Dampak Pemberian MakananTambahan pada Ibu Hamil Kekurangan Energi Kronis terhadap Kadar Hemoglobin, Panjang dan Berat Badan Lahir di Kabupaten Tegal

Abstract

Universitas Diponegoro Fakultas Kesehatan Masyarakat Program Studi Magister Ilmu Kesehatan Masyarakat Konsentrasi Kesehatan Ibu dan Anak 2018 ABSTRAK Sairuroh Dampak Pemberian MakananTambahan pada Ibu Hamil Kekurangan Energi Kronis terhadap Kadar Hemoglobin, Panjang dan Berat Badan Lahir di Kabupaten Tegal xviii + 59 halaman + 29 tabel + 3 gambar + 10 lampiran Pada tahun 2016 penyebab Angka Kematian Bayi tertinggi di Kabupaten Tegal adalah Berat Badan Lahir Rendah (BBLR). Salah satu penyebab BBLR adalah kekurangan energi kronis (KEK) pada ibu hamil. Program pemberian makanan tambahan (PMT) pada ibu hamil merupakan upaya untuk mencegah BBLR. Penelitian ini bertujuan untuk menganalisis pengaruh PMT pada ibu hamil terhadap kadar hemoglobin ibu hamil, berat badan dan panjang badan lahir. Desain penelitian kuasi eksperimen. Subyek penelitian 51 ibu hamil KEK dari keluarga miskin (perlakuan ) yang mendapat PMT dan 51 ibu hamil KEK non keluarga miskin (kontrol). PMT berupa biskuit dari Kemenkes untuk 90 hari, @ 5 keping. Pengumpulan data dengan wawancara terstuktur, pengukuran kadar Hemoglobin ibu sebelum dan sesudah perlakuan, panjang badan dan berat badan bayi satu jam setelah lahir, analisis bivariat dengan uji independent sample T- test, Mann Whitney,Chi square, analisis multivariat dengan General Linier Model. Tidak ada perbedaan karakteristik ibu antara kedua kelompok. Pendapatan keluarga kelompok kontrol lebih tinggi daripada perlakuan (p=0,001). Peningkatan kadar hemoglobin kelompok perlakuan (1,29 ±0,76 g/dl) lebih tinggi (p=0,032) daripada kelompok kontrol (0,97±0,75 g/dl).Tingkat kecukupan energi (TKE) kelompok kontrol (67,6±10,7%) lebih tinggi (p= 0,003) dari TKE kelompok perlakuan (60,4±13,3%), Tingkat kecukupan protein (TKP) kelompok perlakuan (96,4±30,4%) lebih tinggi (p=0,015) dari TKP kelompok kontrol (83,6±20,97%). Tidak ada pengaruh PMT terhadap panjang badan (p=0,452) dan berat badan bayi (p=0,241) antara kelompok perlakuan dan kontrol sesudah di kotrol TKE dan TKP, namun ada pengaruh PMT terhadap kenaikan kadar hemoglobin (p=0,005). Disimpulkan bahwa PMT pada ibu hamil meningkatkan kadar Hemoglobin tetapi tidak meningkatkan berat badan dan panjang badan lahir bayi. Selain itu disarankan kepada Kemenkes agar jenis PMT yang diberikan bervariasi rasa dan bentuknya untuk mencegah kebosanan, diperlukan pengawasan dan pemantauan kepatuhan ibu hamil KEK dalam mengkonsumsi makanan tambahan Kata kunci : Pemberian Makanan Tambahan, Kadar Hemoglobin, Panjang badan dan Berat Badan Bayi Baru Lahir Kepustakaan : 51 ( 2012- 2017 ) Diponegoro University Faculty of Public Health Master’s Study Program in Public Health Majoring in Maternal and Child Health 2018 ABSTRACT Sairuroh The Effect of Supplementary Feeding of Pregnant Women with Chronic Energy Deficiency on Hemoglobin Levels, Birth Weight, and Birth Height in Tegal Regency xviii + 59 pages + 29 tables + 3 figures + 10 appendices In 2016, a main cause of Infant Mortality Rate in Tegal Regency was Low Birth Weight Babies (LBWB). One of the causes of LBWB was chronic energy deficiency (CED) in pregnant women. A program of supplementary feeding of pregnant women was an effort to prevent LBWB. This study aimed at analyzing the influence of supplementary feeding of pregnant women on hemoglobin levels, birth weight, and birth height. This was a quasi-experimental study. An intervention group consisted of 51 pregnant women with CED from poor families who obtained supplementary feeding whereas a control group consisted of 51 pregnant women with CED from non-poor families. Supplementary feeding was a biscuit provided by Ministry of Health for 90 days (@5 pieces).Data were collected by conducting a structured interview, by measuring hemoglobin levels before and after providing the intervention, and by measuring birth weight and birth height undertaken one hour after childbirth.Data were analyzed using tests of Independent Sample T, Mann-Whitney, Chi-Square, and General Linear Model. There was no difference in mothers’ characteristics between these both groups. Family income among the control group was higher than that of among the intervention group (p=0.001). Hemoglobin levels among the intervention group (1.29±0.76 g/dl) were higher than that of among the control group (0.97±0.75 g/dl)with p=0,032.The level of energy adequacy among the control group (67.6±10.7%) was higher than that of among the intervention group (60.4±13.3%)with p=0.003. The level of protein adequacy among the intervention group (96.4±30.4%) was higher than that of among the control group (83.6±20.97%) with p=0.015. Supplementary feeding did not influence birth height (p=0.452) and birth weight (p=0.241) between these both groups after controlling the variables of the level of energy adequacy and the level of protein adequacy. In contrast, supplementary feeding significantly influenced the increase of hemoglobin levels (p=0,005). To sum up, supplementary feeding in pregnant women could increase hemoglobin levels but it could not increase baby’s birth weight and birth height. Ministry of Health needs to provide supplementary feeding with various tastes and various forms to avoid feeling bored. In addition, there needs to monitor obedience of pregnant women with CED in consuming supplementary feeding. Keywords: Supplementary Feeding, Hemoglobin Levels, Birth Height, Newborn Baby’s Birth Weight, Bibliography: 51 (2012-2017)