Search

Objective: To explore the factors that encompass maternal self-efficacy in providing food for the home. Methods: In-depth interviews were conducted with 19 mothers of nutritionally at risk children in an urban area of East Jakarta, Indonesia. This study was based on Social Cognitive Theory, Family Stress Models, and Ecological Frameworks. Data collection was coded and analyzed using the Grounded Theory Method. Results: Most mothers felt secure in providing food for their families knowing that their relatives and neighbors would support them if they lacked the money to buy food; however, most of them did not supply appropriate meals in terms of nutrient content, variety, and timing. Conclusions and Implications: Maternal self-efficacy was mainly characterized by practical issues concerning the preparation of food at home and a lack of knowledge of health and nutrition. Family-based interventions are needed to enhance competence in providing nutritious food from available resources.

Background: Many children in low and middle-income countries (LMIC) have reduced cognitive abilities, but few studies have explored the influencing factors. Objective: To determine the determinants of children's low cognitive development at 4 to 6-year-old. Methods: This is a retrospective cohort study in year 2021. The data was obtained from Bogor Longitudinal Study of Child Growth and Development (BLSCGD) that started from year 2012. For this analysis, we considered 165 of children aged 4-6 years. The dependent variable in this analysis was cognitive development as measured by the Indonesian Wechsler Preschool and Primary Scale of Intelligence (WPPSI) with the indicators of full-scale IQ (FSIQ), verbal IQ (VIQ), and performance IQ (PIQ). The independent variables were determinants of children's cognitive development at 4-6 years, consisted of socio-demographic factors, determinants from early life (0-23 months), as well as determinants from current conditions. Multivariate analysis done with the logistic regression test. Results: Bivariate analysis revealed that paternal education level was significantly associated with FSIQ and inadequate calorie intake in infancy and poor child stimulation were significantly associated with VIQ. In the final model of multivariate analysis, low paternal education level retained a significant association with FSIQ. Psychosocial stimulation was significantly associated with VIQ and inadequate calorie intake during infancy was significantly associated with PIQ. Conclusion: Low paternal education level and inadequate psychosocial stimulation are risk factors for reduced child cognitive development in 4-6-year-olds. Inadequate calorie intake in infancy even though not statistically significant it has high OR values for low VIQ and PIQ, thus the results showed the importance of calory intake in infancy. [ABSTRACT FROM AUTHOR]

Background: Affordable, locally contextual complementary feeding recommendations (CFRs) that take into account cultural diversity and differences in food availability will be more likely to result in long-term improvements in complementary feeding practices than general recommendations. More objective approaches, such as linear programming (LP), have been recommended to identify optimal but CFRs to meet nutrient requirements given local food availability, food patterns, food portions, and cost.Objective: To present results of our previous studies in which we developed CFRs using LP and to provide an example of how these CFRs can be put into practice in a community intervention trial in Indonesia.Methods: Dietary data were obtained using single 24-hour dietary recall or 1-day weighed diet record combined with 1-day 24-hour recall and 5-day food intake tally. With the use of the LP approach, nutrient intakes were optimized while ensuring that a realistic diet was selected by using constraints such as the diet's energy content, food patterns, food portions, and cost. The price per 100 g of edible portion was obtained from market surveys in two or three local markets in each study area. LP analysis was performed using Super Solver in MS Excel or Optifood software.Results: Iron, zinc, calcium, and niacin were problem nutrients in all age groups of children (6 to 8, 9 to 11, and 12 to 23 months) in both rural and periurban areas, except among children of higher socioeconomic status in urban areas. Thiamin and folate were also problem nutrients found in some settings. Animal-source foods (meat, fish, poultry, and eggs [MFPE] and fortified foods were the nutrient-dense foods identified by LP to fill the nutrient gaps of these problem nutrients.Conclusions: Iron, calcium, zinc, niacin, and potentially folate and thiamine are typical "problem nutrients" in complementary foods of Indonesian children. However, the extent of dietary inadequacy varies across age groups, area, and socioeconomic level. MFPE and fortified foods can improve micronutrient adequacy in complementary feeding diets and should be promoted in CFRs. [ABSTRACT FROM AUTHOR]

Background and Objectives: Social cognitive theory provides the opportunity for program development to enhance healthy personal behvioural characteristics. We devised study to employ social cognitive theory to reduce snacking habits and sedentary activity among overweight adolescents .Methods and Study Design: Eight junior high schools in Makassar city were randomly assigned as intervention and control schools. A total of 238 overweight students aged 11-15 years (BMI z-score >=1 SD, according to a 2007 report from the WHO) were recruited. Adolescents from the intervention schools attended 12 weekly 75-min nutrition education group sessions, which focused on behavioural modification assisted by trained facilitators; furthermore, their parents received weekly nutrition education leaflets. Adolescents from the control schools, but not their parents, received leaflets on evidenced-based nutrition information. The BMI z-scores, waist circumference, snacking habits, sedentary activity, and the adolescents' self-efficacy data were assessed prior to and after 3 months of intervention. The outcomes were analysed on an intent-to-treat basis.Results: Compared with the control group, the intervention group showed a higher reduction in BMI z-scores (-0.08; p<0.05) and waist circumference (-1.5; p<0.05) at 3 months. Significant between-group differences were also observed for decreased snacking habits, but not for sedentary activity. Additionally, the programme improved self-efficacy for reducing these behaviours. Mean compliance and satisfaction with the programme were 95% and 92%, respectively.Conclusions: These high reduction rates suggest that the programme is promising and may address the problem of overweightness in adolescents. Additional studies are required to develop the programme in community settings. [ABSTRACT FROM AUTHOR]

Introduction: Childhood stunting is associated with poorer child health, growth and development including diminished cognitive abilities. Mapping out the links between child stunting and Early Childhood Education and Development is critical to increasing understanding of the causes and effects of childhood stunting, and for programme and policy development. The aim of this study is to investigate and compare the development and educational environments across India, Indonesia and Senegal, and to identify the multifactorial drivers and impacts of childhood stunting to inform a new typology., Methods and Analysis: This current study is part of an interdisciplinary observational research study, where women are recruited during pregnancy and mother-infant pairs followed prospectively, up to 24 months after birth. Eight measures will be used to profile children's early development and learning environments in two sample cohorts: (A) children aged 12 and 24 months born to the women recruited during pregnancy (ie, 500 pregnant mothers per country) and (B) a preschool case-control cohort of siblings from the main cohort aged between 3:6 and 5:6 years of age where anthropomorphic measures will be collected to assess degrees of stunting. Profiling of the development and learning environments in the countries will include both parent/caregiver self-reported and local staff (enumerators) direct assessments of children and settings., Ethics and Dissemination: This study was approved by the institutional ethics committees of all partner institutions. In India, Indian Council of Medical Research-National Institute of Nutrition, Hyderabad; In Indonesia, Ethics Committee of the Faculty of Medicine, University of Indonesia; and in Senegal, National Ethics Committee for Scientific Research in Senegal.The findings of the study will be disseminated in national and international meetings, seminars, conferences and peer-reviewed journals., Competing Interests: Competing interests: None., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY. Published by BMJ.)

Introduction: Stunting is a significant and growing global problem that is resisting scientific attempts to understand it in terms of direct nutrition-related determinants. In recent years, research included more complex, indirect and multifactorial determinants and expanded to include multisectoral and lifestyle-related approaches. The United Kingdom Research Initiative Global Challenges Research Fund's (UKRI GCRF) Action Against Stunting Hub starts on the premise that dominant factors of stunting may vary between contexts and life phases of the child. Thus, the construction of a typology of clustered factors will be more useful to design effective programmes to alleviate it.The Shared Values theme seeks to build a bottom-up holistic picture of interlinked cultural contextual factors that might contribute to child stunting locally, by first eliciting shared values of the groups closest to the problem and then enquiring about details of their relevant daily activities and practices, to reveal links between the two. We define shared values as what groups consider 'valuable, worthwhile and meaningful' to them., Methods and Analysis: We will recruit 12-25 local stakeholder groups in each site (in India, Indonesia and Senegal) involved in children's food and early learning environments, such as mothers, fathers, grandmothers, teachers, market vendors and health workers. The WeValue InSitu process will be used to assist them to collectively elicit, negotiate and self-articulate their own shared values through exploration of shared tacit knowledge. Focus group discussions held immediately subsequently will ask about daily activities relevant to the children's environment. These contain many examples of cultural contextual factors potentially influencing stunting locally, and intrinsically linked to shared values articulated in the previous session., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY. Published by BMJ.)

Anemia is one of the major problems among female adolescents in Indonesia. Weekly iron-folic acid supplementation was a cost-effective measure to tackle adolescent anemia. However, adherence to the supplementation is low. This study was aimed to explore the determinants of t highschool females' adherence to consume iron-folic acid tablets. Using cross sectional design with 274 subjects. After obtaining consent the data were collected, coded and analysed using SPSS23. The inclusion criteria were high school female from 18 schools which had iron tablets program. The majority of subjects was 14-16 y old (73.7%). The majority of schools gave iron tablets to students without organizing taking iron tablets together (63.5%). The adherence to consume iron and folic acid tablets in this study was 45.6% (n=125). Almost half of highschool female (36.1%) cited they did not think that iron tablets are necessary while 12.4% cited experiencing side effects. Factors that were correlated (p<0.005) were school organizing taking iron tablets together, the student's age, knowledge, motivation, self efficacy, prior Hb level examination, and teacher educating the benefits of iron tablets to students (OR=9.5, CI=5.4-16.8, OR=0.43, CI=0.23-0.78, OR=2.12, CI=1.29-3.48, OR=6.55, CI=3.77-11.4, OR=6.39, CI=3.7-10.9 respectively). The most important factors which determined highschool female's adherence were school organizing students to take iron tablets together at school (OR=7.2, CI=3.5-14.6, p=0.000), student's motivation (OR=5.3, CI=2.5-11.3, p=0.000), and class teacher educating students on anemia and IFA (OR=2.3, CI=1.2-4.6) meanwhile student's knowledge, self efficacy, and prior Hb level examinations were confounding factor.

The aim of this study was determine mothers knowladge on appropriate complementary feeding of children aged 6-23 mo. A cross-sectional design was applied on 392 mothers of children aged 6-23 mo selected through a cluster sampling in Aceh Besar District Aceh Province Indonesia. Data on mothers knowledge and determinant factors included socio-demographic of mothers were collected using valid and reliable structured questionnaire. The data was analyzed using binary logistic regression at 95% confident interval. Overall, there was less than one-fourth (20.2%) of the mothers have good knowledge on appropriate Complementary feeding. Education level of mothers were significantly associated with mothers knowledge, mothers who have education level elementary school, junior high school and senior high school higher risk of having low knowledge on appropriate complementary feeding (OR=3.11, OR=5.22 and OR=10.20) than those have graduted level. Therefore, an effort and a research to developing nutrition education model is warranted to improving knowledge and skill of mothers is important.

Undernutrition and iron deficiencies on under-five children in Indonesia remain high and very closely related to inadequate complementary feeding. This study investigated the effect of weekly nutrition education by home visite using the food monitoring card (FMC) models and daily provision multi-nutrient biscuits and combination on growth and reduction of iron deficiency and anemia among underweight children aged 6-23 mo in Aceh Indonesia. A 6-mo, cluster randomized, control trial was conducted on 121 children received nutrition education (NE), multi-nutrient biscuit (MNB), combination both nutrition education and biscuits (NE+MNB), and control group. The outcome weight gain and prevalence of underweight (weight for age z-score <-2SD) were collected by anthropometric and iron deficiency were serum ferritin measuring with ELISA method. After the 6-mo intervention, the rate of weight gain was higher in combination intervention group 1.51±0.68 kg than multi-biscuit group 1.40±0.72 kg, NE group 1.34±0.66 kg and control group 1.21±0.42 kg, and the rate increase of serum ferritin was higher in combination NE+MNB and biscuit group (2.54 μg/L and 2,17 μg/L). At the end of study there were a significant decrease in prevalence of underweight (p=0.003), the incidence of underweight in NE+MNB (45.2%) lower than NE group (63.3%), MNB group (64.5%) and control group (69,0%) and significant decrease of iron deficiency (p=0.02), the incidence lower in MNB group (6.5%) than NE+MNB (22.6%), NE group (23.3%) and control group (24.1%). The combination of nutritional education and multi-nutrient biscuits intervention improving nutritional and iron deficiency status on undernourished children. These risearch highlight the need integration of nutrition education and food base intervention to prevent underweight and iron deficiency on children 6-23 mo old.

Background/objectives: The 6-23 months for infants is the longest period in the "first 1,000 days" of life. This period is very important for child development, so complementary feeding (CF) practices should be optimized to maximize children's potential for growth and development. The aim of this study was to analyze the CF practices and nutritional status of children aged 6-23 months., Subjects/methods: For this cross-sectional study, 392 children aged 6-23 months were selected using stratified random sampling. Socio-demographic data were collected through interviews. CF practices, collected by interviews and repeated 24-hour food recall method, were the timely introduction of CF, minimum meal frequency, dietary diversity and minimum acceptable diet, consumption food rich in proteins and vitamin A. Nutritional status was assessed using the indicators of underweight, wasting and stunting. To analyze the association between socio-demographic indicators and CF with nutritional status, the chi-square test with a confidence interval of 95% was used., Results: Results showed that 39% were exclusively breastfed, only 61% received prolonged breastfeeding and 50% received timely introduction of CF. Minimum meal frequency was met by 74% of subjects, but dietary diversity and minimum acceptable diet were only realized in 50% and 40% of the children, respectively. The prevalence of underweight, wasting, and stunting were 26%, 23%, and 28%, respectively. Age of the child, birth order, birth weight, parents' education level, family size and incidence of fever and diarrhea during the previous two weeks were associated with underweight, while child's birth order, fathers' education level, mother's age, family size, completion of the age-appropriate vaccination and fish consumption frequency were associated with wasting. Age of the child, incidence of fever and acute respiratory infection, and fortified food consumption were associated with stunting., Conclusions: Suboptimal CF practices and high prevalence of underweight, wasting and stunting were found among children aged 6-23 months old in Aceh. These results highlight the need to improve CF and nutritional status., Competing Interests: CONFLICT OF INTEREST: The authors declare no potential conflicts of interests.