The impact’s sustainability of nutrition education to mother's nutrition behavior and service quality of Posyandu

Abstract

Integrated Service Center Post (Posyandu) is spearheading the early detection and the first services in prevention of malnutrition in Indonesia. In terms of quality, there are barriers that often occur in the implementation of activities posyandu is weak “Communication, Information, and Nutrition Education” programs which is one of the cornerstone in nutrition programs at posyandu. Besides the quality of cadres that still low because of the training received still lessalso the educational levels are low, so that cadres can not given education to mothers posyandu users. Thus, the specific objective of this study were to:(1) Identified the characteristics of mother and children under five years in posyandu; (2) analyzed impact‟s sustainability of nutrition education to knowledge, attitudes, and practices of mothers toddler in posyandu; (3) analyzed correlations of health history and nutritional status children‟s under five; (4) analyzed correlations of knowledge, participation of cadres, and service quality in posyandu; (5) analyzed the impact‟s sustainability of nutrition education to service quality of posyandu; (6) analyzed the sustainability of nutrition education program in posyandu. The design in this study was quasi-experimental. This study is part of the researchs in collaboration with Nestle Foundation (NF) entitled “A Multi- Approach Intervention to Empower Posyandu Nutrition Program to Combat Malnutrition Problem in Rural Areas” (Khomsan et al. 2012). Location of the study is Sukajadi and Sukaluyu village, Tamansari District, Bogor Regency, West Java was conducted in January 2012 until September 2013. The villages were allocated simples randomly as control and intervention group. Nutrition education given to mother‟s toddler and cadre of posyandu was 6 times with frequency 2 times in one month. Data collection consisted of baseline (before intervention), endline (after intervention), and follow-up (four months after endline). Data was analyzed descriptively using Microsoft Excell 2007 and inferentialy using Analysis of Variance (ANOVA) by SPSS 16 softwarer. The results showed that nutritional education impacts to knowledge, attitudes, and practices of mother‟s toddler was significant (p<0,05). Trend change scores tend to declined at follow-up. However, these showed better than baseline. Therefore, it can be said that nutrition educatioan was sustainable. The results showed that most of the mothers toddler in intervention group (93,3%) expressed a desire to stay abreast/ bring the child to the age of five-yearold child to posyandu at the time of the endline. The ANOVA results indicated a difference in the planned visit to the posyandu to five-year-old childs at baseline and endline in the intervention group (p<0.05). This means education of participation posyandu in the form of motivational visit to posyandu was able to increased the knowledge about the importance posyandu. So, desire of mother toddler to keep abreast posyandu was increased. Based on health status, toddlers in the control group and the intervention had a history of disease respiratory infection was higher than the fever, diarrhea, skin diseases, and other (smallpox and convulsions). Nutrition and health educations given to cadres and mothers toddlers whose were indirectly able to change the trend of the respiratory infection incidences. The results showed that a decline in 1-month history of respiratory infection in the intervention group to 77,4% (1,6±0,9 times/1st last month) on the endline data and 74,2% (1,0±0,8 times/1st last month) follow-up data. Spearman correlation test (baseline, endline, and follow-up data) showed a significant correlation between the history of disease and nutritional status of children under five (Weight/Age, Height/Age, and Weight/Height indicators) (p<0,05). Based on the five dimensions of service quality is known that nutrition education given to cadres have a positive impact on the service quality of posyandu. However, there had indicators which are still less (<60%) and did not show / significant improvement were the support of village officials. The result of Duncan's test showed that nutrition education significantly affect the quality of service posyandu (p<0,05). Although the percentage‟s mother toddlers of satisfaction levels to services quality tends to declined after education and monitoring, but the results were still in a range that is better than before get the nutrition education (baseline). This means that, given the cadre education and procurement of facilities in posyandu can improve service quality of posyandu and sustainable.