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DOI: https://doi.org/10.52845/CMI/2022-3-1-2
CMI 03 (01), 250−256 (2022) ISSN (O) 2694-4626 IF:1.6

RESEARCH ARTICLE

THE RELATIONSHIP BETWEEN NUTRITIONAL HEALTH SERVICES
FOR PREGNANTWOMEN AND THE INCIDENCE OF STUNTING IN
LHOK BOT, ACEH JAYA

Suriati 1 Teungku Nih Farisni
1Public Health Science Study
Program, Faculty of Public
Health, Teuku Umar University,
Indonesia

Abstract
Health services are an effort provided by the public health center 
(puskesmas) to the community which includes planning, implementing, 
evaluating, recording, reporting, and pouring it into a system. Stunting is a 
condition of failure to thrive in children under five as a result of 
chronic malnutrition so that children are too short for their age and 
period. Growth will be stunted unlike normal-born children in general. 
Pregnant women are a group that is vulnerable to nutritional problems. 
Lack of nutrition for pregnant women has a very large impact on the 
child they are carrying. The purpose of this study is to determine if there 
is a relationship between maternal health services pregnant women with 
stunting and the relationship between nutrition of pregnant women who 
experience SEZ and stunting in the working area of the Lageun Public 
Health Center, Setia Bakti sub-district, Aceh Jaya Regency. The method 
used is a quantitative method through a cross-sectional approach. The 
indicators used to assess health services for mothers pregnant women were 
ANC, p-value = 0.095 (p>0.05), pregnant women received at least 90 Fe 
pills (blood-enhancing tablets) p-value = 0.002 (p<0.05), pregnant women 
who attended counseling nutrition/class of pregnant women p-value = 0.246 
(p>0.05), pregnant women got nutritional monitoring resulted p-value = 
0.004 (p<0.05), households with pregnant women had family latrines 
with p-value = 0.435 (p>0.05), pregnant women who had access to safe 
drinking water resulted p-value = 0.590 (p>0.05), households with 
pregnant women had health insurance results p-value = 0.435 (p> 0.05). 
Nutrition of pregnant women resulted p-value = 0.001 (p<0.05). The 
results of the study found that there was a relationship between 
nutritional health services for pregnant women and the incidence of stunting. 
The results were carried out with the chi-square test to obtain results from 
the relationship between health services for pregnant women and the 
incidence of stunting.
Keywords: Health Services, Maternal Nutrition, Stunting

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CMI 03 (01), 250−256

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250

Clinical Medicine Insights

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1 INTRODUCTION

Health service is an effort provided by the
public health center to the community which
includes planning, implementing, evaluat-

ing, recording, reporting, and pouring in a system.
Health services are also the responsibility of the gov-
ernment in an effort to achieve community welfare.
Pregnant women, which is known as ANC, pregnant
women get aminimum of 90 Fe pills (blood-boosting
tablets), pregnant women who take nutritional coun-
seling/pregnant women’s classes, pregnant women
get nutritional monitoring. Access to safe drinking
water and households with pregnant women have
health insurance. The problem in these services is the
lack of health services for pregnant women and can
result in stunting.
Stunting is a condition of failure to thrive in children
under five as a result of chronic malnutrition so
that children are too short for their age and their
growth period will be stunted unlike normal children
born in general. Stunting condition is only seen after
the baby is 2 years old. The definition of stunting
according to the decision of the Minister of Health in
2010 is nutritional status based on the index of body
length for age (PB/U) or height for age (TB/U) in the
standard for assessing children’s nutritional status
with measurement results that are in the standard
value or z-score < -2 SD to -3 SD for short (stunted)
and < -3 SD for very short (severely stunted).
According to Eko (2018), in the village pocket book,
stunting is handled. Stunting is a condition of failure
to thrive in children under five due to chronic mal-
nutrition so that children are too short for their age.
Stunting is caused by multi-dimensional factors. The
most decisive intervention is at 1,000 HPK (1000
days) from the first birth.
Stunting is often described as a poor nutritional sta-
tus and is chronic in development from early life.
This condition is represented by a z-score for height
for age (TB/U) less than -2 standard deviations
(SD) based on growth standards according to WHO
(WHO, 2010).
Factors for stunting or stunting are factors of social
status, economy, food intake, infection, maternal
nutritional status, infectious diseases and micronutri-

ent deficiencies and the environment (WHO, 2018).
Many factors can cause stunting in toddlers including
the nutritional status of mothers during pregnancy,
so it is necessary to have adequate nutrition during
pregnancy as needed to avoid the risk of stunting and
as for other reasons, including a mother’s knowledge
of the problem of balanced nutrition, which is very
lacking, but sometimes the environment is also one
of the causes because if sanitation and hygiene are
poor it will affect nutrition.
In 2017, more than half of children with stunting
came from Asia as much as 55%, Africa is 39%
and Indonesia occupies the top 5 highest preva-
lence with stunting. In Indonesia, stunting has the
highest prevalence compared to other problems such
as malnutrition, thinness, and obesity with stunting
prevalence increased from 2016 which was 27.5%
to 29.6% stunting in 2017, which tended to be static
(Moh, 2018).
Pregnant women are a group that is vulnerable to
nutritional problems. Lack of nutrition for pregnant
women has a very large impact on the child they are
carrying. If pregnant women experience nutritional
problems, it will cause, among others: miscarriage,
stillbirth, neonatal death, congenital defects, anemia
in infants, and infants born with LBW.
The nutrition obtained by pregnant women before
and during pregnancy affects the growth and devel-
opment of the baby in the womb. If the nutrients
needed by pregnant women are fulfilled before and
during pregnancy, they will give birth to healthy
babies.
A pregnant womanwill give birth to a healthy baby if
the level of health and nutrition is in a good position,
but until now there are still many pregnant women
who experience nutritional problems, especiallymal-
nutrition such as Chronic Energy Deficiency (KEK)
and nutritional anemia (Depkes RI, 1996). The re-
sults of the 1996 SKRT show that 41% of pregnant
women suffer from CED and 51% who suffer from
anemia have a tendency to give birth to babies with

Supplementary information The online version
of this article (10.52845/CMI/2022-3-1-2) contains
supplementary material, which is available to autho-
rized users.

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low birth weight (LBW).
Chronic energy deficiency (CED) is a state of mal-
nutrition where the condition of the mother suffers
from chronic food shortages which result in health
problems for the mother in relative or absolute terms
of one or more nutrients (Helena, 2013).
Pregnant women who experience CED and anemia
are at risk of experiencing greater pain, especially in
the third trimester of pregnancy than mothers who
are normal pregnant. Babies who are born with low
birth weight will have an effect on their growth
and development period, so they will be at risk
when they are adults. The risk of morbidity and
mortality in infants is they will get susceptible to
lower respiratory tract infections, learning disorders,
behavioral problems, and so on (Depkes RI, 1998).
The nutritional needs of mothers during pregnancy
are different, therefore WHO recommends an addi-
tional amount of 150 Kcal a day in the first trimester,
350 Kcal a day in the second and third trimesters. In
Canada, the addition for the first trimester is 100Kcal
and 300 Kcal for the second and third trimesters.
Indonesia based on the Widya Karya National Food
and Nutrition VI year 1998, the figure was deter-
mined to be 285 Kcal per day during pregnancy. This
figure certainly does not include additions due to
changes in room temperature, physical activity, and
growth.
Supervision issues for mothers during pregnancy
are very necessary, because we have to monitor
what foods are eaten by pregnant women so that
their nutrition is fulfilled, through this supervision
can be determined such as maternal health during
pregnancy, how to make pregnant women aware of
nutritional problems such as conducting education
on nutrition for pregnant women. In Aceh Jaya, A
Nutrition House (RGG) has also been established to
provide understanding to mothers who are pregnant
and who have toddlers about nutritional problems.
Pregnant women need to maintain the food they
assume during pregnancy, such as foods rich in pro-
tein, fat, calcium, calories which are often found in
tempeh, tofu, vegetables, fruits, and nuts. 23.5cm
while the KEK LILA is 23.5cm. The problem of
supervision for mothers during pregnancy is very
necessary, because we have to monitor what foods

are eaten by pregnant women so that their nutrition
is fulfilled.
Growth parameters continue to be a concern and are
considered as parameters for assessing nutritional
health status. The parameters that are often used are
weight and height or body length (Sediaoethema,
2012). Births with Low Birth Weight (LBW) repre-
sent more than 20 million births every year with an
estimated 15% -20% of births worldwide which is
still a global health problem (WHO, 2014).
To prevent all of this from happening, efforts are
made such as regulating food consumption in preg-
nant women, monitoring weight gain once a week or
once a month, checking HB levels, and measuring
LILA before or during pregnancy.

2 METHOD

The method used is a quantitative method through
a cross-sectional approach. According to Arikunto
(2006) quantitative method is a research approach
that uses a lot of numbers ranging from data col-
lection, interpretation of the data obtained, and ex-
posure of the results of pregnancy and maternal
characteristics during pregnancy on the incidence of
stunting. Cross-sectional research is a study to study
the dynamics of the correlation between risk factors
and effects, by approach, observation, or data col-
lection. Cross-sectional research only observes once
and measurements are made on the subject variables
at the time of the study (Notoatmojo, 2010). The
population in this study was 23 toddlers aged 24-60
years old in the working area of the Lageun Public
Health Center, especially in the village of Lhok Bot.

3 RESEARCH OBJECTIVE

The purpose of this study was to determine whether
there was a relationship between health services for
pregnant women and the incidence of stunting and
the relationship between maternal nutritional status
during pregnancy and the incidence of stunting in
the working area of the Lageun Public Health Center,
Setia Bakti District, Aceh Jaya Regency.

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WOMEN AND THE INCIDENCE OF STUNTING IN LHOK BOT, ACEH JAYA
4 RESULTS AND DISCUSSION

• General data

• Toddler age

Table 1. Distribution of Respondents by age under
five in the work area of the Lageun Public Health
Center.

Table 1 shows 9 toddlers aged 24-36 (39.13%), and
11 toddlers aged 36-48 (47.48%) and 3 (13.04%).
2.Gender
Table 2 Distribution of respondents based on gender
of children under five in the Lageun Health Center
Work Area.

Table 2 shows that there are more male children
under five than male children, namely 13 children
under five (56.52%) and 10 female children under
five (43.48%).

• Special Data

1. Maternal nutritional status during pregnancy

Table 3. Distribution of respondents based on the
nutritional status of mothers during pregnancy in the
Lageun Health Center work area.

Table 3. shows that mothers with LILA (Upper Arm
Circumference) are 19 people (82.61%) while for
mothers with KEK (Chronic Energy Deficiency) 4
people (17.39%)
Respondents who are at risk of giving birth to mal-
nourished babies are 4 people while respondents who
are not at risk of stunting are 19 people. However,
there are also respondents who experience SEZ but
when giving birth the baby is not stunted, because
there are also mothers whose LILA who is normal
but she gave birth babies who are stunted, because
we can see from the results of this study that only
4 mothers have SEZ while 5 stunted children, so
there are stunting children but the mother’s LILA is
normal. Normal LILA >23.5cm.
2.Stunting Incident
Table 4. Distribution of respondents based on the
incidence of stunting in children under five in the
working area of the Lageun Health Center.

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Table 4 shows that the normal number of toddlers is
18 toddlers (27.78%) while the stunting toddlers are
5 toddlers (78.26%).
There are 5 respondents who are at risk of stunting
in Lhok Bot village, while 18 people are not at risk.
3.The relationship between maternal nutrition during
pregnancy and the incidence of stunting in children
under five in the work area of the Lageun Public
Health Center.

Based on the table data above, this study used the chi-
square test from the calculation, it got a p Value of
0.001whichmeans (p <001), therefore there is a rela-
tionship between the nutritional status of the mother
during pregnancy and the occurrence of stunting in
infants/toddlers to be born. From the r value, it is
known that 12,308 which means that the strength
in the relationship is categorized as weak. The less
nutrition of the mother during pregnancy, the greater
the incidence of stunting in a child to be born.
4. Relationship between health services for pregnant
women and the incidence of stunting in the work area
of the Lageun Public Health Center.

Based on the table data above, it is known that the
results of the analysis using the chi-square test found
the relationship between Ante Natal Care and the
incidence of stunting in toddlers, the p-value = 0.095
(p>0.05) therefore there was no relationship between
ANC and stunting. In infants/toddlers. Meanwhile,
the relationship between giving blood-added tablets
and the incidence of stunting was found to be p-value
= 0.002 (p<0.05), therefore there was a relationship
between giving blood-added tablets (fe) and the in-
cidence of stunting with the incidence of stunting,
p-value = 0.246 (p>0.05) then there is no relation-
ship between the class of pregnant women and the
incidence of stunting. There is a relationship between
nutritional monitoring and the incidence of stunting.
The relationship between pregnant women who have
latrines and the incidence of stunting obtained p-
value = 0.435 (p> 0.05), so there is no relationship
between pregnant women who have latrines and the
incidence of stunting. The relationship between preg-
nant women who have safe drinking water and the
incidence of stunting is found to be p-value = 0.590
(p>0.05), so there is no relationship between preg-
nant women who have safe drinking water and the
incidence of stunting. Health insurance with stunting
is obtained with a p-value = 0.435 (p>0.05), so there
is no relationship between pregnant women who
have health insurance and the incidence of stunting.
ANC services are preventive or preventive services
to monitor maternal health and prevent complica-
tions for the mother and fetus. Efforts must be made
to ensure that pregnant women are healthy until
delivery, if any physical or psychological abnor-
malities can be detected immediately, and pregnant
women can giving birth without complications (Bar-
tini, 2012). Ante Natal Care (ANC) examination is
very necessary which aims to optimize the mental,
physical health of the mother and baby return of
normal reproductive health (Manuaba, 1998).
The Ministry of Health recommends that pregnant
women consume at least 90 iron tablets during preg-
nancy. However, the level of compliance of pregnant
women in consuming Fe tablets is still low. There-
fore, the incidence of stunting is related to pregnant
women who do not take Fe tablets.
The class for pregnant women is one way that can
be used to disseminate information related to nutri-

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tion and health during pregnancy. From the results
obtained, it can be concluded that there is no relation-
ship between classes of pregnant women in Lhok Bot
village and the incidence of stunting because there is
no class of pregnant women in the village.
Nutrition monitoring is very influential on the occur-
rence of stunting, therefore it is necessary to monitor
nutrition for pregnant women in order to prevent
stunting. This nutrition monitoring can be through
Posyandu or other education.
According to the Association of Indonesian Envi-
ronmental Health Experts (HAKLI) environmental
health is an environmental condition that is able
to support a dynamic ecological balance between
humans and the environment to support the achieve-
ment of a healthy and happy quality of human life
residents who have latrines. Clean water is clean wa-
ter used for daily needs whose quality meets health
requirements and can be drunk when it has been
cooked. There is no relationship between safe clean
water and the incidence of stunting because almost
all of these villages have safe water for consumption.
Several studies show that health insurance participa-
tion is able to improve nutritional problems. How-
ever, the results obtained through the chi-square test
show that in Lhok Bot village there is no relationship
with families who have health insurance with stunt-
ing.
From 23 samples of pregnant women in the village
of Lhok Bot loyal filial piety, several of them who
suffered from constipation from the data obtained
were 4 people (17.13%). A person’s background is
one of the important elements that can affect health
and nutrition because health problems often occur
due to lack of knowledge or lack of information
about health and good nutrition issues.
Pregnant women whose LILA is SEZ will be vul-
nerable to giving birth to stunting babies, because
of the lack of nutrition that they get when they are
pregnant, so that they are not sufficient for the needs
of the baby in their womb.
In Aceh Province, the prevalence of SEZ risk for
pregnant women aged 15-15 years who are pregnant
is 20% while the prevalence of SEZ risk for women
of childbearing age (not pregnant). Nationally, the

risk of SEZ in WUS is 21% (Aceh Health Profile,
2019)

The occurrence of stunting is caused by a process
of failure to achieve potential linear growth due to
health status and nutritional status. Linear growth or
often called height is influenced by genetic factors,
hygiene and sanitation factors and medical condi-
tions, but there are also nutritional problems as men-
tioned above on.

The implementation of health services is a shared
responsibility between the government and the com-
munity, most of them can be carried out by pub-
lic health center, none other than the Lageun Setia
bakti puskesmas. One of the efforts to improve the
performance of Public health center services is by
implementing health MSS.

5 CONCLUSION

Based on the results of research that has been carried
out: 1) Lack of health services for pregnant women
can also cause stunting, 2) The risk that causes stunt-
ing in infants is greater due to mothers who experi-
ence SEZ during pregnancy because it is very closely
related to stunting compared to normal mothers who
experience seizures but do not give birth to stunting
babies, 3) The status of pregnant women with SEZ in
the Lageun Community Health Center working Area
is in theMediumCategory 4) The health services can
also be related to the incidence of stunting

6 SUGGESTION

Based on the results of the research above, sug-
gestions that can be conveyed to the public health
center workers so that they can provide education to
pregnant women/communities in Lhok Bot village
to be able to improve health services for pregnant
women and provide nutritious and balanced food to
avoid stunting.

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How to cite this article: S., T.N.F. THE
RELATIONSHIP BETWEEN NUTRITIONAL
HEALTH SERVICES FOR PREGNANT
WOMEN AND THE INCIDENCE OF STUNT-
ING IN LHOK BOT, ACEH JAYA . Clinical
Medicine Insights. 2022;250−256. https://doi.org/
10.52845/CMI/2022-3-1-2

CMI 03 (01), 250−256 (2022) MANUSCRIPT CENTRAL 256


	Introduction
	METHOD
	RESEARCH OBJECTIVE  
	RESULTS AND DISCUSSION
	 CONCLUSION
	SUGGESTION  
	REFERENCES



