Anemia pada ibu hamil peserta Program 1000 Hari Pertama Kehidupan di Agats, Asmat, Papua: Prevalensi dan analisis faktor risiko

https://doi.org/10.22146/jcoemph.39261

Pritania Astari(1*), Hanggoro Tri Rinonce(2), Maria Fransiska Pudjohartono(3), Josephine Debora(4), Monica Gisela Winata(5), Fadli Kasim(6)

(1) Program Studi Profesi Dokter, Fakultas Kedokteran, Kesehatan Masyarakat, dan Keperawatan, Universitas Gadjah Mada, Yogyakarta, Indonesia
(2) Departemen Patologi Anatomik, Fakultas Kedokteran, Kesehatan Masyarakat, dan Keperawatan, Universitas Gadjah Mada, Yogyakarta, Indonesia
(3) Program Studi Profesi Dokter, Fakultas Kedokteran, Kesehatan Masyarakat, dan Keperawatan, Universitas Gadjah Mada, Yogyakarta, Indonesia
(4) Program Studi Profesi Dokter, Fakultas Kedokteran, Kesehatan Masyarakat, dan Keperawatan, Universitas Gadjah Mada, Yogyakarta, Indonesia
(5) Program Studi Profesi Dokter, Fakultas Kedokteran, Kesehatan Masyarakat, dan Keperawatan, Universitas Gadjah Mada, Yogyakarta, Indonesia
(6) Departemen Teknik Nuklir dan Teknik Fisika, Fakultas Teknik, Universitas Gadjah Mada, Yogyakarta, Indonesia
(*) Corresponding Author

Abstract


ABSTRAK Pada tahun 2013, terdapat 37% kasus anemia pada ibu hamil di Indonesia. Kejadiannya di Agats, Asmat, Papua masih merupakan fenomena gunung es yang belum banyak mendapat sorotan. Pusat Kesehatan Masyarakat (Puskesmas) Agats menjalankan Program 1000 Hari Pertama Kehidupan (HPK) sejak tahun 2016 untuk meningkatkan kualitas kehamilan dan kelahiran. Penelitian ini bertujuan untuk mengetahui prevalensi anemia pada ibu hamil peserta Program 1000 HPK serta menganalisis faktor-faktor yang berpengaruh terhadap anemia pada ibu hamil di Agats, Asmat, Papua. Penelitian ini merupakan penelitian deskriptif observasional, menggunakan data sekunder dari laporan evaluasi Program 1000 HPK Puskesmas Agats Oktober 2017, yang diambil pada periode pelaksanaan Kuliah Kerja Nyata - Peduli Bencana (KKN-PB) Universitas Gadjah Mada (UGM), 17 Maret sampai 30 April 2018. Sebanyak 97 ibu hamil dari 230 peserta Program 1000 HPK dilibatkan dalam penelitian ini. Data yang diambil meliputi umur kehamilan, kadar hemoglobin (Hb), lingkar lengan atas (LLA), berat badan, dan pemberian suplemen zat besi. Kadar Hb < 11 g/dL pada trimester I atau < 10.5 g/dL pada trimester II dan III digolongkan sebagai anemia. Dilakukan pula analisis kemungkinan faktor risiko anemia berdasarkan hasil observasi di Agats dengan tinjauan pustaka. Dari total 97 ibu hamil peserta Program 1000 HPK, sebanyak 45.4% orang menderita anemia, meskipun 43.4% di antaranya telah mendapatkan suplementasi zat besi. Sebanyak 24.7% ibu hamil memiliki LLA < 23 cm. Beberapa kemungkinan faktor risiko anemia pada ibu hamil di Agats meliputi letak geografis Asmat, rendahnya tingkat pendidikan masyarakat, minimnya tenaga kesehatan serta fasilitas pelayanan kesehatan, kurangnya perhatian masyarakat terhadap kesehatan, keadaan sosioekonomi rendah, dan status gizi ibu hamil. Prevalensi anemia pada ibu hamil peserta Program 1000 HPK di Agats, Asmat, Papua pada Oktober 2017 lebih tinggi dari prevalensi nasional. Penelitian lebih lanjut dibutuhkan untuk mengetahui kaitan pasti antara kejadian anemia pada ibu hamil di Agats dengan faktor-faktor risiko tersebut.

KATA KUNCI anemia; kehamilan; 1000 hari pertama kehidupan; Asmat; Papua

 

ABSTRACT In 2013, it was found that 37% pregnant women in Indonesia suffered from anemia. However, in Agats, Asmat, Papua, this phenomenon has not gained enough attention. In order to improve the quality of birth and pregnancy, Pusat Kesehatan Masyarakat (Puskesmas) Agats is currently implementing the First 1000 Days of Life (1000 HPK) Program since 2016. This study aimed to discover the prevalence of anemia in pregnancy of the 1000 HPK participants in Agats and to understand the possible contributing risk factors. This study was descriptive observational study using secondary data from the evaluation report of 1000 HPK Program in Puskesmas Agats during October 2017. From 230 participants of 1000 HPK Program, 97 of them who were pregnant, were taken as the sample. The data (gestational age, hemoglobin level, upper arm circumference, body weight, and history of iron supplementation) were obtained during the implementation of Kuliah Kerja Nyata - Peduli Bencana (KKN-PB) Universitas Gadjah Mada (UGM), from March 17th to April 30th, 2018. Hemoglobin level in the first trimester < 11 g/dL or in the second and third trimester < 10.5 g/dL were classified as anemia. The observed risk factors were then analyzed using literature review. From 97 participants of 1000 HPK Program, 45.4% suffered from anemia, even though 43.4% of them had received iron supplementation. Moreover, 24.7% of the pregnant women had mid-upper arm circumference < 23 cm. Several observed influencing risk factors included the geographic profile of Asmat, low educational status, lacking of health personnels, facilities and the general awareness of the citizens regarding maternal health, low socio-economical status, and low maternal nutritional status. The prevalence of anemia in the pregnant participants of 1000 HPK Program in Agats, Asmat, Papua, during October 2017 was higher than the national prevalence. Further study needs to be conducted in order to find the correlation between the prevalence of anemia in the pregnant participants of 1000 HPK Program in Agats and the suspected risk factors.

KEYWORDS anemia; pregnancy; first 1000 days of life; Asmat; Papua


Full Text:

PDF


References

  1. Kementerian Kesehatan Republik Indonesia. Penderita menurun, status KLB campak Asmat dicabut [Internet]. Agats: Kementerian Kesehatan Republik Indonesia; 2018 [updated 2018 Feb 5; cited 2018 Aug 2018]. Available from: http://www.depkes.go.id/article/view/18020600001/penderita-menurun-status-klb-campak-asmat-dicabut.html
  2. Yuningsih R. Pendekatan kesehatan masyarakat pasca kejadian luar biasa (KLB) di Kabupaten Asmat Papua. Bidang Kesejahteraan Sosial Pusat Penelitian Badan Keahlian DPR RI. 2018;10(4).
  3. Soma-Pillay P, Nelson-Piercy C, Tolppanen H, Mebazaa A. Physiological changes in pregnancy. Cardiovasc J Afr. 2016;27(2):89–94.
  4. Sifakis S, Pharmakides G. Anemia in pregnancy. Ann N Y Acad Sci. 2006;900(1):125–36.
  5. Stephen G, Mgongo M, Hashim TH, Katanga J, Stray-pedersen B, Msuya SE. Anaemia in pregnancy: Prevalence , risk factors , and adverse perinatal outcomes in Northern Tanzania. Anemia. 2018;2018.
  6. World Health Organization. The global prevalence of anaemia in 2011 [Internet]. Geneva: World Health Organization; 2011 [cited 2018 Aug 30]. Available from: http://apps.who.int/iris/bitstream/10665/177094/1/9789241564960_eng.pdf?ua=1
  7. Badan Penelitian dan Pengembangan Kementerian Kesehatan Republik Indonesia. Riset kesehatan dasar 2013. Jakarta: Departemen Kesehatan Republik Indonesia; 2013. 384 p.
  8. Black RE, Victora CG, Walker SP, Bhutta ZA, Christian P, De Onis M, et al. Maternal and child undernutrition and overweight in low-income and middle-income countries. Lancet. 2013;382(9890):427–51.
  9. Taner CE, Ekin A, Solmaz U, Gezer C, Çetin B, Kelesoglu M, et al. Prevalence and risk factors of anemia among pregnant women attending a high-volume tertiary care center for delivery. J Turk Ger Gynecol Assoc. 2015;16(4):231–6.
  10. Pemerintah Kabupaten Asmat - Papua Indonesia. Pemkab Asmat canangkan Gerakan 1000 Hari Pertama Kehidupan [Internet]. 2017 [cited 2018 Aug 30]. Available from: http://www.asmatkab.go.id/article/pemkab-asmat-canangkan-gerakan-1000-hari-pertama-kehidupan
  11. Calkins LA. Blood transfusion in obstetrics and gynecology. RCOG Greentop Guidel. 2015;22(8):704–7.
  12. Pemerintah Kabupaten Asmat. Geografi [Internet]. Asmat, Papua: Pemerintah Kabupaten Asmat; 2017 [cited 2018 Aug 30]. Available from: http://www.asmatkab.go.id/page/geografi
  13. Belarminus R. Curhat Mensos dan Menkes soal tantangan kondisi geografis Asmat [Internet]. Jakarta: Kompas.com; 2017 [updated 2018 Jan 29; cited 2018 Aug 30]. Available from: https://nasional.kompas.com/read/2018/01/29/20031241/curhat-mensos-dan-menkes-soal-tantangan-kondisi-geografis-asmat
  14. Cox JT, Phelan ST. Nutrition during pregnancy. Obstet Gynecol Clin North Am. 2008;35(3):369–83.
  15. Badan Pusat Statistik Kabupaten Asmat. Kabupaten Asmat dalam angka 2017. Asmat, Papua: Badan Pusat Statistik Kabupaten Asmat; 2017.
  16. Puskesmas Agats. Laporan evaluasi Program 1000 HPK Oktober - Desember 2017. Agats, Asmat, Papua: Puskesmas Agats; 2017.
  17. Melku M., Addis Z, Alem M, Enawgaw B. Prevalence and predictors of maternal anaemia during pregnancy in Gondar, Northwest Ethiopia: An institutional based cross-sectional study. Anemia. 2014;2014.
  18. Tanzania Bureau of Statistics. Tanzania demographic and health survey 2016. Tanzania, Maryland: National Bureau of Statistics Dar es Salaam, Tanzania ICF Macro Calverton; 2016. 482 p.
  19. Linggasari D. Realitas di balik indahnya ukiran: Potret keseharian Suku Asmat di Kecamatan Agats. Yogyakarta: Kunci Ilmu; 2002.
  20. Al-Mehaisen L, Khader Y, Al-Kuran O, Abu Issa F, Amarin Z. Maternal anemia in rural Jordan: Room for improvement. Anemia. 2011;2011.
  21. Pemerintah Indonesia. Rancangan 5 September 2011: Rencana pengembangan tenaga kesehatan tahun 2011 - 2025. Jakarta: Pemerintah Indonesia; 2011.
  22. World Health Organization. WHO Recommendation on antenatal care for positive pregnancy experience [Internet]. Geneva: World Health Organization; 2016 [cited 2018 Aug 30] 172 p. Available from: http://apps.who.int/iris/bitstream/handle/10665/250796/9789241549912-eng.pdf?sequence=1
  23. Tang AM, Dong K, Deitchler M, Chung M, Maalouf-Manasseh Z, Tumilowicz A, et al. Use of cutoffs for mid-upper arm circumference (MUAC) as an indicator or predictor of nutritional and health- related outcomes in adolescents and adults: A systematic review. Food Nutrition Technical Assistance. 2013;(November):1–37.
  24. Ververs M-T, Antierens A, Sackl A, Staderini N, Captier V. Which anthropometric indicators identify a pregnant woman as acutely malnourished and predict adverse birth outcomes in the humanitarian context?. PLoS Curr. 2013;Jun(1).
  25. Lubis Z, Fitria M. Chronic energy malnutrition and anemia in pregnant women in Medan. Proceedings of the 1st Public Health International Conference. 2016;1(PHICo 2016):337–40.
  26. Haldar K, Mohandas N. Malaria, erythrocytic infection, and anemia. Hematology. 2010;1(574):87–93.
  27. Dinas Kesehatan Provinsi Papua. Profil kesehatan Provinsi Papua tahun 2016. Jayapura, Papua: Dinas Kesehatan Provinsi Papua; 2017. 163 p.
  28. Rahmati S, Delpishe A, Azami M, Hafezi Ahmadi MR, Sayehmiri K. Maternal anemia during pregnancy and infant low birth weight: A systematic review and meta-analysis. Int J Reprod Biomed (Yazd). 2017;15(3):125–34.
  29. Kumar KJ, Asha N, Murthy DS, Sujatha M, Manjunath V. Maternal anemia in various trimesters and its effect on newborn weight and maturity: An observational study. Int J Prev Med. 2013;4(2):193–9.



DOI: https://doi.org/10.22146/jcoemph.39261

Article Metrics

Abstract views : 6036 | views : 9977

Refbacks



Copyright (c) 2018 Journal of Community Empowerment for Health

Creative Commons License
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.