EFEK SUPLEMENTASI BESI, VITAMIN C DAN PENDIDIKAN GIZI TERHADAP PERUBAHAN KADAR HEMOGLOBIN ANAK SEKOLAH DASAR YANG ANEMIA DI KECAMATAN KARTASURA KABUPATEN SUKOHARJO THE EFFECT OF IRON, VITAMIN C SUPPLEMENTATION, AND NUTRITION EDUCATION ON THE INCREASE OF HEMOGLOBIN LEVEL AMONG ANEMIC SCHOOL CHILDREN IN KECAMATAN KARTASURA KABUPATEN SUKOHARJO

Abstract

Background : Anemia is one of the major nutrition problems, which affected about half of the number children in Indonesia. It is expected that by giving nutrition education to the school children, their food, especially iron will increase. Iron and vitamin C supplementation to the school children are also expected to increase their hemoglobin levels. Objective : The study was conducted to investigate the effect of iron and vitamin C supplementation, as well as nutrition education on hemoglobin levels of the anemic school age children in Kartasura, Kabupaten Sukoharjo. Methods : This study was a quasy experimental research with a pre-test post- test control group design. The research was conducted on 107 subjects who were divided into three groups, iron (60 mg) and vitamin C (60 mg) group, vitamin C (60 mg) and nutrition education group, and iron (60 mg), vitamin C (60 mg), and nutrition education group. The supplementation was given twice a week in 12 weeks, whereas nutrition education was carried out comprehensively using booklet to the students, their parents and the class teachers. The nutrition education was given to the children twice a week. This nutrition education was also performed for the class teachers and the parents once in four weeks for 12 weeks. Results : The level of hemoglobin and the nutrition knowledge of the three groups were all increased. The group who received iron, vitamin C and nutrition education had the highest increase in their hemoglobin level (2.89 g/dL). The group who received vitamin C and nutrition education had the highest improvement in the score of nutrition knowlegde (17.4 point). All of the groups had significantly higher hemoglobin level after the intervention (p<0.05). However, the intake of the anemic children in the three groups did not change (p>0.05). Conclusion : The combination of nutrition education with iron and vitamin C supplementation improved the hemoglobin levels of the anemic school children better than nutrition education or supplementation in isolated provision. Latar Belakang : Anemia merupakan salah satu masalah gizi utama yang menimpa hampir separuh anak-anak di Indonesia. Pendidikan gizi pada anak anemia di sekolah dasar diberikan dengan tujuan untuk meningkatkan asupan makanan terutama asupan besi. Suplementasi besi dan vitamin C diharapkan akan meningkatkan kadar hemoglobin darah anak. Tujuan : Penelitian ini bertujuan mempelajari efek suplementasi besi, vitamin C, dan pendidikan gizi terhadap perubahan kadar hemoglobin anak sekolah dasar yang anemia di Kecamatan Kartasura Kabupaten Sukoharjo. Metode : Penelitian ini termasuk dalam penelitian Quasy experiment dengan rancangan pretest post-test control group. Penelitian dilakukan terhadap 107 sampel yang dibagi menjadi tiga kelompok yaitu: kelompok suplementasi besi (60 mg) dan vitamin C (60 mg), kelompok suplementasi vitamin C (60 mg) dan pendidikan gizi, serta kelompok suplementasi besi (60 mg), vitamin C (60 mg), dan pendidikan gizi. Suplementasi dilakukan dua kali seminggu dalam 12 minggu, sedangkan pendidikan gizi dilakukan dengan alat bantu booklet pada anak, orang tua dan guru kelas. Pendidikan gizi pada anak diberikan dua minggu sekali, sedangkan pada guru kelas dan orang tua diberikan empat minggu sekali dalam 12 minggu. Hasil : Kadar hemoglobin dan pengetahuan gizi pada ketiga kelompok mengalami peningkatan dengan peningkatan kadar hemoglobin terbesar pada kelompok suplementasi besi, vitamin C dan pendidikan gizi (2,89 g/dL), sedangkan peningkatan pengetahuan gizi terbesar pada kelompok suplementasi vitamin C dan pendidikan gizi (17,44 poin). Secara statistik ada perbedaan bermakna perubahan pengetahuan gizi dan perubahan kadar hemoglobin anak SD yang anemia sebelum dan sesudah intervensi pada ketiga kelompok intervensi (p<0,05), tetapi tidak ada perbedaan bermakna dalam asupan zat gizi pada ketiga kelompok intervensi (p>0,05). Simpulan : Pendidikan gizi dipadukan dengan pemberian suplementasi besi dan vitamin C pada anak anemia akan memberikan hasil kenaikan kadar hemoglobin yang paling efektif dibandingkan dengan pendidikan gizi saja atau suplementasi saja.