Efectivity of Nutrition Education Using Food Monitoring Card Model and Fortified Biscuit to Improving Complementary Feeding Practice, Growth and Anemia Status of Underweight Children aged 6-23 months in Aceh
Undernutrition and micronutrient deficiencies among underfive children in Indonesia remain high. Indonesian National Basic Health Survey in 2013 showed that 19.65% of children suffered from underweight, 35.6% from stunting and 28.1% from anemia. Aceh is the seventh highest for prevalence of underweight and stunting in Indonesia. In 2013, there was 26.3% suffering from underweight, 41.5% from stunting and 67.8% from anemia. One of critical periods for underfive children is 6-23 months of age. This is a transition period from exclusive breastfeeding to complementary feeding and the biggest part of the first 1000 days of life with total of 18 months out of 24 month period after birth. The high number of undernutrition and macro- and micronutrients deficiencies among infants and toddlers are very closely related to the inadequate complementary feeding and inappropriate practice of breastfeeding. World Bank (2010) reported three broad group interventions demonstrated effectiveness in many countries by reducing child mortality and improving nutrition outcomes, namely behavior change intervention, micronutrient intervention and complementary feeding, and also therapeutic feeding intervention.
The objective of this research is to analyze the effectiveness of nutrition education using the Food Monitoring Card Model in improving feeding practices as well as its impact on the growth and anemia status of undernourished children aged 6-23 months in Aceh Besar District. This research is conducted in three stages; the first stage, preliminary studies (formative study) using a cross sectional study design both qualitative and quantitative to determine knowledge, affection and complementary feeding practice and to identify problems related to complementary feeding and food availability. The second stage: Food Monitoring Card (FMC) Development and building capacity of the cadre as the facilitator of education. The third stage, intervention study using experimental research design with Cluster Randomized Control Trial (RCT) to determine the efficacy of nutrition education model combined with Multi Nutrient (MNB) biscuit intervention in improving the knowledge, attitude, intention and complementary feeding practice as well as growth and anemia. A total of 284 children 6-23 month age for formative study will be taken as subjects which then 156 samples (39 in each intervention group) is taken for study intervention study using cluster random sampling method. Variables collected in this study are knowledge, affection, motivation and practices about complementary feeding, growth variables (weight, height) collected by anthropometric measurement, anemia status including hemoglobin level by Cyanmethemoglobin method and serum ferritin measurement by ELLISA method.
To analyze effectiveness of the intervention on output and outcome variables, statistical analysis of dependent t-test, independent t-test and Analysis of Variance (ANOVA) test using 95% confidence level is used.