Model Pencegahan Stunting Berbasis Komunitas pada Anak Periode Enam Bulan Pertama Kehidupan di Kabupaten Mandailing Natal

Abstract

Stunting is still a global problem where in 2020 global data shows that up to 204.2 million (33.0%) children under the age of five suffer from malnutrition in 2020 to 22.3 percent (148.1 million) in 2022 and 27.67 percent in Indonesia. Stunting in North Sumatra Province based on Indonesia's health surveys in 2022 and 2023, has decreased from 21.1 percent to 18.9 percent. One of the districts in North Sumatra Province that has a very high stunting rate (cut off the number of stunting sufferers ≥ 40%) is Mandailing Natal Regency, where the stunting rate in 2019 was 49.91 percent. In 2022 and 2023, there has been a decrease from 34.2 percent to 20.7 percent. The specific causes of stunting depend on the regional social environment. The research aims to develop a stunting prevention model for a six-month period of life in Mandailing Natal. This research is a quantitative study conducted in two stages of research. The first stage of the research is the identification of factors that cause stunting with a cross-sectional study design that will be analyzed with structural equational modeling (SEM). The second stage of research is the implementation of interventions based on the findings of the dominant factors causing the first stage of stunting with a pre experimental design with a one-shot case study design. The research was conducted in Mandailing Natal District with a sample of 399 Baduta in stage one and 3rd trimester pregnant women who were willing to take part in the study totaling 21 people in stage two. The results showed that 62.6 percent of stunting could be explained by the SEM model, while 37.4 percent was explained by other factors outside the model. The variables of complementary breastfeeding and environmental sanitation higiene have a direct and significant effect on incidence of stunting in children under two years old. Assistance by mobilizing the community (Health Cadres, village midwives) for new mothers giving birth until Baduta is 6 months old really supports nutritional status, namely normal body weight and length growth at that age is a strategy for preventing early stunting. Changes in the nutritional status of toddlers after assistance with PB/U indikators showed that no one of Baduta participant was stunted at the end of the mentoring process. Mothers whose children succeed in getting exclusive breastfeeding and whose child's nutritional status is consistently good during the mentoring process can be empowered as health cadres.