Child Health Book Research Articles

Effect of new Maternal and Child Health Book on Iron Supplementation Obedience and Labour Outcome in Pregnant Women, Pringsewu District, Lampung Province, Indonesia

The 2020 edition of the Maternal and Child Health (MCH) book can facilitate pregnant women in monitoring supplementation obedience and labour outcome. There are still few studies that discuss the effectiveness of the MCH book with regard to labour outcomes. This study aimed to determine the effectiveness of the new edition MCH book on obedience to iron supplementation and labour outcomes. The study used a quasi-experimental, non-equivalent control group design. The subjects were pregnant women in the second trimester until labour. The sample of this study comprised 60 people in the intervention group and 61 people in the control group. Research analysis was done using T-test and chi-square tests. The results showed that supplementation obedience increased haemoglobin levels, affected duration of labour in the first and second stages and the amount of blood loss during labour, and the APGAR scores were significantly different in the two groups (p-value >0.05). However, the intake of protein and iron-rich food, placental membrane integrity, duration of the third stage of labour, uterine contractions, APGAR score in the first five minutes, and birth weight did not show a significant difference in the two groups (p-value >0.05). The study concluded that the self-monitoring sheet for iron supplementation in the MCH book could improve obedience and haemoglobin, and thus improve labour outcomes, but it does not increase maternal food intake.

Description of Pregnant Women Using Maternal and Child Health (MCH) Books as Information Media

Introduction: During pregnancy, the mother will experience various physical and psychological changes. Fulfillment of psychological needs is obtained from health information and education, supported by interesting information media. The MCH handbook is very important for mothers to own and understand in order to make it easier to monitor the health of mothers and children. Objective: This study aims to describe pregnant women who use the MCH Handbook as an Information Media in the Sumberjaya Poskesdes Working Area in 2022. Method: This research is a quantitative research with a quantitative descriptive research design. The sample in this study were all pregnant women who came to the Poskesdes to do an examination and have a MCH handbook. Retrieval of data using a total sample technique, namely 40 respondents. Retrieval of data using primary data in the form of a questionnaire. The research was conducted from November-December 2022. Result: The majority of pregnant women aged 20-35 years (85%) had used the MCH Handbook as much as 52.9% as a medium of information. The majority of respondents had low education (70%) with 57.2% had not used the MCH handbook as an information medium. Most of the respondents belong to the second trimester category (55%) and 54.5% have used the MCH Handbook as a medium of information. The majority of respondents are housewives who do not work (65.5%) and the majority have used the MCH handbook as a medium of information as much as 51.6%. The majority of pregnant women did not use the MCH Handbook as Information Media as much as 52% with the majority having sufficient knowledge. Conclusion: Most of the respondents have used the MCH Handbook as an Information Media apart from being a notebook for monitoring Maternal and Child Health.

Low birth weight and low mother education as dominant risk factors of stunting children in Magelang Regency, Central Java

Stunting children are still highly prevalent in Indonesia, especially in Magelang Regency, a stunting locus area. Stunting risk factors were multifactorial and closely related to maternal health and education. The study aimed to analyze the relationship between low birth weight (LBW), mother education and other risk factors with Magelang Regency stunting. This study used a case-control design and involved 328 children aged 24-59 months. The stunting group was 162 children, and the normal group was 166 children. Nutritional status was measured using median z-score height for age from WHO anthropometric standard. Children's birth weight was obtained from Maternal and Child Health books records. Other socio-demographic characteristics were obtained through interviews with mothers. The bivariate association was analyzed using Chi-square with a 95% Confidence Interval (CI). Multivariate analysis was carried out using logistic regression. The result showed that children who had a low birth weight of 7,418 higher risked being stunted (p= 0,000), and low mother education of 1,604 higher risked to be had stunted children (p= 0,041). In conclusion, LBW and low mother education are Magelang's primary determinants of stunting.

Uncovering the Determinants of Birth Weight: An Investigation on Pregnant Women in Makassar City

Birth weight is an essential indicator in assessing a baby's health and a factor that affects the baby's long-term health. This study aimed to determine the relationship between the Body Mass Index (BMI), Hemoglobin levels, and Blood Pressure of mothers during pregnancy and to birth weight of the baby. The study used a cross-sectional survey of a group of mothers who gave birth in Makassar. The data on mothers during pregnancy was the maternal history recorded in the mother and Child Health Book (KIA). And the data on the birth weight of the baby was also from the KIA book with the support of secondary data from the Community Health Center and Midwife. The results showed that 41.7% of the low-birth-weight babies had mothers who experienced underweight during pregnancy, 83.3% of the low-birth-weight babies had mothers who experienced Anemia during pregnancy, and 66.7% of the low-birth-weight babies had mothers who experienced hypertension during pregnancy. There was a significant and close relationship between the mother's BMI, Hemoglobin levels, and Blood Pressure to the baby's birth weight. There was a meaningful relationship between the mother's Body Mass Index, Anemia, and Hypertension during pregnancy to low birth weight. Therefore, it is important to maintain a good quality of nutrition for mothers both before and during pregnancy, following Islamic teachings that Allah SWT has decreed for every pregnant woman a thousand good deeds every day and erases a thousand misdeeds as motivation to remain strong throughout the pregnancy process.

The Relationship between Maternal Anemia History and Exclusive Breastfeeding with Stunting Incidence in Infants 6-12 Months in West Kupang District

Background: Stunting in the infant can caused by a history of exclusive breastfeeding and report of anemia during pregnancy and can also affect growth in the first 1000 days of life. Research Objective: Research objective was to identify the relationship between the mother's history of anemia during pregnancy on the antenatal care examination and the history of exclusive breastfeeding given to infants aged 6-12 months with stunting in Kuanheun Village and Bolok Village. Method: The method is Cross-sectional. This research was assess in august-September 2022. The total number of respondents was 39 people. The inclusion criteria used; like to become research respondents, respondents who had toddlers aged 6-12 months in Kuanheun Village and Bolok Village, and respondents who brought Maternal and Child Health (MCH) books of the study subject. The data type used was the history of Antenatal Care (ANC) in the mother's MCH book and anthropometric measurements on the infant. Results: Spearman's rho test there was no significant association between the history of ANC K4 anemia and the incidence of stunting in infants 6-12 months p = 0.7 >0,05 and there was no significant association between the history of exclusive breastfeeding and the incidence of stunting in infants 6-12 months p = 0.1 >0,05. Conclusion: There is no relationship between the report of anemia in ANC K4 and the history of exclusive breastfeeding with the incidence of stunting in infants aged 6-12 months in Kuanheun Village and Bolok Village.

HUBUNGAN PEMANFAATAN BUKU KESEHATAN IBU DAN ANAK DENGAN KETERATURAN KUNJUNGAN PEMERIKSAAN KEHAMILAN DI PUSKESMAS AMPENAN TAHUN 2021

Based on the result of a preliminary study that has been carried out on the register data for pregnant mothers at UPTD of Ampenan Public Health Center from 2021 showed a decrease from previous years. Visits of pregnant mothers recorded a total of 420 pregnant mothers’ visits decreased by 24.28% from the previous year’s achievement of 523 pregnant mothers. Restriction of health service have an impact on health, education, information, and education received by pregnant mothers. This research is descriptive using a cross sectional approach, the population is 420 pregnant mothers and the sample of this study was taken by accidental sampling and calculated using Slovin formula as many as 81 pregnant mothers. The independent variable was the utilization of maternal and child health book while dependent variable was regularity of pregnancy visits. The instrument uses a questionnaire. Data analysis using univariate analysis using frequency distribution test, bivariate analysis of contingency coefficients. Based on the result of analysis between the utilization of maternal and child health book and the regularity of antenatal care visits, it showed a value (p value) = 0.000 <a 0.05 (significant). The test showed that there was a significant relationship between the utilization of maternal and child health book and the regularity of antenatal care visits. It can be concluded that there is a significant relationship between the utilization of maternal and child health book and the regularity of pregnancy visits. It suggested to Ampenan Public Health Center to convey the health workers related to the use of regular pregnancy check-ups.

Analisis Sikap Ibu Hamil Terhadap Penggunaan Buku Kesehatan Ibu dan Anak di Puskesmas Minasa Upa Kota Makassar

Infant health status, nutritional status is one of the things that affect the health status of a country. The indicators for choosing a child's health degree include the Infant Mortality Rate (IMR), the purpose of this study is to find out the attitude of pregnant women to the use of the Maternal Child Health (MCH) handbook at the Minasa Upa Health Center. This type of research design uses cross sectional (cross sectional) and the dependent variable is the attitude of pregnant women while the independent variable is the use of the MCH handbook, measurements were taken at the same time with 35 respondents. Data collection using a questionnaire. then data analysis used the Chi Square Test with the result that the value of P = 0.000 > from α = 0.05 then the alternative hypothesis (Ha) is accepted meaning that there is a correlation between pregnant women's attitudes towards the use of maternal and child health books at the Minasa Upa Health Center in 2021.

Non-exclusive breastfeeding as the risk factor of stunting among Indonesian toddler in coastal areas

Background: Indonesia is ranked fifth in the world for the problem of stunting. Stunting in children under the age of five requires special attention, due to its inhibiting effect on children’s physical and mental development. Stunting has been associated with several factors, one of which is non-exclusive breastfeeding. This study aimed to analyse non-exclusive breastfeeding as the risk factor of stunting among Indonesian toddler in coastal area. Methods: This study was an observational analytic study with cross sectional approach, which was carried out for 6 months, from March to September 2022. The sample population was children aged 36-59 months, who lived with their mothers in the coastal areas of Bitung city, north Sulawesi province. Sampling was done by purposive sampling to get 120 samples. Data collection using questionnaires by interview, secondary data in the maternal and child health (MCH) book, and anthropometric measurements using height for age index, for indicated stunting. Results: The results showed the history of exclusive breastfeeding (POR=2.630), energy intake (POR=2.492) and protein intake (POR=1.857) as the risk factors of stunting. It showed that in the group of children who were not exclusively breastfed, have less energy and protein intake, and poor parenting, have a higher risk of stunting compared to children from other groups. Conclusions: Stunting among toddler can be prevent by controlling many factors, such as guarantees that every mother provides exclusive breastfeeding, and maintains adequate energy and protein intake during the growth period, especially in the first 1000 days of a child’s life.

The Correlation Between Gestational Weight Gain with Children Nutritional Status Age 0 – 2 Years in Simomulyo Health Center Sukomanunggal Village Surabaya City

Background: The golden period of child growth begins in the womb where a rapid growth and development occurs. Throughout the pregnancy, there is a gestational weight gain so that the mother’s nutritional intake can meet the needs of herself and her fetus. Low gestational weight gain can affect the next child’s life. Methods: This study is an observational analytic study with a cross-sectional approach. Samples were taken by using a total sampling with a sample size of 57 mothers with children aged 0 – 2 years. The independent variable is the gestational weight gain and the dependent variable is the child’s nutritional status. The data collection method was carried out by collecting secondary data through integrated health center’s data and the Maternal and Child Health (MCH) book, then the results were analyzed by the chi square test. Results: Most gestational weight gain found in this study was in the adequate category according to IOM 2009 recommendations (45.61%). Most children’s nutritional status was normal according to the WAZ, LAZ, and BMI Z-score index (78%). The chi square test showed no relationship between gestational weight gain and children’s nutritional status (p>0.05) Conclusion: In this study, there was no relationship between the weight gain of pregnant women and the nutritional status of children aged 0-2 years based on the of WAZ, LAZ and BMI Z-score index.

Analysis of the use of mother and child health (mch) books by pregnant women in controlling stunting in the working area of Koto Baru community health center, Kuantan Singingi District

The Maternal and Child Health Book (KIA) contains important information needed by mothers and children,The low utilization of the MCH handbook is still constrained by the lack of knowledge about the benefits of the MCH handbook and some mothers also think that the MCH handbook is just an examination notebook..Koto Baru Health Center is one of the health centers in the districtKuantan singingi whose KI coverage reaches 100%. The high coverage of K1 is not in line with the use of MCH books by pregnant women.This research aims to knowing determinants related to the use of Maternal and Child Health (KIA) books by pregnant women in stunting control in the Koto Baru Health Center Work Area, Kuantan Singingi Regency. Types of research quantitative research with analytical research design and using a cross sectional approach. The sample was taken by total sampling technique with a sample of 36 respondents. Data were analyzed by univariate and bivariate.Research results obtained respondents used the MCH book well (61.1%), highly knowledgeable (63.9%), positive perception (52.8%), received family support (55.6%) and received the role of health workers (72, 2%). The results of the chi square test showed that there was a relationship between knowledge (p = 0.002), perception (p = 0.001), family support (p = 0.003) and the role of health workers (p = 0.001)with the use of Maternal and Child Health books. Kepada Health workers to improve services such as provide counseling, promotion and continuous information to pregnant women about the contents of the MCH handbook and its benefits for mothers and children so that pregnant women know the condition of their pregnancy and immediately check with health workers if they experience problems in pregnancy.

Penerapan pijat oksitosin pada nyonya S dalam Asuhan Kebidanan Masa Nifas di Klinik Pratama Amanda

Introduction : Lactation is the process of breastfeeding starting from the process of producing breast milk (ASI), secretion, and expulsion of breast milk to the process of the baby sucking and swallowing. Factors that cause non-smooth milk production in primiparous postpartum mothers can be caused by stress, fatigue, lack of rest, as well as nutrition and nutritional factors. Efforts made to improve breastfeeding and increase milk production in primiparous postpartum mothers include a balanced nutritional diet for breastfeeding mothers, early mobilization, oxytocin massage and breast care. Oxytocin massage is one of the efforts made to facilitate milk production for primiparous postpartum mothers. Oxytocin massage done after giving birth can stimulate the release of the hormones prolactin and oxytocin.
 Purpose: Applying oxytocin massage to breastfeeding on Mrs. S at Amanda Pratama Clinic, Patukan, Ambarketawang, Gamping, Sleman Regency, Special Region of Yogyakarta
 Methods: The type of research method used is descriptive analytic method. This research instrument used the results of examinations, observations or observations of the author, interviews with clients and supporting data listed in the maternal and child health book owned by the client.
 Results : The results of research on breastfeeding on Ny. S after doing Oxytocin massage 15-20 minutes every day for 7 days it increased, starting from the first day 90 ml to 680 on day 7. The increase in milk expenditure occurred as much as 88% for 7 days. The biggest increase occurred on the third day.
 Conclusions: There is an effect of oxytocin massage on breastfeeding in Mrs. S at Amanda Pratama Clinic, Patukan Ambarketawang, Gamping, Sleman Regency, Special Region of Yogyakarta

Edukasi Persiapan Persalinan Pada Ibu Hamil Trimester III di Puskesmas Kalumpang Mamuju

The third trimester of pregnancy starts at 28 weeks to 40 weeks of gestation. Pregnant women tend to look worried at this gestational age, perhaps feeling the discomfort experienced by pregnant women in the third trimester, this discomfort can affect labor and the postpartum period. In the second pillar of safe motherhood, it is stated that antenatal care is a means for pregnant women to prepare for the birthing process. Maternal unpreparedness for childbirth is one of the causes of the high maternal mortality rate. If during pregnancy there are obstetric complications and the mother does not know what preparations are needed before giving birth, then the mother will not receive appropriate and timely services. This activity aims to provide education regarding preparation for childbirth in the hope that pregnant women can know in advance the preparations for childbirth. In this activity, pre and posttests were carried out using a questionnaire to measure the knowledge of pregnant women and provide education using the counseling method. This activity was carried out at the Kalumpang Community Health Center. The results obtained from this activity were that the knowledge of pregnant women after counseling changed to good at 86.5% from previous knowledge which was adequate at 55.2%. This is because pregnant women receive additional information regarding preparation for childbirth through counseling. From this activity, it is hoped that all pregnant women will be active in using Maternal and Child Health books, not only keeping them but reading and studying them for maternal knowledge.

The Relationship of Various Risk Factors with LBW in South Tangerang City General Hospital for the Period March-October 2021

Background Low birth weight (LBW) is a serious child health problem that requires global attention, especially in developing countries or with low economic status. Indonesia itself is in the ninth position of the country with the highest prevalence of LBW in the world. Therefore, it is important to examine various factors that can increase the risk of LBW, and it is hoped that it can prevent the occurrence of LBW, considering the complications that LBW can experience in both the short and long term.Objectives This study aims to determine the relationship between various risk factors and LBW in South Tangerang City General Hospital for the period March-October 2021.Methods This study is an analytical observational study using the cross-sectional method. Sources of data were obtained from medical records and books on Maternal and Child Health (KIA) of respondents, with the criteria of respondents being mothers with a history of giving birth to low birth weight (<2500 g), having an active cell phone number and recorded in the NICU registration at South Tangerang City General Hospital, and still having Maternal and Child Health (KIA) book.Results There was a significant relationship between risk factors for gestational age (p=0.046) and frequency of ANC visits (p=0.035) with low birth weight, but there was no significant relationship between risk factors for maternal age (p=0.193), maternal education (p=0.087), maternal occupation (p = 0.618), and family income (p = 0.320) with low birth weight in South Tangerang City General Hospital for the period March-October 2021.Conclusion Gestational age and frequency of ANC visits are statistically significant risk factors for LBW incidence in South Tangerang City. Maternal age, maternal education, mother's occupation, and family income are not statistically associated with low birth weight in South Tangerang City General Hospital

The Determinants of Stunting Incidence in Children Aged 24-59 Months

Majene Regency has the second highest prevalence of stunting in West Sulawesi by having the highest number of cases found in the village of Rangas. Due to these reasons, it is necessary to research the determinants of stunting, so the studies are expected to provide input to the Majene district government in conducting interventions related to stunting. A case-control study design was used. The subjects were the children aged 12-59 months who lived in the Rangas Village which the children under five years diagnosed stunting based on measurements from the Nutrition Executors (NE) of the Public Health Center. Meanwhile, the controls were children under five years who had not been diagnosed stunting based on measurements from the Nutrition Executors (NE) of the Public Health Center. The samples were 72 respondents with a ratio of 1:1, and the under-five children's mothers as the research respondents. Purposive sampling was used. The stunting data was obtained from the health office, while the identity of the respondents, the characteristics of the mothers, and the characteristics of the children under five years were carried out directly by interview using a questionnaire and strengthened by Mother and Child Health (MCH) Book. Data analysis used the chi-Square test and multiple logistic regression tests. Multivariate analysis results showed that the incidence of stunting was influenced by several factors, including parity (OR=30.40; 95%CI: 3.86-239.43), Maternal Mid-Upper Arm Circumference (MUAC) history < 23.5 cm during pregnancy (OR=2.41; 95%CI: 1.04-5.56) and not exclusive breastfeeding (OR=3.21; 95%CI: 1.29-7.94). The conclusion of this study is parity, a history of maternal MUAC during pregnancy, and not exclusive breastfeeding are risk factors for stunting in children under five years in Banggai District. Therefore, it is necessary to improvement of health promotion strategy for pregnant women by maximizing the first 1000 days of life and campaign two healthy children needs to be maximized.

Penggunaan teknologi informasi untuk mengelola data imunisasi dan gizi pada posyandu Kureksari kecamatan Waru Sidoarjo

Posyandu is one of the main programs of the Government of Indonesia related to public health services, especially for the health of infants, toddlers and pregnant women. Routine activities carried out by posyandu include monitoring pregnant women, monitoring growth and providing immunizations for infants, toddlers and pregnant women. Posyandu is usually driven by selected cadres with guidance from health workers in their area. The Sakura Posyandu located in Kureksari Village, Waru District, Sidoarjo Regency has activities that empower and provide convenience to the community in obtaining basic health services. The main goal is to reduce maternal and infant mortality. In the management of immunization and nutrition data, the data input process is still carried out in two stages, namely by entering the cadres' books and maternal and child health books. This often results in redundancy and data loss, in addition to inefficient time and asynchronous data between the original and stored data. Therefore, it is necessary to apply immunization and nutrition data management at the Sakura Posyandu to facilitate the management of the data they have. As a result, the processing process becomes more efficient, there is no duplicate data and data retrieval becomes faster.

Association of infectious disease history with wasting among Indonesian toddler in coastal areas

Background: Wasting prevalence in Indonesian toddler has been decreasing from 2013 to 2018 (12.12-10.19%), but this number remains in medium category according to WHO. Identification of risk factors by looking at infectious disease history as the cause of wasting can provide information to appropriate intervention. This research aimed to analyze the association between infectious disease history with wasting in toddler.Methods: This research was an observational analytic study with cross sectional approach, which was carried out for 6 months, from April to October 2021. The sample population was children aged 36-59 months, who lived with their mothers in the coastal areas of the Siau Tagulandang Biaro Regency, North Sulawesi Province. Sampling was done by purposive sampling to get 221 samples. Data collection using questionnaires by interview, secondary data in the maternal and child health (MCH) book, and anthropometric measurements namely body mass index by age, for wasting variables.Results: The results showed the history of infectious disease (p value =0.045; OR=3.491) and mother’s education (p value =0.025) have significant relationship with wasting among Indonesian toddler. The results of the analysis on history of exclusive breast feeding, birthweight, immunization status and father’s education, showed no significant relationship with wasting (p>0.05).Conclusions: Wasting among toddler can be prevent by controlling many factors, such as keeping them safe from infectious diseases, also ensure that every mother and mother-to-be gets a proper education.

Development screening bags onenoday implemented by parents who have toddlers

This research was carried out by implementing onenoday development screening bag by parents who have toddlers. Implementation of the media is needed to assess the product used. Developmental delays can be caused by a lack of concern for parents in carrying out stimulation, early detection, and intervention. So far, mothers under five have used the Mother and Child Health book as a medium for stimulation and early detection of child development. Unfortunately, the use of MCH book media by mothers under five is in the less category, parents do not read MCH books for various reasons. Providing stimulation by providing conventional counselling before, makes the material unacceptable. Therefore, this study proposes the implementation of a one no day development screening bag to assess parents' response to the product.
 This research design is descriptive and quantitative. The research sample was 30 parents who had children under five in the working area of the Kalimanah Health Center. Incidental sampling technique. The instrument is in the form of a questionnaire, a Likert scale measurement scale. The data obtained is analyzed by calculating the percentage of answers to the questionnaire for each item.
 The results showed that it was easy to use 86.7%, instructions for use were clear 84.2%, users felt interested 87.5%, felt enthusiastic and motivated 85.8%, easy to understand material 83.8%, gained knowledge about early detection of toddler development 85.8%, could use 89.2%. Conclusion: onenoday development screening bags, can be implemented by parents who have toddlers.

Peningkatan Pengetahuan dan Deteksi Dini Tanda Bahaya Kehamilan di Wilayah Kerja Puskesmas Sipahutar Kabupaten Tapanuli Utara Tahun 2022

Early detection of danger signs and symptoms during pregnancy is the best effort to prevent serious disruption to pregnancy or the safety of pregnant women. Predisposing factors and the presence of comorbidities should also be recognized early on so that maximum efforts can be made to prevent serious disturbances to both pregnancy and the safety of the mother and the baby she is carrying. Community service activities in the form of providing health education on Early Detection of Danger Signs in Pregnancy were carried out to 76 pregnant women in 6 Classes of Pregnant Women in the Sipahutar Health Center Work Area, namely Siabal-abal Villages I, II, III, V and VI, Tapian Nauli II, Nihuta Fighting I, II and III. The activities carried out were pretest, health education, history taking and checking for signs of danger in pregnancy, namely blood pressure, temperature, fetal movement, edema, urine protein and post test. Based on the results of the pre and post test, it can be seen that there is an increase in the number of pregnant women who have good knowledge from 6 (7.90%) pregnant women at the time of the pre test to 31 people (40.79%), with sufficient knowledge of 49 people (64.47%). ) to 37 people (48.68%), while the number of pregnant women with less knowledge of pregnant women at the time of the pre test was 21 people (27.63%) at the time of the post test to 8 people (10.53%). From the examination of the danger signs in pregnancy, it was found that the results of high blood pressure were 3 people (3.95%). The activity went well and smoothly. Expected to pregnant women to always be aware of all risks of pregnancy complications by actively conducting early detection of any complications that will occur during pregnancy. In addition, pregnant women are also expected to take advantage of the Maternal and Child Health (KIA) book, in which the book also provides various kinds of danger signs of pregnancy that can occur in pregnant women.

IMPROVING THE COMMUNITY'S ABILITY TO ASSESS CHILDREN'S GROWTH AND FULFILLMENT OF FAMILY NUTRITION

Monitoring the growth and development of children in the first 1,000 days of life is very important given the rapid growth and development at this age. This very rapid brain development at the age of under 2 years (a critical period of development) is the right time to make recovery, if there are growth disorders and nutritional deficiencies. Increasing the community's ability to assess children's growth and development and fulfillment of family nutrition is very important as an effort to optimize the process of child growth and development as the nation's next generation. The purpose of this programme is to improve the ability of the community (independently) in assessing children's growth and development and fulfilling family nutrition. The methods used in this programme are focus group discussions as the basis for making modules, health promotion with interactive lectures and discussion techniques, and simulations of how to assess toddler growth and development using maternal and child health books (KIA) and family nutrition fulfillment. This programme was carried out for 1 day and took place in Kaliasin Village, Tanjung Bintang District, South Lampung Regency. The participants were 30 people who were members of the community in Kaliasin Village, Tanjung Bintang District, South Lampung Regency. The results of the evaluation found that there was an increase in participants' understanding as much as 90% became a good understanding, 10% of participants had a fairly good understanding, and none of the participants had a poor understanding of how to assess the growth and development of toddlers and the fulfillment of family nutrition. The average pretest result was 50.5 and an increase in the posttest result was 83.5. Based on the analysis using the Wilcoxon test, it was found that there was a statistically significant mean difference between the pretest and posttest scores participants on how to assess toddler growth and family nutrition (p=0.000). Increasing the community's ability to assess children's growth and development and fulfillment of family nutrition with this technique of increasing knowledge and skills has proven to be effective.

The Factors That Influence The Use Of Maternal And Child Health Books In Mothers

Background: The MCH Book is a tool for the early detection of any disturbances or health problems for mothers and children. This book is important, but its use is not optimal. The purpose of this study was to determine and analyze the factors that influence the use of maternal and child health books by mothers.
 Methods: This study uses an analytic observational design with a cross-sectional approach with a sampling technique using an accidental sampling technique with a sample of 78 people. Respondents were selected who met the age of 22–40 years, could read and write, and were willing to be respondents. This study used a research instrument in the form of a questionnaire and was measured using a scale. The data was analyzed by multiple linear regression tests using SPSS for Windows version 22.
 Results: Variable knowledge and attitudes together (simultaneously) have a significant effect on the utilization of MCH books. The results of the statistical test obtained p value = 0.021 on the knowledge variable, p = 0.000 on the attitude variable, where p < (0.05). 
 Conclusion: There is a relationship between knowledge and attitudes of the millennial generation of pregnant women towards the use of MCH books at the Pacar Keling Health Center. It is hoped that millennial-generation pregnant women will not only seek information about health through social media/the internet but also by reading and understanding the contents of the MCH book.