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Effectiveness Study of Program Taburia (Multi Micronutrition Supplement) on
Children 6 24 Months in South Sulawesi Province
Veni Hadju, Khidri Alwi, A. Razak Thaha
How far effectiveness of Taburia Program in children 6 24 mo in
PROGRAM NICE (Nutrition Improvement Through Community Empowerment)
1. Tenaga (SDM) a.Kader , KGM, FM, PKK &
ORMAS , idan, TPG dan Kepala Seksi Gizi
2. Dana a.Oprasional Pendistribusian b.Pertemuan, Pelatihan, Promosi c.Pencatatan & Pelaporan
3. Sarana dan Prasarana a.T4 pendistribusian b.T4 penyimpanan c.Ketersediaan taburia d.Data sasaran e.Fom pencatatan dan pelaporan
4. Metode a.Buku panduan, b.Juklat, c.Juknis,
5. Sasaran a Balita umur 6-24 bulan bGakin
Input Proses Output Outcome
EVALUASI PROGRAM TABURIA (Pemberian Taburia Anak Umur 6-24 bulan)
1 Perencanaan Sosialisasi, Pertemuan theniks, t4, Mobilisasi, Promosi, ketersediaan Taburia, jadwal supervisi
2 Pengorganisasian Pembagian tugas dan tanggung jawab
3 Pelaksanaan kegiatan aSebelum Pemberian bSaat Pemberian c Setelah Pemberian 4Controliing
5 Evaluasi aTingkat desa bTingkat Kecematan cTingkat Kabupaten
1Ketepatan sasaran aBalita Umur 6-24 bln bGakin 2 K e t e p a t a n
pendistribusian aJumlah pemberian bFrekuensi pemberian cTata cara pembrian
bubuk taburia 3Cakupan bubuk
Taburia aBaik bSedang cKurang 4Kepatuahan
aPatuh bTidak Patuh
Anak Umur 6-24 bulan
Reality in one the field
1.Man a.Kader Posyandu b.Village midwife c.Puskesmas staff d. Other e. KGM, FM, TPG
-Enough as needed. The work of kader was overloaded due to also involved with other progra.PNPM, Posyandu -Kader and midwife distributed to subjects.
Reality at the field
2. Budget a. Distribution
- Supported by local and central government. - There was not money/budget at Puskemas and Village.
b. Meeting, Training, and promotion
- Only for consumption - Makassar has for Monev
c. Recording and reporting
- Not available
Kenyataan di lap. (reality)
3. Meterials a.Distribution place b. Storage
- Dinkes ; Taburia stored at Farmacy warehouse - PKM; medicine storage - Partly at kader house
c. Availability of taburia
d. Targeted subjects - Available and adequate
e. Form recording and reporting
- Available at district and PKM, - - but not in Kader
Reality at the field
4. Method Guidance book
- Available at PKM - Kader: has booklet (juklak)
Reality in the field
1.Planning - Socialization,
technical meeting, place, mobilization, promotion, availability of Taburia, schedule for supervision
- Dinkes plan socialization at district level or PKM - Plan promotion by Dinkes - Monev was done by Dinkes at PKM level
Reality in the field
2. Organization - Responsibility
- Dinkes responsible for the program
-District by PKM. -TPG facilitate and evaluate kader and socialization to community.
-GM and Kader; distribute to target group and control.
a. P r e -intervention
- Sosialization and promotion targeted to 6-24 mo, malnourished and low SES
- Training not for all kader - Distribution, in some areas, prior to training of kader.
- Few subjects were normal children and from moderate SES.
b. During supplementation
- Kader distributed the to targetted children
- Kader take the Taburia directly to the children houses.
- Some distributed Taburia more than recommended, 1 mo >15 sachet.
- Some received more than one or twice. - Distributed at Posyandu
c. Post intervention
- Recording and acceptance were noted. - Shown appetite increased and practically served.
- Accompanied complimentary feeding.
- Problem taste and smell - Error at served, mixed with soup - Kader sometimes do observation.
4.Controliing a.Supervision b.Monitoring
- Supervision by Health Depart. - Supervision at PKM for adequate distribution
- Observed how kader bagaimana distribute taburia and gave information to subjects.
-Only few kader did monitoring - No evidence for recording
5. Evaluation a.At village b.At
subdistrict c.At district
- Supervision was done at PKM towards kader at Posyandu day.
- Recording and reporting Taburia was available made by health staffs but it is not concerned number of children with full received Taburia was not written.
- At PKM evaluation was done for availability of planning for targetted number and Taburia needed.
- Local Health Depdo evaluation of training for kader, orientation program, and orientasi for widwife as well as other health staffs.
Reality in the field
1.Adequacy of target
a.Under two yr old
- Children 6-24 bulan - Only those who are malnourished
- Poor family or UMP less than Rp. 1.100.000)
1.Adequacy of distribution
- Taburia was distributed to all targeted children but it was not suited to guidance (should be step by step)
a.Amount of Taburia
- In general, from health office to PKM was suited to guidance.
- Tahap I; -15 pieces52.89% -16-30 pieces; 46.22% - 31-45 pieces0,.44%, - 46 pieces0.44%. - Tahap II; - 80,8% not received anymore still has from the first step. - Tahap III: - 96,44%.not received anymore still has from the second step.
a.Frequency of giving.
- Received Taburia at the last month, 71,56%
- Consume once in two days 39.11%
- 1 piece 1 child, 90.22%, 1 piece two children, 8.89% , 1 piece > 2 children, 0,89%.
a.Procedure of giving
- Consume at breakfast, 70,22% - Once a day, 82.67%, twice a day,
1.78%, three times a day, 1.78%. - Mixed with porridge, 20.89% - Mixed with rice, 69.33%, - Mixed with soup, 6.67%, - Mixed with fried noodle 1.78% , - Provided by mother, 93.33%, - Provided by grandma, 5.78%, - Provided by other member of
a.Coverage of Taburia
b.Good; On track > 80%
c.Enough(To wacth) 50-79%,
d.Poor (High Alert) < 50%.
- Coverage of taburialevel enough; 78,86%
- Received taburia 64,527 children under two yr old.
- Lot of children ate snack such as, cemilan; kerupuk, biskuit or bread.
- Some didnt like taste and smell
- Some children rewel and refused the food.
- Some like soup food mother didnt give taburia kepatuhan was low
a.Compliance - Compliance cut off point 60% (n = 398)
- Comply only 21,9%
Mean of hemoglobin and ferritin before and after intervention
No Measurem. x SD Min Max p value
1 Hb. baseline 10.88 1.17 7,00 13.40
0.000 Hb.eEndline 11.24 1.07 6.90 13.20
2 Fe baseline 28.09 25.99 1.50 114.00
0.332 Fe endline 30.13 23.14 1.16 99.49
Mean of hemoglobin endline based on compliance of Taburia
Did not comply 11,19 1,096
Comply 11,35 1,026
Determinant factors for compliance
References person or family Kader Posyandu Social support: - father- other family members - Kader
Easy to feed the children Increase appetite and want to eat frequently Adequacy of nutrient for the child Cognitive and brain development
Positive attitude due to providing Taburia :
Taburia has been successfully distributed and accepted by children 6 24 mo of age from poor family at Nice Project areas.
Some aspects of management and compliances prevent children to have a better nutritional status in this study.