INCREASING MATERNAL KNOWLEDGE IN PREVENTING STUNTING THROUGH COMMUNITY-BASED NUTRITION EDUCATION

. Stunting is a disorder of growth and development of children due to chronic malnutrition and recurrent infections, which is characterized by their length or height being below the r mark set by the minister who organizes government affairs in the health sector. The respondents in this activity were mothers and toddlers in RW 02, RT 01, 02


INTRODUCTION
According to Presidential Regulation of the Republic of Indonesia Number 72 of 2021, stunting is a disorder of growth and development of children due to chronic malnutrition and recurrent infections, which is characterized by their length or height below the standards set by the minister who organizes government affairs in the health sector. Meanwhile, based on the Ministry of Health, stunting is children under five with a z-score of less than -2.00 SD / standard deviation (stunted) and less than -3.00 SD (severely stunted). Stunting is associated with birth weight, diarrhea, maternal knowledge and education level, family income, and sanitation (Herlina et al., 2021).
Risk factors for stunting children are nutritional status and birth weight <2,500 grams, maternal education factors, low household income factors, poor sanitation factors. (Sutio, 2017). In addition, stunting risk factors tend to be more men than women, healthy and clean living habits that can affect the incidence of diarrhea as well. (Anwar, Winarti and Sunardi, 2022). Risk factors that can occur in rob areas, caused by protein intake, iron intake, incidence of diaera, ISP, history of exclusive breastfeeding, sanitary hygiene and economic status. (Yuniarti, Margawati and Nuryanto, 2019).
Kelurahan Bandarharjo is a kelurahan located in JL. South Bandarharjo No.17, Bandarharjo, North Semarang, Semarang City, Central Java 50175. Which consists of 12 RW and 103 RT. Based on stunting data from the Semarang city government in 2023, there are 61 stunting cases. With 33 male children, and 28 female children. Integration activities were carried out in RW 02 RT 01, 02, and 03. The number of toddlers is 42, Rt 01 is 17 toddlers, Rt 02 is 15 toddlers, and Rt 03 is 10 toddlers. There is a problem of stunting cases as many as 9 toddlers, the most cases are in Rt 01 with 4 toddlers, Rt 2 with 2 toddlers, and Rt 3 with 3 toddlers.
Increasing maternal knowledge about child nutrition can be done through nutrition education. Nutrition education activity is an activity for nutrition-related information with the aim of increasing knowledge and changing behavior for the better (Muzarofatus, 2021). Knowledge about the health and nutrition of mothers will greatly affect the nutritional status of children under five (Sahanggamu, Purnomosari and Dillon, 2017) Good maternal nutrition behavior can have a positive impact on toddler nutrition. The ability of mothers to provide the right food ingredients and menus supported by their knowledge about nutrition can prevent nutritional problems in toddlers (Dwi Pratiwi, Masrul and Yerizel, 2016).
One of the efforts to prevent and overcome stunting is to implement balanced nutrition. Balanced nutrition is the fulfillment of food needs that are consumed daily and contain nutrients with the type and amount needed by the body (Fajriani, Aritonang and Nasution, 2020) UNICEF framework explains the factors that cause malnutrition. Two direct causes of stunting are disease factors and nutrient intake. Both of these factors are related to parenting factors, access to food, access to health services and environmental sanitation.
The impact that can be caused by stunting in the short term disrupts brain development, intelligence, impaired physical growth, and metabolic disorders in the body. The adverse effects in the long term are decreased cognitive ability and learning achievement, decreased immunity so that it is easy to get sick, and a high risk for the emergence of diabetes, obesity, heart and blood vessel disease, cancer, stroke, and disability in old age, as well as uncompetitive work quality which results in low economic productivity (Mother, 2012). Several studies show the risks caused by stunting are decreased academic achievement, increased risk of obesity, more susceptible to non-communicable diseases and increased risk of degenerative diseases according to United Children's Fund Indonesia (Mother, 2012). The purpose of this study is to find out whether there is an increase in maternal knowledge through nutrition education.

METHODS
The type of research carried out isQuasi-Experimental research with the design of the research carried out, namely One Group Pre-Post Test Design, which means that this test is carried out before and after the intervention of knowledge extension of mothers to prevent stunting. This activity began with filling out the pre-test and then continued with community-based nutrition education counseling intervention activities, cooking demos, discussions and questions and answers, at the end of filling out the post test. The duration of this intervention is carried out for 4 hours. The media used are posters, questionnaires about knowledge to prevent stunting, and the Si Gembul application. The population of this study was all children under five in Bandaharjo RW 2 sub-district. Samples were taken as many as 42 toddlers. Pprocesses this sampling with confirmation to RT 01,02, 03 to show parents who have toddlers. The technical data analysis used is using the Wilcoxon Test with a confidence level of 95% and α = 0.05. The Wilcoxon test is performed as an alternative dependent paired t-test because the pre-test and post-test data are not normally distributed. (Alfedo et al., 2023). This data analysis was performed using SPSS software version 26.

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The maternal characteristics of the study subjects included the mother's age, and the mother's height. For toddler characteristics of the study subjects include the sex of toddlers, the age of toddlers (months), and the length of birth of toddlers. Based on Table 1. The age characteristics of IBU are grouped into 3, namely 22-33 years as many as 11 people, 34-37 years as many as 9 people and 38-52 as many as 5 people. Based on the characteristics of the mother's height, the average height of the mother is 155 cm as many as 10 people. While the mother's height is more than 130 cm as many as 24 people. Mothers with a height below 150 cm are at risk of having stunted children.
Based on the sex characteristics of respondents, it was found that the survey results of respondents were more women, which was as much as 60% compared to men as much as 40%. Based on the age characteristics of toddlers, they are divided into 3 categories, namely the age of 10-30 months as many as 9 toddlers (36%), the age of 31-42 months as many as 7 toddlers (28%) and the age of 43-56 months as many as 9 toddlers (36%). Based on the characteristics of the birth length of toddlers, the average toddler has a length of 49 cm as many as 7 people.

Overview of nutritional status conditions according to Z Score PB/U
The condition of nutritional status according to Z Score according to PB/U in 25 toddlers in RW 02 RT 01, 02, 03 in Bandarharjo Village. The Z Score is managed from the "The Gembul" application. Based on the results of the description of stunting conditions according to PB / U with 25 toddlers, it can be known the nutritional status of toddlers who are stunted as many as 5 toddlers, 19 toddlers who have normal nutritional status, and 1 toddler has high nutritional status. The average Z Score for toddlers is -0.86, with a minimum value of -3.68 and a maximum of 5.27, so the category of z score is good (>= -0.86). Based on the results of the normality test, the data above was foundthat maternal knowledge in preventing stunting before and after the intervention was not normally distributed (p -value < 0.005).

Normality Test Results and Wilcoxon Test
The following is data processing using nonparametrics because the results of the normality test are not normally distributed. So it uses the Wilcoxon test to find out if there is a difference after counseling. Based on the results of the Wilcoxon test, it produces with α (0.05) obtained a value of p = 0.000. Because the value of 0.000 < 0.05 so that there is a difference between knowledge to prevent stunting for pre-test and post-test scores. There are differences in knowledge before and after counselingso that the community pays attention to the material that has been delivered.
These results are in line with James Kevin's research which states that the Wilcoxon test results of pre-test and post-test data are < 0.05 =, these results show that there is a difference between pretest results before counseling and post-test results after counseling experienced effective results (Alfedo et al., 2023). This result is also in line with Ravi Masitah's research which states that nutrition education in mothers can have a positive impact on increasing maternal knowledge related to stunting with the results of data analysis (p-value < 0.005) (Masitah, 2022

Community-Based Education Methods
The following methods of community-based education that can be done, namely: -Data collection using interview techniques using Google Form.
-Application "Si Gembul" as a medium to calculate the nutritional status of toddlers.
-Intervention activities were carried out by socializing stunting prevention using book guidelines from BKKBN with the themes "Skata Demi Keluarga Understand Important Steps to Prevent Stunting" and "Cook Delicious According to My Plate". -Division of Pre Test and Post Test as a medium to measure maternal knowledge. -Nutritious food demo as a medium to increase mothers' creativity in food processing for toddlers. -The distribution of posters with the theme "Various Healthy Preparations to Prevent Stunting" as a medium to add ideas for processed food creations. -The distribution of PMT (Supplementary Feeding) aims to improve nutritional status and meet the nutritional needs of toddlers.

CONCLUSION
Stunting cases in RW 02 RT 01, 02, and 03 in Bandarharjo there are 5 toddlers. The occurrence of stunting cases can be triggered by risk factors that can affect stunted toddler growth and development. In an effort to handle stunting cases in RW 02, RT 01, 02, and 03 in Bandarharjo, counseling activities were carried out on the importance of preventing stunting attended by mothers and toddlers, conducting nutritious food demonstrations, distributing posters of processed fruit creations to toddlers, and distributing PMT (Supplementary Feeding). Based on the results of the Pre Test and Post Test using the Wilcoxon Test to find out if there is a difference after counseling and show an increase in maternal knowledge about stunting.

THANK YOU SPEECH
The students expressed their gratitude for the cooperation and support during the implementation of Integration activities to Bandarharjo Village, North Semarang District, which has allowed and helped all activities carried out by students so that they can run smoothly, All RW 02 communities who have actively participated in the implementation of integration activities, Posyandu Minasari 1 which has helped increase public awareness, especially in terms of maintaining maternal and child health, as well as BKKBN of Central Java Province which has supported Integration, Monitoring, Evaluation activities in the field of population control and family planning.