International Journal of Science and Healthcare Research Vol.3; Issue: 4; Oct.-Dec. 2018 Website: www.ijshr.com Original Research Article ISSN: 2455-7587

Factors Affecting Nutrient Status of Children Under Five Years at Puncak Jaya District Sub Province Papuan

Arinius Weya1, A.L. Rantetampang2, Rosmin Tingginehe3, Anwar Mallongi4

1Magister Program of Public Health, Faculty of Public Health, Cenderawasih University, . 2,3Lecturer of Master Program in Public Health, Faculty of Public Health, Cenderawasih University, Jayapura 4Environmental Health Department, Faculty of Public Health, Hasanuddin University, Makassar

Corresponding Author: Arinius Weya

ABSTRACT Keywords: Nutrient State, Child Under Five Years, Puncak Jaya District Introduction: The child including child in age five year is risk a group nutrient state. The 1. INTRODUCTION mother is very important to nutrient state of Toddlers are included in the child and influencing of by characteristic, community group of vulnerable nutrition knowledge, attitude, income; eat culture and groups and if not addressed immediately are role of eating. very vulnerable to various types of Target of research: To knowing the factors affecting with nutrient state of child age under infectious diseases which can cause an five year at Puncak Jaya District Sub Province increase in under-five mortality (Badriah, Papuan. 2013). The causes of malnutrition, namely Method Research: Analytic of observational nutritional intake due to the low knowledge with sectional cross study design. Research of maternal nutrition and understanding of executed on July 2018 in Puncak Jaya District foods that are safe to eat, infectious with population is child under five years and diseases, the environment, access to health respondent counted 100 mother and child with services and parenting (Marmi, 2012). The purposive sampling. Data approach used emergence of nutritional problems in questionnaire and analyzed used chi square test children under five is influenced by many and logistics binary regression. interrelated factors. Directly influenced by Result of research: There is relation with nutrient state to child under five years at Puncak several things, namely children do not get Jaya District is working, (p-value 0,000; RP = enough nutritious balanced food at the age 3,107; CI95% (2,041– 4,731), studied (p-value of toddlers, children do not get adequate 0,046; RP = 0,542; CI95% (0,306– 0,959), nutritional care and children suffer from knowlegde (p-value 0,000; RP = 4,702; CI95% infectious diseases. Poverty is also one of (3,005 – 7,359), attitude (p-value 0,000; RP = the causes of the emergence of cases of 4,000; CI95% (2,596 – 6,162), eat culture (p- malnutrition related to the availability and value 0,000; RP = 4,964; CI95% (3,121 – 7,893) consumption of family food (Indonesian and role of eat (p-value 0,000; RP = 3,254; Ministry of Health, 2015). Factors causing CI95% (2,132 – 4,966). Meanwhile there is not malnutrition, first food and possible relationship nutrient state to child under five infectious diseases in children suffering, years at Puncak Jaya District is age (p-value 0,463; RP = 0,735; CI95% (0,382– 1,412), both food security in the family, patterns of financial of eat (p-value 0,183; RP = 1,518; childcare, health services and environmental CI95% (0,909– 2,534). The knowledge and eat health. The three factors are the level of culture is dominant variable with nutrient state education, knowledge and skills, there is a to child under five years, meanwhile attitude is possibility that the better the level of family interaction variable. food security, the pattern of childcare, and families make use of, existing health services. The inaccessibility of health

International Journal of Science and Healthcare Research (www.ijshr.com) 70 Vol.3; Issue: 4; October-December 2018 Arinius Weya et.al. Factors affecting nutrient status of children under five years at Puncak Jaya district sub province Papuan services (because they are far away, unable Observational analysis with cross sectional to pay) can also have an impact on study design. The study was conducted on children's nutritional status (Parii, 2014). July 2018 in the Puncak District with a Data on nutritional status of infants population of children under five and the in Province, from 2015 to 2016 number of respondents as many as 100 showed a decrease in poor nutritional status, mothers and toddlers by purposive where in 2015, malnutrition was recorded at sampling. Data were obtained using a 5.7% and malnutrition 12.4%, whereas in questionnaire and analyzed using the chi 2016 malnutrition was recorded 3, 7% and square test and logistic binary regression. malnutrition 11%. Decreasing poor nutritional status and under-five in children 3. RESEARCH RESULTS has not shown a significant decline (Provincial Health Office of Papua, 2017). Bivariate Analysis Puncak Jaya is one of the districts a. Table 1. Relationship between Age of Mother and Nutritional Status of Children under five in the Papua Province with the geographical No Age Nutritional Status of Children n % conditions of the mountainous regions and under five Less Good the livelihoods of the majority of the n % n % population as farmers who depend on 1 < 21 year 8 28,6 20 71,4 28 100 2 > 21 year 28 38,9 44 61,1 72 100 natural resources (forests), both as a source Total 36 36 64 64 100 100 of income and to meet family needs and p-value = 0,463; RP = 0,735; CI95% (0,382– 1,412) some still depend on nature in meeting life's needs. Based on the preliminary study, the Table 1 shows that out of 28 mothers 2017 nutritional status of toddlers' status in aged less than 21 years there were 8 people of 9,117 toddlers (28.6%) with poor nutritional status and 9 were weighed, toddlers who gained weight people (75%) with good nutritional status. as much as 7,378 (80.92%), while toddlers Whereas from 72 mothers over the age of 21 under the red line (BGM) were 1,709 years there were 28 people (38.9%) with (19.08%). When compared to 2016 the less nutrition status and 44 people (61.1%) number of children under the red line with good nutritional status. The results of (BGM) as many as 9,004 under-fives was the chi square statistical test on the weighed, under fives under the red line significance value of 95% ( = 0.05) (BGM) were 1,653 toddlers (18.35%). This obtained p-value 0.463 or p > α (0.05). This shows an increase in malnutrition status in means that there is no relationship between children under five in Puncak Jaya Regency maternal age and nutritional status of (Puncak Jaya District Health Office, 2017). children under five in the Puncak District of In general, the provision of Puncak Jaya Regency. The results of the nutritional intake for children under five in value of RP = 0.735; CI95% (0.382– 1.412) Puncak Jaya Regency is done with a variety less than 1, so age is a protective factor with of foods. Feeding follows food available as nutritional status of children under five. a menu in adults. There is no special menu provided for babies or balit. As many as 6 b. Relationship between mother's mothers who did not have the right nutrition education and nutritional status of knowledge about providing good nutritional children under five intake from 10 mothers who were made Table 2. Relationship between maternal education and nutritional status of children under five in the Puncak District respondents. The purpose of the study was of Puncak Jaya Regency in 2018 to find out "Factors Associated With No Education Nutritional Status of Children n % under five Nutritional Status in Toddlers in Puncak Less Good Jaya District". n % n % 1 Low 12 25 36 75 48 100 2 High 24 46,2 28 53 52 100 2. RESEARCH METHODS Total 36 36 64 64 100 100 p-value = 0,046; RP = 0,542; CI95% (0,306– 0,959)

International Journal of Science and Healthcare Research (www.ijshr.com) 71 Vol.3; Issue: 4; October-December 2018 Arinius Weya et.al. Factors affecting nutrient status of children under five years at Puncak Jaya district sub province Papuan

Table 2 shows that of the 48 low-educated with malnutrition status in children under mothers there were 12 people (25%) with five are 3,107 times higher than mothers poor nutritional status and 36 people (75%) who do not work. with good nutritional status. Whereas from 52 highly educated mothers there were 24 d. Relationship between food people (46.2%) with poor nutritional status expenditure and nutritional status of and 28 people (53%) with good nutritional children under five status. The results of the chi square Table 4. Relationship between maternal food expenditure and statistical test on the significance value of nutritional status of children under five in the Puncak District 95% ( = 0.05) obtained p-value 0.046 or of Puncak Jaya Regency in 2018 No Expense Nutritional Status of Children n % p> α (0.05). This means that there is a for food under five relationship between the education of Less Good n % n % mothers and the nutritional status of 1 Low 15 46,9 17 53,1 32 100 children under five in the Puncak District of 2 High 21 30,9 47 69,1 68 100 Total 36 36 64 64 100 100 Puncak Jaya Regency. The results of the p-value = 0,183; RP = 1,518; CI95% (0,909– 2,534) statistical test obtained a value of Rp = 0.542; CI95% (0.306– 0.959) with a value Table 4 shows that food expenditure from of <1, so education is a protective factor the family expenditure of mothers of 32 with the nutritional status of children under people with expenditure on low food five. contained 15 people (46.9%) with poor nutritional status and 17 people (53.1%) c. Relationship between the work of with good nutritional status. Whereas from mothers and Nutritional Status of 68 mothers with high food expenditure there children under five were 21 people (30.9%) with poor

Table 3. Relationship between the work of mothers and nutritional status and 47 people (69.1%) nutritional status of children under five in the Puncak District with good nutritional status. The results of of Puncak Jaya Regency in 2018 No Occupation Nutritional Status of Children n % the chi square statistical test on the under five significance value of 95% ( = 0.05) Less Good n % n % obtained p-value 0.183 or p> α (0.05). This 1 Work 14 62,4 3 17,6 17 100 means that there is no significant 2 Not work 22 26,5 61 73,5 83 100 Total 36 36 64 64 100 100 relationship between expenditure on p-value = 0,000; RP = 3,107; CI95% (2,041– 4,731) maternal food and the nutritional status of children under five in the Puncak District of Table 3 shows that of the 17 working Puncak Jaya Regency. The results of the mothers there were 14 people (62.4%) with value of RP = 1.518; CI95% (0,909– 2,534) poor nutritional status and 3 people (17.6%) with a lower value of less than 1, so it is not with good nutritional status. While from 83 meaningful. mothers who did not work there were 22 people (26.5%) with poor nutritional status e. Relationship between knowledge of and 61 people (73.5%) with good nutritional mothers and toddlers' nutritional status. The results of the chi square status statistical test on the significance value of Table 5. Relationship between knowledge of mothers and 95% ( = 0.05) obtained p-value 0,000 or p nutritional status of children under five in the Puncak District <α (0.05). This means that there is a of Puncak Jaya Regency in 2018 No Knowledge Nutritional Status of Children n % significant relationship between maternal under five work and the nutritional status of children Less Good n % n % under five in the Puncak District of Puncak 1 Less 20 95,2 1 4,8 21 100 Jaya Regency. The results of the value of 2 Good 16 20,3 63 79,7 79 100 Total 36 36 64 64 100 100 RP = 3.107; CI95% (2,041– 4,731) p-value = 0,000; RP = 4,702; CI95% (3,005 – 7,359) interpreted that mothers who work at risk

International Journal of Science and Healthcare Research (www.ijshr.com) 72 Vol.3; Issue: 4; October-December 2018 Arinius Weya et.al. Factors affecting nutrient status of children under five years at Puncak Jaya district sub province Papuan

Table 6 shows that out of 21 mothers with less risky with less nutritional status in less knowledge there were 20 people children under five are less than 4 times (95.2%) with poor nutritional status and 1 higher than mothers who are good person (4.8%) with good nutritional status. While from 79 mothers with good g. Relationship between Diet and knowledge there were 16 people (20.3%) Toddler Nutrition Status with poor nutritional status and 63 people Table 7. Relationship between diet and nutritional status of (79.7%) with good nutritional status. The children under five in the Puncak District of Puncak Jaya results of the chi square statistical test on the Regency in 2018 No Diet Nutritional Status of Children n % significance value of 95% ( = 0.05) under five obtained p-value 0,000 or p <α (0.05). This Less Good n % n % means that there is a significant relationship 1 Less 15 83,3 3 16,7 18 100 between maternal knowledge and nutritional 2 Good 21 25,6 61 74,4 82 100 Total 36 36 64 64 100 100 status of children under five in the Puncak p-value = 0,000; RP = 3,254; CI95% (2,132 – 4,966) District of Puncak Jaya Regency. The result of the value of RP = 4.702; CI95% (3,005 - Table 7 shows that out of 18 mothers with a 7,359) interpreted that respondents with less diet less than 15 people (83.3%) with poor risk knowledge with malnutrition status in nutritional status and 3 people (16.7%) with children under five were 4,702 times higher good nutritional status. While from 82 than those with good knowledge. mothers with good children's diet there were 21 people (25.6%) with poor nutritional f. Relationship between mother's status and 61 people (74.4%) with good attitude and toddler's nutritional nutritional status. The results of the chi status square statistical test on the significance

Table 6. Relationship between mother's attitude and value of 95% ( = 0.05) obtained p-value nutritional status of children under five in the Puncak District 0,000 or p <α (0.05). This means that there of Puncak Jaya Regency in 2018 No Attitude Nutritional Status of Children n % is a significant relationship between eating under five patterns and nutritional status of children Less Good n % n % under five in the Puncak District of Puncak 1 Less 18 90 22 10 20 100 Jaya Regency. The results of the value of 2 Good 18 22,5 10 77,5 80 100 Total 36 36 64 64 100 100 RP = 3.254; CI95% (2,132 - 4,966) which is p-value = 0,000; RP = 4,000; CI95% (2,596 – 6,162) interpreted that the diet of children under five is less risky with less nutritional status Table 6 shows that of the 20 mothers who of 3,254 times higher than the diet of a good behaved less there were 18 people (90%) child. with poor nutritional status and 22 people (10%) with good nutritional status. While h. Relationship between mother's eating from 80 mothers with good attitudes there culture and Nutritional Status of were 18 people (22.5%) with poor children under five nutritional status and 10 people (77.5%) Table 8. Relationship between mother's eating culture and with good nutritional status. The results of nutritional status of children under five in the Puncak District the chi square statistical test on the of Puncak Jaya Regency in 2018 No Eating Nutritional Status of Children n % significance value of 95% ( = 0.05) culture under five obtained p-value 0,000 or p <α (0.05). This Less Good n % n % means that there is a significant relationship 1 Less 21 95,5 1 4,5 22 100 between maternal attitudes and nutritional 2 Good 15 19,2 63 80,8 78 100 Total 36 36 64 64 100 100 status of children under five in the Puncak p-value = 0,000; RP = 4,964; CI95% (3,121 – 7,893) District of Puncak Jaya Regency. Results value of Rp = 4,000; CI95% (2,596 - 6,162) Table 8 shows that out of 22 mothers who which is interpreted that mothers who are have a culture of eating there are less 21

International Journal of Science and Healthcare Research (www.ijshr.com) 73 Vol.3; Issue: 4; October-December 2018 Arinius Weya et.al. Factors affecting nutrient status of children under five years at Puncak Jaya district sub province Papuan people (95.5%) with less nutritional status other research variables that more strongly and 1 person (4.5%) with good nutritional influence mothers with underfive nutritional status. While from 78 mothers with good status such as knowledge and attitudes of eating culture there were 15 people (19.2%) mothers. with poor nutritional status and 63 people This is according to Notoamodjo (80.8%) with good nutritional status. The (2011), that increasing age affects one's results of the chi square statistical test on the behavior in gaining knowledge that affects significance value of 95% ( = 0.05) one's attitude. In adulthood, individuals will obtained p-value 0,000 or p <α (0.05). This play an active role in society and social life means that there is a significant correlation and prepare more for the success of efforts between the mother's eating culture and the to adjust to old age, besides that adults will nutritional status of children under five in use more time to read (Fitriani, 2013). the Puncak District of Puncak Jaya Regency. The results of the value of RP = 2. Relationship between mother's 4.964; CI95% (3,121 - 7,893) interpreted education and nutritional status of that respondents with a less risky eating children under five culture with nutritional status of children The results showed that there was a under five were less than 4,964 times higher relationship between the education of than mothers who had a good family eating mothers with nutritional status of children culture. under five in Puncak District, Puncak Jaya District, i.e. 25% of those with low DISCUSSION education had under-five children with poor 1. Relationship between Age of Mother nutritional status, while 46.2% of mothers and Nutritional Status of Children with high education were underweight. This under five research is in line with the research The results showed that there was no conducted by Kristianti (2017) in Pontianak relationship between maternal age and that maternal education is related to nutritional status of children under five in children's nutritional status. Education is the Puncak District, Puncak Jaya Regency, process of changing attitudes and behavior where mothers less than 21 years old were of a person or group of people in an effort to 28.6% with poor nutritional status, while mature people through teaching and training mothers over the age of 21 had children (Prayoto, 2014). Maternal education is the under five as much as 38.9%. This shows main capital in the preparation of family that the proportion of those in the age group meals, child care and care (Suhardjo, 2003 is the same - having a risk in children under in Kristianti, 2017). In this study a portion five with poor nutritional status. This of maternal education was 48% with low research is in line with Labada's (2016) education and 52% with higher education research in Bahu Manado Health Center, and the most was high school. In this study, that the age of the mother does not affect the there was no educational relationship to the nutritional status of the toddler. According nutritional status of children under five due to Prayoto (2014), the older a person is, the to the level of education affecting people's experience will increase so that he will comprehension or thinking power towards increase his knowledge of an object. In this access to information obtained. Thus study the percentage of gizibalita status was mother's education in this case is related to more or less in mothers who were younger the amount of information. than 21 years old. However, this risk factor According to Sulistyaningsih (2011) cannot be explained, this is evident from the that not always mothers with low education results of the prevalence ratio test that is have less knowledge compared to mothers stated as age is not at risk for the nutritional who are highly educated. This is due to status of children. This is influenced by exposure to information, but with higher

International Journal of Science and Healthcare Research (www.ijshr.com) 74 Vol.3; Issue: 4; October-December 2018 Arinius Weya et.al. Factors affecting nutrient status of children under five years at Puncak Jaya district sub province Papuan education makes it easier for mothers to expenses in fulfilling family food security, have the power of thought, so that the but the busyness of working mothers, so the mudha receives the information conveyed. intake or consumption of children's food is There are a lot of low-educated mothers, so less attention that affects the diet of it is expected that Puskesmas efforts in children. As children in mothers who work improving health education about nutrition in care are given to family or caregivers have an impact on increasing knowledge, who are hired, but the mother's own because according to Suhardjo (2009) the attention is different compared to family and low level of education is closely related to carers. Working mothers need to pay the inactivity of mothers who have toddlers attention to children under five in providing to provide food nutrition. The low level of nutritional intake to their children by maternal education affects the receipt of regulating the mother's work schedule and information so that knowledge about feeding time, so that the status of the child's nutrition is hampered or limited. gzi is well maintained.

3. Relationship between the work of 4. Relation of expenditure for mother's mothers and Nutritional Status of food with Toddler Child Nutrition children under five Status The results showed that there was a The results showed that there was no relationship between the work of mothers relationship between expenditure on food and the nutritional status of children under for mothers and nutritional status of children five in the Puncak District of Puncak Jaya under five in the Puncak District of Puncak Regency. Mothers who work have children Jaya Regency. Mothers who have low under five with malnutrition as much as expenditure for food as much as 46.9% of 62.4% and mothers who do not work as people with poor nutritional status and much as 26.5% with poor nutritional status. mothers with expenditures for foods with This shows that many mothers who work high expenditure as much as 30.9% with for children under five have malnutrition of poor nutritional status. The results of the 3,107 times. This research is in line with the value of RP = 1.518; CI95% (0,909– 2,534) research of Khotimah (2013), that work is with a lower value of less than 1, so it is not related to the nutritional status of children meaningful. This research is in line with the under five Work is something that is done to research conducted by Kristianti (2017), that earn a living, make a living (Prayoto, 2014). expenditure on food affects maternal The work environment can make a person expenditure in meeting children's nutritional gain experience and knowledge, both intake. directly and indirectly (Mubarak, 2011). With the mother working, you can Today women have the opportunity to work add expenditure on food affects the family's openly. The basic reason for a woman to purchasing power in meeting the nutritional have a marriage is not the same between one needs of children and other family another. The reason that is commonly found members. Families with more income are is due to financial needs to enrich personal more likely to be good and even excessive experience and knowledge, achievement in meeting food needs, whereas families (Prayoto, 2014). with limited income are more likely to be In this study the proportion of lacking in fulfilling food needs, especially nutritional status of children under five with to meet nutritional needs (Kristianti, 2017). malnutrition status in working mothers, Expenditures for high food and good because of the lack of mothers provides management can affect family spending in supervision to children on the fulfilment of strengthening family food security. High nutritional intake. Although mothers who expenditure on children's eating needs is work will certainly influence family related to nutritional intake according to

International Journal of Science and Healthcare Research (www.ijshr.com) 75 Vol.3; Issue: 4; October-December 2018 Arinius Weya et.al. Factors affecting nutrient status of children under five years at Puncak Jaya district sub province Papuan children's needs. But this is related to the This is certainly a concern for variable knowledge of mothers in the officers about increasing maternal selection of good food, so that high knowledge about nutritional intake for expenditure has not been able to meet the children under five as well as more adequate nutritional needs of families, especially health education efforts for mothers by children. This is evident from the results of collaborating with nutrition cadres in the prevalence ratio test that high family Posyandu with a language that is easily opinion is meaningless. understood, because most mothers have low education, so knowledge the good gives 5. Relationship between mother's lasting action and connects with the knowledge and toddler's nutritional nutritional status of children under five. status The results showed that there was a 6. Relationship between mother's relationship between knowledge of mothers attitude and Toddler's Childhood and nutritional status of children under five Nutrition Status in the Puncak District of Puncak Jaya The results showed that there was a Regency. Knowledgeable mothers were as relationship between maternal attitudes and much as 95.2% with poor nutritional status, nutritional status of children under five in while well-informed mothers as many as the Puncak District of Puncak Jaya 20.3% had children under five with poor Regency. Mothers who have less attitudes nutritional status. The less knowledge of as much as 90% with less nutritional status, mothers increases the incidence of while mothers who have good attitudes as malnutrition status in children under five at much as 22.5% with poor nutritional status. 4,702 times. This research is in line with Mothers who have less attitudes have a Labada's research (2016), that knowledge is chance to have children under five times a factor that is related to the nutritional less 4 times higher than mothers who are status of children. Knowledge is a guideline good. This research is in line with the in shaping one's actions (overt behavior). research conducted by Labada (2016), Behavior based on knowledge will last knowledge related to children's nutritional longer than behavior that is not based on status. A good attitude about child nutrition knowledge (Maryam, 2014). Most human will have an impact on the pattern of knowledge is obtained through the eyes and feeding given to children under five so that ears. Knowledge or cognitive is dominant it affects the nutritional status of children which is very important for one's actions under five (Astuti, 2017). Family attitudes (Prayoto, 2014) and environmental conditions play an Knowledge that is owned by a good important role in feeding children at this mother knows the benefits of posyandu in age, for example by creating a pleasant detecting the nutritional status of children, eating atmosphere (Proverawati, 2011). feeding children who are more recommended to adults, selecting and 7. Relationship between Diet and processing food ingredients that are good at Toddler Nutrition Status feeding their children and mother's The results showed that there was a knowledge about the frequency of eating in relationship between diet and nutritional children. Lack of knowledge will have an status of children under five in the Puncak impact on the actions of mothers in District of Puncak Jaya Regency. Mothers providing good nutrition for mothers, so that who have children with less diet are 83.3% nutritional intake is not in accordance with with less nutritional status while mothers the needs of the body where malnutrition is who have children with a good diet are related to knowledge as much as 95.2%. 25.6% with poor nutritional status. The results of the value of RP = 3.254; CI95%

International Journal of Science and Healthcare Research (www.ijshr.com) 76 Vol.3; Issue: 4; October-December 2018 Arinius Weya et.al. Factors affecting nutrient status of children under five years at Puncak Jaya district sub province Papuan

(2,132 - 4,966) which is interpreted that the status, hunger, appetite, satiety, and health diet of children under five is less risky with (Baliwati, 2009). less nutritional status of 3,254 times higher than the diet of a good child. 8. Relationship between eating culture Diet is a variety of information that and Nutritional Status of children gives an idea of the type and amount of food under five consumed by each person by one person and The results showed that there was a is a characteristic of a particular group of relationship between eating culture and people (Sulistyaningsih, 2011). Toddler nutritional status of children under five in children are passive and active consumers. the Puncak District of Puncak Jaya The food depends on what the mother Regency. Mothers who have a culture of provides. Milk teeth have grown, but cannot eating less as much as 95.5% with less be used to chew food that is too hard. But nutritional status, while mothers with a good children should be directed to follow the eating culture as much as 19.2% with under diet of adults. At 4-5 years old children are nutrition This research is in line with the active consumers, that is, they have been research conducted by Watopa (2015) in able to choose the foods they like. They Waropen District that there is a cultural have been given nutrition education both at relationship between family eating and home and at school. Good habits must be children's nutritional status. instilled. A good diet, if the frequency of The culture of eating is lacking, eating 3 times a day (Almatsier, 2011). namely the mother does not provide The prevalence of the problem of children with certain dietary foods that are eating difficulties according to the child believed, Mother follows the child's development clinic of Affiliated program willingness to eat which is not as diverse as for children development at the University eating rice with soy sauce only, Mother of George Town said that 6 types of eating gives children solid food in children who difficulties in children are only eating liquid are easily satisfied. In addition, mothers do or pulverized food: 27.3%, difficulty not provide certain foods, even though sucking, chewing or swallowing: 24.1% mothers know that food is beneficial for strange and odd eating habits: 23.4%, children. While the culture of eating a good disliking variations in food: 11.1%, self- mother, mothers choose foods that are cheap eating delay: 8.0%, mealing time tantrum: and healthy and diverse. A culture of eating 6.1% (Judarwanto, 2011). that is less at risk for underfive nutritional In this study a good family gives status. This is evident from the prevalence their children to eat regularly three times a ratio test of 4.964 times higher compared to day with the fulfillment of balanced mothers who have a good family eating nutrition, but depends on parents in caring culture. for their children because not all children There are interesting things in Papua, in have the same appetite. Healthy eating general, people still place sago and sweet patterns can not be separated from the input potatoes as the main choice of staple food of nutrition which is the process of for the Papuan people. Anthropologists, organisms using food consumed through the view eating habits as a whole complex of process of digestion, absorption, kitchen-related activities, hobbies, and transportation, storage, metabolism and dislike of a type of food, popular proverbs, expenditure of substances that are not used beliefs, prohibitions and superstitions to maintain life, growth and normal related to production, preparation of food functioning of organs, and produce energy. processing and consumption of food as main A person's diet is influenced by cultural categories of culture (Mapandin, 2006). factors, religion and beliefs, socio-economic According to Kristianto (2013), the culture in feeding children under five occurs

International Journal of Science and Healthcare Research (www.ijshr.com) 77 Vol.3; Issue: 4; October-December 2018 Arinius Weya et.al. Factors affecting nutrient status of children under five years at Puncak Jaya district sub province Papuan because mothers and families have beliefs 2. There is a relationship between the that are based on cultural aspects, so the education of mothers and the nutritional mother decides to provide food in status of children under five in Puncak accordance with the cultural conditions. Regency District Puncak Jaya (p-value The Lani and Dani tribes occupy 0.046; RP = 0.542; CI95% (0.306– Puncak Jaya regency, which is a new 0.959). regency which is the result of the expansion 3. There is a relationship between the work of . Puncak Jaya of mothers and nutritional status of Regency occupies the western part of the children under five in Puncak Regency Baliem Valley. The Puncak Jaya Regency District Puncak Jaya (p-value 0,000; RP area consists of hilly areas, steep ravines, = 3,107; CI95% (2,041– 4,731). high mountains up to 2,500 meters above 4. There is no relationship between sea level (asl). Such topographic conditions expenditure on food for mothers and are like natural isolation which is the cause nutritional status of children under five of this region's underdevelopment. The in Puncak Regency District Puncak Jaya shape of the squiggly land of Mimika has (p-value 0.183; RP = 1.518; CI95% resulted in the making of land roads (0.909– 2.534). difficult. The livelihood of the Lani people 5. There is a relationship between the is farming, the crops they plant are cassava knowledge of mothers and the (Somantri, 2008). nutritional status of children under five in Puncak Regency District Puncak Jaya 9. Dominant Factors (p-value 0,000; RP = 4,702; CI95% The results showed that the (3,005 - 7,359) dominant factors related to the nutritional 6. There is a relationship between maternal status of children under five were the attitudes and nutritional status of knowledge and culture of eating is the children under five in Puncak Regency dominant variable on the nutritional status District Puncak Jaya (p-value 0,000; Rp. of children under five while the attitude is 4,000; CI95% (2,596 - 6,162). an interaction variable. Good knowledge 7. There is no correlation between diet and can choose food ingredients and processing nutritional status of children under five good food. Culture of family eating which is in Puncak Regency District Puncak Jaya considered negative is not practiced by (p-value 0,000; RP = 3,254; CI95% mothers because food is not diverse. (2,132 - 4,966). Knowledge that does not have an impact on 8. There is a relationship between eating fulfilling nutritional intake is supported by culture and nutritional status of children the negative culture that is followed by the under five in Puncak Regency District family, so that the provision of nutritional Puncak Jaya (p-value 0,000; RP = 4,964; intake is not diverse, but this depends on the CI95% (3,121 - 7,893). attitude of the mother. So that interaction 9. Knowledge and eating culture are the attitudes affect the knowledge and culture of dominant variables that are related to the family meals. nutritional status of children under five while attitudes are interaction variables. CONCLUSION Based on the results of the discussion it can REFERENCES be concluded as follows:  Ahira (2012). Sosial Budaya. 1. There is no relationship between http://www.aneahira.com diakses 20 maternal age and nutritional status of September 2017. children under five in Puncak Regency  Allender & Spradley (2005). Keperawatan District, Puncak Jaya (p-value 0.463; RP Komunitas Dalam Kesehatan. Edisi Kelima. Philadelhia: Lippincott. EGC, Jakarta. = 0.735; CI95% (0.382– 1.412).

International Journal of Science and Healthcare Research (www.ijshr.com) 78 Vol.3; Issue: 4; October-December 2018 Arinius Weya et.al. Factors affecting nutrient status of children under five years at Puncak Jaya district sub province Papuan

 Arisman (2011).Gizi Dalam Daur Pontianak. Fakultas Kedokteran Universitas Kehidupan. EGC, Jakarta. Tanjungpura Pontianak  Astuti PA (2017). Status Gizi Balita Di  Labada A (2016). Hubungan Karakteristik Posyandu Melati Desa Sendangadi Mlati Ibu Dengan Status Gizi Balita Yang Sleman Yogyakarta. Jurnal Permata Berkunjung di Puskesmas Bahu Manado. Halaman 18-23 Volume 8, Nomor eJournal Keperawatan (eKp) Volume 4 1, Mei 2017 ISSN 2086-9185. Nomor 1, September 2017.  Badriah D. L (2013). Gizi Dalam Kesehatan  Lewa AF (2016). Faktor-Faktor Yang Reproduksi. Refika Aditama, Jakarta. Berhubungan Dengan Status Gizi Pada  Citerawati, 2012. Aspek Sosiobudaya Balita Usia 6-23 Bulan Dikelurahan Berhubungan Dengan Perilaku Kesehatan. Pantoloan Boya Wilayah Kerja Puskesmas www.google.co.id. Diakses pada tanggal 20 Pantoloan. Promotif, Vol.6 No.1, Januari- September 2017. Juli 2016 Hal 09-16 Artikel II 9.  ______Dinkes Provinsi Papua, 2017. Profil  Maryam S, (2014). Promosi Kesehatan. Kesehatan Papua. Jakarta: EGC.  ______Dinkes Kabupaten Puncak Jaya,  Mapandin Wahida (2006). Hubungan 2017. Profil Kesehatan Kabupaten Mimika. Faktor-Faktor Sosial Budaya Dengan  Ferdous, (2013), Severity Of Diarrhea And Konsumsi Makanan Pokok Rumah Tangga Malnutrition Among Under Five-YearOld Pada Masyarakat Di Kecamatan Wamena, Children In Rural Bangladesh. American Kabupaten Jayawijaya Tahun 2005. Journal Of Tropical Medicine And Hygiene, www.undip.coid. Diakses 25 September 89 (2), 223-228 http://web.ebscohost.com. 2017.  Fuada, N. Muljati, S dan Hidayat, T.S  Mubarak W (2011). Promosi Kesehatan (2011) Karakteristik Anak Balita Dengan Untuk Kebidanan. Salemba Medika, Status Gizi Akut Dan Kronis Diperkotaan Jakarta. dan Perdesaan di Indonesia Jurnal Ekologi  Maryunani (2013). Ilmu Kesehatan Anak Kesehatan. 10 (3):174. Dalam Kebidanan. TIM, Jakarta.  Handayani R (2017). Faktor-Faktor Yang  Moehji S (2009). Ilmu Gizi : Pengetahuan Berhubungan Dengan Status Gizi Pada Dasar Ilmu Gizi, Jakarta. Anak Balita. Journal Endurance 2(2) June  Notaotmodjo S (2011). Ilmu Kesehatan 2017 (217-224) Kopertis Wilayah X 217. Masyarakat, Perilaku, Ilmu dan Seni.  Hasmi (2016). Metode Penelitian Kesehatan Cetakan ketiga. Rineka Cipta, Jakarta.  Fitriani (2013). Promosi Kesehatan. Edisi  Notoatmodjo S (2012). Metode Penelitian Pertama, Graha Ilmu, Yogyakarta. Kesehatan. Rineka Cipta, Jakarta.  ------Kemenkes RI, 2017. Profil Kehatan  Parii, 2014. Penilaian Status Gizi. EGC, Indonesia. www.kemenkes_ri.go.id. Diakses Jakarta. pada tanggal 10 Februari 2018.  Prayoto, (2014). Teori, Sikap & Perilaku  Judarwanto, W. (2010). Sulit Makan dan dalam Kesehatan dilengkapi contoh Gangguan Perilaku. Diperoleh tanggal kuesioner. Nuha Medika: Yogyakarta. 4 Januari 2015 dari  Proverawati A dan Wati E.K (2011). Ilmu http://klinikanakonline.com Gizi Untuk Keperawatan dan G8izi  Khomsan A, 2006. Pangan dan Gizi untuk Kesehatan. Nuha Medika, Yogyakarta. Kesehatan. Jakarta: PT. Rajagrafindo  Rolfes (2011). Understanding nutriiton Persada. USA. Wardsworth. Engage Learning.  Khotimah H (2013). Hubungan  Sediaotemo A. D (2009). Ilmu Gizi Untuk Karakteristik Ibu Dengan Status Gizi Balita Mahasiswa dan Profesi. Dian Rakyat, Di Desa Sumur Bandung Kecamatan Jakarta. Cikulur Kabupaten Lebak;. Jurnal  Soetjiningsish (2012). Perawatan Anak Obstretika Scientia Vol. 2 No. 1 Juni 2014. Sakit. EGC, Jakarta. 146  Suhardjo (2009). Pemberian Makanan Pada  Kristianti D (2017). Hubungan Antara Bayi dan Anak, Kanisus Jakarta. Karakteristik Pekerjaan Ibu Dengan Status  Sujianti (2017). Analisis Faktor Ibu Yang Gizi Anak Usia 4-6 Tahun Di Tk Salomo Berhubungan Dengan Status Gizi Balita di Desa Slarang Kecamatan Kesugihan

International Journal of Science and Healthcare Research (www.ijshr.com) 79 Vol.3; Issue: 4; October-December 2018 Arinius Weya et.al. Factors affecting nutrient status of children under five years at Puncak Jaya district sub province Papuan

Cilacap Tahun 2017. Program Studi D3  Yulianah N, Bahar B dan Salam A, 2013. Kebidanan STIKES Al-Irsyad Al- Hubungan Antara Pengetahuan, Sikap Dan Islamiyyah Cilacap. Prosiding: Seminar Kepercayaan Ibu Dengan Pemberian Asi Nasional dan Presentasi Hasil-Hasil Eksklusif Di Wilayah Kerja Puskesmas Penelitian Pengabdian Masyarakat. Bonto Cani Kabupaten Bone. (Online)  Sulistyoningsih (2011). Gizi Untuk (http://www.fkunhas.co.id diakses 20 Kesehatan Ibu dan Anak. Graha Ilmu, September 2017. Yogyakarta.  Yulianti, J. 2010. HUbungan Antara  Swarjana (2013). Metodologi Penelitian Tintgkat Pengetahaun Ibu dan Praktek Kesehatan. Andi, Yogyakarta. Pemberian Makanan Pendamping ASI  SK Gubernur Tentang Upah Minimum Dengan Status Gizi Bayi Usia 6 – 12 Bulan Regional No. 162 Tahun 2018. (di Puskesmas Karanmalang, Kabupaten www.papua.go.id. (online, Sragen). http://www.unsemar.co.id. diakses http://www.papua.go.id. diakses 20 Februari 10 September 2017. 2018).  Supariasa I.D.N (2012). Penilaian Status How to cite this article: Weya A, Rantetampang Gizi. EGC, Jakarta. AL, Tingginehe R et.al. Factors affecting  Watopa E (2015). Hubungan Pengetahuan nutrient status of children under five years at Ibu Dan Budaya Makan Dengan Pemberian Puncak Jaya district sub province Papuan. Makanan Pendamping ASI Anak Usia 6-24 International Journal of Science & Healthcare Bulan di Puskesmas Urei Faisei Kabupaten Research. 2018; 3(4): 70-80. Waropen. Skripsi Uncen Jayapura.  Wiryo, 2002. Peningkatan Gizi Bayi, Anak Ibu Hamil dan Menyusui dengan Bahan Makanan Lokal, Sagung Seto, Jakarta.

******

International Journal of Science and Healthcare Research (www.ijshr.com) 80 Vol.3; Issue: 4; October-December 2018