The Relationship of Socio-Economic with Nutritional Status in Toddlers in Meureubo Sub-District West Aceh Regency

ARTICLE INFORMATION Children's health and growth are issues that need continuous attention by various parties, such as the government and family. As a result of malnutrition status in infancy can cause growth retardation, causing toddlers to be lazy to do activities related to energy production, disruption of the toddler's immune system so they are susceptible to infectious diseases, inhibited optimal brain growth, and changes in behavior exhibited by toddlers such as not calm, easy crying and its ongoing impact is apathetic behavior. Based on the preliminary survey in the Meurebo SubDistrict, West Aceh Regency, there were 4 toddlers suffering from malnutrition and 11 people with underweight nutritional status. The aims of study was to look at the socio-economic relationship with nutritional status of toddlers. This study uses quantitative research with a cross-sectional approach using a chi-square test with a standard error of 0.05. The population of this study were 46 peoples with those taken based on sample distribution. The results obtained by the value of sig = 0.007 which means smaller than the value of α = 0.05, so it can be concluded a significant relationship between socio-economic and nutritional status of toddler. Submitted: 08/01/2020 Revised: 16/02/2020 Accepted: 21/04/2020 Published Online : 15/05/2020


Introduction
Health development is an integrated part of human resource development in promoting a developed and independent nation as well as physical and spiritual prosperity. One of the characteristics of an advanced nation is a nation that has a high degree of health. The ranking of the degree of public health is marked by decreasing the number of infant and maternal mortality rates, improving the nutritional status of the community and increasing life expectancy. (Adisasmito, 2012).
The malnutrition problem is generally caused by lack of food supplies, lack of good environmental quality, poverty, balanced menus, lack of community knowledge about nutrition, and health as well as the presence of poor nutrition areas (iodine). Children's health and growth are issues that need continuous attention by various parties, such as the government and family. Children are the successor to the nation, in their hands the future of this nation will be determined. If a nation has children who are physically and mentally healthy, it will create quality human resources, intelligent and productive. The decline in the quality of a generation can be prevented by saving them from physical, mental and intellectual health disorders. It must be admitted that the concern for parents towards their children is very large. Many factors affect a person's intelligence level, including nutritional factors. (Setiabudhi, T.2012).
As a result of malnutrition status in infancy can cause growth retardation, causing toddlers to be lazy to do activities related to energy production, disruption of the toddler's immune system so that they are susceptible to infectious diseases, inhibited optimal brain growth, and changes in behavior exhibited by toddlers such as not calm, easy crying and its ongoing impact is apathetic behavior. (Wira Mutika.2018).
One way to measure nutritional conditions is by assessing nutritional status. Nutritional status is an expression of a state of equilibrium in the form of certain variables or an embodiment of nutritionure in the form of certain variables. Nutritional status is determined by several factors, according to Unicef in Supariasa (2012).
Poor nutritional status in children under five is caused by several factors, one of which is food intake as a direct cause and maternal skills about nutrition in children under five as the main problem. Food intake or consumption can directly affect a person's nutritional state or nutritional status (Supariasa, et al, 2012).
In the Global Nutrition Report in 2017 showed nutritional status problems in the world including the prevalence of wasting (thin) 52 million children (8%), stunting (short) 115 million children (23%), and overweight 4 million children (6%) with a target 100% (UNICEF and WHO, 2017). In 2019 One in three children under five in the world experience malnutrition and not develop properly. A large number of children suffer from bad food and the food system that makes them fail. Around 200 million children under five suffer from malnutrition or being overweight (overweight / obese). Meanwhile, one in three children (aged between six months and one year), globally does not get proper food. With a target of 17% (UNICEF 2019).
Based on the results of the Basic Health Research (Riskesdas 2018) the Ministry of Health 2018 showed 17.7% of infants under 5 years old (toddlers) were still experiencing nutritional problems. This figure consisted of toddlers who experienced malnutrition of 3.9% and those suffering from malnutrition of 17.8%. Where underweight underweight children have a target of 17% and wasting toddlers at 9%. (Health Office, 2018).
The prevalence of nutritional status in Aceh Province with BB / TB measurement is 12.8% while based on BB / U measurements 24.8% with a target of 100% where the number of children under five is 568,899 children, 149 children under five suffer from malnutrition, and children with underweight status 18.8% , the nutritional status of under-fives is 1.1% and under-fives with a good nutritional status of 74.1% (Aceh Provincial Health Office with Poltekkes, 2017).
Whereas in 2018 the number of toddlers aged 0-4 years old boys as many as 290,035 and women 278,907 which under five suffer from malnutrition and lack of 18% with a target of 100 per 1000 population. Whereas in 2019, there was a target of 28% in February 2019, there were 3,125 children suffering from malnutrition and also identified as many as 12,000 children under five who were suffering from malnutrition. (Aceh Health Propil, 2018).
Based on the observation of the West Aceh Health Service in 2019 in West Aceh until August there were cases of malnutrition in which there were 8 cases in Kuta Padang health center, Drien Rampak health center 4 cases, Pante Cermen health center 10 cases, Arongan Lambalek health center 8 cases, Meurebo health center 14 Cases and Health Centers Cot Seumareng 1 Case, and in 2019 the most common cases of malnutrition were found in the Meurebo Health Center, Meurebo District, West Aceh Regency which has a target of 17%. (West Aceh Health Service, 2019).
Based on the preliminary survey conducted by the author, in the Work Area of the Meurebo Public Health Center, West Aceh Regency, there were 4 toddlers who suffered from malnutrition and of which 2 of the toddlers were cured and 2 toddlers were still in care. While toddlers suffering from malnutrition status there are several cases in various villages in the Meurebo working area, which in Sumber Batu Village have 1 case, Bukit Jaya village 1 case, Peunaga Baro village 1 case, Pasie Mesjit Gampong 1 case, Pasie Mesdit village ADB 1 Case, Paya Baro 2 Case, Bukit Jaya 1 Case, Buloh 1 Case, Pasie Pinag 1 Case, Mestu 2 Case, Ranto Panjang Barat 1 Case, and Pasie Aceh Baroh Village 1 Case.
Based on the results of interviews conducted on 5 mothers who have toddlers, 3 of which mothers have toddlers with undernourished status, of which 3 mothers of toddlers can be concluded that undernutrition experienced by their toddlers is defined by economic factors one of which. Based on the description above, the authors conducted a study entitled "The Relationship of Socio-Economic with Nutrition Status in Toddlers in Meureubo Sub-District, West Aceh Regency".

Method
This research uses quantitative research with cross sectional approach by means of univariate and bivariate analysis using chi-square test with a standard error of 0.05. The population of this study was 46 people with those taken based on sample distribution. sampling technique using total sampling technique, which is taking all members of the population that is as many as 46. This research was conducted in December 2019 in the Work Area of the Meureubo Health Center in West Aceh Regency.

Univariate Analysis
Toddler Frequency Distribution Based on Gender  From the above table it can be stated that respondents with low economic status who have toddlers with good nutritional status are 10 toddlers (32.3%), while respondents with low economic status with poor nutritional status are 14 toddlers (45.2%) and respondents with economic status Low toddlers who have poor nutritional status are absent.

Distribution of Respondents Frequency Based on Social-Economy
Whereas respondents with high economy who have good nutritional status of toddlers are 8 toddlers (80.0%) and respondents with high economic toddlers who have undernourished status are 2 toddlers (20.0%), and respondents with high economy with toddlers with poor nutritional status are absent.
From the results of the chi square test, the sig = 0.007 value is obtained which is smaller than the value of α = 0.05, and it can be concluded that there is an influence between socioeconomic and Toddler Nutrition Status in Meureubo Sub-District,West Aceh Regency.

Discussion
From the results of research conducted the influence of socioeconomic factors with the Nutrition Status of Toddlers in the Work Area of the Meurebo Health Center, West Aceh Regency.
From the results of the regression test, a sig value of 0.007 is obtained, which is smaller than the value of α = 0.05, and it can be stated that there is an influence between socioeconomic and Toddler Nutrition Status in the Work Area of Meurebo Health Center, West Aceh Regency.
Income is the amount of money received from a person's activities in carrying out his work, where the specified income standard is in accordance with the Provincial MSE, if access to food at the household level is disrupted, mainly due to poverty, malnutrition will definitely emerge. Poverty or low family income greatly influences the adequacy of family nutrition (Hertien.2018).
This research is also supported by previous research by Hertien Novi Roficha (2018). Chi-square test results obtained p = 0.026 with significance level α = 0.05. This shows the value of p <α, meaning there is an influence between parental income and the nutritional status of children under five.

Conclusion
From the results of research conducted showed a significant relationship between socioeconomic with Nutrition Status in Toddlers in Meureubo Sub-District, West Aceh Regency.