Partisipasi Masyarakat Pedesaan pada Program Gizi dalam Pembangunan Kesehatan

Kusbandiah, Jajah (1997) Partisipasi Masyarakat Pedesaan pada Program Gizi dalam Pembangunan Kesehatan. UNSPECIFIED thesis, Pusat Penelitian dan Pengembangan Gizi dan Makanan.

Abstract

Participation in nutrition program is the result of the complex interaction between community and government (Ministry of Health), which plans and carries out activities of the program. In promoting community participation, the behavior of people needs to change in a positive direction through an effective education process. The purpose of this study was : ( 1) To investigate community participation of women in nutrition program activities and the extend of nutrition extension in three areas with different kinship systems i.e. : matriarchal, patriarchal, and bilinearchal. (2) To investigate related factors that may effect community participation. (3) To evaluate its association with family's nutritional status. Respondents consisted of pregnant women, lactating women, and non pregnant non lactating women. Each woman had a husband and at least one underfive child in the household. A total of 434 households were studied, of which 188 households were located in the bilinearchal areas located in Cianjur (West Java), 120 households in the patriarchal areas located in Lampung Selatan (Lampung), and 126 households in the matriarchal areas in Tanah Datar (West Sumatra). The selection of households was conducted using the stratified purposive sampling technique. The qualitative as well as quantitative data were obtained from all samples. The qualitative information was gathered using the technique open ended interview, indepth interview, observation and focus group discussion. The quantitative data was obtained through direct measurements. Statistical calculations on data included the chi square test, linear regressions, and path analysis using Minitab Release 10.2 software. The study revealed that the participation levels based on the combination of frequencies of attending Posyandu services, behavior to prevent diseases, and behavior of prenatal care showed the highest level in Lampung Selatan, following by Tanah Datar, and the lowest was in Cianjur. The results of this study also demonstrated that levels of participation differed between kinship systems. In bilinearchal areas, the level of participation was low to medium, while in patriarchal and matriarchal areas participation was medium to high. This difference was statistically significant (P < 0.10). Education had a slight effect (P < 0.10) on the level of participation, where the higher levels of education, seemed to associate with higher levels of participation. Besides kinship system and level of education, the number of underfive children in the family also had a slight significant effect (P < 0.10) on the level of participation. The higher the number of underfive children in the household, associated with a higher level of participation. The family had benefitted from the services at the Posyandu, such as healthier children with fewer episodes or illness and less frequent of sickness, and had a better physical growth. This experience motivated mothers to bring their younger children to the Posyandu. In this study, nutritional status of the family was evaluated based on nutritional status of the underfive children. If one child or more suffered from protein energy malnutrition (pEM), the family was identified as "low nutritional status." On the other hand, if none of the child in the family suffered from malnutrition, then the family was identified as belonged to "well nutritional status." The study revealed hat the level of participation had a significant (p < 0.05) association with the nutritional status of the families. Families with higher levels of participation, showed a greater proportion of well nourished families. In addition, it is possible an even more rapid improvement of nutritional status could be achieved by increasing the community participation in nutrition program, rather than by increasing investments in services alone. Extention activities are, for the most part, one way communication attempts, such as consultation or explanation. The attempt to improve attitude, eating and health behavior requires two way communication that has of yet been adequately, achieved. This situation is further aggravated by a number of constraints: (1) the administration of nutrition extension at community level is not well structured and coordination is weeks, (2) a lack of semi and professional staff in the Ministry of :Health to support communication activities, (3) awareness and conceptualization in he developing of nutrition extension activities flows from the Ministry of Health Policy to require all health workers without exception to conduct health (including nutrition) extension, (4) most village cadres who are volunteers implementing nutrition and health extension activities have never been well trained. Hence their communication performance is very poor. To address these issues, it is necessary to develop a national policy aimed at: (I) increase the level of awareness and resources required, (2) strengthening the capacity of staff and extension workers The outcome would be improve the delivery and quality of nutrition extension services. In this regard it is important to promote the demand for extension activities from side of benefeciaries who are the focus of the extension program. Research to support the sustainability and effectiveness of nutrition extension 3.ctivities, such as improved knowledge which can be applied in the actual program, or appropriate application in different social and culture contexts, need to be developed. Such research can strengthen and update information for program managers and planners in the Ministry of Health.

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