Pengaruh Home Visit Terhadap Penurunan Episode Penyakit Infeksi dan Peningkatan Angka Kecukupan Gizi pada Balita Malnutrisi Akut Berat

Titih Huriah

doi:10.21927/jnki.2017.5(1).33-41

Pengaruh Home Visit Terhadap Penurunan Episode Penyakit Infeksi dan Peningkatan Angka Kecukupan Gizi pada Balita Malnutrisi Akut Berat

Titih Huriah

Abstract

Malnutrition is one of the principal causes of child mortality in developing countries including Indonesia. Severe Acute Malnutrition (SAM) is the most serious form of malnutrition affecting children under-five and is associated with many infectious diseases and nutrition intake. In the last few decades, there has been a paradigm shift in the management of acute malnutrition from a facility-based to community-centered approach. The purpose of this study was to evaluate effect of home care intervention in decreasing infectious diseases episode and increasing nutrition intake of severe acute malnutrition children aged 6-60 months. Quasi-experimental with pretest-posttest control group design was carried out for this study. The study was done in two district involving 32 health centers of Yogyakarta province. 56 children with SAM were selected using purposive sampling. The study was performed in three phases, intensive, strengthening and independent phase applying nursing care approach. Data analysis was done by SPSS software. Mean episodes of infectious diseases in the baseline at home care group was 2,64 days and after the intervention the mean was 0,21 days. Nutritional adequacy rate in the baseline only reached 83,65% and after intervention reached 106,23%. During the three months intervention of home care, there were significant decreases in infectious diseases episode and increases nutrition intake with p value 0,0003 and 0,003 respectively

Keywords

severe acute malnutrition; children; home visit; infectious diseases episode; nutrition intake

Full Text:

PDF

References

Bhutta ZA, Das JK, Rizvi A, Gaffey MF, Walker N, Horton S, et al. Evidence-based interventions for improvement of maternal and child nutrition: what can be done and at what cost? Lancet [Internet]. 2013 Aug;382(9890):452–77. Available from: http://linkinghub.elsevier.com/retrieve/pii/S0140673613609964

Black RE, Allen LH, Bhutta ZA, Caulfield LE, de Onis M, Ezzati M, et al. Maternal and child undernutrition: global and regional exposures and health consequences. Lancet (London, England) [Internet]. 2008 Jan 19;371(9608):243–60. Available from: http://www.ncbi.nlm.nih.gov/pubmed/18207566

Schoonees A, Lombard M, Musekiwa A, Nel E, Volmink J. Ready-to-use therapeutic food for home-based treatment of severe acute malnutrition in children from six months to five years of age. In: Volmink J, editor. Cochrane Database of Systematic Reviews [Internet]. Chichester, UK: John Wiley & Sons, Ltd; 2013. Available from: http://doi.wiley.com/10.1002/14651858.CD009000.pub2

UNICEF. The big picture [Internet]. 2011 [cited 2012 Jan 5]. Available from: https://www.unicef.org/nutrition/index_bigpicture.html

Roche ML. A community-based positive deviance/hearth intervention to improve infant and young child nutrition in the Ecuadorian Andes [Internet]. McGill University; 2011 [cited 2017 Mar 23]. Available from: http://digitool.library.mcgill.ca/webclient/StreamGate?folder_id=0&dvs=1490240761575~684

Kementerian Kesehatan Republik Indonesia. Profil kesehatan Indonesia Tahun 2011. Jakarta: Kementrian Kesehatan RI; 2012.

Puett C. Community case management of acute malnutrition by community health workers in southern Bangladesh: Examining quality of care and cost-effectiveness [Internet]. Tufts University; 2011. Available from: http://pqdtopen.proquest.com/doc/911029633.html?FMT=ABS

Royal College of Nursing. Malnutrition - what nurses working with children and young people need to know and do [Internet]. London; 2006 [cited 2017 Mar 23]. Available from: https://www2.rcn.org.uk/__data/assets/pdf_file/0006/65499/malnutrition.pdf

Correa B, Leandro Merhi VA, Pagotto Fogaca K, Marques de Oliveira MR. Caregiver’s education level, not income, as determining factor of dietary intake and nutritional status of individuals cared for at home. J Nutr Health Aging [Internet]. 2009 Aug;13(7):609–14. Available from: http://www.ncbi.nlm.nih.gov/pubmed/19621196

Goudet SM, Faiz S, Bogin BA, Griffiths PL. Pregnant women’s and community health workers' perceptions of root causes of malnutrition among infants and young children in the slums of Dhaka, Bangladesh. Am J Public Health [Internet]. 2011 Jul;101(7):1225–33. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21653248

Vazir S, Engle P, Balakrishna N, Griffiths PL, Johnson SL, Creed-Kanashiro H, et al. Cluster-randomized trial on complementary and responsive feeding education to caregivers found improved dietary intake, growth and development among rural Indian toddlers. Matern Child Nutr [Internet]. 2013 Jan;9(1):99–117. Available from: http://doi.wiley.com/10.1111/j.1740-8709.2012.00413.x

Ostrach B, Singer M. Syndemics of War: Malnutrition-Infectious Disease Interactions and The Unintended Health Consequences of Intentional War Policies. Ann Anthropol Pract [Internet]. 2012 Nov;36(2):257–73. Available from: http://doi.wiley.com/10.1111/napa.12003

Rodríguez L, Cervantes E, Ortiz R. Malnutrition and gastrointestinal and respiratory infections in children: a public health problem. Int J Environ Res Public Health [Internet]. 2011 Apr;8(4):1174–205. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21695035

Erhardt J, Gross R. Nutrisurvey. 2007.

Herdman HT. Diagnosis keperawatan: Definisi dan klasifikasi 2009-2011. Jakarta: EGC; 2010.

Johnson M. Nursing Outcomes Classification (NOC). 2nd ed. Missouri: Mosby Inc. St.Louis; 2000.

James A. Nursing care of children: Principles and practice. 3rd ed. Canada: Saunders Elsevier; 2007.

Haryanti F. Upaya peningkatan mutu pelayanan keperawatan anak melalui pelatihan Manajemen Terpadu Balita Sakit (MTBS) pada tatanan rumah sakit Di RS Cut Nyak Dhien Meulaboh Pasca Bencana. Universitas Gadjah Mada; 2010.

Depkes RI. Buku bagan Manajemen Terpadu Balita Sakit (MTBS). Jakarta; 2008.

Irena AH, Mwambazi M, Mulenga V. Diarrhea is a Major killer of Children with Severe Acute Malnutrition Admitted to Inpatient Set-up in Lusaka, Zambia. Nutr J [Internet]. 2011 Dec 11;10(1):110. Available from: http://nutritionj.biomedcentral.com/articles/10.1186/1475-2891-10-110

Yebyo HG, Kendall C, Nigusse D, Lemma W. Outpatient Therapeutic Feeding Program Outcomes and Determinants in Treatment of Severe Acute Malnutrition in Tigray, Northern Ethiopia: A Retrospective Cohort Study. Bhutta ZA, editor. PLoS One [Internet]. 2013 Jun 6;8(6):e65840. Available from: http://dx.plos.org/10.1371/journal.pone.0065840

Sarkar R, Sivarathinaswamy P, Thangaraj B, Sindhu KNC, Ajjampur SSR, Muliyil J, et al. Burden of childhood diseases and malnutrition in a semi-urban slum in southern India. BMC Public Health [Internet]. 2013 Jan 30;13:87. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23360429

Das S, Rahman RM. Application of ordinal logistic regression analysis in determining risk factors of child malnutrition in Bangladesh. Nutr J [Internet]. 2011 Dec 14;10(1):124. Available from: http://nutritionj.biomedcentral.com/articles/10.1186/1475-2891-10-124

Nency Y, Arifin M. Gizi Buruk, Ancaman Generasi yang Hilang. Inov Online. 2005;5(17).

Page A-L, de Rekeneire N, Sayadi S, Aberrane S, Janssens A-C, Rieux C, et al. Infections in Children Admitted with Complicated Severe Acute Malnutrition in Niger. von Seidlein L, editor. PLoS One [Internet]. 2013 Jul 17;8(7):e68699. Available from: http://dx.plos.org/10.1371/journal.pone.0068699

Irshad M, Hayat M, Ahmad A, Khalil B, Hussain M. Case Fatality Rate and Etiological Factors of Malnutrition In Children Less Than 5 Years of Age. J Postgrad Med Inst (Peshawar - Pakistan) [Internet]. 2014 [cited 2017 Mar 23];28(1). Available from: http://www.jpmi.org.pk/index.php/jpmi/article/view/1485

Vir S. Community based maternal and child health nutrition project, Uttar Pradesh: An innovative strategy focusing on “at risk” families. Indian J Community Med [Internet]. 2013;38(4):234. Available from: http://www.ijcm.org.in/text.asp?2013/38/4/234/120159

Shafiq Y, Saleem A, Lassi ZS, Zaidi AK. Community-based versus health facility-based management of acute malnutrition for reducing the prevalence of severe acute malnutrition in children 6 to 59 months of age in low- and middle-income countries. In: Shafiq Y, editor. Cochrane Database of Systematic Reviews [Internet]. Chichester, UK: John Wiley & Sons, Ltd; 2016. Available from: http://doi.wiley.com/10.1002/14651858.CD010547.pub2

World Health Organization. Management of Severe Malnutrition: A Manual For Physicians and Other Senior Health Workers. 1999.

DOI: http://dx.doi.org/10.21927/jnki.2017.5(1).33-41