi.org/10.1093/jn/133.11.3911S
Septamarini RG, Widyastuti N, Purwanti R. 2019. Hubungan pengetahuan dan sikap responsive feeding dengan kejadian stunting pada baduta usia 6–24 bulan di wilayah kerja puskesmas bandarharjo, Semarang. J Nutr 8(1):17–21. https://doi.org/10.14710/jnc.v8i1.23808
Simanjuntak BY, Haya M, Suryani D, Khomsan A, Ahmad CA. 2019. Maternal knowledge, attitude, and practices about traditional food feeding with stunting and wasting of toddlers in farmer families. Kesmas Natl Public Heal J 14(2):58–64. https://doi.org/10.21109/kesmas.v14i2.2712
Sjarif DR, Yuliarti K, Iskandar WJ. 2019. Daily consumption of growing-up milk is associated with less stunting among Indonesian toddlers. Med J Indones 28(1):70–76. https://doi.org/10.13181/mji.v28i1.2607
Smith LC, Haddad L. 2000. Explaining Child Malnutrition in Developing Countries: A Cross-country Analysis. Washington DC (USA): IFRI.
Spronk I, Kullen C, Burdon C, O'Connor H. 2014. Relationship between nutrition knowledge and dietary intake. Br J Nutr 111(10):1713–1726. https://doi.org/10.1017/S0007114514000087
[UNICEF] United Nations Children's Fund. 2012. Programming Guide: Infant and Young Child Feeding. New York (USA): UNICEF.
[WHO] World Health Organization. 2006. Physical Status and the use and Interpretation of Anthropometry. Reports of WHO Expert Committee. Technical Report Series: No. 854. Switzerland (CH): WHO.
[WHO] World Health Organization. 2010. Indicators for Assessing Infant and Young Child Feeding Practices: Part 2 Measurement. Switzerland (CH): WHO.
Wali N, Agho KE, Renzaho AM. 2020. Factors associated with stunting among children under 5 years in five South Asian countries (2014–2018): Analysis of demographic health surveys. Nutrients 12(12):3875. https://doi.org/10.3390/nu12123875
Yasmin G, Madanijah S. 2010. Perilaku penjaja pangan jajanan anak sekolah terkait gizi dan keamanan pangan di Jakarta dan Sukabumi. J Gizi Pangan 5(3):148–157. https://doi.org/10.25182/jgp.2010.5.3.148-157
Yue A, Marsh L, Zhou H, Medina A, Luo R, Shi Y, Zhang L, Kenny K, Rozelle S. 2016. Nutritional deficiencies, the absence of information and caregiver shortcomings: A qualitative analysis of infant feeding practices in rural China. PLoS One 11:e0153385. https://doi.org/10.1371/journal.pone.0153385
Yuwanti Y, Mulyaningrum FM, Susanti MM.2021. Faktor-Faktor yang mempengaruhi
stunting pada balita di Kabupaten Grobogan. J Kesehat Masy Cendikia Utama 10(1):74. https://doi.org/10.31596/jcu.v10i1.704
Authors
HendryantiD. N., AndrianiC., IndrianiS., GunawanL., & SiberoM. T. (2023). Dietary Diversity, Stunting, and the Impact of an Education Program on Parents’ Knowledge and Attitudes in West Sumba, Indonesia . Jurnal Gizi Dan Pangan, 18(2), 79-88. https://doi.org/10.25182/jgp.2023.18.2.79-88
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