Doctor of Medical Sciences Proves the Success of the Garbasari Program in Badung Regency in Accelerating the Reduction of Stunting

• Posted by: Admin
• Kamis, 15 Juni 2023
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Located in the graduate courtroom lt. III, Denpasar Postgraduate Building, the Doctoral Promotion exam has taken place with the promovendus candidate, Made Agus Sugianto, SKM., M.Kes. with the dissertation title "The Success of the Garbasari Program in Reducing Village Stunting Rates in Badung Regency, Bali Province." (15/6/2023)

Stunting is a condition of failure to thrive in children under five due to chronic malnutrition, especially in the first 1000 days of life (1000 HPK), which starts from the formation of the fetus in the womb until the child is 2 (two) years old. Stunting is caused by various factors that are multi-dimensional. Therefore, a program and commitment from regional heads are needed to address the stunting problem in a comprehensive manner. In Badung Regency, the program to accelerate the reduction of stunting was realized through the declaration of the Healthy Badung Movement in the First 1000 Days of Life (Garbasari). Garbasari is a program that involves community participation, including the village government, in accelerating the reduction of stunting.

Quantitatively, this study aims to determine the trend of decreasing stunting rates by region, age group and sex in Badung Regency from 2018 compared to 2021, as well as analyze the relationship between the components of the Garbasari program and the reduction in stunting rates in Badung Regency. Furthermore, qualitatively it aims to explore the implementation of the Garbasari program in Badung Regency based on inputs, processes, outputs and outcomes, and to identify best practices for the Garbasari program in Badung Regency which can be disseminated to other regions.

The method used in this study is program evaluation to analyze the effect of the Garbasari program on reducing stunting rates in Badung Regency using a Mixed Method design with Convergent Design. The sample in this study were all villages/kelurahans in the Badung Regency area, totaling 62 villages/kelurahans. The results of the study show that during 2018-2021, there has been a decrease in stunting by age group, sex and type of region in Badung Regency. The results of the bivariate analysis showed that there was a significant difference in the stunting rate between 2018 and 2021 with a p value < 0.001. Likewise the results of the multivariate analysis showed that there was a significant relationship between the reduction in the stunting rate and the percentage of budget realization (p= 0.005; Exp (B) 7,764 ), the percentage of attendance at pregnant women's classes (p = 0,043; Exp (B) 7,915) and the percentage of attendance at mothers' classes toddler (p = 0.044; Exp (B) 6.532).

From the input side, the success of the Garbasari program in reducing stunting rates was due to specific interventions and sensitive interventions carried out by the Badung District Government. Meanwhile, from a process standpoint, this is due to the involvement of multiple parties such as universities, traditional institutions (Klian Adat), MSMEs and the existence of the Sustainable Food Home program as well as the utilization of information technology systems. Likewise from the output side, due to the achievement of activity indicators for access to clean water, budget realization, class attendance of pregnant women and mothers of toddlers. Furthermore, in terms of results, this program has succeeded in reducing the stunting rate for toddlers by an average of 3.9% per year. The best practice for Garbasari's program in reducing stunting is the existence of regulations that support specific and sensitive interventions in the handling of stunting by an integrated team to accelerate stunting reduction by utilizing information technology including social media.

The research news (novelty) from this study is the integration of the government's accelerated stunting reduction program which involves the community and stakeholders through quality health services by utilizing information technology.

Handling the problem of stunting requires the involvement of many parties. Therefore, it is necessary to develop a geographic information system-based stunting mapping information system that can visualize the level of stunting vulnerability in each village, in order to make it easier for relevant agencies to provide support, so that stunting problems can be addressed effectively and on target. In addition, each village has different conditions, so interventions for stunting problems should be adjusted to the characteristics of the region which include; economic conditions, demographic conditions and the level of public education. Furthermore, the stunting reduction acceleration program also needs to be directed at efforts to increase food security at the family level by intensifying the Sustainable Food Homes program.

The exam was led by the Deputy Dean for General Affairs and Finance Dr. dr. I Made Sudarmaja, M.Kes., with a team of examiners:

1. Dr. dr. I Ketut Suyasa, Sp.B., Sp.OT(K) (Promoter)

2. Prof. Dr. dr. I Wayan Weta, MS., Sp.GK (Co-promoter I)

3. Dr. dr. A.A.Wiradewi Lestari, Sp.PK (K) (Co-promoter II)

4. Dr. dr. I Made Bakta, Sp. PD-KHOM

5. Prof. Dr. dr. I Made Jawi, M. Kes

6. Dr. dr. I Made Oka Adnyana, Sp.S (K)

7. dr. I Made Ady Wirawan, S.Ked, MPH., Ph.D

8. dr. Pande Putu Januraga, M.Kes., Dr, PH

9.Dr. dr. I Made Sudarmaja, M. Kes

10.Dr. dr. I Made Muliarta, S.Ked., M.Kes

While academic invitations are:

1.Dr. dr. Luh Putu Ratna Sundari, S.Ked., M.Biomed

2.Dr. dr. Made Agus Hendrayana, M.Ked

3.Dr. Kadek Tresna Adhi, SKM., M.Kes

4.Dr. dr. Putu Ayu Asri Damayanti, M.Kes

5. dr. Agus Eka Darwinata, S.Ked., Ph.D

In this exam, Dr. Made Agus Sugianto, SKM., M.Kes., was declared the 384rd Graduate Doctor of the Doctoral Degree in Medical Sciences, Faculty of Medicine, Udayana University with a very satisfying predicate.

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