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Antenatal Nutrition Social Norms in Indonesia: a Literature Review

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Antenatal Nutrition Social Norms in Indonesia: a Literature Review Advances in Health Sciences Research, volume 30 International Conference of Health Development. Covid-19 and the Role of Healthcare Workers in the Industrial Era (ICHD 2020) Antenatal Nutrition Social Norms in Indonesia: A Literature Review Terry Y.R. Pristya1,*, Azizah Musliha Fitri2, Widayani 3 Wahyuningtyas 1Public Health, Faculty of Health Science, Universitas Pembangunan Nasional Veteran Jakarta, Indonesia 2Nutrition, Faculty of Health Science, Universitas Pembangunan Nasional Veteran Jakarta, Indonesia Corresponding author. Email: [email protected] ABSTRACT Background: Pregnancy was the most important initial period in a thousand days of the golden age of a child's life. Insufficient nutritional intake for pregnant women poses a risk to both the mother and the baby. In some parts of Indonesia, restrictions on food consumption related to social norms during pregnancy still exist. The nutritional content of these foods was important for pregnant women. The purpose of this study was to find a picture of various social nutritional norms during pregnancy in the territory of Indonesia. Methods: This study was a literature review derived from qualitative and quantitative research. Search articles from 2010-2020 came from Google's scholar and PubMed search database with the keywords "social norm" OR "nutrition" OR "pregnancy" OR "belief" OR "food selection" OR "pregnant women" AND "Indonesia". Additional gray literature comes from the desk review and report. The inclusion criteria were only articles related to nutrition, while other behaviors or activities that were not related to nutrition were excluded. Besides, social norms during postnatal or postpartum were also not included in the study. A total of 10 articles were selected. Results: The results of the study showed that some regions in Indonesia prohibit pregnant women even though the food was nutritionally good for mother and baby. Not all studies provide a ban on food and drink as well as for the nutritional social norms of pregnant women in Indonesia. Only three studies provide recommendations on foods and drinks that women should consume during pregnancy. Conclusions: Health workers were expected to play more roles in efforts to educate and promote good nutrition during pregnancy related to the norms prevailing in the society. Keywords: antenatal, nutrition, social norm, food avoidance, pregnant 1. INTRODUCTION However, in certain areas, social norms in the form of abstinence during pregnancy still exist. Prohibition or restrictions on the consumption of Pregnancy is the most important initial period in foods such as meat fish, eggs, vegetables, and fruit the first thousand days of life as the golden day of occur for some reason. The nutritional content of the child's life. Nutrient intake that is not sufficient these foods is important for pregnant women [3]. to meet the needs of pregnant women will In additional to being pregnant, the prohibition on experience energy and protein deficits. The risk consuming certain foods is also during postpartum posed will increase the occurrence of growth because it is considered as an obstacle to the faltering from two-month-old babies to the stunting healing period after childbirth and affects the taste of their babies [1]. and quality of breast milk. Efforts to improve nutrition in the first thousand A study in Europe states that women are days of life help develop children optimally, vulnerable to the perception of information about especially during pregnancy. Interventions carried social expectations, (eg) the perception of social out include two things, namely aspects of specific norms and the role of different reference groups nutrition and sensitive aspects of nutrition. Besides, like other pregnant women, family, and friends. social-environmental support has also been proven We conducted an online trial (Study 2) testing the to improve nutritional status [2]. extent to which pregnant women are vulnerable to Copyright © 2020 The Authors. Published by Atlantis Press B.V. This is an open access article distributed under the CC BY-NC 4.0 license -http://creativecommons.org/licenses/by-nc/4.0/. 274 Advances in Health Sciences Research, volume 30 social norms-based messages compared to non- 4. Limitation of article search is an article pregnant women. The possibility of a moderator published from 2010 to 2020 being explored may have an impact on women's 5. Articles that have only full paper are used in this vulnerability to social norms as well as cultural study aspects which also determine which social norms In its search strategy, data selection uses keywords and guidelines exist. The findings of this project in both English and Indonesian, including: "social can help design effective intervention messages in norm" OR "nutrition" OR "pregnancy" OR "belief" promoting healthy eating behaviors that are OR "food selection" OR "pregnant women" AND specifically targeted at European pregnant women "Indonesia". [4]. Social norms which are inclusion criteria are only In Ethiopia, in terms, of religion there is one social those related to nutrition, while other behaviors or norm for pregnant women is fasting. This is activities that are not related to nutrition are because, according to some of them, fasting might excluded from this study. Social norms during have an impact on perinatal health [5]. In contrast postnatal or postpartum were also not included in to Burnika Faso West Africa, pregnant women in the study. rural areas do not limit their diet during pregnancy. Their additional nutritional burden is not taken into The process of finding literature is carried out by an account in their nutrition practices [6]. Study in author. Then do a qualitative analysis of the articles Eastern Cape South Africa, some pregnant women that have been selected based on the extraction that become susceptible to nutrition due to decreased has been determined together with the second and intake of foods rich in nutrients. The decline was third authors. due to belief in culture and taboo on nutritious food Based on search results using keywords through [7]. search engines using the keywords in the question Some regions in Indonesia still adhere to the and filtered based on eligibility criteria obtained 35 norms surrounding pregnancy. Like for example in appropriate full-text articles. Then, after further Lombok. In terms of environmental health, the checking, there were 25 articles duplicated. Until in children there do open defecation in the open the end only 10 articles were analyzed. Based on the without feeling awkward at all. This is related to analyzed article, the data is then synthesized to the social norms that apply there [8]. In terms of obtain antenatal nutrition social norms in Indonesia. food intake and taboo, in Papua and East Nusa Tenggara (NTT), during pregnancy women are The article search flow is as follows: advised not to eat eggs, rice, tofu, and lentils [9]. There have been many studies in several regions of Indonesia regarding antenatal nutritional social norms. However, not many have made it into a comprehensive study. Therefore, this literature review is expected to be able to find a description of various social nutritional norms during pregnancy in the territory of Indonesia. 2. METHODS This research is a literature review. The article used is both qualitative and quantitative research that discusses social norms during pregnancy that apply in Indonesian society. The selected article is primary data research. Sources of data used in the form of journal publications where research sites are conducted in the territory of Indonesia. Search engine article search comes from a search database on Google scholar and PubMed. Additional gray Figure 1. Flow of Studies Through The Selection literature comes from the desk review and report. Process Eligibility criteria in this study include: 1. Article with a research population of pregnant women in Indonesia 2. Interventions conducted regarding social norms of nutrition that apply in society 3. The text language used is both English and Indonesian 275 Advances in Health Sciences Research, volume 30 3. RESULT In Bali, the results of qualitative research with in-depth interviews of 18 pregnant women showed that they avoid The results of our search obtained as many as ten meat a lot than vegetables because their breast milk will articles that fall into the eligibility criteria can be seen in be a bit sour. On the other hand, nutritional norm social Table 1. The ten articles came from various regions in recommends consuming traditional herbal remedies Indonesia representing the west to the east. These areas during pregnancy to be able to become the baby was include Banten, West Java, Bali, Bogor, Pati, Banjar, vigorous and has been passed down for many Gorontalo, Padang, Kuantan Sengingi that consist of generations. Consumption of tamarind, turmeric, two areas: Pasar Baru Village and Pulau Godang Kari cinnamon, clove, and coconut does not harm their baby Village. because it makes both women and the baby healthier [12]. A cross-sectional study in Bogor of 403 people The study taken is a study in the range 2010 to 2020 eating cereals (rice) with little animal foods for posing a with a variety of study designs. However, studies with risk for poor fetal outcome [13]. qualitative research and conducted through interviews Two villages in Kuantan Sengingi have different social are mostly found here. Participants whose data were norms of nutrition. In Pasar Baru Village on 26 taken were pregnant women. But some studies add pregnant women, a qualitative study using a information from family, husband, village shaman, or questionnaire conducted in 2015 showed that there was midwife. Each study consisted of at least 7 participants a prohibition on the consumption of jangek crackers and at most 403 participants. (cow/buffalo skin) because the women would give birth Table 2 illustrates the prohibited food consumed by to sticky babies and the prohibition of eating spinach. pregnant women in several regions of Indonesia.
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