Factors influencing mother’s participation in Posyandu for improving nutritional status of children under-five in Aceh Utara district, Aceh province, Indonesia

Abstract

Background Posyandu, or pos pelayanan terpadu (integrated service post), is a community-based activity for health services in Indonesia. According to the Indonesian Basic Health Survey, the prevalence of children under five in Indonesia who suffered from being underweight was 19.6 %. The wasting was 12.1 % and the stunting was 37.2 % in 2013, and these values have not changed greatly from 2007; much greater than the WHO targets of, less than 10 % underweight, 5 % wasting, and 20 % stunting. In Aceh were 26.6, 16.8, and 43.3 %, respectively. Also, the participation percentages of mothers to Posyandu was about 45 %, far below the national target of 100 %. In Aceh Province, the percentage was even lower (34 % in 2013). This study aimed to investigate the factors influencing participation of mothers in Posyandu.MethodsThis research used a cross-sectional design with sample of mothers who had children under five. They were chosen by multistage random sampling. Sample size was determined by the WHO formula. Face-to-face interviews were carried out using a questionnaire. The questionnaire consisted of items about socio-demographic characteristics, satisfaction with Posyandu services, attitude towards Posyandu benefits, and intention to attend Posyandu. The collected data were analyzed by using EZR (version 1.21). Fisher’s exact test was performed to examine the associations between the socio-demographic factors, attitude, satisfaction, and intention covariates with participation. Logistic regression was used to describe the strength of the relationship between the predictor variables and participation.ResultsThere were no significant differences in age, marital status, education level, occupation, family size, and distance to Posyandu between low participation group except for the monthly household income. Among the socio-demographic factors, only monthly household income had a significant association with the frequency of mothers’ participation. Satisfaction, attitude, and intention were associated with participation. The logistic regression showed that monitoring the nutritional status of children under five was the main reason that mothers participated in Posyandu. Mothers who were satisfied with the Posyandu services were more likely to attend than those who were dissatisfied. Respondents with intention to participate in Posyandu every month were more likely to attend than those who did not intend to attend every month. Households with low income were more likely to participate in Posyandu than households with high income.ConclusionHousehold income, mothers’ satisfaction with Posyandu services, attitude towards Posyandu benefits and intention to attend Posyandu affect the participation frequency of the mother. In addition, monitoring the nutritional status of children under five was the main reason respondents attend Posyandu. Improving the quality of Posyandu services and providing qualified resources are needed to promote mothers’ participation.

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“…Pada usia ini anak masih merupakan golongan konsumen pasif, yaitu belum dapat mengambil dan memilih makanan sendiri sesuai dengan kebutuhannya sehingga pada usia ini anak sangat rentan terhadap berbagai masalah kesehatan seperti kurang gizi sehingga mengakibatkan terganggunya pertumbuhan badan, mental, kecerdasan dan mudah terserang penyakit infeksi (3). Disamping kurang gizi di temukan juga gizi lebih yang dapat menyebabkan kegemukan dan anak berisiko menderita penyakit degeneratif seperti penyakit hipertensi dan jantung (6,9,10,11,12,13).…”

“…Seorang anak yang mengalami infeksi membutuhkan asupan gizi yang lebih banyak dari biasanya (9,18). Dinas Kesehatan Sulawesi Selatan melaporkan bahwa tingginya kasus gizi kurang dipengaruhi sejumlah faktor seperti penyakit infeksi yang diderita anak, rendahnya pengetahuan orang tua terhadap makanan serta rendahnya pendapatan yang diperoleh kepala keluarga dari hasil pekerjaannya (3,10,19). Asupan gizi pada anak usia sekolah mulai dipengaruhi oleh faktor lingkungan (17), karena anak-anak usia ini sudah mulai mengenal lingkungannya.…”

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“…Community-based rehabilitation services (CBR) are also available in many parts of the country. Other community-related services, including maternal and child health centres (integrated service post/Pos Pelayanan Terpadu (Posyandu)) (12), are spread across the whole of Indonesia and reach the lowest level of governmental structure. In general, the health workforce in Indonesia is quite low; for example, the density of physicians is 0.21 per 1,000 population (13).…”