HEALTH COMMUNICATION STRATEGIES IN ACCELERATING THE REDUCTION OF STUNTING CONDITIONS IN TELUK TAMBA VILLAGE,

Health Communication plays an important role in the success of programs and policies implemented by the government. The rise of health conditions in the community, especially the stunting condition, which is worrying at this time, is a program that is carried out and implemented by the government to reduce the level of stunting conditions, especially in children. Considering that stunting is a government program that must be implemented by all health offices without exception. Therefore, to reduce stunting, the government, especially the puskesmas, must take part in this program so that it can reduce stunting. The purpose of this study was to find out the health communication strategy implemented by the puskesmas for the community, and how successful the program's policies were in reducing stunting rates. The research method used is a qualitative descriptive approach. The data collection techniques used in this study were in three ways, namely in-depth interviews, documentation and through observation with informants from the Head of Teluk Tamba Village, the Chairperson of the PKK and Puskesmas in Teluk Tamba Village, and 6 parents of toddlers who experienced stunting. Data analysis techniques with observation and interviews. The results of the study show that the role of the puskesmas is very much needed for the success of the program's policies and that health communication between the puskesmas and the community runs very well and smoothly.


INTRODUCTION
Stunting is a condition of failure to thrive in children under five due to chronic malnutrition so that the child is too short for his age, or the ability of the brain does not develop properly.The problem of stunting (short toddler) is a crucial nutritional problem, especially in poor and developing countries.Stunting is a form of growth and development failure that causes linear growth disorders in toddlers because of the accumulation of long-term nutritional insufficiency, starting from pregnancy to 24 months of age.
Malnutrition during the growth and development of children at an early age will hinder physical development, hinder children's mental development, hinder the development of children's brain abilities and can even cause death.Toddlers who have stunting nutritional problems have a risk of decreasing intellectual abilities, productivity, and the possible risk of experiencing degenerative diseases in the future.Someone is said to be stunted if the Z-index score is below SD (standard deviation).The incidence of stunting is the impact of inadequate nutritional intake, both in terms of quality and quantity, high morbidity, or a combination of both.This condition is often found in countries with less economic conditions.
Stunting is a disorder of growth and development of children due to chronic malnutrition and recurrent infections, which is characterized by their length or height being below the standard set by the minister in charge of government affairs in the health sector.The implementation of accelerated stunting reduction covers the following target groups: teenagers, brides-to-be, pregnant women, nursing mothers, and children aged 0 (zero) -59 (fifty-nine) months.
Indonesia has a severe nutritional problem which is marked by the many cases of malnutrition in children under five, the age of entering school in both boys and girls.Nutritional problems at school age can lead to low quality levels of education, high absenteeism, and high dropout rates.Malnutrition is an impact of nutritional status both in the short and long term.
Stunting or short stature is a condition in which a person's height (TB) is not suitable for age, which is determined by calculating the Z-index score of Height for Age (TB/U).
Therefore, a person is influenced by his cultural background.Communication and culture are two inseparable entities, as Edward T Hall said, culture is communication and communication is culture.As soon as someone starts talking about communication, it is inevitable that that person also talks about culture, then culture and communication interact closely and dynamically (Muhammad Tariq, 2017) Stunting or short stature is a condition where a person's height (TB) does not match with age, which is determined by calculating the Z-index score for Height for Age (TB/U).Someone is said to be stunted if the Z-index score is below SD (standard deviation).The incidence of stunting is the impact of inadequate nutritional intake, both in terms of quality and quantity, high morbidity, or a combination of both.This condition is often found in countries with less economic conditions.
Many factors cause stunting in toddlers, but because they are very dependent on the mother/family, the family and environmental conditions that affect the family will have an impact on their nutritional status.Reduction in nutritional status occurs due to inadequate nutritional intake and frequent infections.So environmental factors, circumstances and family behaviours that facilitate infection affect the nutritional status of toddlers.Adequacy of energy and protein per day per capita of Indonesian children is seen to be very less when compared to the recommended Adequacy of Nutrition (RDA) for both normal and short children.This is very interesting; Stunting is a condition of failure to thrive in children under five due to chronic malnutrition so that the child is too short for his age, or the ability of the brain does not develop properly.itturns out energy and protein intake did not differ significantly between children who were classified as short or normal.It is assumed that in general, the consumption obtained for all children (short or normal), the conditions are the same, less than the RDA.If this goes on for years, then there is a chronic problem.
The Provincial Government of South Kalimantan, in cooperation with the district/city governments, continues to work together to strengthen the handling of stunting in children under Subdistrict, which is one of the easternmost areas of Barito Kuala Regency, is a remote and underdeveloped area, so this is one of the factors for the high stunting rate in Tabukan District.

RESEARCH METHOD
The type of research conducted in this study is Qualitative Research, namely the way of finding problems that are investigated using observation by describing the state of the object of research in the current situation based on visible facts or as they are.Therefore, qualitative research is research that emphasizes understanding of problems in social life based on the conditions of reality or natural settings that are holistic, complex, and detailed.Research that uses an induction approach with the aim of constructing theories or hypotheses through disclosure of facts is research that uses a qualitative paradigm.
In summary, it can be explained that descriptive qualitative (QD) is a research method that moves on a simple qualitative approach with an inductive flow.This inductive flow means that qualitative descriptive research (QD) begins with an explanatory process or event which can finally be drawn a generalization which is a conclusion from the process or event.The steps of qualitative data analysis include data reduction, display and drawing conclusions.(Nurmalasari & Ardiantoro, 2020).
The data collection techniques used in this study were in three ways, namely in-depth interviews, and documentation through observation with informants from the Head of Teluk Tamba Village, the Chairperson of the PKK in Teluk Tamba Village, and 6 parents of toddlers who experienced stunting.Data analysis techniques with observation and interviews.

Health communication strategy carried out by the Puskesmas towards the communities
Based on the data that researchers have obtained for Teluk Tamba Village, changes in the stunting rate are very difficult to achieve.Because for the people of Tamba Bay there are still many people who don't want to join the toddler posyandu, this is caused by several factors.There is a factor of parents who do not want their children to get sick after being immunized, there is also a factor of parents who are busy working, so they are reluctant to participate in posyandu activities, the factor of underage marriage also influences this.However, through the communication strategy carried out by the village and the community health centre, the community was moved to take part in the program.
Communication by the puskesmas with the community looks very good and is growing because of this work program because the community, especially mothers, can exchange information or ask questions about health, which of course many mothers do not understand about health.
The communication strategy through a direct approach is carried out by providing understanding and education carried out by the health centre to the community so that it can foster even better relations between the health centre and the community around the Teluk Tamba Village Health Centre.The form of communication used by the puskesmas is conversation and of five.South Kalimantan continues to prioritize reducing the stunting rate in children under five through a concrete integrated program.It is important to prevent stunting as early as possible to free every child from the risk of hampered brain development which causes the child's intelligence level to not be optimal.Stunting cases in South Kalimantan based on nutrition surveillance data e-PPGBM have increased 0.4% from 2020.The research was focused on villages in the Tabukan District, Teluk Tamba Village, with the highest cases of stunting, namely 54.17%, based on the results of initial observations with the village head.Tabukan District is one of the sub-districts with the highest prevalence of stunting under five in Barito Kuala Regency in 2020 and 2021, based on data on the list of Priority Villages for Stunting Prevention and Handling from the Barito Kuala District Health Office.Tabukan

Law
Number 17 of 2007 concerning the 2005-2025 Long-Term Development Plan (RPJP) states that food development and nutrition improvement are carried out across sectors which include production, processing, distribution, and consumption of food with adequate, balanced, and guaranteed nutrition.the safety.Furthermore, the Health Law Number 36 of 2009 concerning Health which states, the direction of nutrition is to improve the nutritional quality of individuals and communities through, improving food consumption patterns that are in accordance with balanced nutrition, improving nutrition awareness behaviours, physical activity, and health, increasing access and quality nutrition services in accordance with advances in science and technology and system improvement on food and nutrition awareness.In line with the two laws, the Law on Food Number 18 of 2012 was issued which has established policies in the food sector to improve the nutritional status of the community.The central government and regional governments prepare a Food and Nutrition Action Plan every 5 (five) years.(Sri Hajijah Purba, 2019).Presidential Regulation Number 42 of 2013 concerning the National Nutrition Improvement Movement was issued to support efforts to address stakeholder participation and concern in a planned and coordinated manner to accelerate nutrition improvement in the First 1000 Days of Life (HPK).Thus, the policy supporting instruments in accelerating nutrition improvement are quite complete and currently require efforts in implementation that are pregnant women and toddlers from underprivileged families, to restore the nutritional status of toddlers and pregnant women to good nutrition.The Permata Bunda program is one of the priority programs for Barito Kuala Regency to reduce stunting rates.This program is carried out in every village in Barito Kuala Regency, this program is a cross-sectoral program that requires cooperation from several related parties so that this program can run optimally.In its implementation, this program uses Village Funds sourced from the APBN.Priority for the use of Village Funds for 2021 is regulated in the Regulation of the Minister of Villages, Development of Disadvantaged Regions, and Transmigration Number 13 of 2021 concerning Priority for the Use of Village Funds for 2021.One of them is included in the national priority program according to village authority, namely the Program to Strengthen Food Security and Prevention of Stunting in Villages.(Republic of Indonesia Cabinet Secretariat Public Relations, 19 February 2022).One form of effort in the stunting reduction program in Batola is to establish a supplementary feeding program for pregnant women and toddlers or abbreviated as Permata Bunda.The program involves the Village Government, Related Agency Services and PKK Cadres as regulated in Barito Kuala Regent Regulation Number 96 of 2020.