Path Analysis on the Effectiveness of the Family Hope Program in Improving the Nutritional Status of Children Under Five in Jombang, East Java

Abstract

Background: Conditional cash transfers (CCT) are one of the most prevalent social assistance programs in low and middle-income countries with the goal of improving for poor families through interventions in health, nutrition and education. Previous study showed that these programs might have helped reduce poverty among program participants. Little is known about the effectiveness of a CCT in Indonesia named Family Hope Program. This study aimed to examine the effect of Family Hope Program on maternal health behavior and children under five nutritional status in poor families, Jombang, East Java. Subjects and Method: This was a retrospective cohort study conducted in Jombang District, East Java, from November to December 2017. A total sample of 210 mothers and their children under five were selected for this study by fixed exposure sampling. The dependent variables were maternal health behavior and child nutritional status. The independent variables were birthweight, history of illness, maternal education, family income, family support, government Family Hope Program, and access to health service. The data were collected by maternal and child book record and questionnaire. The data were analyzed by path analysis. Results: The likelihood of good nutritional status of children under five increased with good nutritional intake (b= 1.9; 95% CI= 1.1 to 2.8; p<0.001), normal birthweight (b= 2.5; 95% CI= 0.9 to 4.1; p= 0.002), rare frequency of illness (b= 1.3; 95% CI= 0.5 to 2.1; p= 0.001), and strong family support (b= 1.5; 95% CI= 0.6 to 2.3; p<0.001). The Family Health Program showed a positive indirect effect on nutritional status of children through improving maternal health behavior. Conclusion: The likelihood of good nutritional status of children under five increases with good nutritional intake, normal birthweight, no history of illness over the past three months, and strong family support. The Family Hope Program is effective in improving child nutritional status by enhancing maternal health behavior and increasing child nutritional intake. Keywords: child nutritional status, maternal health behavior, Family Hope Program