Development of Website-Based Stunting Prevention Educational Media Services (Case Study: UPT Puskemas Tirto Pekalongan)

. UPT Puskesmas Tirto is a public health center located in the West Pekalongan sub-district that provides maternal and child health poly services. This poly provides educational services related to the problem of stunting in children through Posyandu activities. However, providing educational services is less effective and efficient because some parents do not have much time to attend counseling so information is not conveyed properly. This research aims to optimize the provision of educational services to parents, prospective mothers, and young women through the use of information technology by developing a website-based stunting prevention educational media service using the ReactJs framework. The development process of this research is carried out by prototyping method. Based on the results of testing using the Blackbox method, it shows that the main features such as nutrition check services, consultation services with Puskesmas nutritionists, and literacy services in the form of articles in the application can run well according to their functions in providing stunting prevention information with 100% results.


Introduction
Child stunting is one of the health problems that has not been resolved in several countries including Indonesia.In the Central Java region, especially in Pekalongan City, stunting is a serious health problem in children and has not been resolved optimally.This was mentioned in the statement of the Head of Population Control and Family Planning of the Social and Family Planning Agency, who stated that the prevalence rate of child stunting in the Pekalongan City area still reached 23.1% in 2023 [1] considering that the national stunting prevalence standard targeted by 2024 must be below 14% [2] and set by WHO must be below 20% [3].
Based on the results of direct interview observations with one of the maternal and child health clinic officers of the UPT Puskesmas Tirto Pekalongan City, many factors can influence the incidence of stunting in children, this can usually be influenced by several internal factors, including children who are born from anemic or malnourished mothers, low-calorie intake and nutrition in mothers and children.Then external factors, it is caused by poor parenting patterns, lack of knowledge about basic vaccinations in children, and low levels of knowledge and awareness of parents regarding stunting.Maternal and child health clinic service officers have taken several actions to suppress the internal and external factors that cause stunting in children.One of them is by providing free educational services to parents through counseling related to stunting in children.This educational service is routinely held every month complete with counseling with midwives, nutrition officers, and local Posyandu cadres.However, in reality, there are accessibility constraints faced by parents in attending conventional counseling activities such as busyness and time constraints so that they do not get information about stunting prevention provided during counseling activities.In addition, educational counseling that targets adolescent girls at school is less effective due to limited time and space.This is certainly a serious concern because knowledge about anemia and malnutrition is a basic thing that must be considered in adolescent girls so that later they do not give birth to children with stunting conditions [4].The findings of these problems can be the basis for the need to optimize stunting prevention education services.
To optimize stunting prevention education services, an update is needed by utilizing technology [5] in the form of educational media services [6] so that information about the chain of stunting problems is conveyed to parents and adolescent girls who will become prospective mothers [7] [8].The selection of the website as a medium for digitizing the delivery of information and education provides a solution because users have the freedom to access it anytime and anywhere through the browser on Android and iOS devices [9].Digitalization in this study is defined as the process of transforming health education services from conventional forms to be more interactive and integrated with health workers, to provide convenience and more reliable information for users [10].
Some relevant previous research related to the development of health education service applications includes research [11] that provides KIA (Maternal and Child Health) book education services based on Android applications, with this application making it easier for health cadres to provide health assistance to pregnant women by providing information related to stunting, nutrition-related information, body mass index check calculators, and immunizations.However, some things are lacking in this study, namely the absence of an online counseling system that facilitates the educational assistance process.Furthermore, research [12] developed a service that makes it easier for health workers to monitor the growth data of children affected by stunting.This research only focuses on collecting data on children who are stunted so it does not provide educational features such as article features on stunting prevention.Other research [13] built an android-based health application to facilitate monitoring and prevention of stunting through data inputted by parents.The application developed in this study has been successfully tested on Android version 7 nougat but it is still unknown whether it can be compatible with the latest version of Android.In addition, this research is also not equipped with access to information about stunting and a consultation system so it does not provide educational and interactive content.The development of health education service applications in previous studies has made an important contribution to maternal and child health.However, there are still shortcomings that need to be considered, such as the development of features that specifically focus less on providing educational services on stunting prevention and the absence of interactive features such as online consultations with health workers.In addition, the Android application developed has limitations in accessibility and compatibility with certain specifications.
Seeing the existing problems and shortcomings of previous research, this research was conducted to complement these shortcomings.This research aims to develop a website-based stunting prevention educational media service application.This website application provides broad accessibility through a digital platform by providing free educational services in the form of access to articles about stunting, body mass index checks on children, and consultation services via WhatsApp with Puskesmas nutrition officers so that parents and prospective mothers can access information related to stunting prevention education anytime and anywhere according to their needs, which may not be met by conventional counseling methods.Thus, this web-based approach is expected to provide a more effective solution in overcoming the limitations of stunting prevention education.

Research Methods
Application development in this study was developed using the prototyping method.The prototyping method is a process used in software development by involving users directly in the process [14] [15] [16].User involvement in the software development process aims so that researchers do not misunderstand the system requirements needed by their users [17].Another goal is that users can monitor each process so that they can understand how the system works that has been created.This is an advantage of the prototyping method compared to other methods such as Rapid Application Development (RAD) or Waterfall [18] [19].In addition, the use of prototyping methods is very relevant to ongoing projects that require modification because it is responsive to changing user needs [20].

Figure 1. Research stages
Figure 1 illustrates the process of research stages that will be carried out in this study.The stages began with identifying problems related to stunting prevention education services at the mother and child clinic that were not optimal.Research data was obtained through direct interviews with 2 nutrition clinic officers from UPT Puskesmas Tirto, and supported by literature studies such as journals, articles, and relevant sources to understand the need to optimize stunting prevention education services.The questions asked to support the research included factors that cause stunting in children, types of educational services that have been provided to parents, prospective mothers, and adolescent girls, and information related to stunting.The next step is to analyze the interview data in the form of audio recordings and convert them into a table of functional requirements for the features to be developed.In the design stage, a system design will be made which includes use case design and system user interface design.The results of this design are then implemented into code using the JavaScript programming language using the ReactJs framework.After successful implementation, the system will be tested using Blackbox, and maintenance is carried out to ensure the application can run as expected.

Planning and Analysis Stage
The results of the analysis of system requirements obtained through direct interview data with relevant health center officers and literature studies, show some of the functional requirements required by the system to meet user needs.The functional requirements of the system to be developed can be seen in Table 1.Furthermore, these functional requirements will be the main guide in developing the application website to ensure that the features produced can provide solutions that meet user needs.Display a selection of stunting education articles UC4

System Design Stage
At this stage, the developed website will go through the process of designing a user-friendly interface.This process includes creating user requirements diagrams, and lo-fi, and hi-fi designs according to the system functionality requirements that have been determined from the planning and analysis stages.Where the design process includes determining content such as nutritional information, healthy eating patterns, body mass index checks, and consultation services.The use case diagram in Figure 2 aims to clarify the description of the interaction model between the user and the system, with features such as accessing the home page, checking body mass index, accessing the consultation page after login or registration, and accessing articles related to stunting.

Implementation Stage
The following are the results of the website implementation that has been developed.In Figure 3 there is access to the home page which contains an introduction to the SIPENTING website, data on the prevalence of stunting in children according to SSGI, and an overview of stunting articles.In addition, the home page is also equipped with navigation buttons to access the consultation, nutrition check, and article pages.5, is a display of the results of the implementation of the consultation page that can be accessed if the user has logged in or registered first as in Figure 6 by entering a username, email, and password.In Figure 6, there is a consultation button which if clicked the user will be directed to the WhatsApp number of the nutritionist of the UPT Tirto Pekalongan City health center who can be contacted if they want to consult about stunting problems in children.7, is a display of the results of the implementation of the article page.On this page, there are several articles provided to improve user literacy and on this page, a button is also provided to filter articles according to the topic the user wants to read.In addition, there is an article detail page to display the content of the article to be read if the user presses the more button.

Testing Stage
The successfully implemented SIPENTING website requires a test to ensure that the web application runs optimally so that no errors appear on the system.This test is carried out using the Blackbox method by evaluating the input process received and the output given by the system.The test results can be seen in Table 2 below.

Home menu
The user is directed to the home page which contains a brief overview of the website, child stunting prevalence data according to SSGI, and an overview of stunting articles.

Conduct a nutrition check
Users can check nutrition by entering body mass index data such as the child's name, child's gender, child's age child's weight in kilograms, and height in centimeters.

Figure 3 .
Figure 3. Home page view

Figure 4 .
Figure 4. Display of nutrition check page

Figure
Figure5, is a display of the results of the implementation of the consultation page that can be accessed if the user has logged in or registered first as in Figure6by entering a username, email, and password.In Figure6, there is a consultation button which if clicked the user will be directed to the WhatsApp number of the nutritionist of the UPT Tirto Pekalongan City health center who can be contacted if they want to consult about stunting problems in children.

Figure 5 .
Figure 5. Consultation page view

Figure 6 .
Figure 6.Login and register page view

Figure
Figure7, is a display of the results of the implementation of the article page.On this page, there are several articles provided to improve user literacy and on this page, a button is also provided to filter articles according to the topic the user wants to read.In addition, there is an article detail page to display the content of the article to be read if the user presses the more button.

Figure 7 .
Figure 7. Article page view

Table 1 .
Functional requirements