DETERMINANTS OF HEALTH VISIT AMONG MOTHERS WITH TODDLERS AT THE INTEGRATED HEALTH POST, NGANJUK DISTRICT, EAST JAVA
Ambar Dwi Retnoningrum, Ike Nurrochmawati, Dewi Indriani
School of Health Sciences Satria Bhakti Nganjuk
ABSTRACT
Background: Regular visit to the integrated health post is essential to monitor health and nutritional status of children under five years of age. However, the frequency of visits remained low in Nganjuk District, East Java. This study aimed to determine the factors affecting health visit of children under five at the integrated health post in Nganjuk District, East Java. Subjects and Method: This was a cross-sectional study conducted at Ngetos Integrated Health Post, Nganjuk, East Java, in April 2019. A sample of 100 children under five was selected for this study. The dependent variable was visit to the integrated health post. The independent variables were child age, maternal education, maternal work status, and motivation. The data were collected using questionnaires. The data were analyzed by multiple logistic regression. Results: Visit of children under five years of age to the integrated health post increased with child age (OR= 1.60; 95% CI= 0.90 to 12.20; p= 0.071), higher maternal education (OR= 4.66; 95% CI= 2.13 to 28.14; p= 0.002), working mothers (OR= 2.90; 95% CI= 1.57 to 26.45; p= 0.010), and higher motivation (OR= 2.45; 95% CI= 1.35 to 19.05; p= 0.016). Conclusion: Visit of children under five years of age to the integrated health post increases with child age, higher maternal education, working mothers, and higher motivation.
Keywords: children under five years of age, mothers, integrated health post
Correspondence: Ike Nurrochmawati. School of Health Sciences Satria Bhakti, Nganjuk. Jl. Panglima Sudirman VI Nganjuk, East Java. Email: [email protected]. Mobile: +6282141578108.
BACKGROUND centage of the number of children under five Posyandu is an integrated healthcare center being weighed in Nganjuk Regency in 2016 organized by the community assisted health was 85% (Dinkes Nganjuk, 2016). The num- workers in working area of the Community ber of children under five in Nganjuk Regen- Health Center (Sumini, 2014). Community cy in 2017 was 71,860 children and those who participation in visiting posyandu is still low, weighed 86.6% (Dinkes Nganjuk, 2017). even though the mother's participation in These results still did not meet the 90% posyandu activities will affect nutritional target of the Ministry of Health Republic In- status of children under five. One of the goals donesia. of posyandu is to monitor the improvement The mother's participation at the pos- in the community's nutritional status, yandu was affected by maternal age, edu- especially children under five and pregnant cation, motivation, and work status (Reihana women (Cahyono, 2016). and Duarsa, 2012). Motivation starts from The results of Riskesdas (2010) stated encouragement within oneself and the en- that 23.8% of children under five had never vironment (Sumini, 2014). The impact of been weighed in the last 6 months. The per- inactive mothers with toddlers to posyandu were: (1) Growth and development of child- The 7th International Conference on Public Health Solo, Indonesia, November 18-19, 2020 |80 https://doi.org/10.26911/the7thicph-FP.03.16 ren under five is not monitored; (2) Mothers Maternal education was the last formal did not get health education about toddlers; education taken by the mother as measured (3) Children did not get vitamin A supple- by a questionnaire. Categorical measurement ment; and (4) Toddler's mother did not get scale: 0=
The 7th International Conference on Public Health Solo, Indonesia, November 18-19, 2020 | 81 https://doi.org/10.26911/the7thicph-FP.03.16
(OR= 1.40; 95% CI= 0.17 to 0.98), and it was education were 14.52 times more likely to visit statistically not significant (p= 0.036). That posyandu (OR= 14.52; 95% CI= 4.02 to 52.48), was, mothers with toddlers aged less than 12 it was statistically significant (p <0.000). Not months were 1.40 times more likely to be active working mothers with toddlers were 2.90 times visiting posyandu. Mothers with higher more likely to visit posyandu (OR= 4.29; 95% toddlers were 2.45 times more likely to visit CI= 1.56 to 11.76), it was statistically significant posyandu OR= 8.90; 95% CI= 3.19 to 24.80), (p= 0.003). Highly motivated mothers with and it was statistically significant (p <0.000).
Table 1. Sample Characteristics Activeness Variables No Yes n % n % Toddler age (months) <12 16 51.6 50 72 ≥12 15 48.4 19 28 Maternal education Table 2. Determinants of activeness of mothers with under five years old children in visiting posyandu Activeness 95 % CI Variables No Yes OR p n % n N% Lower limit Upper limit Toddler age (months) <12 16 16 49 49 1.40 0.17 0.98 0.036 ≥12 15 15 31 31 Maternal education The 7th International Conference on Public Health Solo, Indonesia, November 18-19, 2020 |82 https://doi.org/10.26911/the7thicph-FP.03.16 3. Multivariate Analysis mothers do not work, and highly motivated Table 3 showed the determinants increased mothers, which were statistically significant. the activeness of mothers with under five The most influential variable from the results years old toddlers visit to posyandu were of multiple logistic regression analysis was childeren aged <12 months, mother's maternal education. education more than high school graduate, Table 3. Multiple logistic regression analysis determinants activeness mother toddler coming to posyandu at Puskesmas Ngetos Nganjuk East Java Province CI 95% Variables OR p Lower limit Upper limit Toddlers age 2.90 0.90 12.20 0.071 Maternal education 4.66 2.13 28.14 0.002 Maternal work status 1.60 1.57 26.45 0.010 Maternal motivation 2.45 1.35 19.05 0.016 N observation 100 DISCUSSION posyandu was held on weekdays and working This study found that mothers with toddlers hours (Ismawati, 2010). There might be dif- aged less than 12 months were more likely to ficulties in dividing their time in taking care visit actively to posyandu. It was found that of the family and being busy because they maternal education was associated with the have to help their husbands for their finan- activeness of mothers with toddlers to pos- cially needs. yandu. Mothers with the last education of In this study, there was a significant more than high school level education were relationship between mothers' activeness more likely to visit posyandu actively. It can with under-five children with maternal mo- be seen that the higher the mother's edu- tivation visiting posyandu. Highly motivated cation level, the higher the understanding of mothers were more likely to visit posyandu knowledge. than less motivated mothers. Family support In the occupational status, mothers is one of the motivations for mothers to be with no job were more likely to visit posyan- active in bringing their children to posyandu du actively than mothers who worked. The (Kurnia, 2013). With support from families, study of Sativa (2017) stated a significant re- midwives, and maternal cadres, mothers will lationship between work and mothers' active- be more enthusiastic and motivated to par- ness with children under five years aged in ticipate actively in posyandu activities every Posyandu activities at Posyandu Dusun Mla- month. ngi, Sleman Regency. Raharjo (2012) also The results of the multivariate analysis stated a relationship between mothers' work in this study showed toddlers age less than 12 status and active visits to posyandu in Jendi, months, maternal education of more than Selogiri Subdistrict, Wonogiri Regency. The high school graduate, mothers not working, work status of mothers was one of the in- and highly motivated mothers increased the hibiting factors of weighing toddlers at Pos- activeness of mothers with children under yandu. Working mothers could not bring five years age visiting posyandu. And it was their children to posyandu, possibly because satistically significant. The most influential The 7th International Conference on Public Health Solo, Indonesia, November 18-19, 2020 | 83 https://doi.org/10.26911/the7thicph-FP.03.16 factor from the results of multiple logistic posite index of anthropometric failure. regression analysis was maternal education. Jurnal Kesehatan Masyarakat Nasional. In accordance with Sukesi (2018) study 7(12): 538-544. doi: http://dx.doi.org- in Suhardjo, maternal education affects heal- /10.21109/kesmas.v7i12.327 th behavioral changes. Therefore, the higher Reihana, Duarsa (2012). Factors associated the mothers' educational status, the more with maternal participation for weigh- awareness to actively participate in posyandu ing toddler at integrated health post activities. Mothers with a high level of educa- (posyandu). Jurnal Kedokteran Yarsi tion have a better understanding of informa- 20 (3): 143-157. https://media.neliti.- tion. 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