Midwives’ Strategies in Preventing Stunting through Nutrition Education at Integrated Health Posts (Posyandu)
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Abstract
Stunting remains a major public health problem that affects child growth and development, particularly during the first 1,000 days of life. In Indonesia, efforts to prevent stunting are closely linked to community-based health services, especially Integrated Health Posts (Posyandu), where midwives play a strategic role as frontline health workers. This study aims to explore midwives’ strategies in preventing stunting through nutrition education at Posyandu, focusing on the types of educational approaches used, levels of community participation, challenges encountered, and perceived impacts on maternal nutrition knowledge and practices. This research employed a qualitative descriptive design conducted at selected Posyandu in Karo Regency/North Sumatra. Participants included midwives, Posyandu cadres, and mothers of children under five, selected through purposive sampling. Data were collected through in-depth interviews, observations of Posyandu activities, and document analysis of nutrition education materials. The data were analyzed thematically to identify patterns and key themes related to midwives’ strategies and their effectiveness. Ethical principles, including informed consent, confidentiality, and voluntary participation, were strictly observed throughout the study. The findings indicate that midwives implement a variety of strategies, including individual counseling, group-based nutrition education, and home visits, supported by educational media such as posters, flipcharts, and food demonstrations. Major challenges included low attendance, limited resources, and cultural beliefs affecting feeding practices. Despite these challenges, nutrition education delivered by midwives contributed to improved maternal knowledge and positive changes in feeding behaviors. In conclusion, midwives integrated and context-sensitive strategies play a vital role in stunting prevention through nutrition education at Posyandu.
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Aramico, B., Huriyati, E., & Dewi, F. S. T. (2020). Determinant factors of stunting and effectiveness of nutrition, information, education interventions to prevent stunting in the first 1000 days of life: A systematic review. The International Conference on Public Health Proceeding, 5(01), 285–300.
Balon, R., Guerrero, A. P. S., Coverdale, J. H., Brenner, A. M., Louie, A. K., Beresin, E. V, & Roberts, L. W. (2019). Institutional review board approval as an educational tool. In Academic Psychiatry (Vol. 43, pp. 285–289). Springer.
Blair, R. (2004). Public participation and community development: The role of strategic planning. Public Administration Quarterly, 28(1), 102–147.
Bogdan-Lovis, E. A., & Sousa, A. (2006). The contextual influence of professional culture: certified nurse-midwives’ knowledge of and reliance on evidence-based practice. Social Science & Medicine, 62(11), 2681–2693.
Busza, J., Walker, D., Hairston, A., Gable, A., Pitter, C., Lee, S., Katirayi, L., Simiyu, R., & Mpofu, D. (2012). Community‐based approaches for prevention of mother to child transmission in resource‐poor settings: a social ecological review. Journal of the International AIDS Society, 15, 17373.
Danaei, G., Andrews, K. G., Sudfeld, C. R., Fink, G., McCoy, D. C., Peet, E., Sania, A., Smith Fawzi, M. C., Ezzati, M., & Fawzi, W. W. (2016). Risk factors for childhood stunting in 137 developing countries: a comparative risk assessment analysis at global, regional, and country levels. PLoS Medicine, 13(11), e1002164.
DaRosa, D. A., Skeff, K., Friedland, J. A., Coburn, M., Cox, S., Pollart, S., O’connell, M., & Smith, S. (2011). Barriers to effective teaching. Academic Medicine, 86(4), 453–459.
Halcomb, E. J., & Davidson, P. M. (2006). Is verbatim transcription of interview data always necessary? Applied Nursing Research, 19(1), 38–42.
Helms Andersen, T., Folmann Hempler, N., & Willaing, I. (2014). Educator challenges using participatory methods in group-based patient education. Health Education, 114(2), 152–165.
Hill, K. G., Woodward, D., Woelfel, T., Hawkins, J. D., & Green, S. (2016). Planning for long-term follow-up: strategies learned from longitudinal studies. Prevention Science, 17(7), 806–818.
Holschneider, S., Subandoro, A. W., Karjadi, E., Provo, A. M., Herkutanto, R., Ayuningtyas, P., Dharmawan, A., & Sudarjo, M. N. (2021). Improving the Quality of Frontline Nutrition Services in Indonesia’s Health Sector. World Bank.
Hyden, C., Kahn, R., & Bonuck, K. (2013). Bottle-weaning intervention tools: The “how” and “why” of a WIC-based educational flipchart, parent brochure, and website. Health Promotion Practice, 14(1), 75–80.
Islam, M. S., Zafar Ullah, A. N., Mainali, S., Imam, M. A., & Hasan, M. I. (2020). Determinants of stunting during the first 1,000 days of life in Bangladesh: A review. Food Science & Nutrition, 8(9), 4685–4695.
Kupolati, M. D., MacIntyre, U. E., & Gericke, G. J. (2014). School-based nutrition education: features and challenges for success. Nutrition & Food Science, 44(6), 520–535.
Le Menestrel, S., & Kizer, K. W. (2019). Strengthening the military family readiness system for a changing American society.
Moon, M. D. (2019). Triangulation: A method to increase validity, reliability, and legitimation in clinical research. Journal of Emergency Nursing, 45(1), 103–105.
Nankumbi, J., Ngabirano, T. D., & Nalwadda, G. (2018). Maternal nutrition education provided by midwives: a qualitative study in an antenatal clinic, Uganda. Journal of Nutrition and Metabolism, 2018(1), 3987396.
Nazri, C., Yamazaki, C., Kameo, S., Herawati, D. M. D., Sekarwana, N., Raksanagara, A., & Koyama, H. (2015). Factors influencing mother’s participation in Posyandu for improving nutritional status of children under-five in Aceh Utara district, Aceh province, Indonesia. BMC Public Health, 16(1), 69.
Nenobais, D. I., & Katmini, K. (2021). Application of health belief model theory on prevention of stunting in toddlers through nutritional behavior. Journal for Quality in Public Health, 5(1), 27–34.
Ober, K., & Sakdapolrak, P. (2017). How do social practices shape policy? Analysing the field of ‘migration as adaptation’with Bourdieu’s ‘Theory of Practice.’ The Geographical Journal, 183(4), 359–369.
Organization, W. H. (2018). Reducing stunting in children: equity considerations for achieving the Global Nutrition Targets 2025.
Rahmawati, N. D., & Sartika, R. A. D. (2020). Cadres’ role in Posyandu revitalization as stunting early detection in Babakan Madang Sub-District, Bogor District. ASEAN Journal of Community Engagement, 4(2), 485–499.
Retnaningtyas, E., & Mardjengi, R. A. (2020). Knowledge of Supplementary Foods on Behavior in Infants 0-6 Months in Sigenti Village, Parigi Mautong Regency Central Sulawesi Province. Open Access Health Scientific Journal, 1(2), 27–33.
Setyowati, W. (2003). The impact of village midwives and cadres in improving the nutritional status of pregnant women in selected rural villages in two districts, Banten Province Indonesia 2003: a longitudinal descriptive study.
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