Women’s Double Burden and its Impact on Stunting: A Case Study in Sawa Erma District, Asmat Regency, South Papua
Abstract
In 2022, the Ministry of Health of the Republic of Indonesia reported that Asmat Regency has the highest stunting prevalence in the country (54.5%). Stunting is primarily caused by chronic malnutrition, particularly during the first 1,000 days of life (1,000 HPK). However, in Asmat, this issue is not solely attributable to nutritional deficits but stems from a complex, cumulative double burden affecting pregnant and lactating women, which must be systematically addressed. This study aims to examine the nature of this double burden among women in Asmat and its impact on stunting incidence. A mixed-methods approach was employed, combining descriptive, qualitative, and quantitative research designs. Data were collected through structured questionnaires using a five-level Likert scale, administered to respondents selected proportionally across four villages with a 95% confidence level and 5% margin of error, based on Krejcie and Morgan’s sample size table. To enrich findings, Focus Group Discussions (FGDs) were conducted with community members in each village, and in-depth interviews were held with key informants. Anthropometric measurements were used to assess maternal nutritional status. Results indicate a strong correlation between the double burden faced by women during the 1,000 HPK period, characterized by malnutrition or risk of malnutrition, and high stunting rates, particularly in Er, Sona, Agani, and Mumugu villages. The double burden includes: limited health knowledge and inadequate counseling; maternal undernutrition and unmet nutritional needs for fetuses and young children; heavy domestic workloads combined with income-generating activities outside the home; efforts to care for family members alongside exposure to intimate partner violence; and a desire for education constrained by limited opportunities.
The complexity of factors contributing to stunting in Asmat calls for a comprehensive, multi-sectoral, and integrated response. Effective interventions must include sustained community mobilization, continuous mentoring, health education, and counseling provided by healthcare workers, especially for pregnant and lactating women, as preventive measures to improve maternal and child health outcomes in Asmat Regency.
Keywords: double burden; stunting; Asmat women.
Full Text:
PDFReferences
AZIZAH R E. Stunting: Permasalahan pahit yang harus diatasi. Kementerian Keuangan Republik Indonesia, 2023. https://www.kemenkeu.go.id
PUTRI A B I, & OKDIYANTI S A. Analisis kebijakan pemerintah Kabupaten Jember dalam menangani stunting dengan perspektif problem tree analysis. Jurnal Media Akademia, 2024, 2(5): 1–15. https://doi.org/10.62281/v2i5.275
KEMENKES RI. Buku saku hasil survei status gizi Indonesia (SSGI). Kementerian Kesehatan Republik Indonesia, 2022.
ARIF A. Masyarakat adat & kedaulatan pangan. Kepustakaan Populer Gramedia, 2021.
MENDROFA H K, BOLI E B, AGAMAWAN L P I, KARTIKA K, & WENDA Y. Bebas stunting melalui melek informasi kesehatan dan mandiri pangan berbasis teknologi pada kelompok ibu-ibu posyandu Kampung Komra. I-Com Indonesian Community Journal, 2024, 4(4): 3001–3012. https://ejournal.uniramalang.ac.id/i-com/article/view/5742
LESTARI T R. Stunting di Indonesia: Akar masalah dan solusinya. Info Singkat Kajian Singkat Terhadap Isu Aktual dan Strategis, 2023, 15(14): 21–25.
MAHMUD A. Visibilitas kelaparan dalam hak atas pangan dan gizi. 2021. http://repository.uinjkt.ac.id/dspace/handle/123456789/52741
DEBORA J, RINONCE H T, PUDJOHARTONO M F, ASTARI P, WINATA M G, & KASIM F. Prevalensi malaria di Asmat, Papua: Gambaran situasi terkini di daerah endemik tinggi. Jurnal Community Empowerment for Health, 2018, 1(1): 11–19. http://doi.org/10.22146/jcoemph.38309
IZAH N, ZULFIANA E, & RAHMANINDAR N. Effect of family characteristics on stunting events in toddlers aged 6–59 months. Jurnal Kebidanan Midwiferia, 2020, 6(1): 47–51. https://doi.org/10.21070/midwiferia.v6i1.508
SILABAN V F, DEWI L R, SINAGA L M, ASMITA L, GINTING L J, & SIMANJUNTAK L. The relationship of body weight, exclusive breastfeeding, MP-ASI and energy intake with stunting in toddlers. Jurnal Kegawatdaruratan Medis Indonesia, 2024, 3(1): 35–46. https://doi.org/10.58545/jkmi.v3i1.242
DAS S, HOSSAIN Z, & NESA M K. Levels and trends in child malnutrition in Bangladesh. Asia-Pacific Population Journal, 2009, 24(2): 51–78. https://coilink.org/20.500.12592/f7zr5q
SAKTI S A. Pengaruh stunting pada tumbuh kembang anak periode golden age. Biormatika: Jurnal Ilmiah Fakultas Keguruan dan Ilmu Pendidikan, 2020, 6(1): 169–175. https://ejournal.unsub.ac.id/index.php/FKIP/article/view/709
PUTRA N A, & AFIFAH W. Pertanggung jawaban negara atas pembiaran gizi buruk di daerah 3T (terdepan, terluar, tertinggal) di Indonesia. Causa: Jurnal Hukum dan Kewarganegaraan, 2024, 2(2): 71–80. https://doi.org/10.3783/causa.v2i2.1865
HADI N I. Challenges and opportunities of collaborative governance in addressing stunting: Lessons from Papua. KnE Social Sciences, 2023: 857–866. https://doi.org/10.18502/kss.v8i11.14477
KOGOYA Y, TOGODLY A, TINGGINEHE R M, RURU Y, BOUWAY D, & MEDIATI N. Evaluation of policy implementation (G. Edward III theory) on the stunting prevention and treatment program at Waena Health Center, Jayapura City, Papua Province. Formosa Journal of Science and Technology, 2024, 3(2): 233–246. https://doi.org/10.55927/fjst.v3i2.8105
SITUMORANG H E, & SINAGA E. Eksplorasi pengalaman tim kesehatan stunting di puskesmas dalam pencegahan dan penatalaksanaan stunting pada anak di Jayapura, Papua. Manuju Malahayati Nursing Journal, 2022, 4(11): 3004–3021. https://doi.org/10.33024/MNJ.V4I11.7476
WIDIYASTUTI S, LISANGAN M M, & WAMBRAUW L T. Analisis kasus stunting dan faktor-faktor yang berhubungan di Kampung Arowi, Distrik Manokwari Timur. Cassowary: Jurnal Penelitian Pendidikan Biologi, 2021, 4(2): 159–171. https://doi.org/10.30862/casssowary.cs.v4.i2.97
MISHRA R, & BERA S. Geospatial and environmental determinants of stunting, wasting, and underweight: Empirical evidence from rural South and Southeast Asia. Nutrition, 2024, 120: 112346. https://doi.org/10.1016/j.nut.2024.112346
SIANIPAR T M E, NURHASANA R, HANITA M, & AYUNINGTYAS D. Improving human resources as local food processors to accelerate stunting prevention to realize the SDGs: Case study in Asmat, Papua. In IOP Conference Series: Earth and Environmental Science, IOP Publishing, 2021, 120: 095. https://doi.org/10.1088/1755-1315/120/1/012095
HARDANI M, & ZURAIDA R. Penatalaksanaan gizi buruk dan stunting pada balita usia 14 bulan dengan pendekatan kedokteran keluarga. Medula: Jurnal Ilmu Kedokteran, 2019, 9(3): 565–575. http://repository.lppm.unila.ac.id/id/eprint/20412
MATHUR S, MALHOTRA A, & MEHTA M. Adolescent girls’ life aspirations and reproductive health in Nepal. Reproductive Health Matters, 2001, 9(17): 91–100. https://doi.org/10.1016/S0968-8080(01)90075-8
KURNIATI P T. Penyuluhan tentang pencegahan stunting melalui pemenuhan gizi pada wanita usia subur. Jurnal Altifani: Penelitian dan Pengabdian kepada Masyarakat, 2021, 1(2): 113–118. http:// doi.org/10.25008/altifani.v1i2.125
IDYAWATI S, AFRIDA B R, & ARYANI N P. Pendampingan pada keluarga dengan balita gizi kurang dan stunting. Jurnal Abdimas Kesehatan, 2023, 5(1): 91–96. https://doi.org/10.36565/jak.v5i1.447
VIKALIANA R, MARIAM S, ARYANI F, HIDAYAT Y R, & HERMAWAN E. Pencegahan stunting melalui penanganan material pangan dan pengelolaan keuangan rumah tangga. JPM: Jurnal Pengabdian Masyarakat, 2024, 4(3): 257–265. https://doi.org/10.47065/jpm.v4i3.1374
GUSNEDI G, NINDREA R D, PURNAKARYA I, UMAR H B, SUSILOWATI A, & LIPOETO N I. Risk factors associated with childhood stunting in Indonesia: A systematic review and meta-analysis. Asia Pacific Journal of Clinical Nutrition, 2023, 32(2): 184–195. https://doi.org/10.6133/apjcn.202306_32(2).0003
SARI D D P, SUKANTO S, MARWA T, & BASHIR A. The causality between economic growth, poverty, and stunting: Empirical evidence from Indonesia. Jurnal Perspektif Pembiayaan dan Pembangunan Daerah, 2020, 8(1): 13–30. https://doi.org/10.22430/jppd.v8i1.1452
NARYONO E. Stunting, the main threat to human quality. OSF Preprints, 2023. https://doi.org/10.31219/osf.io/2w9yn
SUSILAWATI S. Hubungan antara pendidikan ibu, ekonomi keluarga, pekerjaan ibu, dan pola pemberian makan dengan stunting pada balita di wilayah kerja UPTD Puskesmas X Kota Depok tahun 2021. Indonesian School Journal of Medicine and Health Sciences, 2022, 1(5): 171–179. https://doi.org/10.58547/isjmhs.v1i5.1937
ANITYA P C, SENJAYA A A, & SOMOYANI N K. Hubungan status gizi ibu saat hamil dengan kejadian stunting di wilayah kerja Unit Pelaksana Teknis Puskesmas Kintamani VI tahun 2022. Jurnal Ilmiah Kebidanan (The Journal of Midwifery), 2023, 11(1): 1–8. https://doi.org/10.33992/jik.v11i1.2075
KURNIA E, PRADIPKA H, & NEGARA M A P. Literature review: Evaluasi kebijakan program pencegahan stunting di Indonesia. JARSI: Jurnal Administrasi Rumah Sakit Indonesia, 2024, 3(2): 92–104.
RAHMA M. Pengaruh paket pendidikan kesehatan siaga risiko stunting (skoring) terhadap pengetahuan dan sikap ibu hamil dalam mencegah stunting di wilayah kerja Puskesmas Guntur Demak. Thesis. Universitas Islam Sultan Agung Semarang, 2023.
ROSIDA B S, & KUSMIATI Y. Pengaruh budaya pola konsumsi makanan ibu hamil terhadap kejadian stunting di Kecamatan Kembayan, Kabupaten Sanggau, Kalimantan Barat. Jurnal Kebidanan, 2023, 13(1): 75–86. https://jurnal.stipaba.ac.id/index.php/123akpb/article/view/210
CHRISTINA C, GUNAWAN, G, SULTANEA R., LESTARI D, AZIZAH U, … & FARHAN M M. Pola asuh orangtua dan kurangnya gizi anak penyebab stunting di Desa Karangduwur, Kalikajar, Wonosobo. Jurnal Pengabdian Masyarakat Madani, 2022, 2(2): 188–195. http://doi.org/10.51805/jpmm.v2i2.88
APRILUANA G, & FIKAWATI S. Analisis faktor-faktor risiko terhadap kejadian stunting pada balita (0–59 bulan) di negara berkembang dan Asia Tenggara. Media Penelitian dan Pengembangan Kesehatan, 2018, 28(4): 247–256. https://doi.org/10.22435/mpk.v28i4.472
PUDJOHARTONO M F, RINONCE H T, DEBORA J, ASTARI P, WINATA M G, & KASIM F. Survei status gizi balita di Agats, Asmat, Papua: Analisis situasi pascakejadian luar biasa gizi buruk. Jurnal Community Empowerment for Health, 2019, 2(1): 10–21. https://doi.org/10.22146/jcoemph.39235
HANIFAH N A A, & STEFANI M. Hubungan pernikahan usia dini dengan angka kejadian stunting pada balita di Kelurahan Mekarsari. Jurnal Gizi Ilmiah, 2022, 9(3): 32–41. https://doi.org/10.46233/jgi.v9i3.819
INDRIANI F. Hubungan menikah usia anak terhadap kejadian stunting pada balita di Wonosobo. Jurnal Keperawatan Widya Gantari Indonesia, 2023, 7(1): 1–10. https://doi.org/10.52020/JKWGI.V6I3.5494
KHUSNA N A, & NURYANTO N. Hubungan usia ibu menikah dini dengan status gizi balita di Kabupaten Temanggung. Jurnal Nutrition Collage, 2017, 6(1): 1–10. http://doi.org/10.14710/jnc.v6i1.16885
KHASANAH E N, PURBANINGRUM D G, ANDITA C, & SETIANI D A. Kebijakan penanggulangan stunting di Indonesia. Jurnal Akuntansi Publik, 2023, 1(2): 217–231.
NINGSIH R Y, ZURIYATI Z, & ATTAS S G. Citra perempuan Asmat dalam roman Namaku Teweraut karya Ani Sekarningsih: Kajian sastra feminis. Bahtera: Jurnal Pendidikan Bahasa dan Sastra, 2021, 20(2): 196–209. https://doi.org/10.21009/bahtera.202.06
SAMDERUBUN G, & IZDIHA A. Dinamika kedudukan, peran dan status perempuan suku Asmat: Pendekatan arena kultural Pierre Bourdieu. Social: Jurnal Ilmu Administrasi dan Sosial, 2023, 12(1): 153–170. https://doi.org/10.35724/SJIAS.V12I1.5118
KRISHNAKUMAR P, ARUN S, & RENU G. Protein-energy malnutrition and its association with stunting in under-five children: A cross-sectional study from South India. International Journal of Contemporary Pediatrics, 2020, 7(5): 1868–1873. https://doi.org/10.18203/2349-3291.ijcp20202547
GERA T, SHARMA S, KHEPAR S, BANSAL S, & ARORA N. Environmental risk factors for stunting in low- and middle-income countries: A systematic review and meta-analysis. Journal of Family Medicine and Primary Care, 2021, 10(1): 1–9. https://doi.org/10.4103/jfmpc.jfmpc_1457_20
ASTUTI I D P, DWIATMIKA I G A, & KARTIKA I A A. Sanitation and drinking water quality as determinants of stunting in Papua and West Papua: A secondary data analysis. Bali Medical Journal, 2022, 11(2): 678–685. https://doi.org/10.15562/bmj.v11i2.3495
APRIZAH R. Promoting Clean and Healthy Living Behavior (PHBS) at home to prevent stunting in early childhood. Jurnal Ilmiah Pengetahuan dan Pendidikan, 2021, 3(3): 112–118. https://ejournal.uniba-bpn.ac.id/index.php/JIPENDIK/article/view/102
PRABANDARI Y S, SUPADMI I G A A, & PURWANTO D W. Barriers to exclusive breastfeeding among working mothers in urban Indonesia: A qualitative study. Midwifery Journal of Indonesia, 2021, 5(2): 67–74. https://doi.org/10.35842/mji.v5i2.123
ERNAWATI T, & DWIYANI R. Determinants of stunting among children under five in rural areas of Central Java, Indonesia. Indian Journal of Public Health, 2020, 64(S2): S289–S294. https://doi.org/10.4103/ijph.IJPH_683_19
TAMBUNAN T. Access to health services and its impact on maternal and child nutrition outcomes in remote areas of Papua. Journal of Health Systems and Reform in Indonesia, 2023, 2(1): 33–41. https://doi.org/10.35842/jhsri.v2i1.156
ASMURI A, & SETIAWAN M I. The role of gender dynamics and household decision-making in child malnutrition: A qualitative study in rural East Java. Indonesian Journal of Public Health and Community Medicine, 2022, 6(1): 45–52. https://doi.org/10.20473/ijphcm.v6i1.2022.45-52
HIDAYAT S, & UTAMI D S. Gender roles and women’s agency in indigenous communities of Papua: A qualitative study. Jurnal Sosiologi Reflektif, 2020, 15(1): 45–60. https://doi.org/10.21009/JSR.15104
KREJCIE R V, & MORGAN D W. Determining sample size for research activities. Educational and Psychological Measurement, 1970, 30(3): 607–610. https://doi.org/10.1177/001316447003000308
Refbacks
- There are currently no refbacks.
