INTRODUCTION
The
World Health Organization (WHO) estimates that 35-75% of pregnant women in
developing countries are anemic. According to (AKRIM, 2022) anemia in pregnant women� is a health problem that can affect the
mother and fetus and can even� cause death among many pregnant women who
have suffered from anemia with an estimated
prevalence of� 43% of women become
pregnant in developing� countries.
ASEAN
in 2007 the incidence of anemia varies, from the
highest in our own country Indonesia around 70% and the lowest rate is in
Singapore which is 7%. According to Research Amirudin,
said maternal death can occur due to several causes including anemia (Wahyuni & Azwar, 2022).� In Indonesia Even though the
Maternal Mortality Rate (MMR) was recorded at 228/100,000 live births, even
though the government targets that in 2015 MMR will decrease to 102/100,000
live births (KH). MMR is an indicator of health success in a country. The
Maternal Mortality Rate (MMR) in North Sulawesi Province in 2015 was 73 people,
while in Manado City itself it became the highest among other Regencies/Cities
in North Sulawesi at 11 cases of maternal deaths, in the Book Health Profile of
North Sulawesi Province in 2015, while at the Minanga
Health Center when researchers conducted an initial
survey, data on pregnant women in the last 6 months were obtained as many as 153
pregnant women.
Anemia in pregnant women also results in
placental disorders such as hypertrophy, classification and infarction,
resulting in impaired function. Thing this can result in impaired fetal growth (Roza et al., 2018). Term pregnant women tend to�
suffer from Iron Deficiency Anemia (ADB)
because at that time the fetus hoards iron reserves
for itself in order to� stock up
immediately after birth (Xue et al., 2018).
In pregnant
women with anemia there is a disruption in the
distribution of oxygen and food substances from the mother to the placenta and fetus, which affects placental function. Decreased
placental function can result in fetal growth and
development disorders. Anemia in pregnant women can
result in fetal growth and� development disorders, abortion, old partus, puerperal sepsis, maternal and fetal
mortality (Cunningham, 2005); (Roza et al., 2018) increases the� risk of low
birth� weight (Beldon & Crozier, 2005) in (Volkoff & London, 2018), neonatal asphyxia prematurity (Chu et al., 2020). Impaired growth and placental function in pregnant women with anemia are strongly related to fetal
survival. Placental birth weight reflects the function and growth and
development of the placenta itself and placental growth and development related
to birth weight (Uzun et al., 2020).
Efforts have been made to
prevent anemia in pregnant women such as improving
nutritional intake, iron administration programs and administratio
Iron preparations long before
planning a pregnancy, but the efforts that have been� made have not been very satisfactory (Ayazbekov et al.,
2020). This means anemia in pregnant women can
threaten the health of pregnant women. One solution carried out by researchers
is to provide health counseling about the prevention of anemia in pregnant
women at the Minanga Health Center. Based on the data
above, researchers are interested in conducting research with the title of� the effect of health� counseling on prevention (Sholihah &
Hanafi, 2017).
Anemia against the knowledge of pregnant women at the polyclinic KIA/KB minanga health center Manado with the aim of knowing the
influence of health counseling on the prevention of anemia on the knowledge of
pregnant women.
The type of research� used is by Analytics with research in
pre-experimental� design using� a one-group pre-test design- Post test design
is a research design where� there is no
comparison group (control),� but at
least� the� first observation (pretest)� has been made which allows testing changes� that occur after the experiment� (program).
Population on.ased
on the table above, respondents� before
being given health counseling about anemia prevention were many in the category
of less than 21 respondents (60%).
RESULTS AND DISCUSSION
This research was
located at the Minanga Health Center located on Jalan
Perum Minanga Indah, Malalayang II Village, Environment IX, Malalayang
District Based on the table above, respondents showed that after being given
health counseling about the prevention of aenmia
there were many in the good category, there were 30 respondents (85.7).
Bivariate analysis results
The
difference in the average knowledge before and after being given Health
Counseling on Anemia Prevention analyzed by Wilcoxon Signed Ranks
Test.
Table 1. the average value of knowledge of pregnant
women before being given health education
|
Variabel |
Median (Minimum-
Maximum) |
Mean |
SD |
p- value |
|
Knowledge
of pregnant womenPretest Posttest |
1.00
(1 � 2) 3.00
(2 � 3) |
1,40 2,86 |
0,497 0,355 |
� 0,000 0,000 |
Table 1. shows that the average value of
knowledge of�� pregnant women before
being given health counseling on anemia prevention was a mean of
1.40 with SD 0.497 and after being given health�� counseling about anemia, the average
value of knowledge of pregnant women is mean 2.86 with SD 0.355.
Based on the results of statistical tests
using the Wilcoxon Signed Rank Test, p results were obtained ≤
α 0.05, namely p = 0.000.�� This
shows that the intervention or treatment given, namely health counseling on the
prevention of anemia, gives meaningful results.�
So that there is an influence of health counseling on anemia prevention
on respondents' knowledge.
The results of the study were presented based on the� purpose of the� study, namely knowing the� knowledge of�
respondents before and after being�
given health counseling about prevention anemia and analyze the� effect of�
health counseling on� anemia� prevention on the knowledge of pregnant women
at the MCH Polyclinic / KB Minanga Health Center.
Knowledge of
pregnant women beforeand after health counseling
about the prevention of anemia
Knowledge is the result of knowing and this happens after someone
senses a particular object. Cognitive knowledge is a very important domain for
the formation of one's actions.A person is said to
understand when he has been able to explain about a known object (Sota & Peltzer, 2017). Knowledge is obtained from information, and
when the acceptance of information is less then knowledge will also decrease.
Based on research conducted on July 2-5, 2018, knowledge of pregnant women
before being given health counseling about anemia prevention from 35
respondents based on table 4.6 was in the less category, namely 60% or 21
respondents. This research is in line with the research of Angrainy
Rizka (2017) who said most pregnant women lack
knowledge about anemia prevention, said as many as 70.4% of pregnant women have
less knowledge about anemia in pregnancy (Dim & Onah, 2007).
The lack of knowledge of pregnant women at the MCH Polyclinic/KB Minanga Health Center is caused by lack of information from
health workers and from maternal factors, most of whom are primigravida mothers and are
still in the early trimester so there is still a lack of discussion or asking
health workers and finally when the mother's knowledge pretest is carried out
is still lacking.
Increased knowledge occurs when they see and hear an activity that is
presented through the media in the form of leaflets during counseling. In this
study, after being given health counseling on the prevention of anemia, the
highest percentage was 85.7% or 30 respondents. This means that respondents'
knowledge has increased after being given health counseling about anemia
prevention. This� research is in� line with Kiftiyah's
which said there was an increase in knowledge before and after health
counseling about anemia on anemia prevention behavior during pregnancy at the Mengaluh Health Center, Jombang
Regency (Febry et al., 2020).
According to researchers, this happens because they have been given
good knowledge about anemia prevention so as to increase individual knowledge
about the right way to prevent anemia during pregnancy and what to do pregnant
women during pregnancy to prevent anemia in pregnancy. This is also because the
age of� most respondents at the age
of� 21-30 years or in the� age of productive women (Smith et al., 2019).
Where at that age respondents have rational and� psychomotor maturity,� where rational maturity is useful when
mothers receive health education about anemia prevention, then they will
immediately understand about anemia prevention and encourage them to pay more
attention to her pregnancy (Doody & Noonan, 2016). The characteristics of the respondent's
education level show that most respondents have education up to high school
level. Education level is related to the respondent's ability to understand
information received from someone because the better a person's education
level, the better his ability to understand health information. The
distribution of respondents' education levels shows the highest distribution is
high school (Nurhaeda et al., 2022).
This level of education helps respondents understand the information
conveyed by researchers during health counseling. After counseling was given, there
were still respondents who had sufficient knowledge, respondents' knowledge
that was still within the criteria was�
sufficient according to the researcher was caused by several factors of
pregnant women who had just had experience in pregnancy or mothers Pregnant
with primigravida DA is still in the early trimester so that the knowledge of
pregnant women has not been able to increase�
rapidly, lack of interaction with health workers and some educational
factors are located� at the elementary
and junior high school education levels as well According to researchers is one of the factors
so that some pregnant women have enough knowledge and do not increase
significantly (Siregar, 2021).
The Effect of
Health Counseling on Anemia Prevention on the Knowledge of�� Pregnant Women at the MCH Polyclinic/KB Minanga Health Center�
Health counseling or education activities about the prevention of
anemia in pregnant women have actually been widely publicized, but there are
still many people, including pregnant women who do not or have not received
information that can be they understand that health counseling activities on
anemia prevention at the MCH Polyclinic/KB Minanga
Health Center provide pregnant women with new knowledge. In this study it was
proven that there was an increase in knowledge as well as the�� average knowledge that increased significantly,
further testing with the Wilcoxon Signed Rank Test proved health counseling
about Prevention of anemia is effective in increasing the knowledge of pregnant
women at the MCH Polyclinic/KB Minanga Health Center.
This research is in line with Kiftiyah (2015) that
there is a significant influence of health counseling on� pregnant women about anemia (Serudji et al., 2019).
According to researchers, this significant increase in knowledge is
influenced by respondents' social factors, such as people around respondents
who work in the health sector and always remind. The health of respondents so
that when given education, respondents have improved significantly and have
known and understood the prevention of anemia. Other factors are also from
various media such as mass media, print media and electronic media (TV and Handphone)
that can be accessed by everyone so that respondents can find information from
these media or when given education respondents who have accessed and seen
about anemia and prevention can immediately understand the education provided.
Informal education also affects the increase in knowledge of pregnant
women because pregnant women can get knowledge not only from formal education
but through informal education for example from posters, banners, and flipcarts available in crowded centers that are easily
accessible to pregnant women (Deasy et al., 2016).
So according to researchers, by conducting health counseling about the
prevention of anemia correctly, in this case, education is provided using media
(leaflets and audiovisuals) and clear explanations from speakers can improve
quality Knowledge of pregnant women about anemia prevention,� this can also be taken into consideration for
health centers such as puskesmas, clinics,� and hospitals�
in order to� consider programs
related to the health of pregnant women,�
especially anemia in pregnancy.
CONCLUSION
The results of the study on: "The Effect
of Health Counseling on Anemia
Preventionon the Knowledge of Pregnant Women at the MCH
Polyclinic/KB��� Minanga
Health Center" can be concluded that: 1) Knowledge
of pregnant women before Health Counseling on
Prevention of anemia is still lacking. 2). Knowledge
of pregnant women after Health Counseling about anemia prevention is generally in the good category. 3).
Health Counseling on Anemia
Prevention�� has a significant effect in
increasing the knowledge of pregnant women at the MCH Polyclinic/KB Minanga Health Center.
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