KEPATUHAN KONSUMSI BISKUIT MAKANAN TAMBAHAN PADA BALITA DAN FAKTOR YANG BERHUBUNGAN

Abstract

Adherence to supplementary feeding is an important factor determining the effectiveness of nutritional interventions for children under five. This study aimed to assess adherence to biscuit supplementary feeding and identify factors associated with adherence among children under five. A cross-sectional study was conducted using secondary data from the 2017 evaluation of the supplementary feeding programme among 812 children aged 6–59 months in 56 primary health centres, 28 districts/cities, and 11 provinces in Indonesia. Fifteen recipient children were targeted in each primary health centre, with wasted children prioritised; when more children were eligible, they were selected randomly from the recipient register. Adherence was defined as consuming at least 80 percent of the biscuits received during the feeding period. Data were analysed using chi-square tests and multiple logistic regression with cluster-robust standard errors at the primary health centre level. Mean adherence was 73.1 percent, and 51.7 percent of children were classified as adherent. Only 15.8 percent of children received the recommended 90-day ration, and only 3.7 percent consumed it. Children aged 6–23 months were less likely to be adherent than those aged 24–59 months (AOR=0.67; 95% CI: 0.50–0.91), whereas receiving biscuits four or more times was associated with higher adherence (AOR=1.77; 95% CI: 1.18–2.66). The main reasons for not finishing the biscuits were consumption by other household members and child refusal or boredom. Adherence to biscuit supplementary feeding was suboptimal, and actual intake fell far below the programme recommendation. Smaller rations distributed more frequently and specific feeding guidance for children under two years may improve adherence.