Class Of Pregnant Women Research Articles

The Effectiveness of Using Gym Ball in Reducing Back Pain in the Third-Trimester Pregnant Women

Back pain is one of the problems that pregnant women often experience during the third trimester. If the pain is not treated immediately, it will have serious consequences for the mother. One effort is simple physical therapy using a ball, which is useful for strengthening the abdominal and lower back muscles. It is usually called gymball training. This study aimed to determine how effectively a gym ball reduces back pain felt by pregnant women in the third trimester.This research used a pre-experiment with one pretest-posttest group and a sample of 30 pregnant women in the Singojuruh Public Health Center area. It was conducted from September to October 2023. This study applied simple random sampling techniques to determine the sample and analyse data using the Wilcoxon test.This study revealed that the prevalence of back pain in pregnant women was reduced from 43.3% to 6.7% for pain in the moderate category. Furthermore, 10% of respondents no longer felt back pain after using the gymball. Based on the Wilcoxon signed ranks test results on data before and after testing, a p-value of 0.000 was obtained, which shows that using a gym ball effectively treats back pain in pregnant women in the third trimester. The use of a gym ball can be used as a complementary care alternative to relieve pregnant women's back pain during pregnancy, especially in the third trimester. It is hoped that this gymball can be implemented in health facilities in classes for pregnant women.

THE RELATIONSHIP OF MOTHER'S CHARACTERISTICS AND HUSBAND'S SUPPORT REGARDING MOTHER'S PARTICIPATION IN PREGNANCY CLASS IN MEDANGASEM VILLAGE, KARAWANG DISTRICT YEAR 2023

Class This Pregnant Mother is government program used as a means to learn together about health for pregnant women. Activity the can form stare advance in group Which aim For increase knowledge And Skills moms about pregnancy, maintenance pregnancy, preparation face labor, maintenance moment postpartum, newborn care, myths during pregnancy, childbirth, postpartum nor maintenance baby new born, as well as diseases Which join And certificate birth. This study aims to determine the relationship between maternal characteristics and husband's support with maternal participation in classes for pregnant women in Medangasem Village. This research design uses cross method sectional analytic with a quantitative approach, namely carrying out measurements or observations on variable free (independent) with variable depends (dependent) done during Which The same sampling of 35 pregnant women from December 202 3 – January 202 4 in the region Work Public health center Medangasem Karawang.Results Analysis using the Shapiro-Wilk data test uses the statistical test used in this research is the Chi-Square test to obtain a p-value of 0.025 which has a lower value than the p-value <0.05 so that means Ha is accepted It means It can be said that there is a relationship between husband's support with the mother's participation in attending pregnancy classes in Medangasem village. Expected power health especially midwives can increase visits to pregnant women's classes by continuing to socialize pregnant women's classes as a whole in language that is easy for pregnant women to understand because there are still so many pregnant women at a relatively young age. young, low education and lack of birth experience.

STRATEGI PEMERINTAH DESA DALAM PENANGGULANGAN STUNTING

This research aims to evaluate the village government's strategy in dealing with cases of stunting risk. The technique used is descriptive qualitative, which is divided into primary data and secondary data. The focus of this research is the village government's strategy to overcome cases of stunting risk through an accelerated stunting reduction program. The results of this research show that the village government's strategy in overcoming stunting has not been optimal, this is due to the lack of formation of a Stunting Reduction Acceleration Team (TPPS) whose task is to evaluate the implementation of accelerated stunting reduction at the village level, lack of tools to monitor the growth and development of toddlers, lack of socialization about stunting to village communities. With the village government's strategy of carrying out stunting prevention activities by providing a budget for providing additional food (PMT), increasing the provision of clean water and sanitation and holding classes for pregnant women

Pengaruh Kelas Ibu Hamil terhadap Pengetahuan tentang Kehamilan

The Pregnant Women Class is an activity to discuss the contents of the Maternal and Child Health (MCH) Handbook in the form of group face-to-face meetings, followed by discussions and experience-sharing between pregnant women and health workers. The goal is to improve the knowledge and skills of mothers regarding pregnancy, childbirth, postpartum care, postpartum family planning, prevention of complications, newborn care, and physical activities/exercises for pregnant women. The type of research used is an intervention study targeting pregnant women using a "pre-experimental" method with a "pretest-posttest with control group design." This design involves measurements in the pretest and posttest groups to observe the improvement in knowledge as a result of the intervention. The research was conducted in February 2022 at UPT Puskesmas Ulaweng, Ulaweng District, Bone Regency. The sample consisted of a subset of the population selected to represent it. In this study, the sample included pregnant women who participated in three Pregnant Women Classes held in February, totaling 40 participants. Correlation tests or relationship tests yielded a value of 0.373, indicating a moderate causal relationship between the increase in knowledge before and after attending the Pregnant Women Class. Meanwhile, the impact test showed a value of p=0.018 < α= 0.05, indicating that the Pregnant Women Class had a significant influence on knowledge about pregnancy at UPT Puskesmas Ulaweng, Ulaweng District, Bone Regency.

Relationship between Knowledge and Compliance of Pregnant Women in Consuming Fe Tablets in the Work Area of the Kartasura Public Health Center

<div><table cellspacing="0" cellpadding="0" align="left"><tbody><tr><td align="left" valign="top"><p><em>One of the common health issues that can seriously affect both the mother and the foetus is anaemia disease in pregnant women. Taking iron (Fe) supplements on a regular basis throughout pregnancy is one way to prevent anaemia. Numerous expectant mothers in the Kartasura Health Center's service area are still unaware of the benefits of taking iron supplements during pregnancy, which leads to anaemia in many of them. In the Kartasura Health Centre, the purpose of this study is to ascertain the association between pregnant women's level of understanding on the use of Fe pills. This study employed a cross-sectional methodology and an analytical survey design. The research was conducted in the Kartasura Health Center Working Area, Sukoharjo Regency, Central Java Province, and was carried out from August 2024. The study population of pregnant women in trimesters 1-3 who were in the Kartasura Health Center Working Area was 258. The sample was taken by purposive sampling from pregnant women registered at the Kartasura Health Center, so the research sample obtained was 72 pregnant women. Data collection was done through questionnaires</em><em>. </em><em>Univariate analysis and the bivariate chi-square test were used to analyse the data. The results showed a significant relationship between pregnant women's knowledge level and compliance level in taking Fe tablets (p-value=0.020 < α 0.05). When it comes to taking Fe pills, pregnant women with greater knowledge are generally more obedient than those with less information. It is recommended that health workers enrich the knowledge of patients by more routinely providing education related to the need to consume Fe tablets, using leaflets or posters that are made attractive. This can be given by health workers at every pregnant women's class meeting so that the level of knowledge of mothers becomes better and they become more compliant in consuming Fe tablets.</em><em></em></p><p><em> </em></p></td></tr></tbody></table></div><p><strong><em>Keywords : Knowledge, Compliance, Pregnant Women, Fe Tablets, Anemia</em></strong></p>

Peningkatan Kapasitas Ibu Hamil Melalui Buku KIA Kelas Ibu Hamil Tahun 2024

Health development programs in Indonesia are currently prioritized towards improving the health status of mothers and children, particularly in the most vulnerable groups such as pregnant women, mothers giving birth, perinatal infants, toddlers, and women of reproductive age. In response to this, a community service activity titled "Enhancing the Capacity of Pregnant Women through the Maternal and Child Health (MCH) Handbook in Pregnant Women's Classes in the Working Area of Puskesmas Cempaka, Banjarbaru City, in 2024" was conducted. This initiative aims to reduce child mortality rates and improve maternal health. The use of the MCH Handbook is considered a strategic step to enhance community independence. The target of this community service activity was 12 pregnant women attending the Pregnant Women's Class facilitated by Midwife Maulida. The implementation methods included preparation and execution of activities in June 2024 in Bangkal, Cempaka Subdistrict, Banjarbaru City. Evaluations were conducted through pre-test and post-test assessments of the mothers' knowledge about the MCH Handbook. The results showed that 83% of the participants always brought the MCH Handbook during antenatal visits, 41.6% had read the handbook in its entirety, and 58.3% only read the sections related to examinations. Therefore, further evaluations of pregnant women's knowledge about pregnancy through the MCH Handbook are needed to broaden their insights and enable effective implementation.

Improving Maternal Health Through Pregnant Women’s Nutrition Education in Pregnancy Women’s Classes

Lack of nutrition in pregnant women can cause abortion, low birth weight (LBW), premature birth, or even stillbirth during labor. Low levels of knowledge cause mothers to not understand how to fulfill the nutritional needs of pregnant women during their pregnancy. This activity aimed to increase pregnant women's knowledge of nutrition during pregnancy. The population was 10 pregnant women in the Pregnant Women's class in Kedungbanteng village. The method of the activity was to provide education through counseling, providing leaflets, and conducting pretest and posttest evaluations. The activity was carried out on Saturday, March 22, 2024, by a service team from Stikes Ganesha Husada Kediri. The results of the study showed that education for pregnant women increased knowledge about: Healthy eating patterns for pregnant women, benefits of healthy eating patterns for pregnant women, problems related to eating patterns for pregnant women, nutritional needs for pregnant women, signs and symptoms of malnutrition in pregnant women and the impact of nutritional status on the labor process. The result showed that before education, the number of pregnant women who had good knowledge was 3 people (30%), sufficient knowledge was 2 people (20%), and poor knowledge was 5 people (50%). After the intervention, the number of pregnant women who had good knowledge was 8 people (80%), sufficient knowledge was 1 person (10%) and poor knowledge was 1 person (10%). This revealed that education through pregnancy classes needs to be carried out and evaluated routinely by the midwife in charge, so that pregnant women have broad knowledge and insight and can make the right decisions in preparing for childbirth and the baby will be born healthy and safe as well as the mother healthy and safe without complications. The cadre mother should patiently provide assistance during pregnancy and childbirth.

Factors That Influence Adherence to Breast Tumor Patients at Surgical Clinic in The Bhayangkara Brimob Hospital

ABSTRACT The impact of pre-operative anxiety is that pre-operative anxiety can cause physical and psychological changes which ultimately activate the sympathetic autonomic nerves, thereby increasing heart rate, blood pressure, respiratory frequency, and generally reducing energy levels in the patient, and ultimately can be detrimental to the patient. itself because it will have an impact on the implementation of operations. To determine the relationship between therapeutic communication and the level of anxiety of primigravida mothers in facing SC delivery at Bhayangkara Brimob Hospital in 2023. The research approach used in this research is cross-sectional. The population in this study was 30 women pre-SC surgery. The sample in this study was 30 people. The sampling technique is total sampling. Researchers used the Chi Square test. The research results showed that the majority's anxiety level was moderate anxiety level at 46.7%. The majority of therapeutic communication is good therapeutic communication as much as 63.3%. From the statistical test results, it was found that P value = 0.002, meaning P value < α (0.05). There is a relationship between therapeutic communication and the level of anxiety of primigravida mothers in facing SC delivery at Bhayangkara Brimob Hospital in 2023. Suggestions for hospitals to create educational classes for pregnant women before delivery regarding the birth process Keywords: Communication, Anxiety, Sectio Caesarea

Cohort Study: Pregnant Exercise with Primigravida Stage II of Labor Delivery

Pregnancy exercise is a program for healthy pregnant women to prepare for the mother's physical condition. Suppose the mother does not do pregnancy exercise. In that case, she will experience aches, get tired quickly during pregnancy, and her delivery is not smooth in the second stage, thereby increasing fetal distress. This study determined the relationship between pregnancy exercise and the duration of the second stage of labor in primigravida in the Ambunten Health Center Work Area. The study design used a cohort analytic using a retrospective approach. The population was all primigravida women giving birth from September 2019 to September 2021. The sample taken was 179 respondents using a non-probability sampling technique. The second stage of labor They were then analyzed using the chi-square test. The results obtained from 179 respondents who did pregnancy exercise during the second stage of labor (74%) and did not do pregnancy exercise were not smooth (9%). The data analysis obtained the results with a p-value (0.000) and an error rate of the p-value (0.05). Conclusion H0 is rejected, and H1 is accepted. This means that there is a relationship between pregnancy exercise and the duration of the second stage of labor in primigravida in the Ambunten Health Center Work Area. This study concludes that respondents who did pregnancy exercise experienced a smooth process of the second stage of labor. Thus, it is recommended that respondents be more active in carrying out pregnancy exercises and that health workers intensify pregnant women to participate in classes for pregnant women.

Development of monopoly learning media in lactation education classes

<p><strong><em>Background</em></strong><em>: Exclusive breastfeeding is one of the rights that children should have, as breastfeeding for the first six months is the best way to fulfill a child's nutritional needs to continue the growth of their brain, liver, and immune system. Exclusive breastfeeding can also reduce infectious mortality by 88 percent in infants less than 3 months old. Currently, the achievement of exclusive breastfeeding is 69.7% and has met the 2021 target of 45%. One of the causes is influenced by the learning process. Interesting and fun learning media can affect learning outcomes. Therefore, it is important for midwives to grow the interest and attractiveness of pregnant women in the learning process with the help of appropriate learning media and involve pregnant women in lactation education classes through Monopoly games. </em></p><p><strong><em>Objectives</em></strong><em>: This study aims to develop Monopoly game media in lactation education classes and describe the feasibility of Monopoly game media as learning media in lactation education classes for pregnant women. </em></p><p><strong><em>Methods</em></strong><em>: This study uses research and development methods, namely expert sampling. The data collection instrument was a Likert scale questionnaire and descriptive statistical analysis techniques. The design of research activities only reached the feasibility test of monopoly learning media. </em></p><p><strong><em>Results</em></strong><em>: The learning media developed regarding the feasibility of learning aspects by material experts and users obtained an average score of 4.32, entered the good category. Meanwhile, according to media experts, an average score of 4.9 was obtained based on media engineering aspects, and based on visual communication aspects, an average score of 4.62 was obtained. </em></p><p><strong><em>Conclusions</em></strong><em>: This study shows that the development media for lactation education classes in the form of monopoly is in a good category</em> <em>and suitable for use</em></p>

Edukasi Tanda Bahaya Kehamilan Pada Kelas Ibu Hamil Puskesmas Cipaku

Introduction: The success of maternal health programmes can be assessed through the key indicator of maternal mortality rate (MMR). Maternal mortality is defined as all deaths during the period of pregnancy, labour, and puerperium that are caused by its management but not due to other causes such as accidents or incidentals. Knowledge of danger signs in pregnancy is very helpful in reducing MMR, because by knowing the danger signs in pregnancy a pregnant woman will seek health services more quickly so that risks in pregnancy will be detected and handled earlier. Objective: This community service was carried out to increase the knowledge of pregnant women in the Cipaku Health Centre pregnant women class about danger signs in pregnancy. Method: The method of implementing this community service by providing education in the form of lectures, discussions and answering questions from participants. Result: The results of the pre-test given before the provision of education showed that there were 6 (60%) mothers who were able to answer the pre-test questions correctly. The post test was given after the provision of education, where the results showed that there were 10 (100%) pregnant women who could increase their knowledge about danger signs in pregnancy. Conclusion: Pregnant women are very enthusiastic in participating in activities that include providing education about pregnancy danger signs. Community service activities also increase the knowledge of pregnant women so that pregnant women can detect danger signs in pregnancy and immediately check with health workers if there are danger signs of pregnancy.

The Relation of Pregnant Women's Class Participation and Childbirth Preparation in Third-Trimester Pregnant Women

The maternal mortality rate remains high both globally and in Indonesia. Approximately 75% of these deaths are due to complications during pregnancy and childbirth. Therefore, childbirth preparation is essential. Active participation in pregnant women's class activities at least four times during pregnancy is recommended. However, class participation at the Long Kali Community Health Center is still low, with only 53% attendance. This research aims to determine the relationship between active participation in pregnant women's classes and preparation for childbirth among third-trimester pregnant women in the Long Kali Community Health Center's working area. The research method used is descriptive analytics with a cross-sectional approach. The research population consisted of all third-trimester pregnant women who participated in pregnant women's class activities, with a sample size of 33. A questionnaire was used as the instrument for data collection. Data were analyzed using the Chi-square test. The results showed that the majority of respondents were aged 20-35 years (72.7%), had low education levels (48.5%), were not employed (81.8%), had multiparous parity (51.5%), actively participated in class activities (63.6%), and were prepared for childbirth (57.6%). The statistical test results showed a p-value of 0.001, indicating a significant relationship between active participation in pregnant women's classes and childbirth preparation among third-trimester pregnant women in the Long Kali Community Health Center's working area.

THE CORRELATION BETWEEN ACTIVENESS PREGNANT WOMEN CLASSES AND THE KNOWLEDGE OF POSTPARTUM KB AT WAVA HUSADA HOSPITAL

Background : The results of a preliminary study conducted on 10 pregnant women, there were only 3 people who could answer about postpartum contraception planning, so researchers were interested in knowing more about the relationship between the activeness of the pregnant women class to knowledge about postpartum contraception planning. Subjects and Methods : This research uses Correlational Analytic Design and Cross Sectional Time Approach. The total population is 157 pregnant women and the samples used are 62 samples. Results : Of this study indicate that the majority of respondents who attended classes for pregnant women were active in attending classes for pregnant women as many as 37 people, the knowledge of pregnant women about family planning after childbirth was dominant in respondents having good knowledge with a value of ≥ 60%, namely 53 people. The results of the Chi Square test showed that there was a relationship between the active participation of pregnant women in classes and the knowledge of pregnant women about postpartum contraception planning as evidenced by a P value of 0.000 <0.05. Conclusion : Most pregnant woman are active and understand well about the knowledge of postpartum KB in pregnant woman’s class activities.

PENCEGAHAN ANEMIA PADA IBU HAMIL MELAUI “PEDIKUR“ (PENDEKATAN EDUKASI DAN PUDING KURMA) DI DESA WONOSARI – NGORO

Anemia in pregnancy is still a major problem experienced by almost half of pregnant women in all countries in the world including Indonesia. Many pregnant women refuse and do not comply with taking FE tablets for various reasons so that the prevalence of anemia in pregnant women is still high. A mother is said to be compliant with taking FE tablets if ≥ 90 % of the amount should have been taken. Anemia in pregnancy is a national problem because it reflects the value of the socio-economic welfare of the community, and has a very large impact on the quality of human resources, which is called "potential danger to mother and child". The purpose of the service is to provide education on the addition of nutrients to reduce anemia. Based on the results of the activity, the delivery of material. The results of this activity are the participation of pregnant women during educational and simulation activities running smoothly, indicated by the activeness of pregnant women and attended by all pregnant women class participants and there is an increase in understanding of anemia by 50 %. The service was carried out on 23 June 2023 at Waonosari Polindes in the class of pregnant women. The method used was education and simulation in making soy milk and date pudding. Indonesia itself has an anemia prevention program for pregnant women by providing a minimum FE supplement of 90 tablets during pregnancy.

Edukasi Anemia melalui Kelas Ibu Hamil Menggunakan Buku Saku Cegah Anemia pada Kehamilan sebagai Upaya Pencegahan Anemia pada Ibu Hamil

Anemia is one of the most frequent complications associated with pregnancy. Normal physiological changes in pregnancy affect hemoglobin (Hb) and there is a relative or absolute decrease in Hb concentration. Anemia adversely affects maternal and fetal well-being and is associated with increased fetal morbidity and mortality. Adverse perinatal outcomes includeintrauterine growth retardation (IUGR), prematurity and low birth weight are significant risks of death, especially in developing countries. This service to society is of a natureeducational persuasive by providing health education in the form of health education about anemia in pregnancy through classes for pregnant women using media in the form of a pocket book to prevent anemia in pregnancy. The characteristics of pregnant women who took part in this community service activity included an average age of 29.13 years, most of them had low and middle education, did not work, were multigravida and most were in the third trimester of pregnancy. The average knowledge score of pregnant women before receiving health education using a pocket book to prevent anemia in pregnancy was 56 and after the education was carried out there was an increase in the knowledge score of 86 so that the pocket book could be an alternative use of health education media to increase the knowledge of pregnant women.

Optimalisasi Peran Ibu dalam Pijat Bayi Melalui Kelas Ibu Bayi

Baby massage can improve sleep quality and stimulate growth and development. The application of baby massage by mothers is still rare and not common because the training provided has not yet become a culture in society, even though baby massage by mothers can reduce symptoms of anxiety, and depression, increase bonding and attachment, and optimize the breastfeeding process. One effort to improve baby massage behavior is with parent classes for baby massage. This activity aims to provide mothers with experience in practicing baby massage regularly over 5 meetings guided by a certified instructor. The result of community service is that mothers feel confident in doing baby massages independently. The parent class for baby massage activity is expected to become a routine program for every baby mother, such as classes for pregnant women to achieve optimal maternal and child health.

Pemberdayaan Ibu Hamil dan Kader Kesehatan dalam Penerapan Program Stimulasi Pralahir

Delays in a child's growth and development can be caused by a lack of stimulation. Some pregnant women do not know, do not realize and have a bad attitude in providing prenatal stimulation. Not all health service facilities provide classes for pregnant women that are equipped with prenatal stimulation programs. Even though parents play an important role in providing stimulation since the fetus is in the womb. Providing prenatal stimulation supports the child's growth and development after birth. Based on this urgency, there is a need for training for pregnant women and health cadres. The aim of this community service is to increase knowledge, awareness and ability of pregnant women in providing prenatal stimulation, as well as increasing community participation in supporting the implementation of prenatal stimulation programs. The results showed an increase in the knowledge aspect of 27.28 points, with an average pre-test score of 64.54 (fair category), post- test 91.82 (good category). The average ability to perform prenatal stimulation was in the good category (94.55). These results show that this training can increase participants' knowledge and abilities in carrying out prenatal stimulation programs.

The Relationship Of Pregnant Women Class Activities To Pregnant Mothers' Readiness In Facing Labor At The Puskesmas Bangun Rejo Village, Deli Regency, Serdang In 2021

Background: Pregnant women class is a study group for pregnant women who get various health information and pregnancy exercises in preparing for childbirth. The number of pregnant women participating in the Maternity Class is 40 people. They do not prepare for childbirth because they feel that they do not need to be prepared in the face of childbirth. The purpose of the study was to determine the relationship between pregnancy exercise class activities and the preparation of pregnant women in preparation for childbirth. Method: This type of research is analytical with a cross sectional approach. The population was 40 pregnant women who took part in the class of pregnant women and all of them were used as research samples. Data were analyzed bivariately using the chi square test at a significance level of 95%. Result: The results showed that pregnant women carried out various activities in the class for pregnant women with the highest frequency in the less category 23 people (57.5%) and 25 people were not ready to give birth (62.5%). There is a relationship between pregnancy exercise class activities with the readiness of pregnant women in facing childbirth (p 0.039 <0.05). Conclusion: It is hoped that the Puskesmas will optimize the implementation of classes for pregnant women through various innovative and interesting activities that can make pregnant women feel at home in participating in pregnancy exercise classes from start to finish.

The Influence of Media Leaflet on Increasing Knowledge of Reproductive Health of Brides-to-Be in Padang City

According to WHO (2019), the Maternal Mortality Rate is the number of maternal deaths resulting from pregnancy, childbirth, and postpartum processes, which are used as indicators of women's health status. Maternal Mortality Rate (MMR) is one of the global targets of the Sustainable Development Goals (SDGs) to reduce maternal mortality (MMR) to 70 per 100,000 live births by 2030. Several efforts to reduce MMR have been carried out by the Padang City government, including implementing the Childbirth Planning and Prevention of Complications (P4K) Program, using MCH books, implementing classes for pregnant women, and health counseling activities. This quantitative research uses a pocketbook of the bride and groom using leaflet media. This is a guide for brides-to-be as part of marriage advice and guidance for those who have registered their marriage at the Regional Office of Religious Affairs (KUA). The subject of this study was a bride-to-be in Padang City. Providing reproductive health counseling on women's knowledge in premarital preparation in the working area of KUA Koto Tangah District has an influence.

Analisis Model Pengambilan Keputusan Dalam Program Pemberian Suplemen Makanan Pada Anak-Anak Stunting Kota Surabaya

Stunting in children and toddlers is an urgent health issue in the city of Surabaya, Indonesia. This research aims to develop effective decision-making strategies in tackling stunting in the city. Through a risk factor analysis approach, evaluation of local needs, and cross-sector collaboration, a holistic and sustainable intervention strategy can be formulated. This study highlights the importance of active community involvement, including the role of mothers and families, as well as support from local governments and health institutions. Regular evaluation of program implementation and monitoring of its impact are also the main focus. Surabaya has allocated a special budget, formed a Stunting Reduction Acceleration Team, and designed an integrated recording system. Even though the food supplement program is supported by the pregnant women class, there are still obstacles such as managing a large population and low food availability. The Fishbone model is used to analyze children's nutritional needs and the factors that cause stunting. It is hoped that the results will provide practical guidance for decision makers and stakeholders in designing and implementing effective stunting prevention programs, with the ultimate aim of improving the health and welfare of children in the city of Surabaya.