THE ROLE OF POSYANDU CADRES IN EFFORTS TO IMPROVE THE NUTRITIONAL STATUS OF TODDLERS IN SUKA MAKMUR VILLAGE, PATILANGGIO DISTRICT

Abstract

THE ROLE OF POSYANDU CADRES IN EFFORTS TO IMPROVE THE NUTRITIONAL STATUS OF TODDLERS IN SUKA MAKMUR VILLAGE, PATILANGGIO DISTRICT
 
 Ripanwati Aridi1), Titin Dunggio2), Novian S. Hadi3)
 1.2.3)University Of Bina Mandiri Gorontalo, Gorontalo
 E-Mail: [email protected]
 
 ABSTRACT
 The Integrated Health Post is a community role that is managed by cadres, generally who manages the Posyandu in their respective regions voluntarily. The success of Posyandu can be seen from the maternal mortality rate, infant mortality rate, and under-five mortality rate. Posyandu's specific goal is to increase community participation in the implementation of basic health efforts (primary health care), increase the role of cross-sector, and increase the reach of basic health services. The purpose of this study was to find out the role of Posyandu cadres in improving the nutritional status of toddlers in Suka Makmur Village, Patilanggio District. This research was conducted in Suka Makmur Village, Patilanggio District.
 The method in this study is quantitative using a cross-sectional approach with a point time approach design. The population in this study was mothers who have children aged 1 to 5 years in Suka Makmur Village, Patilanggio District. The sampling technique was taken by total sampling.
 The results of the study about the role of cadres in Suka Makmur Village, Patilanggio District, the best roles were 25 people (83.3%). The increase in the nutritional status of toddlers in Suka Makmur Village, Patilanggio District, the most with good nutritional status was 26 respondents (86.7%).
 The results of statistical tests with Fisher's Exact Test correction obtained p-value = 0.048 <á (0.05), thus there is a significant relationship between the role of Posyandu cadres in efforts to improve the nutritional status of toddlers in Suka Makmur Village, Patilanggio District.
 Keyword: The Role of Cadres, improved Nutritional Status, Toddle
 
 INTRODUCTION
 Posyandu is a Community Based Health Efforts (UKBM) which is managed, by, for, and with the community to empower the community and provide facilities for the community in obtaining basic health services. The Integrated Health Post is a community role that is managed by cadres, generally, these cadres manage posyandu in their respective areas voluntarily [1].
 If the Posyandu is programmed thoroughly the problems of malnutrition in children under five, malnutrition, edema, and other health problems related to the health of mothers and children will be easily avoided because remembering that Posyandu is also one of the places for public health services that directly interact with the community. The Success of Posyandu can be seen from the maternal mortality rate, infant mortality rate, under-five mortality rate, and also coverage of other Posyandu programs such as immunization [2].
 RPJMN policy direction for health 2020-2024 Improves health services towards universal health coverage, especially strengthening primary health care by encouraging increased promotional and preventive efforts, supported by innovation and the use of technology. RPJMN Strategy 2020-2024 to Improving maternal and child health, family planning, and reproductive health, accelerating community nutrition improvement, increased disease control, strengthening the Healthy Living Community Movement (Germas), Strengthening Health Systems, Drug and Food Control. Ministry of Health Strategic (2020-2024) Increasing quality universal health coverage, Improving public health status through a life cycle approach, increasing the culture of healthy living people through community empowerment and health mainstreaming, increased disease prevention and control and management of public health emergencies, increased health resources, improved good governance [3].
 Village Community Health Development (PKMD) is an activity carried out by the community, from the community, and for the community. One of the operational forms of community participation or UKBM (community-based health efforts) namely with the posyandu. Posyandu is one of the means in health service efforts carried out by, from, and with the community, to empower the community and provide facilities for the community to obtain maternal and child health, which is the main objective of posyandu. Posyandu's specific goal is to increase community participation in the implementation of primary health care, increasing the role across sectors, and increasing the reach of basic health services [4].
 Posyandu is held for the benefit of the community so that the community itself is actively involved in forming, organizing, and making the best use of posyandu. Community participation is needed in utilizing posyandu. In carrying out their duties, previous health cadres will be given the training to support the smooth implementation of activities to improve the nutritional status of children under five [5].
 Nationally, the nutritional status of children in various regions in Indonesia is still a problem. The amount of people with malnutrition in the world reaches 104 million children, and malnutrition is the cause of one-third of all causes of child deaths worldwide. Indonesia is among a group of 36 countries in the world that contribute 90% of the world's nutritional problems [6].
 Cadres are the central point in implementing posyandu activities. It is hoped that participation and activeness will be able to drive community participation. However, the presence of cadres is relatively unstable because their participation is voluntary, so there is no guarantee that they will continue to carry out their functions properly as expected. If there are family interests or other interests, the posyandu will be abandoned [7].
 In 2017, the total of Posyandu in Indonesia was 291,447 but only 164,487 were active with the percentage of active Posyandu 56.57% [8]. In Gorontalo Province in 2017, the highest proportion of Posyandu was Posyandu Madya 48.5%, then Posyandu Purnama 39%, Posyandu Pratama 10.7%, and Posyandu with Independent strata only 1.9%. According to data from the health office of Gorontalo Province, in 2017 the highest of posyandu was in the Gorontalo Regency area, namely 442 posyandu and the least in the Gorontalo City is 128 posyandu [9].
 The development of posyandu in Gorontalo Province aims to provide services to the community, especially improving the nutritional status of children under five. Based on data from the Health Office of Gorontalo Provincial. The results of nutritional surveillance through a survey of monitoring nutritional status (PSG) in 2015 in all areas of Gorontalo province involving the Poltekes of the Ministry of Health found that the prevalence of underweight/malnutrition in Gorontalo province is 24.4%, consisting of 18.8% malnourished toddlers and 5.6% malnutrition. Then the prevalence of stunting / short and very short was 36.5% consisting of 22.4% short and very short toddlers and 14.1%. The prevalence of wasting / thin and very thin children was 13.4% consisting of thin children 9.0% and 4.4% very thin. In 2015 the number of cases of malnutrition in Pohuwato Regency reached 105 cases, in 2016 it decreased to 57 cases and in 2017 totaled 57 cases of malnutrition, this shows that there is still a lack of health services provided by health workers and the role of cadres, especially in improving the nutritional status of children under five [9].
 From the results of observations in the work area of Puskesmas Patilanggio, there are 21 posyandu with 30 cadres active in implementing posyandu. Although all of them are active, their roles are still not optimal. There are those whose participation is good and those that are lacking. From 30 cadres, it was found that 60% of their roles were motivators, 70% were administrators, and 60% were educators. After the researcher saw the implementation of posyandu activities carried out by cadres based on the implementation of the Vtable system, it did not implement properly. The implementation is limited to table II (weighing) and table III (recording in KMS). The counseling that should be provided by cadres is, in fact, in the field most cadres are still very dependent on health workers. Cadres only weigh children under five and if there is a scale that is less or more, cadres do not provide health education to mothers who bring a toddler. From the results of interviews conducted by researchers with 5 cadres, 2 cadres said that besides being active in implementing the posyandu, the cadres also do house visits to invite mothers with toddlers to come to the posyandu and take time to discuss with mothers who the house is close to each other. Meanwhile, 3 cadres said that their activities were limited to implementing posyandu.
 Based on the monthly reports of Puskesmas Patillanggio, in March 2020 the total of all toddlers was 120 people, with 1 person with malnutrition status, 23 people deficient nutrition, 1 person over nutrition, and 95 good nutrition. Meanwhile, in the Sukamakmur village in April 2020 the total of all toddlers was 167 people, with a malnutrition status of 15 people, over-nutrition 2 people, and good nutrition 143 people. The background above encourages researchers to research “The Role of Posyandu Cadres in Improving the Nutritional Status of Toddlers in Suka Makmur Village, Patilanggio District.
 
 RESEARCH METHODS
 This type of research is quantitative using a cross-sectional approach with a point time approach design. This research was conducted from June 2020 to August 2020. The location of this research was in Suka Makmur Village, Patillanggio District. The population in this research was mothers who have children aged 1 to 5 years in Suka Makmur village, Patilanggio district, with a total of 167 mothers of children under

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