1
|
Nirmala IR, Februhartanty J, Agustina R, Sekartini R. Cooking behavior among mothers of children aged 2-5 years old in Kendari, Southeast Sulawesi, Indonesia. BMC Public Health 2024; 24:391. [PMID: 38321429 PMCID: PMC10848546 DOI: 10.1186/s12889-024-17826-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 01/19/2024] [Indexed: 02/08/2024] Open
Abstract
BACKGROUND Cooking at home was associated with parental feeding practices. This study aimed to explore the interplay of components in cooking behavior of mothers with young children aged 2-5 years old in Kendari city of Southeast Sulawesi, Indonesia. METHODS This qualitative study involved 33 mothers from Kendari city, which was represented by each two sub-districts in coastal and mainland areas that were randomlyselected. Six focus group discussions (FGDs) were carried out using 20-item guide questions. The guide questions were developed following the Model of Goal-Directed Behavior (MGDB) theory approach exploring the components of cooking behavior i.e., skill, intention, desire, confidence, and attitude in cooking. Data analysis was performed in the field to assist decision on data saturation, followed by data analysis at desk through multilevel coding from the verbatim transcripts using NVivo R1 software. The data was analyzed thematically using pre-determined themes according to the MGDB theory. Emerging topics on enabling factors and constraints were captured to enhance our understanding of the complexity of cooking behavior. RESULTS The mothers' mean age was about 30 years old with a comparable representation of younger and older mothers. Most mothers were housewives and accomplished secondary school level. The mothers' intention was shown as they frequently cooked at home and allocated time for cooking. The enabling factors included their knowledge about food and nutrition, food source availability, their confidence in cooking meals and following recipes, and their motivation to keep their children healthy representing some intrinsic factors. The main constraint was the lack of skill to make snacks. The other extrinsic barriers were dependence on mobile food sellers and the availability of food kiosks that facilitated children's snack preferences. CONCLUSION The study obtained some insights that mothers had favorable cooking intention and desire, were supported with a confidence in some basic cooking skills. However, the existing constraints that encouraged the development of unfavorable children's snacking habit were beyond the mothers' control. A cookbook specifically for snack recipes that utilizes local ingredients may assist mother in preparing more healthier options for the children.
Collapse
Affiliation(s)
- Intan R Nirmala
- Department of Nutrition, Faculty of Medicine, Universitas Indonesia - Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
- Department of Nutrition, Health Polytechnic of Kendari, Ministry of Health, Kendari, Indonesia
| | - Judhiastuty Februhartanty
- Department of Nutrition, Faculty of Medicine, Universitas Indonesia - Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia.
- Southeast Asian Ministers of Education Organization Regional Centre for Food and Nutrition (SEAMEO-RECFON)/PKGR Universitas Indonesia, Jakarta, Indonesia.
| | - Rina Agustina
- Department of Nutrition, Faculty of Medicine, Universitas Indonesia - Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
- Human Nutrition Research Center, Indonesian Medical Education and Research Institute (HNRC-IMERI), Faculty of Medicine, Universitas Indonesia , Jakarta, Indonesia
| | - Rini Sekartini
- Department of Nutrition, Faculty of Medicine, Universitas Indonesia - Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
- Department of Pediatric, Faculty of Medicine, Universitas Indonesia - Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| |
Collapse
|
2
|
Paramashanti BA, Dibley MJ, Alam A, Huda TM. Wealth- and education-related inequalities in minimum dietary diversity among Indonesian infants and young children: a decomposition analysis. Glob Health Action 2022; 15:2040152. [PMID: 35389332 PMCID: PMC9004518 DOI: 10.1080/16549716.2022.2040152] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Background Over the last two decades, Indonesia has experienced remarkable economic growth. However, the percentage of infants and young children meeting the minimum dietary diversity (MDD) criteria has stagnated. Despite the growing body of evidence of the association between MDD and socioeconomic factors, there is little information about socioeconomic inequalities in MDD in Indonesia. Objectives The current study seeks to quantify the wealth- and education-related inequalities in MDD among infants and young children in Indonesia and determine the contribution of different factors to these disparities. Methods We included a total of 5038 children aged 6–23 months of the 2017 Indonesia Demographic and Health Survey. We measured wealth- and education-related inequalities using the concentration curve and Wagstaff normalised concentration index. Using a concentration index decomposition analysis, we then examined factors contributing to wealth- and education-related inequalities in MDD. Results The concentration indices by household wealth and maternal education were 0.220 (p < 0.001) and 0.192 (p < 0.001), respectively, indicating more concentration of inequalities among the advantaged population. The decomposition analysis revealed that household wealth (29.8%), antenatal care (ANC) visits (16.6%), paternal occupation (15.1%), and maternal education (11.8%) explained the pro-rich inequalities in MDD in Indonesia. Maternal education (26.1%), household wealth (19.1%), ANC visits (14.9%), and paternal occupation (10.9%) made the most considerable contribution to education-related inequalities in MDD. Conclusions There is substantial wealth- and education-related inequalities in MDD. Our findings suggest an urgent need to address the underlying causes of not reaching dietary diversity by promoting infant and young child feeding equity in Indonesia.
Collapse
Affiliation(s)
- Bunga A Paramashanti
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.,Department of Nutrition, Faculty of Health Sciences, Universitas Alma Ata, Yogyakarta, Indonesia
| | - Michael J Dibley
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Ashraful Alam
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Tanvir M Huda
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| |
Collapse
|
3
|
Bidira K, Tamiru D, Belachew T. Effect of community‐based nutritional education on dietary diversity and consumption of animal‐source foods among rural preschool‐aged children in the Ilu Abba Bor zone of southwest Ethiopia: Quasi‐experimental study. MATERNAL & CHILD NUTRITION 2022; 18:e13394. [PMID: 35758010 PMCID: PMC9480921 DOI: 10.1111/mcn.13394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 05/19/2022] [Accepted: 06/01/2022] [Indexed: 11/29/2022]
Abstract
Dietary diversity (DD) is a concern for poor people in developing countries, particularly in Africa. Most people's diets consist primarily of monotonous carbohydrate staples, with little or no animal products and few fresh fruits and vegetables. The aim of this intervention was to see how nutrition education delivered by trained health professionals improved preschool‐aged children's consumption of DD and animal‐sourced foods. The study used a quasi‐experimental design with 588 preschool‐aged children. Researchers used a multistage sample technique followed by a systematic random sampling technique. A χ2 test was used to determine the baseline differences in demographic and socioeconomic factors between the two groups, as well as the relationship between predictors and child DD and animal‐source foods (ASFs). The researchers used generalized estimating equations to assess the change in the difference in outcomes between the intervention and control groups, as well as the association between predictors and child DD and ASFs. The adjusted odds ratio with the corresponding 95% confidence intervals was reported to show the strength of the association. The findings of this study revealed that there was a highly significant difference in both DD scores (DDS) and ASFs between the control and intervention groups DDS (p < 0.003) and ASF (p < 0.001). According to the findings of this study, nutrition education can significantly improve DDS and ASF consumption among preschool‐aged children. Promoting minimum dietary diversity in feeding practices is essential to improve child health and development on a global scale. Community‐based nutritional education, delivered by trained health professionals, improved feeding practices among caregivers. This nutrition education increased children's dietary diversity and consumption of animal‐derived foods significantly. Our findings highlight the need for future research to investigate relevant aspects not covered in this study.
Collapse
Affiliation(s)
- Kebebe Bidira
- Department of Nutrition and Dietetics, Institute of Health Jimma University Jimma Ethiopia
| | - Dessalegn Tamiru
- Department of Nutrition and Dietetics, Institute of Health Jimma University Jimma Ethiopia
| | - Tefere Belachew
- Department of Nutrition and Dietetics, Institute of Health Jimma University Jimma Ethiopia
| |
Collapse
|
4
|
Salem MK, Pitchik HO, Sultana J, Rahman M, Jannat KK, Luby SP, Mridha MK, Winch PJ, Fernald LCH. Prevalence of Sugar-Sweetened Food Consumption in Rural Bangladeshi Children Aged 6-24 Months. J Nutr 2022; 152:2155-2164. [PMID: 35709397 DOI: 10.1093/jn/nxac119] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 05/09/2022] [Accepted: 05/24/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND While the prevalence of undernutrition in children has decreased in many low- and middle-income countries since the 1990s, prevalences of overweight and obesity have increased. Frequent consumption of sugar-sweetened food might have contributed to this change, although very little is known about sugar-sweetened food consumption in early life. OBJECTIVES The objective of this study was to explore the associations between individual, household, and maternal factors and the prevalence of sugar-sweetened food consumption in 6- to 24-month-old children in Bangladesh. METHODS Multistage sampling was used to select households with children aged 6-24 months in rural Chatmohar, a subdistrict of Bangladesh (n = 1635). Research assistants conducted a 24-hour qualitative dietary recall questionnaire with the enrolled child's primary caregiver to measure maternal and child dietary patterns. We examined factors associated with the prevalence of child sugar-sweetened food consumption with multivariate logistic regression models. We conducted tests of heterogeneity to explore differential associations between the child sugar-sweetened food consumption prevalence and household income by maternal nutrition knowledge and wealth. RESULTS Primary caregivers reported that 62% of toddlers had consumed sugar-sweetened food in the past 24 hours. A higher prevalence of child sugar-sweetened food consumption was associated with both a higher dietary diversity score (OR, 1.19; 95% CI, 1.09-1.29) and a higher prevalence of maternal sugar-sweetened food consumption (OR, 2.54; 95% CI, 1.97-3.28). At higher levels of maternal nutrition knowledge and wealth, more household income was associated with a lower prevalence of child sugar-sweetened food consumption. CONCLUSIONS Almost two-thirds of 6- to 24-month-old children in rural Chatmohar, Bangladesh, had consumed sugar-sweetened food in the last day. This is a high and concerning prevalence, and the associated factors identified in this study should be investigated further to identify potential areas of intervention to decrease the prevalence of child sugar consumption in Bangladesh.
Collapse
Affiliation(s)
- Marie K Salem
- Division of Community Health Sciences, School of Public Health, University of California Berkeley, Berkeley, CA, USA
| | - Helen O Pitchik
- Division of Epidemiology, School of Public Health, University of California Berkeley, Berkeley, CA, USA
| | - Jesmin Sultana
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research Bangladesh, Dhaka, Dhaka District, Bangladesh
| | - Mahbubur Rahman
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research Bangladesh, Dhaka, Dhaka District, Bangladesh
| | - Kaniz K Jannat
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research Bangladesh, Dhaka, Dhaka District, Bangladesh
| | - Stephen P Luby
- Division of Infectious Diseases and Geographic Medicine, Stanford University, Stanford, California, USA
| | - Malay K Mridha
- Center for Noncommunicable Diseases and Nutrition, BRAC James P Grant School of Public Health, BRAC University, Dhaka, Dhaka District, Bangladesh
| | - Peter J Winch
- International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Lia C H Fernald
- Division of Community Health Sciences, School of Public Health, University of California Berkeley, Berkeley, CA, USA
| |
Collapse
|
5
|
Siswati T, Iskandar S, Pramestuti N, Raharjo J, Rialihanto MP, Rubaya AK, Wiratama BS. Effect of a Short Course on Improving the Cadres' Knowledge in the Context of Reducing Stunting through Home Visits in Yogyakarta, Indonesia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:9843. [PMID: 36011477 PMCID: PMC9408553 DOI: 10.3390/ijerph19169843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 08/05/2022] [Accepted: 08/06/2022] [Indexed: 06/15/2023]
Abstract
Background: Stunting is primarily a public health concern in Low- and Middle-Income Countries (LMIC). The involvement of Integrated Health Service Post (Indonesian: Posyandu) cadres is among the strategies to combat stunting in Indonesia. Objective: This study aimed to determine the effect of a short course on cadres' knowledge. Method: A single group pre-test post-test design was conducted in Yogyakarta, Indonesia, from March to May 2022. Thirty cadres were selected based on the following criteria: willingness to participate, the number of stunted children in their Posyandu, able to read and write, and full attendance at the short course. The knowledge scores were measured by a questionnaire using true and false answers after a short course (post-test 1) and 4 weeks later (post-test 2). We apply STATA 16 to calculate the Mean Difference (MD) using a t-test and a Generalized Estimated Equation (GEE). Furthermore, the adequacy of the short course was evaluated with in-depth interviews. Result: GEE analysis showed that after controlling for age, education, occupation, and years of experience, the short course improved cadres' knowledge significantly on post-tests 1 and 2, i.e., knowledge regarding Children Growth Monitoring (CGM) (Beta = 6.07, 95%CI: 5.10-7.03 and Beta = 8.57, 95%CI: 7.60-9.53, respectively), Children Development Monitoring (CDM) (Beta = 6.70, 95%CI: 5.75-7.65 and Beta = 9.27, 95%CI: 8.31-10.22, respectively), and Infant Young Children Feeding (IYCF) (Beta = 5.83, 95%CI: 4.44-7.23 and Beta = 11.7, 95%CI: 10.31-13.09, respectively). Furthermore, the short course increased their self-efficacy, confidence, and ability to assist stunted children through home visits. Conclusion: The short courses consistently and significantly boosted cadres' knowledge of CGM, CDM, and IYCF, and appropriately facilitated cadres in visits to the homes of stunted children's home.
Collapse
Affiliation(s)
- Tri Siswati
- Department of Nutrition, Politeknik Kesehatan Kemenkes Yogyakarta, Tata Bumi No. 3, Banyuraden, Gamping, Sleman, Yogyakarta 55293, Indonesia
- Pusat Unggulan Iptek Inovasi Teknologi Terapan Kesehatan Masyarakat, Politeknik Kesehatan Kemenkes Yogyakarta, Tata Bumi No. 3 Banyuraden, Gamping, Sleman, Yogyakarta 55293, Indonesia
| | - Slamet Iskandar
- Department of Nutrition, Politeknik Kesehatan Kemenkes Yogyakarta, Tata Bumi No. 3, Banyuraden, Gamping, Sleman, Yogyakarta 55293, Indonesia
- Pusat Unggulan Iptek Inovasi Teknologi Terapan Kesehatan Masyarakat, Politeknik Kesehatan Kemenkes Yogyakarta, Tata Bumi No. 3 Banyuraden, Gamping, Sleman, Yogyakarta 55293, Indonesia
| | - Nova Pramestuti
- Balai Litbang Kesehatan Banjarnegara, Selamanik No. 16 A, Banjarnegara 53415, Indonesia
| | - Jarohman Raharjo
- Balai Litbang Kesehatan Banjarnegara, Selamanik No. 16 A, Banjarnegara 53415, Indonesia
| | - Muhammad Primiaji Rialihanto
- Department of Nutrition, Politeknik Kesehatan Kemenkes Yogyakarta, Tata Bumi No. 3, Banyuraden, Gamping, Sleman, Yogyakarta 55293, Indonesia
- Pusat Unggulan Iptek Inovasi Teknologi Terapan Kesehatan Masyarakat, Politeknik Kesehatan Kemenkes Yogyakarta, Tata Bumi No. 3 Banyuraden, Gamping, Sleman, Yogyakarta 55293, Indonesia
| | - Agus Kharmayana Rubaya
- Pusat Unggulan Iptek Inovasi Teknologi Terapan Kesehatan Masyarakat, Politeknik Kesehatan Kemenkes Yogyakarta, Tata Bumi No. 3 Banyuraden, Gamping, Sleman, Yogyakarta 55293, Indonesia
- Department of Environmental Health, Politeknik Kesehatan Kemenkes Yogyakarta, Tata Bumi No. 3, Banyuraden, Gamping, Sleman, Yogyakarta 55293, Indonesia
| | - Bayu Satria Wiratama
- Department of Epidemiology, Biostatistics and Population Health, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta 55281, Indonesia
- Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei 11031, Taiwan
| |
Collapse
|
6
|
Rahmadiyah D, Sahar J, Widyatuti W. Public Health Interventions to Reduce Stunting in Toddlers: A Systematic Review. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.8610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Handling stunting in toddlers is not only the responsibility of the government, but the most important thing is family and community responsibility. Public health interventions involving the family and community are important for stunting prevention because the family environment is one of the factors that determine the provision of adequate conditions for the nutritional status and development of children.
AIM: The purpose of this systematic review is to synthesize various public health interventions that are practice-based evidence derived from programs implemented to reduce stunting in toddlers.
METHODS: Initial steps doing this systematic review articles included in this study were retrieved from ProQuest, EBSCOhost, MEDLINE/CINAHL (Academic Search Complete) that were published within 2011–2019 and written in English. Study Quality Assessment was done using keywords and by assessing compatibility of the articles with the study context. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was used to analyze the found articles.
RESULTS: After filtering process, there were 11 articles from 859 articles emphasize on using a combination of two or more Public Health Interventions to reduce stunting in toddlers. The most common public health interventions done to reduce stunting in toddlers are health teaching, counseling, collaboration, and community organizing.
CONCLUSIONS: Here, we show that public health interventions performed by public health nurses to reduce stunting require the involvement of the community itself, especially the family. Public health interventions can be combined with one or more other public health interventions to increase success in preventing stunting in children under five.
Collapse
|
7
|
Sirajuddin S, Sirajuddin S, Razak A, Ansariadi A, Thaha RM, Sudargo T. The intervention of maternal nutrition literacy has the potential to prevent childhood stunting: Randomized control trials. J Public Health Res 2021; 10. [PMID: 33855419 PMCID: PMC8129741 DOI: 10.4081/jphr.2021.2235] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 04/06/2021] [Indexed: 11/26/2022] Open
Abstract
Background: Stunting is the impaired growth and development of children due to poor nutrition, repeated infection, and inadequate psychological stimulation. This research aims to examine the impact of maternal nutritional literacy (MNL) in increasing the height or score of a stunted child. Design and Methods: This study is a randomized control trial, which uses a sample size of 85 participants, 43 interventions and 42 controls, an 80% stress test and a 95% confidence level. The intervention group of the MNL consists of families with children under the age of five, focused on the mother’s ability to perform breastfeeding, hygiene activities, care, and intervention for 3 months. Result: The status of stunting was determined by the different distribution of stunting before and after the intervention in both the intervention and control groups. There was a decrease of about 9.3% of MNL in the intervention group, while in the control group it decreased by just 2.4% (p<0.05). Conclusions: It can be concluded that MNL has an effect in preventing stunting, and it is recommended that preventive measures should focus more on normal children, while stunted children should be provided with breastfeeding as the core of MNL. Significance for public health Preventing stunting requires an effort based on the family potential, and the nutritional literacy of the maternal is the most appropriate measure in achieving the preventive goals. This article shows that the maternal nutrition literacy interventions are very good in such a way that they become a reference for improving the nutrition and public health.
Collapse
Affiliation(s)
- Sirajuddin Sirajuddin
- Student Doctoral Public Health, Hasanuddin University, Makassar; Department of Dietetic and Nutrition, Health Polytechnic of Makassar.
| | - Saifuddin Sirajuddin
- Department of Health Nutrition, Faculty of Medicine, Gadjah Mada University, Yogyakarta.
| | - Amran Razak
- Department of Health Nutrition, Faculty of Medicine, Gadjah Mada University, Yogyakarta.
| | - Ansariadi Ansariadi
- Department of Health Nutrition, Faculty of Medicine, Gadjah Mada University, Yogyakarta.
| | - Ridwan M Thaha
- Department of Health Nutrition, Faculty of Medicine, Gadjah Mada University, Yogyakarta.
| | - Toto Sudargo
- Faculty Public Health Hasanuddin University, Makassar.
| |
Collapse
|
8
|
Effendy DS, Prangthip P, Soonthornworasiri N, Winichagoon P, Kwanbunjan K. Nutrition education in Southeast Sulawesi Province, Indonesia: A cluster randomized controlled study. MATERNAL AND CHILD NUTRITION 2020; 16:e13030. [PMID: 32468687 PMCID: PMC7507461 DOI: 10.1111/mcn.13030] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 04/27/2020] [Accepted: 04/29/2020] [Indexed: 11/28/2022]
Abstract
This study evaluated the impact of a nutrition education intervention on child feeding practices and children's nutritional status. Using a randomized controlled trial, we conducted an intervention for 6 months among caregivers with children aged 6-17 months in two subdistricts of Kendari, SE Sulawesi Province, Indonesia. In all, 22 integrated health posts were randomly assigned to an educational intervention or control group with 266 participants in both groups. Participants in the intervention group attended four nutrition classes and received a monthly home visit by cadres (community volunteers), whereas participants in the control group only received standard monthly health care at the health post. The primary study outcome was children's dietary diversity scores (DDSs). Mixed model analysis was conducted to examine the intervention effects on DDS and children's growth adjusting for clustering within subvillages. The study showed the educational intervention had a significant effect on children's DDS. Children in the intervention group had a larger DDS compared with children in the control group (Beta [mean difference] = 0.34, 95% CI: 0.02 to 0.66, P = 0.038). The intervention effect on height-for-age z-score (HAZ) could not be shown (Beta = 0.24, 95% CI: -0.06 to 0.56, P = 0.112). However, stunting prevalence remained stable in the intervention group but increased in the control group. These results indicated nutrition education delivered through nutrition classes combined with regular home visits by cadres as influencers provided a great potential to be adopted to complement other nutrition programmes in community health centres.
Collapse
Affiliation(s)
- Devi Savitri Effendy
- Department of Tropical Nutrition and Food Science, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.,Department of Public Health, Public Health Faculty, Halu Oleo University, Kendari, Indonesia
| | - Pattaneeya Prangthip
- Department of Tropical Nutrition and Food Science, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | | | | | - Karunee Kwanbunjan
- Department of Tropical Nutrition and Food Science, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| |
Collapse
|