Abstract
Background: In August 2018 Lombok Island in Indonesia was hit by a 7 Richter scale earthquake. This study aimed to assess the effectiveness of comprehensive nutrition disaster rehabilitation, based on the holistic integrated early child development concept, on the growth and development of children under five. Methods: A community-based intervention was performed in the East Lombok district; four villages in two sub-districts were randomly allocated into intervention or control groups. Mothers of 6–49-month-old children in the intervention group (n = 240) attended parenting classes (twice weekly) and received shredded fish/liver/anchovy and optimized complementary feeding/food-based recommendations, developed using linear programming. Health staff from the public health center and teachers from early childhood education (ECE) centers delivered parenting sessions on health–nutrition and care–education. The control group (n = 240) received existing health services. Indicators measured at baseline and the end line point were weight, length/height, hemoglobin, feeding practices, psychosocial care (HOME) and maternal stress (SRQ). At the end line point, child development was assessed using BSID-III. Results: At the end line point, maternal stress and child morbidity (cough) were lower and dietary diversity (+1) in 6–23-month-old children, and weight-for-age Z-score (+0.26) and social emotional score (+10 points) in ≥24-month-old children were higher in the intervention group. Conclusions: The nutrition rehabilitation intervention delivered through ECE centers has a positive effect on the growth and development of children under five in post-disaster conditions.
Highlights
To prevent negative consequence of emergency situations on child growth and development, we developed integrated nutrition rehabilitation targeted at children under five and their caregivers, which translated the holistic integrated Early Childhood Development (ECD) concept
This study aimed to assess the effectiveness of comprehensive nutrition rehabilitation intervention based on holistic integrated ECD in reducing maternal stress and child morbidity, improving psychosocial care, dietary intake and eventually the nutritional status and developmental outcomes of children under five whose families had just been affected by the 2018 Lombok earthquake
All subjects who were brought to the early childhood education (ECE) centers came with their caregivers, no subject was excluded
Summary
Indonesia is situated in the Ring of Fire, which is prone to natural disasters. 2018 Lombok Island in Indonesia was hit by a 7 Richter scale earthquake. Disruptions of access to clean water, food and health services and maternal stress caused by the disaster could have had negative consequences for the nutritional status of vulnerable groups, especially young children. The 2011 Edition of the Sphere Handbook Humanitarian Charter and Minimum Standards in Humanitarian Response emphasizes the importance of nutritional assessments
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