%A  . SUTARTO 
%T PENGARUH SOSIAL EKONOMI KELUARGA, BUDAYA, KESEHATAN LINGKUNGAN, GIZI IBU DAN ANAK TERHADAP KEJADIAN STUNTING
DI KABUPATEN WAY KANAN
PROVINSI LAMPUNG
%X Stunting merupakan kondisi kurang gizi kronis disertai komplikasi penyakit infeksi. Faktor deteminan yang berpengaruh pada kejadian stunting sangat beragam mencakup status sosial ekonomi, budaya, kesehatan lingkungan, kesehatan ibu dan anak. Prevalensi stunting di Indonesia menurut data hasil RISKESDAS 2018 (29,9%) dan Provinsi Lampung (27,4%) terbanyak berada di pedesaan. Prevalensi stunting Lampung tertinggi di Kabupaten Way Kanan (36,07%). Pemerintah Daerah Way Kanan melalui Dinas Kesehatan telah melakukan intervensi namun belum berhasil optimal. Melalui penelitian multi variabel dengan analisa model struktural ini dapat memberikan saran masukkan kepada pemerintah daerah dalam rangka untuk pengendalian dan pencegahan stunting di Kabupaten Way Kanan. Tujuan penelitian ini adalah mendapatkan dan menjelaskan model persamaan sosial ekonomi, sosial budaya, kesehatan lingkungan dan kesehatan gizi ibu-anak di Kabupaten Way Kanan sebagai variabel yang berpengaruh secara simultan terhadap kejadian stunting. Penelitian menggunakan metode penelitian deskriptif analitik dengan desain kasus-kontrol. Populasi utama balita usia 2-3 tahun dan ibu kandung sebagai responden. Data primer diambil dari riwayat masa lalu keluarga saat anak usia 0-2 tahun tentang status ekonomi, budaya, ibu saat hamil, bersalin dan pola asuh anak. Pengumpulan data menggunakan metode multistage cluster sampling pada 490 balita (245 kasus - 245 kontrol). Terdapat 7 (tujuh) variabel dengan indikator 51 (lima puluh satu) yang dianalisa menggunakan SEM smartPLS. Hasil uji 16 hipotesis terdapat 12 hipotesis pengaruh yang signifikan variabel status sosial ekonomi dan status sosial budaya terhadap kejadian stunting. Perubahan status sosial ekonomi dan sosial budaya berpengaruh pada status kesehatan lingkungan rumah, status kesehatan ibu saat hamil, status kesehatan ibu paska bersalin, pola asuh dan status kesehatan anak terhadap kejadian stunting. Sosial ekonomi melalui kesehatan lingkungan (sanitasi) rumah, status kesehatan ibu saat hamil, status kesehatan ibu paska bersalin, perilaku pola asuh anak dan status kesehatan anak saat usia 0-2 tahun berpengaruh pada kejadian stunting anak usia 2-5 tahun. Sosial budaya melalui kesehatan lingkungan (sanitasi) rumah, status kesehatan ibu saat hamil, status kesehatan ibu paska bersalin, perilaku pola asuh anak dan status kesehatan anak saat usia 0-2 tahun berpengaruh pada kejadian stunting usia 2-5 tahun. Kejadian stunting di Way Kanan dipengaruhi langsung oleh status kesehatan anak saat usia 0-2 tahun sebesar 31,5%, status kesehatan ibu saat hamil sebesar 20,2%, dan status tinggi orang tua sebesar 4,3%. Kemudian kejadian stunting melalui status kesehatan anak dipengaruhi tidak langsung oleh kesehatan lingkungan rumah sebesar 9,4%, status sosial ekonomi sebesar 22,9%, status sosial budaya sebesar 11,0% dan pola asuh orang tua sebesar 21,5%. Selanjutnya kejadian stunting yang dipengaruhi langsung oleh status kesehatan ibu hamil sebelumnya dipengaruhi tidak langsung oleh status kesehatan lingkungan sebesar 15,8%, status sosial ekonomi sebesar 18,4%, dan status sosial budaya sebesar 19%. Status sosial ekonomi dan status sosial budaya secara bersama-sama dengan keadaan kesehatan lingkungan rumah balita, status kesehatan balita saat usia 0-2 tahun, status kesehatan ibu hamil (saat mengandung balita), pola asuh anak saat usia 0-2 tahun, dan status kesehatan ibu paska bersalin berpengaruh terhadap kejadian stunting di Kabupaten Way Kanan. Kebiasaan budaya senden secara turun menurun di Kabupaten Way Kanan berpengaruh pada kejadian stunting karena senden pada ibu paska bersalin dapat memengaruhi praktik pemberian ASI eksklusif pada anak saat usia 0-6 bulan.
Kata Kunci: budaya, ekonomi, pencegahan, sosial, stunting
Stunting is a condition of chronic malnutrition accompanied by infectious disease complications. The determinant factors that influence the incidence of stunting vary widely, including socioeconomic status, culture, environmental health, and maternal and child health. The prevalence of stunting in Indonesia according to RISKESDAS 2018 data (29.9%) and Lampung Province (27.4%) is mostly in rural areas. The highest prevalence of stunting in Lampung is in Way Kanan Regency (36.07%). The Way Kanan Regional Government through the Health Service has intervened but has not been optimal. Through multi-variable research with structural model analysis, this can provide input suggestions to the local government in the context of controlling and preventing stunting in the Way Kanan Regency. This study aimed to obtain and explain models of socio-economic, socio-cultural, environmental health and maternal-child nutritional health models in Way Kanan District as variables that simultaneously influence the incidence of stunting. This research uses a descriptive-analytic research method with a case-control design. The main population of toddlers aged 2-3 years and biological mothers as respondents. Primary data was taken from past family history when children aged 0-2 years regarding economic status, culture, mother during pregnancy, childbirth and child-rearing patterns. Data collection used the multistage cluster sampling method on 490 toddlers (245 cases - 245 controls). There are 7 (seven) variables with 51 (fifty-one) indicators which are analyzed using SEM smartPLS. The results of the 16-hypothesis test show that 12 hypotheses have a significant effect on the variables of socio-economic status and socio-cultural status on the incidence of stunting. Changes in socio-economic and socio-cultural status affect the health status of the home environment, the health status of mothers during pregnancy, the health status of postpartum mothers, parenting styles and children's health status on the incidence of stunting. Social economy through home environmental health (sanitation), maternal health status during pregnancy, postpartum maternal health status, parenting behaviour and children's health status at the age of 0-2 years affect the incidence of stunting in children aged 2-5 years. Social culture through home environmental health (sanitation), maternal health status during pregnancy, postpartum maternal health status, parenting behaviour and children's health status at the age of 0-2 years affects the incidence of stunting aged 2-5 years. The incidence of stunting in Way Kanan is directly affected by the health status of children aged 0-2 years by 31.5%, the health status of mothers during pregnancy is 20.2%, and the height status of parents is 4.3%. Then the incidence of stunting through children's health status was indirectly influenced by the health of the home environment by 9.4%, socioeconomic status by 22.9%, socio-cultural status by 11.0% and parenting style by 21.5%. Furthermore, the incidence of stunting, which was directly affected by the health status of pregnant women, was indirectly influenced by environmental health status by 15.8%, socioeconomic status by 18.4%, and socio-cultural status by 19%. Socio-economic status and socio-cultural status together with the condition of the environmental health of the toddler's home, the health status of the toddler at the age of 0-2 years, the health status of pregnant women (when carrying a toddler), the child's parenting style at the age of 0-2 years, and the status postnatal maternal health influences the incidence of stunting in Way Kanan District. The cultural habit of sending for generations in Way Kanan Regency affects the incidence of stunting because senden in postpartum mothers can affect the practice of exclusive breastfeeding in children aged 0-6 months..
Keywords: culture, economy, prevention, social, stunting
%D 2023
%I PASCASARJANA
%L eprints74239