RELATIONSHIP BETWEEN STUNTING AND ANIMAL PROTEIN CONSUMPTION IN CHILDREN

RESEARCH PROPOSAL

RELATIONSHIP BETWEEN STUNTING AND ANIMAL PROTEIN CONSUMPTION IN CHILDREN

Dr. dr. I Gusti Ayu Trisna Windiani, Sp.A(K)

Dr. dr. I Gusti Lanang Sidiartha, Sp.A(K)

dr. I Gusti Agung Ngurah Sugitha Adnyana, Sp.A(K)

dr. I Wayan Gustawan, M.Sc, Sp.A(K)

CHILD HEALTH DEPARTMENT

FACULTY OF MEDICINE

UNIVERSITAS UDAYANA

2019

Resume

RELATIONSHIP BETWEEN STUNTING AND ANIMAL PROTEIN CONSUMPTION IN CHILDREN

Stunting is defined as impaired growth and development that children experience from poor nutrition, repeated infection and inadequate psychosocial stimulation. Stunting affects not only growth but also development of a child. A child can be categorized as stunting if the height/length based on age below -2 SD plotted in WHO growth chart. Data from Riskesdas 2018 showed 30,8% of toddler in Indonesia are categorized as stunting. This number placed Indonesia as the fifth nation with the highest prevalence of stunting in the world. In Bali, there are 21,9% children with stunting. There are 5 districts in Bali with prevalence of stunting between 20-25%, including Gianyar. Low intake of animal protein is assumed as one of the factors causing stunting.

       This research aimed to prove relationship between stunting and intake of animal protein as the primary outcome. The secondary outcome includes developmental screening in children with stunting. This research was done in Tulikup Village, Gianyar Disctrict as one of fostered village of Child Health Department, Faculty of Medicine Universitas Udayana. This research employed cross-sectional method. Data was gathered with questionnaire which include characteristics of samples, food recall of animal and plant protein and developmental status of the children. Protein intake in this study was calculated with nutritional survey. Study samples are children aged 6 months to 2 years old with stunting meeting inclusion and exclusion criterias. Developmental status of the children was screened with Kuesioner Pra Skrining Perkembangan (KPSP). Relationship between stunting and animal protein intake in children was analyzed with chi-square with significance p < 0,05. If proven, this study result would be scientific basis to give animal protein to children aged 6 months up to 2 years old.

Keywords: stunting, animal protein, development, children

CHAPTER I

PREFACE

1.1              Background

Stunting is defined as impaired growth and development that children experience from poor nutrition, repeated infection and inadequate psychosocial stimulation.  Stunting is defined as toddler with length/weight based on age ranging below -2 SD in WHO growth chart. Approximately 160 millions children in the world categorized as stunting. Based on data from Riskesdas 2018, there are 30,8% toddler categorized as stunting. This number placed Indonesia as the fifth nation with the highest prevalence of stunting in the world (Headey et al, 2017). In Bali, there are 21,9% children with stunting (Sekretariat Wakil Presiden Republik Indonesia, 2017). Stunting lead to under optimal intelligence and higher risk of contracting a disease. All in all, stunting can cause lower productivity. Factors causing stunting including mal-parenting, shortage of pregnancy health services, limited access to clean water and sanitation also low intake of protein (Laurus et al, 2016; Sekretariat Wakil Presiden Republik Indonesia, 2017).

Protein is a macronutrient needed by human being. Protein can be classified based on its origin which are animal protein or plan protein (Wu, 2016). Protein is needed in children for growth, development, neurocognitive, organ and immune system maturation.  Low intake of protein can cause delay in children growth and development (Cusick dan Georgieff, 2016).

Development is defined as growth of ability, body structure and function to a more complex and regular pattern. Development happened as the result of cell, tissue and organ differentiation. Brain develop the fastest in the first two years of life (Probosiwi dkk, 2017). Delay of development can cause stress to the family and producing incompetent human-being. Kuesioner Pra-Skrining Perkembangan (KPSP) is used as pre-screening for children development with sensitivity 75% and specificity 99%  (Dhamayanti, 2006).

With this knowledge, relationship between stunting and animal protein intake in children is an important topic to be further studied.

1.2              Problem

Based on the background stated, the research problem should be: in children with stunting, is there any relationship between animal protein intake with stunting?

1.3       Purpose

1.3.1    General purpose

To know the relationship between animal protein intake and stunting in children

1.3.2    Specific purpose

To know developmental status of children with stunting.

1.4       Convenience

1.4.1    Theoretical convenience

To give information regarding relationship between animal protein intake with stunting in children.

1.4.2        Practical convenience

1.4.2.1  Convenience for the researchers

1.   The result of this study can further approve the importance of animal protein intake in children development.

2.    The result of this study can be a pilot study for similar study(s) in the future.

1.4.2.2  Convenience for the community

1.        To give the government a general characteristics data of children with stunting in Bali. The information provided can be the basic to give animal protein to improve human resources quality in the future.

CHAPTER II

LITERATURE REVIEW

Malnutrition in the first 1000 days of life can cause permanent growth and development delay. Cognitive impairment can cause children not being able to catch up in school. Long term impact of malnutrition in children is stunting (Probosiwi dkk, 2017).

            2.1       Stunting

Stunting is a chronic malnutrition condition caused by long-term low nutritional intake. Globally, approximately 160 millions children in the world is categorized as stunting. Based on data from Riskesdas 2018, there are 30,8% toddler categorized as stunting. This number placed Indonesia as the fifth nation with the highest prevalence of stunting in the world (Headey dkk, 2017). In Bali, there are 21,9% children with stunting (Sekretariat Wakil Presiden Republik Indonesia, 2017).

To detect stunting, WHO growth chart is used. There are several WHO growth charts which are weight based on age, length/height based on age, weight based on length/height, arm circumference based on age, head circumference based on age and body mass index based on age. To diagnose stunting, length/height based on age growth chart is used. Children length or height is measured and the plotted in the growth chart. If the length or height of the children is below -2 SD, the children is categorized as stunted. If the length or height of the children is below -3 SD, the children is categorized as severely stunted (Kementerian Kesehatan Indonesia, 2016).  Stunting happening before the first two years of life can cause cognitive impairment, motoric and language delay in children (Probosiwi dkk, 2017; Azmy dan Mundiastuti, 2018).

Stunting can be caused by several factors such as low birth weight baby, education background of the mother, low family income and improper hygiene practice