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"Kemiskinan merupakan salah satu penyebab utama timbulnya masalah gizi kurang pada balita di perkotaan. Pola asuh keluarga dan kurangnya pengetahuan orang tua terkait kebutuhan gizi anak juga dapat mempengaruhi status gizi balita. Karya ilmiah ini bertujuan untuk memberikan gambaran tentang pengaturan pola makan bergizi seimbang sebagai upaya meningkatkan status gizi balita dengan masalah ketidakseimbangan nutrisi kurang dari kebutuhan tubuh. Metode yang digunakan dalam karya ilmiah ini yaitu melakukan asuhan keperawatan keluarga selama tujuh minggu. Intervensi keperawatan unggulan berupa pengaturan pola makan pada balita meliputi pengaturan 3J yaitu jenis makanan, jumlah makanan, dan jadwal makan. Hasil evaluasi menunjukkan bahwa pengaturan pola makan efektif dalam meningkatkan status gizi balita ditandai dengan adanya peningkatan berat badan dari 14,5 kg menjadi 16,5 kg. Karya ilmiah ini direkomendasikan kepada perawat komunitas untuk menerapkan intervensi berupa pengaturan pola makan dalam melakukan asuhan keperawatan keluarga dengan balita yang memiliki masalah gizi kurang.

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Poverty is one of the main causes of under-five-year-old children malnutrition problems in urban areas. Besides that, parenting and lack of parental knowledge related to the nutritional needs of children can also affect the under-five-year-old children nutritional status. This paper aims to provide an overview of eating pattern regulation in balanced nutrition as an effort to improve the under-five- year-old children nutritional status with imbalanced nutrition problem less than body requirements. The method used in this paper is by doing a family nursing care for seven weeks. The main nursing intervention of eating pattern regulation in under-five-year-old children include 3J, that is, the type of food, quantity of food, and eating schedules conducted over five weeks. The results showed that eating pattern regulation is effective in improving the under-five-year-old children nutritional status that is marked by an increase of body weight from 14.5 kg to 16.5 kg. This paper is recommended for community nurses to implement interventions in the form of eating pattern regulation in performing nursing care families with under-five-year-old children who have a malnutrition problem."

"Praktek pemberian makanan yang tidak memadai adalah salah satu penyebab utama kekurangan gizi. Wasting dan stunting biasanya meningkat antara usia 6 sampai 23 bulan. Minimum Acceptable Diet (MAD) adalah salah satu indikator utama untuk menilai praktik pemberian makan bayi dan anak yang menggabungkan Minimum Meal Frequency (MMF), Minimum dietary diversity (MDD) berdasarkan status pemberian makan. Tujuan penelitian ini untuk memperoleh informasi secara mendalam dan memperoleh fakta terkait faktor penghambat dan pendukung dalam praktik pemberian makan bayi dan anak usia 6-23 bulan di Jakarta Pusat. Penelitian ini menggunakan metode kualitatif dengan pendekatan Rapid Assesment Procedure (RAP) dengan metode pengumpulan data Focus Group Discusion (FGD) dan wawancara mendalam terhadap infroman ibu dengan anak MAD tercapai sebanyak 23 informan dan tidak tercapai sebanyak 31 informan, kader Posyandu sebanyak 3 informan, dan Petugas Gizi sebanyak 3 informan. Faktor penghambat dalam keberhasilan praktik pemberian makan bayi dan anak yaitu, keterbatasan fasilitas memasak, pemberian makanan selingan yang lebih sering disbanding makanan utama, kebiasaan pemberian MPASI dini dalam keluarga, pelatihan PMBA untuk kader belum menyeluruh, dan keterbatasan tenaga gizi, sedangkat faktor pendukung yaitu, pengetahuan dan sikap ibu yang baik, akses pelayanan kesehatan yang mudah dicapai, keaktifan ibu dalam kegiatan Posyandu, dan daya beli keluarga yang baik mempengaruhi keberhasilan praktik pemberian makan bayi dan anak usia 6-23 bulan. Perlu adanya monitoring dan evaluasi dalam pelaksanaan kegiatan penyuluhan/konseling pemberian makan bayi dan anak di lapangan, membuat inovasi kedai balita sehat yang berisikan jajanan sehat yang aman dan bergizi baik bagi balita yang dibina secara langsung oleh dinas kesehatan, melakukan kegiatan penyegaran (refreshing) kepada fasilitator kota, Puskesmas, dan kader Posyandu, dan melibatkan anggota keluarga lain dalam melakukan penyuluhan dan konseling pemberian makan bayi dan anak.

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Inadequate feeding practices are one of the main causes of malnutrition. Wasting and stunting usually increase between the ages of 6 to 23 months. The Minimum Acceptable Diet (MAD) is one of eight core indicators for assessing infant and young child feeding practices that is composite indicators composed of the Minimum Meal Frequency (MMF) and Minimum Dietary Diversity (MDD). The purpose of this study is to obtain in-depth information and obtain facts related to inhibiting and supporting factors infant and young child feeding practices at 6-23 month in Central Jakarta. This study uses a qualitative method with the Rapid Assessment Procedure (RAP) with the Focus Group Discussion (FGD) and in-depth interviews with mothers in children achieve by MAD as 23 informants and not achieve by MAD as 31 informants, Posyandu cadres as 3 informants, and Nutritionists as 3 informants. Inhibiting factors in infant and young child feeding practices is limited cooking facilities, provision of distinctive food more often than the main food, preparation of early complementary feeding in the family, IYCF training for cadres has not comprehensive. Supporting factors in infant and young child feeding practices is good knowledge and attitude of mothers, access to health services that are easily achieved, active mothers in Posyandu activities, and good family purchasing power increase the success of the infant and young child feeding practices aged 6-23 month. There is a need for monitoring and evaluation in the implementation of counseling / counseling activities for infant and child feeding in the field, making healthy toddler shops containing healthy snacks that are safe and nutritious both for toddlers who are directly fostered by the health department, conducting refreshing activities for facilitators cities, Puskesmas, and Posyandu cadres, and invite other family members to conduct counseling of the infant and young child feeding practices."

"Gizi kurang menjadi salah satu masalah kesehatan yang sering ditemukan di wilayah perkotaan yang disebabkan karena faktor sosial ekonomi, lingkungan dan pengetahuan ibu. Balita merupakan salah satu kelompok usia yang rentan mengalami masalah gizi. Karya Ilmiah Akhir Ners ini menggambarkan asuhan keperawatan keluarga dengan balita yang memiliki masalah ketidakseimbangan nutrisi dari kebutuhan tubuh. Implementasi unggulan yang telah dilakukan yaitu edukasi gizi seimbang tinggi energi dan tinggi protein selama 3 minggu dan dilakukan kunjungan 4 kali dalam satu minggu. Edukasi diet tinggi energi dan tinggi protein ini dimana menjelaskan bahwa dalam 1 kali pemberian makan mengandung energi dan protein di atas kebutuhan normal. Evaluasi yang didapatkan yaitu meningkatnya kepatuhan dalam memberikan makan tinggi energi dan protein secara konsisten memberikan sumber protein tinggi (susu, telur, daging) dan adanya peningkatan berat badan anak sebanyak 500 gram dari 9 kg menjadi 9,5 kg. Intervensi edukasi gizi seimbang tinggi protein dan energi dapat meningkatkan berat badan anak. Peningkatan pengetahuan ibu dalam penyusunan menu makanan anak sesuai dengan tinggi energi dan tinggi protein untuk balita gizi kurang perlu ditingkatkan agar mendapatkan peningkatan berat badan lebih signifikan.

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Malnutrition is one of the health problems that are often found in urban areas caused by socioeconomic, environmental and maternal knowledge factors. Toddlers are one of the age groups that are prone to nutritional problems. This Ners' Final Scientific Work describes the nursing care of families with toddlers who have nutritional imbalance problems from the needs of the body. Featured implementation that have been carried out is education of balanced nutrition high in energy and high in protein for 3 weeks and visits 4 times in one week. This high-energy and high-protein diet education explains that in 1 feeding contains energy and protein above normal needs. The evaluation obtained was an increase in compliance in providing high-energy and protein foods consistently providing high protein sources (milk, eggs, meat) and an increase in children's body weight by 500 grams from 9 kg to 9.5 kg. The intervention in balanced-nutrition education high in protein and energy can increase children's weight. Increasing maternal knowledge in the preparation of children's food menus in accordance with high energy and high protein for undernourished toddlers needs to be improved in order to get a more significant weight increase."

"Gizi kurang pada balita menjadi masalah kesehatan perkotaan hal ini dapat disebabkan karena berbagai faktor, salah satunya adalah pola makan yang salah dan tidak sesuai. Perawat komunitas berperan untuk memberikan asuhan keperawatan keluarga dalam membantu mengatasi masalah gizi kurang pada balita. Salah satu intervensi keperawatan yang dilakukan dalam upaya mengatasi masalah gizi kurang adalah optimalisasi pola makan balita dengan melibatkan peran keluarga. Intervensi diberikan kepada keluarga dengan balita gizi kurang di Kelurahan Sukatani, Depok selama 6 minggu. Evaluasi didapatkan hasil keaktifan peran serta keluarga dalam menerapkan pola makan sesuai dengan jadwal menu harian yang disusun bersama, hal ini dapat dilihat dari adanya peningkatan berat badan balita. Peran serta keluarga dalam optimalisasi pola makan balita efektif dalam upaya meningkatkan berat badan balita.

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Malnutrition among children under five had become urban health problem, this can be caused by various factors, one of which is the wrong and not appropriate eat pattern of the children. Community nurse have a role as care provider in nursing care to helping families with the problem of malnutrition. One of the nursing interventions is the optimum of eat pattern to a children under five by involving the family. Interventions provided to families with children under five malnutrition in Sub Sukatani, Depok for 6 weeks. Evaluation of the results obtained of the family in applying the apropriate eat pattern in accordance with the schedule arranged with daily menus, it can be seen from the increase in weight children. The family involvement in the optimization of the toddler eat pattern effective in promoting weight children."

"ABSTRAKPerkotaan merupakan wilayah yang memiliki kepadatan penduduk yang besar. Kemiskinan yang terjadi akibat tingginya arus urbanisasi menjadi salah satu penyebab timbulnya masalah kesehatan di daerah perkotaan. Gizi kurang pada balita menjadi masalah utama yang perlu diselesaikan di wilayah perkotaan. Karya Ilmiah Akhir ini menggambarkan asuhan keperawatan keluarga Bapak S dengan masalah ketidakseimbangan nutrisi kurang dari kebutuhan tubuh pada balita yang dilakukan selama 7 minggu. Penyebab dari ketidakseimbangan nutrisi pada Anak F (36 bulan) yaitu asupan yang tidak adekuat akibat perilaku mengkonsumsi susu formula secara berlebihan dan buruknya manajemen lingkungan makan. Intervensi yang dilakukan bersifat kognitif, afektif dan psikomotor dengan menggunakan pendekatan lima tugas kesehatan keluarga. Implementasi unggulan yang telah dilakukan yaitu pengaturan jadwal dan lingkungan makan yang menyenangkan saat anak makan. Evaluasi yang didapat yaitu adanya peningkatan berat badan Anak F dari 13,5 kg menjadi 14,5 kg. Pengaturan jadwal dan kreativitas dalam menciptakan lingkungan makan yang menyenangkan harus diterapkan secara konsisten, pengetahuan keluarga terkait nutrisi juga perlu terus ditingkatkan sebagai upaya mengatasi masalah gizi pada balita.

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ABSTRACTUrban is an area with a very dense population. Poverty which happens because of an increasing urbanization can be one of causes for urban health problems. Less Nutrition on child maybe the main problem that have to be done on urban community. This final scientific paper ners illustrate nursing care on Mr. S’s family with imbalance nutrition less than body problem which implemented for 7 weeks. The reasons for imbalance nutrition on child F are inadequate nutrition which caused by habit of consumption formula milk too excessive and bad management environment for eat. Intervention tends to aspect cognitive, affective, and psikomotor with used of five family health tasks. Main implementation which has be done are schedule ad environment setting for fun eating. The result from an evaluation is increasing weight on child F from 13,5 kg became 14,5 kg. Schedule setting and creative environment to create fun environment when eating have to be applied consistently, knowledge of family about nutrition need to be increased as an effort to overcome nutrition problem on child."

"ABSTRACTThe social impact of the crisis in Indonesia, both monetary and natural disaster had been investigated by some studies. There is empirical evidence at national level that suggests the crisis impact is very heterogeneous both between urban and rural areas and across regions. It is also found that there is little connection between initial poverty levels and the extent to which an area had been hit by the crisis. The main objective of this study was to investigate the influence of the recent economic crisis and the benefit of the Social Safety Net Program for the nutritional status of under-five children during the economic crisis in selected poor areas of Indonesia. A cross sectional study to get information on the nutritional status of children and its determinants in urban poor area of Jakarta, and rural areas of Banggai in Central Sulawesi, and Alor-Rote in East Nusa Tenggara was followed by another cross sectional study in one selected poor urban area of Cilincing sub-district, Jakarta to see the changes of key determinant(s) of the under-five children's nutritional status after receiving the Social Safety Net intervention program for 1 year period. Two-stage cluster sampling was used to get 1078 households with under-five children in the urban poor area of Jakarta, and 262 and 631 households with under-five children each for the rural areas of Banggai and Alor-Rote, respectively as the subjects of the cross-sectional study-1; and 587 households with under-five children for the cross sectional study-2 in poor urban area of Cilincing sub-district. For both studies, general socio-demographic characteristics, socio-economic, health and nutritional status, and child feeding practices data were collected through interview and observation methods using structured questionnaires. Anthropometrical assessments (of weight, stature, and arm-circumference) were done both for children and their mothers in both studies. Hemoglobin assessment was done for sub-samples of approximately 50% of the total under-five children in both studies. Quality control procedures were performed during the course of the study. Data collection for both studies was performed from January 1999 to January 2001. It revealed that 34% of fathers in the study area of Jakarta had finished junior high school and even less for mothers (22%). More than 70% of the fathers had no regular income and 7% of the sample households had both the fathers and mothers work regularly. About 42 % of the sample households was classified as having sufficient purchasing power and less that 60% of sample households was classified as having appropriate luxury goods (mostly of electronic goods). For the study area in Banggai, 23% of fathers had finished junior high school and even only 10% for mothers. Approximately 14% of the fathers had no regular income and 24% of the sample households was classified as having appropriate employment status. About 45% of the sample households was classified as having sufficient food production/purchasing power in this study and less than 50% of the sample households was classified as having appropriate luxury goods (mostly of cultivated land). For the study area in Alor-Rote, 23% of fathers had finished junior high school and even only 10.9% for mothers. Approximately 21% of the fathers had no regular income and 47% of the sample households had both the fathers and mothers work regularly. About 48% of the sample households was classified as having sufficient food production/ purchasing power in this study and 26% of sample household was classified as having appropriate luxury goods (mostly of cultivated land). Besides having a high severity of anemia (>40%), under-five children in the urban poor area of Jakarta had a very high severity of wasting (>15%) as compared to the medium severity of stunting condition (20-29%). Similar findings were found for the rural area of Banggai. Different findings for the rural area of Alor-Rote were only for its very high severity in stunting condition (>40%). By multivariate and path analyses, it was shown that Jakarta as the study site contributed significantly to the variation of wasting indicator (WHZ value) as the recent-type of malnutrition, and Alor-Rote as the study site contributed significantly to the variation of stunting indicator (HAZ value) as the longterm-type of malnutrition. For hemoglobin value, both Jakarta and Alor-Rote as the study sites contributed to its variation. High prevalence of infectious diseases in all study areas were significantly related to the higher prevalence of wasting in the study areas of Jakarta and Banggai, and also significantly related to the higher prevalence of stunting and anemia in the study area of Alor-Rote. For Jakarta, besides infectious diseases, BMI status of mothers and the possession of motorcycle used for income earning were also significantly related to the prevalence of wasting. On the other hand, for Alor-Rote, besides infectious diseases, possession of luxury goods (access to electricity, possession of transportation facility and electronic goods), environmental sanitation (housing conditions), maternal nutritional knowledge and access to complete immunization were also significantly related to the prevalence of stunting. And, infectious diseases and households' employment status contributed to the variation of stunting (HAZ value). Furthermore, for anemia, access to health services (for complete immunization) was the only key determinant which contributed significantly to the variation of hemoglobin value in Jakarta. For Alor-Rote, besides infectious diseases, formal education of the parents, employment status (especially working mothers), environmental sanitation (especially access to safe drinking water), maternal nutritional knowledge and access to health services were also significantly associated with the prevalence of anemia. And, infectious diseases, environmental sanitation, access to health services and households' employment status contributed significantly to the variation of hemoglobin value in Alor-Rote. The Social Safety Net Intervention Program in the urban poor area of Cilincing sub-district, Jakarta resulted in significant improvement in the prevalence of wasting and anemia among under-five children but not for the prevalence of stunting. It was also found that maternal and childcare, access to health services and hemoglobin were still retained as determinants of child malnutrition besides households' employment status and variety of food intake. There is a need to improve the nutritional and health status of under-five children and their mothers through the existing health care system providing basic health services and improving the capacity of health staffs across Indonesia as part of the decentralization process. Besides, the private sector and communities may support the local government in the form of informal Social Safety Net intervention programs. The significant association found between mother's BMI and wasting status of their under-five children found in this study can be used to prioritize the appropriate type of intervention needed by the poor households. Furthermore, since anemia was highly prevalent, besides iron supplementation, chronic diseases such as tuberculosis and malaria, and the prevalence of thalasemic-trait should also be considered. Further operational and academic research in the area of health and nutrition are needed to be able to construct a model that provides indicators used to predict the nutritional condition in each community setting across Indonesia during any crisis. "

"Kurang gizi menjadi masalah kesehatan perkotaan terutama pada balita. Faktor langsung yang mempengaruhi status gizi adalah asupan makanan dan penyakit penyerta. Upaya pemerintah melalui program gizi balita di Puskesmas, menerap kan program melalui kebijakan Perkesmas. Peran perawat dalam pelaksanaan Perkesmas adalah memberikan asuhan keperawatan berbasis keluarga. Bentuk intervensi keperawatan memberikan edukasi kesehatan, melatih psikomotor penyusunan dan membuat menu makanan pendamping ASI. Tujuannya adalah memperbaiki nutrisi dan peningkatan berat badan anak. Intervensi diberikan kepada keluarga selama 7 minggu di Kelurahan Sukatani Tapos Depok. Kesimpulan: Tercapainya penurunan penderita gizi kurang pada balita, sehingga penyusunan menu dan membuat makanan pendamping ASI (MPASI) menjadi cara yang efektif mengatasi dan memperbaiki balita dengan nutrisi kurang.

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Urban health problems is poor nutrition, especially at infants. Factors that directly affect nutritional status are food intake and comorbidity. Government efforts through nutritional programs in health centers, implementing the program through PHN policy. The role of nurses in the implementation of PHN is to provide family based nursing care. Nursing interventions provide health education, training and preparation psychomotor make feeding menu. The goal is to improve the nutrition and weight gain in children. Interventions provided to the family for 7 weeks in the Village Sukatani Tapos Depok.

Conclusion: Achieving decline less severely malnourished children under five, so the preparation of menus and make complementary foods (complementary feeding) be an effective way to overcome and improve the toddlers with poor nutrition."