Pemberian paket gizi masyarakat proyek NICE berpengaruh terhadap kinerja posyandu, tetapi tidak meningkatkan status gizi balita di Provinsi NTB

Abstract

ABSTRACT

Background: The province of NTB had the prevalence of underweight 30.5% in 2010 for children under five, this figure is above the national prevalence. A nutrition improvement through community empowerment (NICE) has been developed aimed to supporting community nutrition service to overcome nutrition and health problem independently. One of the programs is CNP (community nutrition package) which got the highest fund allocation compared to other NICE program.

Objectives: To evaluate the effect of CNP supplementation in NTB Province to the increase of nutritional status of children under five through index of weight by age and performance of posyandu.

Methods: The study was evaluative with quantitative and qualitative method and one group pre and post test design, from January to April 2012 at 4 districts/ municipalities area of NICE Project, comprising 72 villages/cities that received CNP in 533 posyandu with 7,975 of children under fives. Posyandu’s performance was measured by baseline data collection for NICE project questionairre, weight measured by scale, and indepth interview was made to individuals administering CNP before and after receiving the package. Samples were randomly selected. Data analysis used paired t-test.

Results: There was significant difference in performance of posyandu (p< 0.001, 95% CI: 9.88-11.05) and nutritional status of children under five based on index of weight/age (p<0.001, 95% CI: -1.23 to -1.32) before and after CNP supplementation. CNP supplementation increased performance of posyandu, but did not increase the nutritional status of children under five (index of weight/age). There were supporting factors of community nutrition supplementation such as human resources, participation across sectors, villages and community/religious leaders and integration with other programs (PNPM-Mandiri, GSC, local budget).

Conclusions: CNP supplementation affected performance of posyandu but did not increase nutritional status of children under five at Province of NTB in 2011.

KEYWORDS: NICE project, nutritional status, performance of posyandu, children under five

ABSTRAK

Latar belakang: Provinsi Nusa Tenggara Barat memiliki prevalensi balita underweight di atas prevalensi nasional, yaitu sebesar 30,5 persen tahun 2010. Proyek perbaikan gizi NICE (nutrition improvement through community empowerment) dikembangkan melalui pemberdayaan masyarakat untuk mendukung pelayanan gizi masyarakat. Salah satu programnya adalah paket gizi masyarakat (PGM) yang mendapat alokasi dana paling tinggi dibanding proyek NICE yang lain.

Tujuan: Mengevaluasi pengaruh pemberian PGM di Provinsi NTB terhadap peningkatan status gizi balita indeks berat badan menurut umur dan kinerja posyandu.

Metode: Penelitian ini merupakan penelitian evaluatif menggunakan metode kuantitatif dan kualitatif pada bulan Januari sampai dengan April 2012. Penelitian menggunakan rancangan one group pre and post test design. Penelitian dilaksanakan di 4 kabupaten/kota wilayah NICE mencakup 72 desa/kota yang mendapat PGM dengan jumlah posyandu sebanyak 533 dan 7.975 balita. Pengukuran kinerja posyandu menggunakan kuesioner yang diadopsi dari baseline data collection for NICE project, pengukuran berat badan menggunakan dacin dan indepth interview dilakukan pada pengelola PGM sebelum dan sesudah PGM. Pemilihan subjek penelitian dilakukan secara simple random sampling. Analisis data menggunakan paired t-test.

Hasil: Terdapat perbedaan bermakna kinerja posyandu (nilai p<0,001, 95% CI: 9,885763-11,05232) dan status gizi balita menurut indeks BB/U (nilai p< 0,001, 95% CI: -1,233254-1,321063) antara sebelum dan sesudah pemberian PGM. Kinerja posyandu meningkat setelah pemberian PGM, namun belum mampu meningkatkan status gizi balita (indeks BB/U) di Provinsi NTB tahun 2011. Terdapat faktor pendukung pemberian PGM di antaranya kualitas sumber daya manusia (SDM) kelompok gizi masyarakat (KGM), keterlibatan lintas sektor, desa/ kelurahan, dan tokoh masyarakat/agama serta keterpaduan program lainnya (PNPM-Mandiri, GSC, dana daerah).

Kesimpulan: Pemberian paket gizi masyarakat berpengaruh terhadap kinerja posyandu tetapi belum mampu meningkatkan status gizi balita di Provinsi NTB tahun 2011.

KATA KUNCI: proyek NICE, status gizi, kinerja posyandu, balita