Overview of the first 1000 days of life and stunting in toddlers 0-2 years old in Tegallalang District, Bali Province

ORIGINAL ARTICLE Journal of International Surgery and Clinical Medicine (JISCM) 2023, Volume 3, Number 1: 11-15 E-ISSN: 2807-7008 Overview of the first 1000 days of life and stunting in toddlers 0-2 years old in Tegallalang District, Bali Province Published By : Surgical Residency Program Universitas Syiah Kuala Luh Gede Pradnyawati1*, Dewa Ayu Putu Ratna Juwita1, Komang Triyani Kartinawati1, Made Indra Wijaya1, Anak Agung Sagung Mirah Prabandari1 ABSTRACT Lecturer, Department of Community and Preventive Medicine, Faculty of Medicine and Health Sciences, Universitas Warmadewa. 1 *Corresponding to: Luh Gede Pradnyawati; Lecturer, Department of Community and Preventive Medicine Faculty of Medicine and Health Sciences, Universitas Warmadewa; Received: 2022-10-26 Accepted: 2023-01-22 Published: 2023-02-28 Introduction: The most crucial time for a child’s physical and cognitive development is the first 1000 days of life. Their nutritional state will influence toddlers’ future health, intelligence, and productivity in the first 1000 days of life. The study aimed to describe the first 1000 days of life in toddlers aged 0-2 years. Methods: This cross-sectional study used a household survey in 30 clusters. Five samples of children between 0-1 years old and five samples between the ages of 1-2 years old were selected by simple random sampling from each census block for 300 respondents. Nutrition adequacy was analyzed in Nutrisurvey 2007 program. All data were analyzed descriptively in the SPSS program. Results: The prevalence of stunting in children aged 0-2 in Tegallalang District was 12%. Among children 0-1 years old was 8%, while in children aged 1-2 years was 17%. 41% of pregnant women and toddlers were exposed to secondhand smoke. The rate of exclusive breastfeeding was 44%, vitamin A supplementation was 43.7%, deworming treatment was 52%, and only 20% of people had clean water. There were 115 toddlers aged 1-2 years w deficits in carbohydrates, 140 toddlers with deficits deficiencies, and 80 toddlers with deficits in iron. Conclusion: The problem of stunting in Tegallalang District still exists. Community health workers should encourage women and their male partners regarding second-hand smoke, exclusive breastfeeding, vitamin A supplementation, and deworming treatment. Access to clean water is also urgently required. Further study is needed to determine the modifiable risk factors for stunting. Keywords: Stunting, the first 1000 days of life, toddlers, Tegallalang. Cite This Article: Pradnyawati, L.G., Juwita, D.A.P.R., Kartinawati, K.T., Wijaya, M.I., Prabandari, A.A.S.M. 2023. Overview of the first 1000 days of life and stunting in toddlers 0-2 years old in Tegallalang District, Bali Province. Journal of International Surgery and Clinical Medicine 3(1): 11-15. DOI : 10.51559/jiscm.v3i1.41 INTRODUCTION The first 1000 days of life are crucial as all the important organs and systems of the body begin to develop rapidly. This is a golden period where immune system maturation, optimal physical growth, and cognitive construction occur. However, 1000 days of life that is not optimal may result in stunting.1 Stunting is a nutritional problem caused by an imbalance between food consumption and body needs that occur for a long time. Children are categorized as stunted or experiencing short/very short stature based on the index of body length or height for age with a Z-score of -3 SD to <-2 SD for the short (stunted) category and <-3 SD for the very short (severe stunted) category. The number of children under 5 years old with stunting reached 154.8 million (22.9%) worldwide in 2016, where Asia occupied the highest position compared to other continents, namely 87 million, followed by Africa with 59 million and Latin America with 6 million.2 Indonesia is ranked the 3rd highest prevalence of stunting in Southeast Asia, with a prevalence of 36.4% in 2005-2017. National Health Research (Riskesdas) data in 2018 showed that the prevalence of toddlers with stunted and stunted nutritional status reached 30.8%. (37.2%).3 This is a decrease of 6.4% compared to stunting in 2013 but has not yet met the National Medium-Term Development Plan (RPJMN) 2019 goal, which sets the prevalence of stunting at 28%. World health organization (WHO) states that stunting prevalence should be under 20%. Bali Province is one of the provinces with a prevalence of stunting above the limit set by WHO, which is 24.9%. The ten highest stunting villages in Bali were located in Gianyar Regency, including Tegallalang district.4 The 2015-2017 Nutrition Status Monitoring (PSG) revealed that the prevalence of stunting in Gianyar Regency was 22.5%.5 Socio-economic conditions and environmental sanitation are closely related to the incidence of stunting. Families with low economic conditions may find it difficult to meet nutritional needs and gain access to health services for pregnant women and toddlers.6 Poor sanitation can increase the risk of Published Open access: by Surgical https://jiscm.id/index.php/JISCM/ Residency Program Universitas Syiah Kuala | JISCM 2023; 3(1): 11-15 | DOI: 10.51559/jiscm.v3i1.41 11 ORIGINAL ARTICLE infectious diseases such as diarrhea and intestinal worms, which can affect the nutritional status of toddlers. Long-term worm infections can interfere with the absorption of nutrients in the digestive tract and, in the long term, may disrupt the physical growth of toddlers.7 Reducing the stunting rate by 40% in 2025 is one of the targets of the Sustainable Development Goals (SDGs). To achieve this, the government has established specific and sensitive nutrition intervention programs involving all relevant government sectors.8 Specific nutrition interventions contribute as much as 30% to reducing the prevalence of stunting. This intervention consists of providing supplementary feeding and iron plus folic acid supplement for pregnant women, implementation of integrated antenatal care, counseling of early initiation of breastfeeding (EIBF) and exclusive breastfeeding, monitoring of toddler growth, implementation of the School Children Nutrition program, counseling on clean and healthy living behavior (PHBS), and family planning (KB) for adolescents and adults. The sensitive nutrition intervention programs contributed as much as 70% to reducing the prevalence of stunting. The programs include providing access to clean water and sanitation, health services and family planning, fortification of Vitamins A and D in food, provision of National Health Insurance (JKN), early childhood care education, community nutrition education programs, and provision of assistance and social security for low-income families.9 METHODS Study Design This cross-sectional household survey was conducted in Tegallalang District, Gianyar Regency, Bali Province, Indonesia. We performed interviews with a structured questionnaire to obtain socio-demographic characteristics, the achievement levels of First 1000 Days (...truncated)