Beyond Beliefs: Integrating Cultural Practices, Family Dynamics, and Ecological Vulnerabilities in Explaining Childhood Malnutrition in Indonesia Elly Dwi Masita, Annif Munjidah, Uke Maharani Dewi, Hinda Novianti International Journal of Child Health and Nutrition, 2026 Childhood malnutrition remains a major public health issue in Indonesia, with prevalence in some communities reaching 68.2%, far above the national average. Despite multiple government programmes, progress has been limited. Previous studies have primarily examined biomedical or socioeconomic factors, while less attention has been given to how cultural beliefs, ecological vulnerabilities, and familial decision-making interact to shape nutritional outcomes. This gap constrains the design of effective interventions. A cross-sectional mixed-methods study was conducted in rural East Java among 179 caregivers of children aged 1-5 years. Nutritional status was assessed using weight-for-age (<90% of the WHO median defined as malnutrition). Quantitative analyses included descriptive statistics, independent t-tests, and logistic regression with diagnostic checks. Qualitative interviews explored beliefs about feeding, food taboos, ecological barriers, and household decision-making. Findings were integrated using triangulation. Malnutrition prevalence was 68.2%. Independent t-tests revealed significant differences in Health Belief Model (HBM), cultural integration, and ecological scores between malnourished and adequately nourished children (p<0.05). Logistic regression, however, did not retain any variable as an independent predictor (Hosmer-Lemeshow p=0.411, Nagelkerke R²=0.115, AUC=0.669). Qualitative data explained these contradictions, highlighting systemic poverty, food scarcity, weak health service outreach, and intergenerational authority as key barriers despite caregiver knowledge. Malnutrition in Indonesia is shaped by the convergence of cultural, ecological, and familial determinants rather than single risk factors. Effective responses must integrate culturally sensitive behaviour change with structural support, address ecological vulnerabilities, and engage family decision-making. Mixed-methods approaches are essential to capture the complexity of these interactions.
The efficacy of implementing family-centered care in child feeding practices Annif Munjidah, Elly Dwi Masita, Hinda Novianti, Uke Maharani Dewi Healthcare in Low Resource Settings, 2024 Nutrition is a basic need for a child to grow optimally. Improper child feeding practices are still found in the community, leading to malnutrition. The incidence of malnutrition has increased sharply in children aged 6 to 18 months in various countries, primarily due to ignorance and/or an inability to prepare food. The family plays a crucial role in the prevention and treatment of child nutrition problems. Families can provide education and practical supervision in addressing nutrition-related issues, including promoting healthy lifestyle patterns. The objective of this study was to determine the effectiveness of implementing family-centered care in changing child feeding practices. The research design employed was true experimental analysis with a pre-posttest group design. The population consisted of 130 respondents, infants aged 6 to 23 months, selected using a probability sampling technique with purposive random sampling. The research was conducted in Wonokromo, Surabaya, Indonesia, from March to June 2023. The measuring instrument utilized was a family-centered care-based child feeding guide. The independent variable in the study was family care, while the dependent variable was the change in the child's feeding practices. Test analysis was performed using the Mann-Whitney test. The results of the Mann-Whitney test indicated a significant difference in feeding practices before and after counseling with the family-centered care approach (p = 0.043). Thus, family-centered care was found to be effective in changing child feeding practices.
Analysis of family roles in infant and child feeding based on sociocultural factors and family functions Annif Munjidah, Elly Dwi Masita, Hinda Novianti, Uke Maharani Dewi, Norhaini Majid, et al. Healthcare in Low Resource Settings, 2024 The issue of complementary feeding in developing countries is often marked by poor food quality and quantity, leading to growth failure in children during this critical period. This problem is largely due to insufficient family involvement in managing infant and child feeding. This study examines the effects of sociocultural factors and family functions on family roles in feeding practices. The objective was to analyze how sociocultural factors and family functions influence infant and child feeding roles. This study used an observational analytical design with a cross-sectional approach. The population consisted of families with children under two years old in Surabaya, Sidoarjo, and Gresik, Indonesia, with data collection taking place from March to June 2024. From a population of 250, a sample of 120 participants was selected using a purposive sampling technique. Questionnaires that had been validated for reliability and accuracy were used to measure sociocultural variables, family functions, and family roles. Data analysis was performed using multiple linear regression tests. The findings revealed a significant effect of culture on family roles (P=0.026) and a significant effect of family functions on family roles (P=0.025). Additionally, there was a significant combined effect of culture and family functions on family roles (P=0.000). These results indicate that sociocultural factors and family functions positively influence family roles in feeding practices. In essence, stronger cultural values and well-functioning family dynamics contribute to a more effective family role in feeding infants and children. This research highlights the importance of collaborative efforts to strengthen family values and foster positive family functions, which are essential for supporting optimal feeding practices and child growth.
The effectiveness of the self-care management model in midwife care through android application as an effort to increase the ability of pregnant mothers in early detection of pregnancy at risk during the COVID-19 pandemic Ika Mardiyanti, Annif Munjidah, Nanik Handayani, Siska Nurul Abidah, Hinda Novianti, et al. Bali Medical Journal, 2022 Introduction: The ability of pregnant women to detect early-risk pregnancies is still low, which is one of the causes of complications that can endanger the welfare of the mother and fetus. This research analyzed the effectiveness of the Self Care Model in Midwifery Care through an Android Application on the Ability of Pregnant Women to Early Detection of Risky Pregnancy During the Covid-19 pandemic. Methods: The data of this study of pregnant women who conducted examinations at PMB Ika Mardiyanti in Maret-May 2021 involved a sample of 100 obtained by simple random sampling. This study uses an analytic design with a cross-sectional design. Data analysis using the Wilcoxon Signed Rank Test. Results: The results show that Asym. Sig. (2-tailed) obtained < (0.0001 < 0.05), this means that the Self Care Model in Midwifery Care through the Android Application is effective for increasing the ability of pregnant women in early detect risky pregnancies during the COVID-19 pandemic. Conclusion: The research conducted to analyze the self-care model in midwifery care through the android application contributes to increasing the efforts of pregnant women to care for their care during pregnancy to prevent the dangers of pregnancy.
The effect of nutritional education using cognitive approaches and psychomotor approaches on fruit and vegetable consumption behavior in children Fritria Dwi Anggraini, Fauziyatun Nisa, Siti Nur Hasina, Annif Munjidah Open Access Macedonian Journal of Medical Sciences, 2021 BACKGROUND: One of the problems related to eating behavior in children less than 5 years is the lack of consumption of fruits and vegetables. With this problem, an approach is needed to better consume it. AIM: This study aims to determine the effect of nutritional education using cognitive approaches (using illustrated storybooks and puppet shows) and psychomotor approaches (using puzzle and fruit and vegetable cards) on fruit and vegetable consumption behavior in children in the An-Nur Surabaya Kindergarten. METHODS: This study used a quasi-experimental study with a pre- and post-test group. The population is 48 respondents. Sampling uses the Probability sampling method with simple random sampling. The independent variable was nutrition education using media illustrated storybooks media, puppet shows, puzzles, and fruit and vegetable cards, meanwhile the dependent variable is consumption behavior of fruits and vegetables. The intervention was carried out 4 times. FFQ form was used to assess fruit and vegetables consumption behavior. RESULTS: The results showed that the average consumption of fruits and vegetables before the intervention was 168 g or equivalent to 1 portion, and the average after intervention was 304 g or equivalent to 3 servings. There is a significant influence (p = 0.000) on fruit and vegetable consumption through nutritional education. CONCLUSION: Nutritional education using media should be accompanied by a commitment to increase children’s motivation in eating fruits and vegetables.
The effects of tui na massage on the growth status of children under five years of age with KMS T status (Low weight gain) Annif Munjidah, Fitria Dwi Anggraini Journal of Public Health in Africa, 2019 Nutritional problem in urban area is generally caused by food absorption disorder which can be treated by Tui Na massage. This article was aimed to investigate the effect of Tui Na massage on the growth status of children less than five years of age with KMS T status (low weight gain in Indonesia medical record). This quasiexperimental study was conducted by implementing pre-and-posttest design with control group. This study involved 26 children less than five years of age with KMS T as research samples chosen by simple random sampling technique. The results of analysis using paired t-test on the effect before and after Tui Na massage showed p=0.019 < α=0.05, while independent t-test in control and treatment group obtained p=0.065 > α=0.05. It shows that Tui Na massage affects the growth status of children under five years of age. Based on those results, midwives are expected to be able to perform Tui Na massage as an effort to develop the growth status of children under five years of age.
RECENT SCHOLAR PUBLICATIONS
Gadget Use Correlated with Emotional Development in Preschool Children A Munjidah, SN Diana, Y Anggasari, ED Masita Jurnal Ners dan Kebidanan (Journal of Ners and Midwifery) 12 (3), 213-220 , 2025 2025
The Use of the Maternal and Child Health (KIA) Book as a Medium to Improve Mothers’ Knowledge and Skills in Toddler Development Stimulation: A Community Service in Wage Village … UM Dewi, H Novianti, A Munjidah, ED Masita, C Choirotussanijjah Amalee: Indonesian Journal of Community Research and Engagement 6 (2), 401-410 , 2025 2025 Citations: 2
The Role of Parenting in Supporting Early Childhood Emotional Development U maharani Dewi, A Munjidah, H Noviyanti, U Rowaikhan, ED Masita Community Development Journal 9 (2), 620-627 , 2025 2025
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Analysis of family roles in infant and child feeding based on sociocultural factors and family functions A Munjidah, ED Masita, H Novianti, UM Dewi, N Majid, N Hashim Healthcare in Low-Resource Settings 13 , 2025 2025
Parenting Style Practice as an Effort to Optimize Children's Social-Emotional, Psychosexual Development ED Masita, UM Dewi, H Novianti, A Munjidah Community Development Journal 8 (3), 479-484 , 2024 2024 Citations: 1
The efficacy of implementing family-centered care in child feeding practices A Munjidah, ED Masita, H Novianti, UM Dewi Healthc. Low-resource Settings, 1-16 , 2024 2024 Citations: 4
Peningkatan Peran Serta Kader dalam Menurunkan Kejadian Diare Pada Bayi dan Balita H Novianti, A Munjidah, ED Masita, UM Dewi Jurnal Pengabdian Kesehatan 7 (2), 437-440 , 2024 2024
The Role Of Stimulation Model, Parenting, Social Support, And Local Culture In Toddler Development. ED Masita, A Munjidah, UM Dewi, H Novianti Frontiers in Health Informatics 13 (3), 7281 , 2024 2024 Citations: 3
Effectiveness of Information Education And Communication Using E Book Café For Increase Mother's Creativity in Processing Complementary Foods For Breast Milk. H Novianti, A Munjidah, ED Masita, UM Dewi Frontiers in Health Informatics 13 (3) , 2024 2024
The Function of Cadres in Putting Child Development Stimulation, Detection, and Early Intervention Programs into Practice UM Dewi, H Novianti, A Munjidah, ED Masita, N Zuwariah, SI Midwifery 2024 Citations: 2
Prenatal class sebagai upaya untuk meningkatkan self Efficacy ibu hamil N Handayani, A Munjidah, SN Abidah, JP Kencana, EM Zannah Jurnal Keperawatan 16 (2), 527-534 , 2024 2024 Citations: 4
Edukasi Meningkatkan Literasi Ibu Dalam Memberikan MPASI (Pedoman Buku KIA 2020) A Munjidah, NE Putra JKM (Jurnal Kesehatan Masyarakat) Cendekia Utama 11 (3), 319-330 , 2023 2023 Citations: 2
THE EFFECTIVENESS OF THE TAR GRIP TOSS GAME ON THE GRIP STRENGTH OF THE ELDERLY I Noventi, S Nurjanah, A Munjidah Prosiding Seminar Nasional IPEGERI Jateng (SNIJ) 1, 180-181 , 2023 2023
The effect of tummy time and oral massage on infants' oral motor skills as an effort to receive complementary food A Munjidah, N Handayani Bali Medical Journal 12 (3), 3261-3264 , 2023 2023 Citations: 3
Pemberdayaan Ibu dan Kader Dalam Upaya Meningkatkan Keterampilan Makan Anak A Munjidah, ED Masita, UM Dewi, H Novianti, L Delina Jurnal Pengabdian Kesehatan 6 (4), 332-336 , 2023 2023
The Relationship of Feeding Complementary Foods with Complete Menu on Babies Weight A Munjidah, EE Rukmana, F Nisa, EP Rahayu, AH Khotimah Jurnal Ners dan Kebidanan (Journal of Ners and Midwifery) 10 (2), 202-209 , 2023 2023 Citations: 2
RUMAH ASI DAN PENERAPAN BACK MASSAGE TREATMENT SEBAGAI UPAYA PENINGKATAN PRODUKSI ASI PADA IBU MENYUSUI H Novianti, A Munjidah, R Amalia, Y Windarti, RAD Andriani, N Gebrina, ... BERNAS: Jurnal Pengabdian Kepada Masyarakat 4 (3), 2304-2308 , 2023 2023
Pemberdayaan Kader Kesehatan Dan Tutor Sebaya Stunting Sebagai Upaya Pencegahan Stunting Dan Pengelola Stunting Center ED Masita, UM Dewi, A Munjidah, H Noviyanti, PH Putri, H Agustina Prosiding Seminar Nasional Pengabdian Kepada Masyarakat 3 (1), 573-580 , 2023 2023 Citations: 3
MOST CITED SCHOLAR PUBLICATIONS
Efektifitas pijat tui na dalam mengatasi kesulitan makan pada balita di RW 02 kelurahan wonokromo surabaya A Munjidah Journal of Health Sciences 8 (2) , 2015 2015.0 Citations: 65
Pengaruh penerapan feeding rules sebagai upaya mengatasi kesulitan makan pada anak (picky eater, selective eater dan small eater) A Munjidah, EP Rahayu JKM (Jurnal Kesehatan Masyarakat) Cendekia Utama 8 (1), 29-39 , 2020 2020.0 Citations: 58
Quality of life pada lansia C Zahroh, L Ekawati, A Munjidah, W Afridah, I Noventi, PMP Winoto Jurnal Ilmiah Keperawatan 6 (2), 248-251 , 2020 2020.0 Citations: 14
The effects of Tui Na massage on the growth status of children under five years of age with KMS T status (low weight gain) A Munjidah, FD Anggraini Journal of Public Health in Africa 10 (1s), 127-130 , 2019 2019.0 Citations: 13
Quality of Life pada Lansia L Ekawati, C Zahroh, A Munjidah, W Afridah, I Noventi, PMP Winoto Jurnal Ilmiah Keperawatan (Scientific Journal of Nursing) 6 (2), 248-251 , 2020 2020.0 Citations: 8
Perbedaan Hasil Belajar Manajemen Terpadu Balita Sakit (MTBS) Melalui Media Pembelajaran Visual dan Audiovisual A Munjidah Journal of Health Sciences 9 (1) , 2016 2016.0 Citations: 8
Pengaruh Pijat Tui Na Terhadap Status Pertumbuhan Pada Balita Dengan Status Kms T A Munjidah Journal Of Health Sciences , 2019 2019.0 Citations: 7
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R, L. K., & Maharani, U.(2020). Buku Ajar Asuhan Kebidanan Persalinan dan BBL FD Anggraini, N Zuwariyah, F Nisa, N Masruroh, A Munjidah UNUSA Press , 0 Citations: 6
Hubungan Macam Rujukan Kegawatdaruratan Dengan Keluaran Maternal Neonatal Dalam Masa Pandemi Covid-19 H Novianti, YI Safitri, A Munjidah Jurnal Keperawatan dan Kesehatan Masyarakat Cendekia Utama 11 (1), 65-70 , 2022 2022.0 Citations: 5
Hubungan Tempramen Dasar Dan Pendidikan Orang Tua Terhadap Pembentukan Karakter Anak Usia Prasekolah A Munjidah, S Nurjanah, HP Sulistyana Jurnal Kesehatan STIKes Muhammadiyah Ciamis 6 (1), 8-19 , 2019 2019.0 Citations: 5
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Prenatal class sebagai upaya untuk meningkatkan self Efficacy ibu hamil N Handayani, A Munjidah, SN Abidah, JP Kencana, EM Zannah Jurnal Keperawatan 16 (2), 527-534 , 2024 2024.0 Citations: 4
Meningkatkan Peran Family Centered Maternity Care (Fcmc) Dalam Upaya Meningkatkan Kunjungan Ibu Hamil N Handayani, A Munjidah, SN Abidah, HA Rahma, JP Kencana Communnity Development Journal 4 (3), 5887-5891 , 2023 2023.0 Citations: 4
Optimalisasi Pemberian MPASI Dengan Menu Olahan Ibu Berbasis Buku KIA 2020 A Munjidah, N Handayani, N Huda, F Firdaus Jurnal Pengabdian Kesehatan 5 (4), 338-343 , 2022 2022.0 Citations: 4
The effect of nutritional education using cognitive approaches and psychomotor approaches on fruit and vegetable consumption behavior in children FD Anggraini, F Nisa, SN Hasina, A Munjidah Open Access Macedonian Journal of Medical Sciences 9 (E), 1161-1165 , 2021 2021.0 Citations: 4
Differences Between Massage Tui Na And Acquisit Point BL 20, BL 21 And SP 6 In Overcoming Eating Difficulty A Munjidah, FD Anggraini PROCEEDING SURABAYA INTERNATIONAL HEALTH CONFERENCE 2017 1 (1), 293-299 , 2017 2017.0 Citations: 4
The Role Of Stimulation Model, Parenting, Social Support, And Local Culture In Toddler Development. ED Masita, A Munjidah, UM Dewi, H Novianti Frontiers in Health Informatics 13 (3), 7281 , 2024 2024.0 Citations: 3
The effect of tummy time and oral massage on infants' oral motor skills as an effort to receive complementary food A Munjidah, N Handayani Bali Medical Journal 12 (3), 3261-3264 , 2023 2023.0 Citations: 3
Pemberdayaan Kader Kesehatan Dan Tutor Sebaya Stunting Sebagai Upaya Pencegahan Stunting Dan Pengelola Stunting Center ED Masita, UM Dewi, A Munjidah, H Noviyanti, PH Putri, H Agustina Prosiding Seminar Nasional Pengabdian Kepada Masyarakat 3 (1), 573-580 , 2023 2023.0 Citations: 3
