Multilevel Analysis on the Contextual Effect of the Integrated Health Post Activity on Development of Children Under Five in Kubu Raya, West Kalimantan

Lolita Lolita, Yulia Lanti Retno Dewi, Bhisma Murti


Background: It is estimated that 200 million children in developing countries do not develop optimally. Child development is a complex improvement in body structure and function that include gross and fine motoric, speech, language, socialization, and independence aspects of development. The success of children in achieving optimal development determines the future of a nation. The purpose of this study was to analyze the contextual effect of integrated health post (posyandu) in child development in Kubu Raya District, West Kalimantan.

Subjects and Method: This study was a cross sectional conducted at 25 integrated health post in Kubu Raya District, West Kalimantan, from November to December 2018. A sample 200 of children under five was selected by simple random sampling. The dependent variable was child development. The independent variables were maternal age at marriage, maternal education, parental income, parenting style, birth weight, birth length, child development monitoring, child development intervention, and integrated health post strata. Data collection was conducted using questionnaire and analyzed using multilevel logistic regression analysis in Stata 13.

Results: Child development disorder increased with early maternal age at marriage (b= 3.18; 95% CI= 0.77 to 5.59; p = 0.010), but decreased with high maternal education (b= -2.22; 95% CI= -3.92 to -0.52; p= 0.010), high parental income (b= -4.01; 95% CI = -6.55 to -1.47; p= 0.002), proper parenting style (b= -2.89; 95% CI= -5.18 to -0.60; p= 0.013), normal birth weight (b= -2.87; 95% CI= -4.80 to -0.95; p= 0.003), normal birth length (b= -3.13; 95% CI= -5.63 to -0.63; p= 0.014), child development monitoring (b= -2.97 95% CI= -5.58 to -0.36; p= 0.025), and child development intervention (b = -3.53; 95% CI= -6.19 to -0.87; p= 0.009). The integrated health post had a contextual effect on child development with ICC= 19.9%.

Conclusions: Child development disorder increases with early maternal age at marriage, but decreased with high maternal education, high parental income, proper parenting style, normal birth weight, normal birth length, child development monitoring, and child development intervention. The integrated health post has a contextual effect on child development.

Keywords: child development, children under five, multilevel analysis

Correspondence: Lolita. Public Health Masters Program, Universitas Sebelas Maret, Jl. Ir Sutami 36A, Surakarta, Central Java, Indonesia. Email : Seluler: 082328463344.

Journal of Maternal and Child Health, 2019, 4(4): 222-229

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Badan Pusat Statistik (BPS). 2012. Survei Demografi dan Kesehatan Indonesia (SDKI) 2012. Jakarta.

Badan Pusat Statistik (BPS), UNICEF 2016. Analisis Data Perkawinan Usia Anak di Indonesia. Jakarta : Badan Pusat Statistik

Datar, A. Jacknowitz, A. 2009. Birth weight effects on children’s mental, motor, and physical development: Evidence from Twins Data. Matern Child Health J. 13:780–794. Doi: 10.1007/s1099500904616

Efevbera, Y,. et al. 2017. Girl child marriage as a risk factor for early childhood development and stunting. Social Science and Medicine Journal. DOI: 10.1016/j.socscimed.2017.05.027

Escamilla, P R., Moran, V. H. 2016. The role of nutrition in integrated early child development in the 21st century: contribution from theMaternal and Child Nutritionjournal. Maternal & Child Nutrition, 13(1), e12387. doi:10.1111/mcn.12387

Ford, N D., Stein, A D. 2015. Risk factors affecting child cognitive development: a summary of nutrition, environment, and maternal–child interaction indicators for sub Saharan Africa. Journal of Developmental Origins of Health and Disease (2016), 7(2), 197–217. doi:10.1017/S2040174415001427

Kemenkes RI. 2016. Pedoman Umum Program Indonesia Sehat denga Pendekatan Keluarga. Jakarta

Kemenkes RI. 2016. Pedoman Pelaksanaan Stimulasi, Deteksi dini dan Intervensi Dini Tumbuh Kembang Anak. Jakarta

Kemenkes RI. 2011. Pedoman Umum Pengelolaan Posyandu. Jakarta : Kementerian Kesehatan RI. 2011 ISBN 978-602-9364-87-

Kemenkes RI. 2011. Riset Hasil Kesehatan Daerah. Direktorat Jendral Kesehatan Ibu dan Anak. Jakarta

Khalifatunisak, A., Salimo, H., Dewi, Y L R. Multilevel Analysis on the Determinants of Overweight among Children Under Five in Kediri, East Java. e-ISSN: 2549-0257. Journal of Maternal and Child Health (2018), 3(4): 261-268 262

Maggi, S., Irwin Lori J, Siddiqi A, Hertzman C. 2010. The social determinants of early child development: An overview. Jurnal of Pediatric and Child Health. doi:10.1111/j.14401754.2010.01817.x

Murti B. 2018. Prinsip dan Metode Riset Epidemiologi Edisi keempat. Surakarta: Program Studi Ilmu Kesehatan Masyarakat, Program Pascasarjana, Universitas Sebelas Maret.

Ribeiro, CC. Regina, MOP. et al. 2017. Development skills of children born premature with low and very low birth weight. DOI: 10.1590/23171782/20162016058

Richter, L M, Lombardi J, et al. 2016. Investing in the foundation of sustainable development: pathways to scale up for early childhood development. doi: 10.1016/S01406736(16): 316981

Stolt, S. Korja, R. et al 2014. Early relations between language development and the quality of mother child interaction in very low birth weight children. Early Human DevelopmentVolume 90, Issue 5, May 2014, Pages 219225

Ye A, Yan S, Huang K, et al. 2018. Maternal intelligence quotient and motor development in early childhood: The mediating role of mother’s education. doi:10.1111/jpc.14123

Zachrisson, HD, Dearing. E 2015. Family Income Dynamics, Early Childhood Education and Care, and Early Child Behavior Problems in Norway. doi: 10.1111/cdev.12306

Lee, J J. ,Kapur K., Rodrigues, E G., et al. 2017. Anthropometric measures at birth and early childhood are associated with neurodevelopmental outcomes among Bangladeshi children aged 2–3years. Science of the Total Environment. Elsevier.


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