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Abstrak :
One way to improve the success of exclusive breastfeeding promotion is to understand the factors that directly of indirectly influence a mother's decision to initiate complementary feeding, as well as their interaction. The present study employed the use of a newly developed qualitative dietary survey-Food Choice Map method-to investigate those factors for 40 mothers with infants aged 4 - 6 months old residing in Pondok Labu sub-district of South Jakarta, Indonesia, regarding the `military' and 'civilian' communities. K -Means Cluster Analysis was used to create relatively homogenous groups based on demography and socioeconomy characteristics using variables such as mother's age, child's age and sex, study groups, ownership of house, phone, and motorcycle. Nearly all infants (97%) received complementary feeding before the age of 4 months old with "to calm child" as the most common reason why mothers initiated the feeding. Most infants were given banana as their first food as the "social circle suggested" or because it is "commonly used food." Another large percentage received instant baby food due to "its practicality." The findings suggest factors such as socioeconomy and demography-as described by the cluster characteristics-whom mothers were dependent on, feeding experience, and self-confidence influenced mother's decision in initiating complementary feeding. Furthermore, they interact with one another that their existence of affecting mothers' behavior is the result of not only one factor. It is recommended to establish breastfeeding support groups for the mothers, as well as to greaten encouragement from the social circle and medical professionals to motivate mothers and increase their self-confidence to breastfeed the infants.

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ABSTRACT
This study was done in order to obtain information about current breastfeeding behavior among resident and migrant lactating mothers in Hanoi Vietnam for the general purpose of breastfeeding promotion in Vietnam. The research hypothesis is that there is a different breastfeeding behavior of resident and migrant lactating mothers. A cross-sectional study was carried out between December 1994 and March 1995. The subjects consisting of 80 lactating mothers with 9 months old baby are divided into 2 groups. Those mothers have been living for at least 15 years in Hanoi (resident mothers) and the other mothers for between 5 months to 3 years (migrant mothers). Information of breastfeeding behavior and the socioeconomic status of mothers were obtained by using open-ended questionnaire. A second questionnaire was applied to 30 health professionals in maternity clinics where the mothers delivered. One hundred percent of mothers breastfed their child, 95% of the resident and 85% of the migrant mothers were still breastfeeding at the time of the study. Almost all of the residents (95%) and 87.5% of the migrants had positive attitude towards colostrum. About 42.5% of the resident mothers and 35% of the migrant ones started breastfeeding within 6 hours after birth. The rooming-in rate was 67.5% of the resident mothers and 52.5% of the migrant ones. The rate of early initiation of breastfeeding was significantly higher in the mothers group who had rooming-in than the others. The exclusive breastfeeding rate within the first 4 months of age was 35% of the residents and 30% of the migrants. All health professionals (100%) had positive attitude towards colostrum and breastfeeding. About 86.7% of doctors and 80% of midwives knew that 'mother' should start breastfeeding within the first 30 minutes after birth. Around 86.7% of doctors and 100% of midwives said that there was no need to give other liquid before starting breastfeeding. But their practices were not according to their knowledge: They gave wrong advises to the resident mothers (8.7%)., about 38.4% of babies from the resident mothers and 60.9% of babies from migrant ones were prelacteal fed by health professionals. Additional information on breastfeeding and child feeding were still expected by mothers especially by the migrant ones (71.4%). The results of the study suggest education on breastfeeding and proper feeding practices, especial early initiation, prolonged exclusive breastfeeding, and rooming-in.

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A cross sectional study to determine the salt consumption at household level was carried out in Sukabumi District. Two hundred households with children 1-5 years were selected randomly. This study consisted of interviews of the mothers, observation of iodized salt usage and analysis of the iodine content in iodized salt.

The results showed that all households in the study area have used iodized salt but they were not aware that. they used iodized salt.

The average salt consumption at household level was 4.8 gr per day per capita with majority iodine intake (71 %) less than 100 pg. Using lodometry test, 47 % of households had iodine content in iodized salt was less than 30 ppm. In general, all cooked food used salt except for rice as staple food, but not all of food prepared with salt were consumed by children 1-5 years.

According to mothers' perception, the mother with better knowledge had higher percentages on using iodized salt and also had better educational level.

These findings showed that the recommended iodine intake by WHO of 100-300 pg per day per capita was not fulfilled, mainly because of the low quality of iodized salt, as well as improper ways of salt storage and food preparations. Lack of knowledge due to low educational level of mother was worsening this condition.

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A cross-sectional study was carried out to investigate qualitatively the current breastfeeding behavior of mothers having the first baby about six months of age and the current behavior regarding breastfeeding of health professionals working in several health care facilities (HCF) in Jakarta. The samples of mothers and health professionals were selected from HCF representing two different socioeconomic strata (middle-high and middle-low group). The result of this study shows that mother's breastfeeding behavior (the time of breastfeeding initiation, frequency and duration of breastfeeding) was in favor for the mothers of the middle-low group. Better practice concerning the time of breastfeeding initiation was also found among the health professionals of the middle-low group. Giving prelatic feed in the HCF was still common especially in the middle-high HCF. The duration of exclusive breastfeeding practice was still inadequate among mothers regardless socioeconomic status, which was also revealed in the health professional's knowledge. This study suggests that mother's motivation regarding breastfeeding should be encouraged continuously through various channels. All health professionals should be well informed and well motivated to promote breastfeeding particularly regarding the time of breastfeeding initiation, giving prelatic feed in the health care facility and the recommended time of giving supplementary feeding.

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Most poverty prevalence in developing countries is found among people living in rural areas, which depend on agricultural activities as their main source of livelihood (Suryana, 1992, Kuhonta, 1986).

This study assessed the overall condition of the rural community in Pasaman (Jambak and Sarik village) and Sawahlunto/Sijunjung (SP I and SP IV village) district regarding to the poverty and nutritional situation by using an adapted Rapid Rural assessment method which was called RAPID: Rapid Nutritional Assessment for Community Based Poverty Alleviation Projects in Developing Countries, developed by GTZ. The method consists of interviewing key persons, focus group discussion, observation and height measurement of school children (6-9 years old).

Other method to diagnose and analyze the nutritional situation of risk group is a nutritional survey. Interview and anthropometrics measurement of fewer than five children and the mother were done in this method.

A poor state of nutrition and health also leads to lower productivity and reduces the availability of food at the household level, which now forms a vicious cycle. The availability of food can describe the food security status of the household. This study also attempted to look into the main problems of food security on rural community by using food security questionnaire developed by SEARCA (South East Asian Regional Center for Agriculture). The result of interviewing the mothers by this method revealed that current food security status in Jambak and Sarik was better than SP I and SP IV while SP IV was worse than SP I. The similar result was found by other two methods.

RAPID method described the overall condition of the study area in a short time. This method also collected preliminary information on the nature and importance of poverty and nutritional problem, and supply of the resources of the study area. However this method insufficient to describe the relationship between nutritional problem and its determinant factor.

Baseline survey gave the extent of the nutritional problem in the area, nevertheless this method needed some resources; fund, personnel, equipments and time.

Food security method assessed the extent of food security problems in the area, however in this study, it was proved that the questionnaire was not fully applicable, therefore further analyses based on SEARCA method could not be completely applied.

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The recommendation and estimation of human energy and dietary requirement until today has been based only on the physiological needs of food nutrients. The fact that food is also an integral part of socialization process seemed to be ignored. In some communities beside having a social function, food is also used non-physiologically such as in religious ceremonies. It was hypothesized that for communities like Bali Island where food is used extensively for non-physiological purpose, such as in religious ceremonies, the present recommendation is still inadequate as--it failed to consider the food needed for that purpose. Furthermore it was believed that the quality and quantity of food used for that practice depends on the socio-economic status of the households.

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The general objectives of this study was to observe the non-physiological. usage of food in Balinese household, in order to calculate the total food requirement of households for both physiological and social needs and to obtain information on the religious and cultural background or explanation of the practice.

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The results of semi-structured interviews and observations on 60 households from two villages in Tabanan Districts, Bali, indicated that there were no statistically significant relationship between the quality and quantity of food used non-physiologically and the socio-economic status of the households. Based on the three alternate days 24-hour recall, it was calculated that the food used for' non-physiological purpose in terms of kcal amounted to 3.6 % of the total daily average energy intake of households in village Timpag and 4.1 % of households in Pandakbandung village. Based on observation, Focus Group Discussion and in-depth interview with selected key informants it was estimated that in term of energy, the average daily usage of food for non-physiological purpose for the whole year, were more than 641 kcal which equals to more than 7.5 % of aver-age daily calorie intake of-the sample households.

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The general objective of this study is to determine the influence of TV foods/drinks/vitamin-mineral supplement advertisements on the food consumption pattern of male and female adolescents. This research used cross sectional study design. Eighty adolescents of both sexes, between 15-17 years old and living in East Jakarta were randomly selected from a public high school. A preliminary study was conducted to observe food/drink/vitamin-mineral supplement advertisements on TV during several weeks and different daytimes as well as the relative price of advertised foods at different outlets and nearby the school. The information obtained helped to decide which of the advertised products should be included in the research.The main study consisted of in-depth interviews of the adolescents and the TV advertisement managers.

There was found an association between duration of watching TV and advertised foods consumption. Attitude towards advertisement indicated _a positive trend towards advertised foods/drinks/vitamin-mineral supplements consumption. The higher nutrition knowledge score they got, they drank Vitamin/Mineral more frequently and ate candy (Relaxa) less frequently. In general amount of pocket money had positive trend towards consumption of advertised foods. Males consumed more low nutritious food/drink such .85 Silver Queen and Teh Botol than females while females tend to consume more nutritious -advertised products than males (vitamin/mineral supplements and milk). Males watched TV more than females. Females got more pocket money than males but more females saved part of their pocket money instead of spending most of it for foods. Females were more knowledgeable on nutrition than males. Duration of spending time with the peer group was significantly associated with the consumption of advertised foods/drinks/vitamin-mineral supplements. The more adolescents spent time in hours with their friends, the more they consumed advertised food/drink/vitamin-mineral supplements.

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An experimental community trial study was conducted to observe the influence of communication program on weekly iron supplementation in Tanzanian adolescent school girls.

A sample of 237 school-going adolescent girls aged 14 -17 years was randomly recruited from 5 schools in Darus-Salaam and placed into 3 groups. One group received 65 mg elementary iron with 0.25 mg folic acid on a weekly dose along with communication sessions. The second group received the same dose of iron tablets and no communication sessions. No intervention was made to the control group.

A VENN Diagram to assess the most closer person whom the girls would listen to was drawn prior to study. Three Focus Group Discussions at different stages with the adolescents and teachers were conducted. Anthropometrics in-dices were done once at baseline. Supplementation and communication strategies lasted for 8 weeks.

Measurements of Hemoglobin levels to obtain a general picture about the nutritional status of the participants were carried out before and after the intervention. Hemoglobin increased in school 1&2, (iron supplementation plus communication schools), (p<0.001); and anemia dropped significantly (p<0.001). School 3 (iron without communication) had zero anemia decrease; while school 4 (control); had anemia rates unchanged. To the contrary; anemia levels increased significantly in control school 5; (p>0.05).

Knowledge test was carried out before and after intervention; and an in-crease in test scores of school 1&2 was observed (p<0.001). Compliance was checked through stool examination (observed compliance) and iron pill distribution record (reported compliance). The results as indicated by two positive stool tests, were 94% and 75% in school 1 and 2 respectively; in school 3 (iron supplementation only) it was 50%. Reported compliance was 89% for school I&2 each, and 48% for school 3.

It was concluded that, carefully planned communication strategies can influence ingestion of iron supplementation; and, as anemia in adolescents in Tanzania is high, therefore a National Iron Supplementation Program was recommended.

Abstrak :
Female adolescents are vulnerable to iron deficiency anemia (IDA) and if it persists into their reproductive years has serious implications not only for the health of their offsprings but for their own as well. An iron supplementation is warranted in order to provide sufficient iron stores prior to pregnancy and to effect desirable birth outcomes. A communication component of the supplementation is regarded as essential for improving compliance. Therefore, an experimental community trial involving adolescent female students in two public high schools in Metro Manila was conducted between October-December 1997. The objective of the study was to asses the effect of communication on compliance to weekly iron supplementation. The students were assigned to three groups: iron plus communication (FeC group, n = 82), iron (Fe group, n = 89), and control group (n=78). The FeC and Fe groups received iron tablets containing 60 mg. Elemental iron and 250 mcg. Folic acid while the control group received placebo tablets from Physical Education Health and Music (PEHM) teachers once a week of eight subsequent weeks. Teachers assigned to the FeC group were trained communication. Comparison were made between the three groups on compliance as communication. Comparisons were made between the three groups on compliace as measured by attendance to tablet distribution and actual ingestion through stool test, record on index card and interview. Additionally, levels and prevalence of anemia were measured before and after intervention and a pre and post test about knowledge on IDA and possible causes and treatments were included. Data about side-effects, reaction from students, parents and teachers about the supplementation-communication activities and suggestions for futher improvements in conductiong such future undertaking were obtained from focus group discussions (FGDs). Comparisons of actual tablet ingestion between the three groups showed significantly higher compliance in the FeC group (P<0.001) than in the other two group as measured by record on index card and interview desoite more side effects felt. Changes from pre to post-test knowledge scores o iron were significantly greater for the FeC group (p<0.001) than in the Fe and control groups. However, hemoglobin levels improved significantly in the Fe group (p<0.05) but not in the FeC group and remained the same in the control group. Reactions obtained through focus group discussions from parent (as reported by students), teachers and the participants found the program beneficial and feasible for implementation on a larger scale. Compliance enhancing strategies and motivational approaches for adolescent female students must consider the potential influence of family, fiends and teachers as revealed by the Venn diagram in planning iron supplementation programs with communication for this target group.