FOSTERING A PROSPEROUS FAMILY, HEALTHY, AND FREE OF STUNTING IN CENTRAL JAVA: EMPIRICAL STUDY IN TINGKIR SALATIGA

ABSTRACT


INTRODUCTION
Family development is one of the national development issues with an emphasis on the importance of strengthening family resilience.Protection and empowerment of the family as the smallest unit in society is the main target in family development.Family development is an effort to create a quality, resilient, and prosperous family that lives in a healthy environment at every stage of life.Some interventions that can be done in supporting family development programs include increasing access to information, education, and socio-economy, and improving the quality of the family environment, health, and child care and development (dpp3p2kb, 2020).In building a healthy and prosperous family, there are five family health tasks, including recognizing health problems, making appropriate health action decisions, and providing care to sick family members.Modifying the environment or creating a healthy home atmosphere, and 5) Referring to public health facilities.Families are expected to be able to recognize signs and symptoms and prevent diseases that affect family members.Among the health problems that are being the focus of the Indonesian government's current handling is stunting.
Stunting is a condition when toddlers have a minimal height or length when compared to age.According to WHO, this situation can be calculated from height or body length that exceeds -2 standard deviations of medium from the child's growth standard.This stunting toddler is a chronic nutritional disorder problem caused by various triggering factors including socioeconomic conditions, pain felt by babies, maternal nutrition during pregnancy, and lack of nutritional supply to infants.This stunting toddler when he reaches the age of children will experience poor physical and cognitive development (Ministry of Health RI, 2018).Stunting that occurs if not balanced with catch-up growth (growing chase) results in decreased growth, the problem of stunting is a public health problem associated with an increased risk of illness, death, and obstacles to both motor and mental growth.Stunting is formed by inadequate growth faltering and catch-up growth which reflects the inability to achieve optimal growth, it reveals that the group of toddlers born with normal weight can experience stunting if the fulfillment of further needs is not met properly (Ministry of Village Development of Disadvantaged Regions and Transmigration, 2017).
Factors that influence the occurrence of stunting in children under five in rural and urban areas are maternal education, family income, maternal knowledge about nutrition, exclusive breastfeeding, age of breastfeeding, adequate levels of zinc and iron, history of infectious diseases, and genetic factors (Ministry of Health, 2023).Other factors that influence the occurrence of stunting are low maternal knowledge, improper parenting, low nutritional status, and low family economic status have a significant relationship with the incidence of stunting in children.Children of mothers with low education are at greater risk of stunting.Maternal education is indirectly related to stunting related to decision-making on nutrition and health care.Mothers with better education will consider better nutrition for children.In addition, improper parenting also contributes indirectly to the risk of stunting.Hygiene, health, and feeding practices applied by parents to children have a significant relationship with the incidence of stunting (Zikria, Masrul &;Bustami, 2018).Children with poor feeding, poor hygiene, and poor health practices have a higher risk of stunting (Zikria et al., 2018).
The stunting rate in Indonesia is still high at 24.4% (SSGI 2021), although there is a decrease from the previous year of 27.7% in 2019, efforts are still needed to achieve the stunting reduction target in 2024 of 14%.Stunting occurs before birth, judging from the 2018-2021 SSGI trend, it is consistently seen that stunting rates are high at birth and rise high in the age range of 6-24 months.Data shows that the stunting rate in infants aged 6-11 months is 13.8% and 12-23 months old is 27.2% (SSGI 2021).Meanwhile, the prevalence of stunting in Salatiga City in 2021 is 15.2%.The Mayor of Salatiga has established a Decree (SK) number 440/329/2022 which stipulates seven urban villages as focus locations for accelerating stunting prevention in 2023.The decree consists of Kelurahan Ledok, Kutowinangun Lor, Blotongan Mangunsari, Randuacir, Kumpulrejo, and Tingkir Tengah.For 3 months from June to September 2023, the Salatiga City Government through the Family Welfare Development (PKK) community organization in collaboration with the Office of Women's Empowerment, Child Protection, Population Control and Family Planning (DP3AP2KB) and the professional organization Nutritionist Association (Persagi) of Salatiga City provided a Supplementary Feeding (PMT) assistance program.PMT assistance is given in the form of 2 meals a day, namely breakfast and seating, and one snack.
Based on data from DP3AP2KB Tingkir Tengah Village is a target area of the DP3AP2KB Office with 20 children receiving PMT assistance.From the data analyzed by the beneficiary families, the cause of stunting is economic factors that are less able by 55% and parenting by 45%.For this reason, community empowerment with the theme "Fostering Prosperous, Healthy, and Stunting-Free Families" needs to be carried out in efforts to handle and prevent stunting, especially in Central Tingkir Village.Kelurahan Tingkir Tengah itself is a village located on Jalan Tingkir Raya.This village is located at the foot of Mount Merbabu at an altitude of 640m above sea level.The population of the Central Tingkir sub-district based on beautiful village data in February 2023 is 5,128 people, consisting of 2,576 males and 2,552 females.Central Tingkir Village still relies on the economy in the agricultural sector and other sectors are found in MSMEs, especially those carried out by housewives.The purpose of the output target activities of this community service activity in Tingkir Tengah Village is to increase awareness of stunting prevention through improving parenting, understanding the role of housewives, increasing knowledge about financial literacy in the family, and understanding the nutritional needs of pregnant women.The results of this community service can also be submitted to partner institutions and can be published.

METHOD
Community service activities were carried out in the meeting room of Tingkir Tengah Village with the target of participants involving representatives from 10 RWs as many as 45 people.Participants consisted of Posyandu cadres, PKK cadres, Healthy Kitchen Cadres to Overcome Stunting (Dashat), and pregnant women.For details of the stages of implementation of activities as follows: 1. Preparation a.The stage of licensing activities to the Central Tingkir Subdistrict and involving its residents to play an active role in activities.b.Coordinating with resource persons, namely Lurah Tingkir Tengah, Psychologists from the DP3AP2KB Office, and Field Supervisors.c. Preparing material related to nutrition for pregnant women and cooking demonstrations d.Prepare Moringa leaf seeds that will be distributed to participants.e. Prepare equipment and equipment used during activities.2. Implementation a. Remarks as well as material delivered by Lurah Tingkir Tengah "The Role of Housewives in Efforts to Build a Prosperous, Healthy, and Stunting-Free Family".b.Education by Clinical Psychology with the theme "The Importance of Parenting in Efforts to Build a Prosperous, Healthy, and Stunting-Free Family".c. Delivery of material from Field Supervisors (DPL) "Financial Literacy in the Household".d.Demo cooking snack pudding with color leaf base ingredient e. Providing education about nutritional needs in pregnant women and the benefits of Moringa leaves on health.f.The distribution of Moringa leaf seeds by students KKN_PPM.g.Q&A and interactive discussions with attendees.
In addition to community service in the form of coaching containing education, other activities are also carried out in the RW 06 area and educational institutions in the Central Tingkir Village area.RW 06 was chosen as one of the target areas because based on data from RW 06 sub-district, there are most stunted children.The activities carried out are also to support efforts to reduce stunting problems, namely nutrition education for elementary, junior high, and vocational children, equalization of perceptions of posyandu cadres related to nutritional status measurement, nutrition counseling, promotion of Clean and Healthy Living Behavior (PHBS) and activities that support the economic sector such as entrepreneurship education and marketing optimization for business actors.Evaluation of activities is carried out by providing feedback in the form of questions to participants related to the material that has been submitted to find out whether the material can be received properly.In addition, representatives of the participants gave impressions and mentioned the benefits obtained after participating in the event.Program sustainability After this community service program is completed, it is hoped that participants after being given coaching in the form of education can increase knowledge and can carry out their duties and roles properly so that stunting reduction and prevention can be implemented.

RESULTS AND DISCUSSION
Community service activities went well according to plan.The event was attended by more than 80% of the invited participants consisting of posyandu cadres, dashat cadres, and pregnant women.The material is delivered alternately, with added interactive discussions, questions and answers, and quizzes.In addition, there were also presentations from students who practiced moringa leaf pudding cooking demos, exposure to the nutritional needs of pregnant women, and the distribution of moringa tree seeds.The nutritional needs of pregnant women are very important to be met in stunting prevention.Nutrition of pregnant women is necessary for the growth of the fetus they contain.Pregnant women with good health conditions without nutritional disorders in the pre-pregnancy period or during pregnancy will produce babies that are bigger and healthier than pregnant women whose conditions have nutritional disorders.
Based on several questions and discussions, many participants were very enthusiastic about parenting.This is certainly related to the cause of the stunting problem in Tingkir Tengah Village, which is 55% related to improper parenting.Not all parents get information about parenting well.Parenting programs or education about parenting are very necessary.The program includes how to educate children, communicate well, the importance of monitoring growth, and techniques to provide stimulus to children including the importance of meeting children's nutritional needs.In addition, the resource person from Clinical Psychology also reminded the role of cadres to provide good support to parents so that they remain diligent in monitoring their children's growth and development at posyandu.For nutrient-dense snack food innovation activities, KKN students held a cooking demo using Moringa leaves, because Moringa leaves have various benefits that are good for the body including helping to ward off free radicals, lowering blood sugar levels, reducing inflammation in the body, maintaining brain function and health, controlling blood pressure, preventing premature aging (flavonoids and polyphenols as anti-inflammatory), Helps improve digestion, increases good cholesterol (prevents heart disease), maintains liver health and improves bone health.

CONCLUSION
Knot Community service activities with the theme "Fostering Prosperous, Healthy, and Stunting-Free Families" went well with the plan that had been prepared.This activity is also carried out based on the problems that cause stunting in Central Tingkir Village, namely parenting and economic factors.The implementation of this activity was attended by more than 80% of all participants.The output targets measured from interactive discussions and interviews of participant representatives are in line with expectations, namely increasing awareness of stunting prevention through improving parenting, understanding the role of housewives, and understanding the importance of meeting nutritional needs in pregnant women.Suggestions that can be given related to this community service activity are the need for sustainable coaching activities, especially in the fields of parenting, maternal nutrition knowledge, and community empowerment.Cooperation for these activities can be carried out by Central Tingkir Village with related agencies such as Puskesmas, DP3AP2KB, Health Office, and related health professional organizations so that stunting prevention and reduction can run optimally.

Figure
Figure 4. Moringa Leaf Pudding-Making Process