Helda Khusun

Role of family support and women's knowledge on pregnancy-related risks in adherence to maternal iron-folic acid supplementation in Indonesia.

OBJECTIVE To examine whether womens knowledge of pregnancy-related risks and family support received during pregnancy are associated with adherence to maternal iron-folic acid (IFA) supplementation. DESIGN Secondary data analysis of the 2002-03, 2007 and 2012 Indonesia Demographic and Health Survey. Analysis of the association between factors associated with adherence (consuming ≥90 IFA tablets), including the womens knowledge and family support, was performed using multivariate logistic regression. SETTING National household survey. SUBJECTS Women (n 19 133) who had given birth within 2 years prior to the interview date. RESULTS Knowledge of pregnancy-related risks was associated with increased adherence to IFA supplementation (adjusted OR=1·8; 95 % CI 1·6, 2·0), as was full family (particularly husbands) support (adjusted OR=1·9; 95 % CI 1·6, 2·3). Adequate antenatal care (ANC) visits (i.e. four or more) was associated with increased adherence (adjusted OR=2·2; 95 % CI 2·0, 2·4). However, ANC providers missed opportunities to distribute tablets and information, as among women with adequate ANC visits, 15 % reported never having received/bought any IFA tablets and 30 % had no knowledge of pregnancy-related risks. A significant interaction was observed between family support and the womens educational level in predicting adherence. Family support significantly increased the adherence among women with <9 years of education. CONCLUSIONS Improving womens knowledge of pregnancy-related risks and involving family members, particularly the husband and importantly for less-educated women, improved adherence to IFA supplementation. ANC visit opportunities must be optimized to provide women with sufficient numbers of IFA tablets along with health information (especially on pregnancy-related risks) and partner support counselling.

Food Store Choice Among Urban Slum Women Is Associated With Consumption of Energy-Dense Food

The aim of this study was to examine the associations of food store choice with food consumption among urban slum women. A cross-sectional survey was carried out among 188 urban slum women (19-50 years old) in Jakarta, Indonesia. A semiquantitative food frequency questionnaire was used to assess food consumption. Associations between food consumption and food store choice were tested by linear regression. This study found that frequencies of buying food from small shops (warung), street food vendors, and modern food stores were significantly associated with consumption of snacks, mixed dishes, and fruit respectively. In addition, buying food from traditional markets and small cafes (warung makan) was not significantly associated with particular types of food consumption. As modern food stores are rarely utilized by these women, small shops (warung) and street food vendors are likely to be important channels to improve slum dwellers’ diet.

Development and evaluation of a semiquantitative food frequency questionnaire for estimating omega-3 and omega-6 fatty acid intakes in Indonesian children.

BACKGROUND AND OBJECTIVE A balance ratio of dietary omega-3 (n-3) and omega-6 (n-6) fatty acids reduces childhood obesity. However, few studies have focused on validation of semiquantitative food frequency questionnaire (SFFQ) for determining the n-3 and n-6 intakes in children. Therefore, a valid SFFQ for assessing n-3 and n-6 intakes among Indonesian children is required. METHODS AND STUDY DESIGN A cross-sectional study was conducted by selecting 89 healthy children through multistage random sampling. Dietary intakes were assessed using the SFFQ and a 3-day non-consecutive 24-h recall. Randomly selected children (n=35) were assessed for plasma phospholipid fatty acid (PFA). In total, 78 food items in the SFFQ, as in the Thai, Vietnamese, and American food composition databases, were validated using dietary recall and PFA. The SFFQ was readministered after 4 weeks to assess its reproducibility. The validity and reproducibility of the SFFQ were determined by Bland-Altman analysis. RESULTS Favourable agreement was found between the SFFQ and recall for docosahexanoic acid, eicosapentanoic acid, docosapentanoic acid, and arachidonic acid, but not for total n-3, n-6, α-linolenic acid, or linoleic acid. Significant correlations were found between the SFFQ estimations and plasma n-6 and LA (r=0.40, p=0.025; and r=0.42, p=0.018, respectively). A 95% limit of Bland-Altman agreement was observed between the first and repeat SFFQ for all fatty acids. CONCLUSION The proposed SFFQ is sufficiently valid and reliable for assessment of essential fatty acids intakes in Indonesian children.