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e-ISSN: 2580-1163 (Online)
p-ISSN: 2580-9776 (Print) 295

Renyoet et al. | Amerta Nutrition Vol. 7 Issue 2 (June 2023). 295-306
LITERATURE REVIEW
OPEN ACCESS
English Version
Literature Review: Intervention on Adolescent Girls in 8000 First

Days of Life (HPK) as Stunting Prevention in Future Generations
Literatur Review: Intervensi pada Remaja Perempuan 8000 Hari Pertama
Kehidupan (HPK) sebagai Upaya Pencegahan Stunting pada Generasi di Masa
Depan
Brigitte Sarah Renyoet1*, Dary Dary2, Christantya Vita Rena Nugroho1
1Program Studi Gizi, Fakultas Kedokteran dan Ilmu Kesehatan, Universitas Kristen Satya Wacana, Salatiga, Indonesia
2Program Studi Ilmu Keperawatan, Fakultas Kedokteran dan Ilmu Kesehatan, Universitas Kristen Satya Wacana, Salatiga,
Indonesia
ABSTRACT
ARTICLE INFO Background: The complex nutrition problem until now in Indonesia is stunting.
Stunting is a failure-to-grow condition due to prolonged malnutrition since the
Received: 05-09-2022 baby was born during pregnancy. Therefore, the nutrition and health of adolescent
Accepted: 17-01-2023 girls as the future mother have a crucial role in preventing stunting.
Published online: 09-06-2023 Objectives: Identified various programs intervention to adolescent girls as stunting
prevention to the next generation and identify the successful various programs
*Correspondent: intervention to adolescent girls as stunting prevention to next generation
Brigitte Sarah Renyoet Discussion: This research method used a literature review of ten journals from
brigitte.renyoet@uksw.edu 2011 to 2021. The research results were various interventions for adolescent girls
as stunting prevention for the next generation. There were nutrition education,
stunting education, early marriage education, hygiene and sanitation education,
DOI:
fulfillment of micro nutrient intake and consumption of balanced food, Multi Micro
10.20473/amnt.v7i2.2023.295-306
Nutrient (MMN) supplementation, school feeding program, and high calcium milk
intake. Intervention for adolescent girls is the main target of 8000 HPK programs
Available online at:
as holistic stunting prevention has a vital role, so it needs to be implemented as
https://e-journal.unair.ac.id/AMNT
early as possible.
Conclusions: Appropriate Interventions for adolescent girls have the potential to
Keywords:
reduce stunting and increase the opportunity for human resources in the future.
8000 HPK, Adolescent girls, Stunting,
Intervention
INTRODUCTION are estimated at IDR 96 billion - IDR 430 billion or around

Indonesia still faces the triple burden of 2%-9% seen in the average Gross Regional Domestic
malnutrition in the health and nutrition sector, one of Product (GRDP) of the provinces in Indonesia5.
which is stunting. Stunting is a major nutritional problem The Indonesian government has launched a
for toddlers with short stature due to long-term specific and sensitive nutrition fulfillment program for
malnutrition. According to Indonesian Basic Health children early on through the 1000 First Days of Life
Research (Riskesdas) data for 2007, the prevalence of Nutrition Improvement Movement (1000 HPK). The first
stunting under five in Indonesia was relatively high at thousand days of life become one of the crucial periods in
36.8%, then in 2010, it decreased slightly to 35.6%. The a person's life, starting from pregnancy until the child is
prevalence of stunting under five in Indonesia increased two years old. During this period, the health of pregnant
again in 2013 by 37.2% and decreased to 30.8% in 2018, women and the fetus is the main focus that must be
then decreased again in 2019 at 27.67%1. Stunting considered to fulfill their nutrition through food. The
remains a severe nutritional problem in Indonesia mother's diet during pregnancy significantly affects the
because the percentage is above the threshold set by the child's concentration, memory function, mood, and
World Health Organization (WHO) of 20%2. As of 2018, emotions later in life6.
WHO revealed that stunting in Indonesia occupies the The application of 1000 HPK in preventing
third position in all of Southeast Asia with a percentage of stunting has not produced optimal output. This condition
36.4%3. The economic scale to prevent stunting globally has been proven by the fact that the prevalence of
represented by 34 countries in the world spent $9.559 stunting in Indonesia is still above 20% from year to year2.
million4. In contrast, the estimated economic losses due Therefore, expanding the intervention to The First Eight
to stunting under-fives in 32 Indonesian provinces in 2013 Thousand Days of Life (8000 HPK) is necessary as a holistic
Copyright ©2023 Faculty of Public Health Universitas Airlangga

Open access under a CC BY – SA license | Joinly Published by IAGIKMI & Universitas Airlangga
How to cite: Renyoet, B. S., Dary, D., & Nugroho, C. V. R. Literature Review: Intervention on Adolescent Girls in 8000 First Days of Life (HPK) as Stunting
Prevention in Future Generations: Literatur Review: Intervensi pada Remaja Perempuan 8000 Hari Pertama Kehidupan (HPK) sebagai Upaya Pencegahan
Stunting pada Generasi di Masa Depan. Amerta Nutrition, 7(2), 295–306.
p-ISSN: 2580-9776 (Print) 296
stunting prevention effort from 1000 HPK plus 7000 METHODS

days7. After the next 7000 days, human life will This research method used a literature review.
experience three sensitive phases, namely the age of 5-9 A literature review is a method of searching literature by
years, where infectious diseases and malnutrition are the combining and identifying facts from several scientific
primary growth and development problems. At the age of sources accurately and validly. Literature searches were
10-14, the increase in body mass and physiological carried out nationally and internationally using databases
changes due to puberty and the age of 15-21 is needed. on Google Scholar, Research Gate, NCBI, Science Direct,
Brain maturation supports interventions8. The 8000 HPK and PLOS by entering several Indonesian language
program targets teenage girls to prepare for pre- keywords such as intervention, teenage girls, and
conception adolescent health and nutrition to reduce stunting. In contrast, English keywords included:
stunting childbirths in the future. intervention, adolescent girls, and stunting.
The 8000 HPK has not received the attention of The flow of writing a literature review starts
the Indonesian government, but the intervention of the with a search using the various keywords above through
Continuum of Care (CoC) approach to improve the quality databases from Google Scholar, Research Gate, NCBI,
of continuous care for stunting has been implemented in Science Direct, and PLOS, which obtain 1,269 pieces of
Indonesia9. The scope of CoC interventions relate to literature. The literature was then selected for the last ten
family, community, outpatient, and clinical care years, from 2011 to 2021, using Indonesian and English to
throughout the life cycle, including adolescence10. obtain 1,006 literature. The flow of writing a literature
Adolescent nutrition interventions can break the chain of review was continued by selecting journals and
under nutrition problems that positively impact health duplicates, which obtained 53 pieces of literature. Fifty-
but still receive little attention11, so it is essential to three kinds of literature that were obtained identified the
conduct further studies of various intervention programs exclusion criteria seen from several things such as
for young girls as the target of the 8000 HPK program to problems that were not following the topic, the outcome
determine their impact on stunting. had no effect, and the researchers did not choose the
This literature review aims to identify various study design literature review or systematic review so
intervention programs for young girls to prevent stunting that a total of thirty literature were obtained.
in future generations and identify the success of various Thirty kinds of literature were then re-identified
intervention programs for young women to prevent for their abstracts, and 20 pieces of literature were
stunting in future generations. The benefits of this obtained that were not used due to the
research are expected to be additional knowledge and inappropriateness of respondents, such as male
insight regarding various interventions for young girls as adolescents and toddler age groups, and the purpose of
the focus of the 8000 HPK target to prevent stunting in the research that was not used was to identify factors
the future, increase the attention of the Indonesian related to stunting so that ten works of literature were
government towards various interventions for young girls obtained that could be analyzed to be used as as a
as sustainable stunting prevention, reference for writing. The creation of citations and
bibliography in this study uses the Mendeley application,
which is done by grouping and entering all related
journals into the application
.

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Inclusion and Exclusion Criteria:
Search using keywords
Search using keywords through Google

Scholar, Research Gate, NCBI, Science
Direct, and PLOS databases
Exclusion Criteria (n= 23)
(n= 1,269)
Problem
-Not in accordance with the topic (n= 12)
Outcomes
-No effect (n=1)
Design studies
-Literature review (n= 4)
Selection of journals for the last 10 years -Systematic review (n= 6)
from 2011-2021, using Indonesian and
English
(n= 1,006)
Journal selection and duplicates

(n=53)
Exclusion Criteria (n= 20)

Abstract identification Respondent discrepancy (n= 10)
(n=30) Discrepancies in research objectives (n= 10)
Journals that can be analyzed based on the

suitability of respondents and research
objectives
(n= 10)
Figure 1. Literature search flow

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Table1. Literature data search based on the literature search research, the following data can be obtained.
Author, Title Intervention Research methods Research result Conclusion
Razzak A et al., 201612 Nutrition education using various Randomized control -The increased percentage of balanced food -Nutrition education can improve
Research title: media such as charts, leaflets, and trial study using a consumption habits in the intervention group adolescent girls' behavior,
Role of Nutrition posters for young girls aged 10-19 questionnaire. (22.8%) compared to the control group (8.5%). attitudes, and health and
Education in years consisted of 241 people in the -Increased iron supplementation in the nutrition practices in rural
Improving the intervention group and 236 people intervention group (56.8%) compared to the Bangladesh.
Nutritional Status of in the control group from January control group (15.7%).
Adolescent Girls in 2014 to April 2016. -The increased percentage of normal
North West Areas of nutritional status in the group of female
Bangladesh adolescents who were given intervention from
44.8% to 52.6% compared to the control group.
Hasanah and Providing stunting booklet media to Pretest-posttest and -The difference in the level of knowledge of -Media booklets can increase
Permadi, 202016 99 high schools (SMA) young girls analysis of non- young women before and after being given the young women's knowledge about
Research title: with an average age of 16 in 12 high parametric statistical stunting booklet media through the Wilcoxon stunting in Probolinggo.
The Effect of Booklet schools in Probolinggo. tests Wilcoxon test. Signed Test with a value of p < 0.001.
Media on Young
Women's Knowledge
of Stunting in
Probolinggo
Sondakh et al, 202022 Providing early marriage counseling Quasi-experimental one -The results of the pretest and posttest -Counseling can increase the
Research title: to 24 female students aged 16 years group with pretest and knowledge of 24 students aged 16 years at SMA knowledge of 16-year-old
The Effect of at SMA Negeri I Suwawa, Gorontalo. posttest. Statistical test Negeri I Suwawa before counseling got a score students at SMA Negeri I Suwwa,
Counseling on This research lasted two months, using the Wilcoxon test. of 82.5, while after being given counseling, they Gorontalo, shown through the
Adolescent from 29 July to 20 August 2020. got a score of 90. Wilcoxon test with a p-value of
Knowledge About <0.001 <0.05.
Early Marriage at SMA
Negeri I Suwawa

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Shapu et al., 202124 Educational intervention on Randomized cluster -Increased sanitation hygiene practices for -Providing interventions in the form
Research title: hygiene and sanitation practices control trial. young girls in the intervention group compared of effective health education
Effectiveness of Health for 417 young girls aged 10-19 to the control group were shown through the improves sanitation hygiene
Education Intervention years in 4 schools in Nigeria. The Independent T-Test value, p <0.001. practices for young girls in
on Water Sanitation and intervention group was given Maiduguri Metropolitan Council.
Hygiene Practices education about sanitation
among Adolescents hygiene related to drinking
Girls in Maiduguri water sources and basic
Metropolitan Council, sanitation hygiene practices,
Borno State, Nigeria: A while the control group was
Cluster Randomized given education on malaria
Control Trial health interventions. The
intervention took place from
October 2019-March 2020.
Khadilkar A et al., Provision of micronutrient Cohort study -Increase in the Height for Age Z-Score in group -Providing calcium, vitamin D, zinc,
201425 supplementation (group 1): 1 female adolescents with intervention (zink 15 and multivitamin supplementation
Research title: (zink 15 mg/day + multivitamin, mg/day + multivitamin, calcium 500 mg/day, effectively increases the height of
Effect of Micronutrient calcium 500 mg/day, and and vitamin D 30,000 IU per 3 months) young women with a low economy
Supplementation on vitamin D 30,000 IU per 3 compared to female adolescents without in India.
Height Velocity of months), (group 2): (calcium intervention
Underprivileged Girls in 500 mg/day and vitamin D -A significantly accelerated height in group 1
Comparison with Un- 30,000 IU per 3 months), (group female adolescents with intervention (zink 15
Supplemented Healthy 3): (multivitamin and vitamin D mg/day + multivitamin, calcium 500 mg/day,
Controls 30,000 IU per 3 months) to and vitamin D 30,000 IU per 3 months).
young girls aged 8-12 years with
low economic status while
healthy young women with high
economic status were not given
intervention. The intervention
was carried out for one year.

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Srinivas P et al., Nutrition intervention for female Prospective -Increased height of 6.83 cm/year in the -Adequacy of nutrients and
201727 adolescents aged 10-18 was divided into a interventional control group and 7.97 cm/year in the micronutrient supplementation in
Research title: control group and a case group of 64 study. case group. The increase in height in short adolescent girls can cause
A Study of Impact on people. The control group was given a the case group was 1.14 cm higher than height.
Targeted Height balanced nutritional diet, iron, and the control group.
among Adolescents deworming medication. The case group was
Girls given a balanced nutritional diet, iron,
worm medicine, and additional
micronutrients (zinc, calcium, vitamins A, B
complex, and D). Intervention for 1.5 years
and analyzed every month.
Nguyen P et al., Giving weekly supplements to 5,011 pre- Randomized control -Increase in the value of Length for Age -Supplementation of iron and folic
201731 conception women was divided into three trial. Z score (LAZs) by 0.14 SD in children acid and administration of multiple
Research title: groups. Group 1: (2,800 µg folic acid). Group aged two years from the group of pre- micronutrients to pre-conceptional
Pre-conception 2 (60 mg + 2,800 μg iron folic acid). Group 3 conceptional women with iron and folic women increases the linear growth
Micronutrient (multiple micronutrients) until conception. acid intervention than the group of pre- of children up to 2 years of age than
Supplementation with Anthropometric measurements for children conceptional women with folic acid pre-conceptional women to folic acid
Iron and Folic Acid from women of conception who received alone. alone.
Compared with Folic weekly supplements were measured -Increased LAZs by 0.10 SD in children
Acid Alone Effects starting at 3, 6, 12, 18, and 24 months of aged two years from the pre-
Linear Growth and age. conceptional women with multiple
Fine Motor micronutrient interventions compared
Development at 2 to the pre-conceptional women who
Years of Age; A were given folic acid intervention.
Randomized
Controlled Trial in
Vietnam

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Sumarmi et al, 201833 Provision of micronutrients to 156 Randomized double-blind, -The average body length of newborns -Providing micronutrients since
Research title: women aged 16-35 years in 9 community-based trial. from group II (MMN group) since the pre- pre-conception can prevent
Pre-conception Probolinggo Districts. Group I conception period was 49.3 cm higher stunting of babies from birth
Multimicronutrient (Plasebo-IFA) every other day than group I (Placebo-IFA group), compared to giving iron and
Intervention in Bride-to-be to during the pre-conception period receiving iron and folate only during folic acid supplements since
Prevent Neonatal-Stunting in (2-6 months before pregnancy), pregnancy which was 47.6 cm. pregnancy.
Probolinggo District, East Java followed by 60 mg of iron and 250
μg of folic acid with daily doses
during pregnancy. Group II (MMN
group) was given multi-
micronutrients containing 15
vitamins and minerals every other
day from pre-conception to
pregnancy with daily doses.
Gelli A et al., 201935 The school feeding program in 10 Longitudinal randomized -Increase the Height for Age (HAZ) value -School feeding can be a means
Research Title: regions in Ghana for 2,869 school- cluster control trial. for girls aged 5-8 years by 0.12 SD. to improve nutrition
A School Meals Program age children 5-15 years was divided interventions for elementary
Implemented at Scale in Ghana into two groups, namely the control school children (SD).
Increases Height-for-Age during group without intervention and the
Mildchildhood in Girls and in intervention group.
Children from Poor Households:
A Cluster Randomized Trial
Matali V, Wungouw H, Sapulete 250 mL of low-fat, high-calcium milk Experimental research on -Based on the results of the Independent -Giving low-fat, high, calcium
I, 201737 was given to 9 girls aged 9-11 years sample selection by T-test, it is known that the value of Sig. milk affects the height of
Research title: at SD GMIM 34 Manado as a purposive sampling. (2-tailed) <0.05 means there is an elementary school girls.
Milk Intake on Height and treatment group, while 11 girls at increase in height in the treatment group
Weight of Elementary School SD GMIM Bethlehem Manado as a compared to the control group.
Children control group were not given low-
fat high, calcium milk. The research
was conducted in September-
December 2017.

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DISCUSSION decision-making, and actions of young women to plan the

Stunting has become a severe nutritional ideal age of marriage and not to marry early17. The
problem in Indonesia, illustrated by the incidence of researcher's analysis of the study indicated that some
undernutrition, which hinders toddlers' growth and information was not conveyed in the journal, such as not
development. The role of young women as future mentioning the number of pretest and posttest questions
mothers to give birth to a new generation is believed to and not explaining educational material related to
have great potential in carrying out various stunting stunting. Researchers suggest that this information is
prevention efforts. Based on the results of a literature conveyed in a journal so readers or researchers get
review in ten journals analyzed by researchers, it was comprehensive information.
found that various factors cause stunting throughout Early marriage is still a problem of a social
adolescence, such as knowledge factors, hygiene, and phenomenon among adolescents in Indonesia. The
sanitation practices, fulfillment of micronutrient intake, World Health Organization (WHO) states that early
and consumption of balanced nutritional food, Multi marriage is a marriage that occurs before someone is 18
Micro Nutrient (MMN) supplementation, feeding in years old18. Early marriage is considered one of the
schools, as well as the fulfillment of high calcium milk causes of stunting because it is related to the age of the
intake. These factors are a problem that is often mother getting married. The age of mothers who are
overlooked, so intervention for young women as future married for less than 18 years is considered insufficient
mothers is urgently needed to prevent future generations parenting knowledge for children, so food needs are not
of stunting. In this literature study, researchers will fulfilled optimally19. The high rate of early marriage
discuss and identify interventions for young girls as the among adolescents can trigger reproductive health
main target of 8000 HPK related to stunting. problems, bearing in mind that adolescence will
Intervention can use various methods, but the experience puberty marked by changes in hormones that
most frequent application of the intervention method in cause physical changes, including the reproductive
the community is education. As a health promotion organs that are not fully ready for reproduction.
approach, education is intended to be the first step in Adolescent girls who have not experienced reproductive
changing perceptions and increasing knowledge and organ maturity and have not experienced physical
awareness of something that can influence a person's maturity will increase morbidity and mortality during
behavior. The research results by Razzak, Hassan, childbirth later. One of the measures to control the
Rahman, Asaduzzaman, Juliana, and Hosain found that incidence of morbidity and mortality during teenage
nutrition education can increase the consumption of childbirth is by conducting early marriage education to
balanced meals in the intervention group with a young women as future mothers to increase knowledge
percentage of 22.8% compared to the control group of and awareness of the risks posed by early marriage.
8.5%. Nutrition education also impacts increasing the The incidence of early marriage is still often
practice and habit of consuming iron supplements and found in Indonesia, especially in Sleman Regency,
increasing the percentage of normal nutritional status in Yogyakarta Special Province (DIY), as the first rank for
the group of female adolescents from 44.8% to 52.6%12. early marriage, namely 159 couples20. This case has
The results of this study align with the research of Lathifa received the Indonesian government's attention to form
and Mahmudiono that nutrition education has an effect one of the Indonesian government's programs through
on increasing the practice of balanced nutritional food the BKKBN to prevent teenage pregnancies by holding
habits for female adolescents with a percentage of the Youth Family Development Program (BKR).
94.4%13. Increasing the practice of balanced nutrition Establishing the BKR program aims to improve parents'
eating habits for young girls will grow along with proper attitudes, knowledge, and skills in monitoring and
nutritional knowledge so that new eating habits are fostering their adolescent children's growth and
formed for young girls to choose the type and amount of development by involving effective communication
food that affects nutritional status. between the two21. Research by Sondakh, Aisyah, and
Education or counseling as an intervention that Pakana through providing early marriage counseling to 24
aims to increase one's knowledge can use various media, young women aged 16 years who measured their level of
one of which is using booklets. A booklet is a small book knowledge through the pretest and posttest obtained an
that contains information about something14. The use of increase in knowledge of 90 compared to before being
booklets as educational or outreach media is now felt given counseling, namely 82.522. The increased
more effective than leaflets because booklets are easy to knowledge possessed by young girls will later influence
carry can be stored in pockets, and contain pictures so their attitudes and awareness of early marriage as a
that readers are more interested in reading15. Counseling cause of stunting.
by Hasanah and Permadi using booklets increased the Stunting is a complex nutritional problem
knowledge of 99 young girls aged 16 about stunting, as requiring an approach from various aspects, so in
evidenced by the average pre-and post-test scores from addition to providing interventions, it is also necessary to
1.99 to 2.79. The Wilcoxon test16 measured these look at the factors that cause stunting, including
results. sanitation and hygiene. Poor hygiene and sanitation
Increasing young women's knowledge will build practices can lead to health problems such as diarrhea
the correct perception to increase their awareness of and respiratory infections (ARI)23. When the body is
various stunting prevention efforts later, including infected with a disease in the long term, it will cause
preventing early marriage. Bugis's research reveals that malnutrition, interfering with the growth and
knowledge of young women can influence attitudes, development of teenage girls. Research by Shapu, Ismail,

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Lim, Ahmad, and Njodi found that education on of vegetables and fruit is needed more to achieve optimal
sanitation hygiene practices to 417 young girls aged 10- growth8. The researcher's suggestion for this research is
19 years in four schools in Nigeria was proven to improve that the provision of interventions can also be connected
sanitary hygiene practices24. According to the with its impact on the process of brain maturity of female
researcher's analysis, providing education on sanitation adolescents.
hygiene practices to adolescent girls aged 10-19 years is Nutrition and health of adolescent girls as pre-
felt too late, considering that infectious diseases most conception women require early preparation to prevent
often occur in the age group 5-9 years8, so the research the birth of stunted children. One of the things to prevent
above is not correct on target. the birth of stunted children is to fulfill various
Adolescence will be a developmental transition micronutrients for teenage girls. Micronutrients play an
from childhood to adulthood, illustrated by an increase in essential role in preventing anemia in female adolescents
height. The intake of micronutrients such as vitamins and because of their relation to LBW births as triggers for the
minerals influences the increase in the height of female birth of stunted children in the future28. Prevention of
adolescents. Research by Khadilkar, Kadam, and anemia is considered adequate by giving MMN compared
Chiplonkar found that female adolescents aged 8-12 to giving Blood Supplement Tablets (TTD), but it seems
years who were given complete micronutrient that there has been no step from the Indonesian
supplements such as calcium, vitamin D, zinc, and government to switch to MMN supplements29. Multi
multivitamins experienced a significant increase in height Micro Nutrient contains 15 types of vitamins and
compared to female adolescents who were only given minerals such as vitamin A, vitamin E, vitamin D, vitamin
calcium and vitamins or multivitamins and vitamins D B1, vitamin B2, niacin, vitamin B6, vitamin B12, vitamin C,
only25. Consuming food sources of calcium, especially iron, folic acid, zinc, copper, selenium and iodine30.
during the adolescent growth period, will help increase Research by Nguyen, Gonzales, Young, Truong, and
height, reflected through bone density and size, but if Hoang obtained the result that pre-conceptional women
calcium needs are not appropriately met, it will reduce with iron and folic acid gave birth to children with a
the formation of bone mass and hardness, which affect Length for Age Z score of 0.14 SD compared to children
height. A deficiency of vitamin D can inhibit the efficiency born to pre-conceptional women with only folic acid and
of absorption of calcium needed during growth, while giving MMN supplementation to pre-conception women
zinc deficiency can interfere with the activity of protein can increase the value of Length for Age Z score by 0.10
synthesis, which plays an essential role in forming new SD in children aged two years compared to the group of
tissue during growth26. The researcher's analysis, pre-conception women with folic acid intervention
according to the provision of interventions in the study, alone31. According to the researchers' analysis of the
can be said to have been right on target because results of the study, the pre-conceptional group of
adolescent girls aged 10-14 years experienced an women with iron and folic acid interventions had an
increase in body mass and physiological changes due to average length of newborns 0.14 SD higher than those
puberty8, so it requires supplementation of vitamins and with folic acid alone because the combination of iron and
minerals to support the growth and development of folic acid was effective in increasing the length of the
teenage girls. baby. nascent than folic acid alone. The group of pre-
When someone enters adolescence, they will conception women who were given MMN showed an
experience a rapid growth spurt, also known as a growth increase in the Length for Age Z score, which was 0.10 SD
spurt, characterized by an increase in height. Various higher than the group of women who received folic acid
interventions to increase the height of teenage girls are alone, which was possible for two reasons. The first thing
continuously carried out, including research conducted is that since the pre-conception period, they have been
by Srinivas, Aisyah, and Prakana. The results of research given MMN intake, which contains 15 types of vitamins
by Srinivas, Aisyah, and Pakana found that adolescent and minerals so that the intake of micronutrients is more
girls aged 10-18 years with the intervention of providing completely fulfilled compared to pre-conception women
balanced nutritional food, iron administration, who only intake folic acid32. The second thing is that the
deworming, and the addition of micronutrients were children involved in the study above were two years old,
monitored for a year there was an increase in the height most likely still being breastfed at that age. Therefore, an
of 7.97 cm. In contrast, female adolescents who were not increase in the Length for Age Z score in children of pre-
given additional micronutrients experienced an increase conception women with MMN supplementation is
in height of 6.83 in a year27. indeed felt to get higher results than in pre-conception
The researcher's analysis related to the results women with folic acid intervention alone. In the above
of this study showed that the increase in height was more study, the researcher found information that was not
significant in the group of female adolescents with the conveyed with certainty, namely the vulnerable age of
addition of zinc, calcium, vitamin D, vitamin A, and pre-conception female respondents to interventions
vitamin B complex compared to female adolescents because the journal only mentioned the number of
without additional micronutrients due to the fulfillment respondents.
of balanced nutritional intake. Fulfilled the consumption The mother's nutritional status determines the
of iron and deworming, also supported by the addition of birth of a stunted child before and during pregnancy. As
micronutrients so that it encourages faster height gain pre-marital women enter the pre-conception period,
than female adolescents without additional adolescent girls require various interventions to achieve
micronutrients, bearing in mind that during adolescence, normal nutritional status through the Body Mass Index
the need for micronutrients which are contained in lots (BMI) value. Adolescent girls with normal nutritional

p-ISSN: 2580-9776 (Print) 304
status have a slight chance of experiencing anemia, of brain maturity that correlates with increased work
thereby reducing the risk of future low birth weight births productivity8.
as a cause of stunting. Efforts to prevent anemia in Milk is a recommended food source for
teenage girls can be prevented through MMN because it adolescents to reach peak bone density. Milk has the
contains folic acid, iron, and vitamin B12 as a form of main content in the form of calcium, which is needed for
hemoglobin30. MMN supplementation would be better bone density, so it affects the increase in height. Research
given during pre-conception to achieve optimal health by Matali, Wungouw, and Sapulete found that giving 250
status before pregnancy29. The results of the research by mL of low-fat high, calcium milk intervention given daily
Sumarmi, Wirjatmadi, Kuntoro, Thaha, and Soekirman to 9 teenage girls aged 9-11 years at SD GMIM 34 Manado
proved that the group of pre-conceptional women aged can increase their height compared to 11 teenage girls
16-35 years who were given MMN supplementation aged 9- 11 years old at SD GMIM Bethlehem who were
during childbirth had an average length of newborns that not given low-fat high calcium milk37. The results of the
was 49.3 cm longer than the group of pre-conception study indicated that according to the results of the
women who were given a placebo and Iron Folic Acid Independent T-test, it was known that the value of Sig. (2-
(IFA) which gave birth to a baby with a body length of 47.6 tailed) <0.05 means giving low-fat, high, calcium milk can
cm33. Other studies that are in line with MMN increase the height of female adolescents with low-fat,
supplementation, conducted by Prihati and Kostania, high calcium milk intervention. Other research that
show that MMN supplementation during pregnancy does supports this research was put forward by Kim SH, Kim
not significantly affect newborn weight gain30. The results WK, and Kang that as many as 664 young women aged
of several studies state that MMN is more effective in 15-17 years in Korea who consumed high-potassium milk
increasing newborn length than newborn weight because could increase bone density, thereby affecting height
MMN contains complete micronutrients which are increase38. The author's analysis regarding the results of
positively related to height increase, in contrast to the research by Matali, Wungouw, and Sapulete through the
case with newborn weight, which will increase as the administration of low-fat high, calcium milk as an
baby grows postnatal and the mother has an excellent intervention has been right on target because, at the age
nutritional status34. of 9-14 years, adolescents will experience growth and
The rapid growth spurt during adolescence development, increase in body mass, and physical
requires intervention from the family environment and changes due to puberty8. The research was right on target
the school. The school feeding program can contribute as but had a high chance of being biased because the
an initiative to fulfill a variety of nutrients to support the research respondents were not in the same school
growth and increase in adolescents' physical activity. The environment, so the heterogeneity was very high. The
results of research by Gelli, Aurino, Folson, Arhinful, researcher's suggestion for this study is to provide low-
Adamba, and Osei showed that the school feeding fat, high-calcium milk interventions to respondents in the
program could increase the height/age score by 0.12 SD same school environment to minimize bias.
in the group of girls aged 5-8 years, while the group of
girls in their early teens aged 9-15 years there was no CONCLUSIONS
increase in the value of TB / U35. This study's measuring In conclusion, young women, as the
height/age results were based on calculations using the forerunners of future mothers, need to prepare for
WHO AnthroPlus software for ages 5-19 years. WHO nutrition and health early to reduce stunted children's
AnthroPlus Software is a global application from WHO for birth through a specific intervention program. Providing
monitoring the growth of school-age children and interventions to young women in the form of education,
adolescents aged 5-19 years35. The school feeding be it nutrition education, stunting education, early
program is intended to reduce the habit of snacking marriage education, as well as hygiene and sanitation
outside the school environment, which harms health. education, can increase the knowledge of young women
Snacks outside the school environment tend to contain so that they can raise awareness and the correct
high energy, high sugar, and high fat and are not perception that stunting prevention needs to be carried
guaranteed cleanliness and safety, affecting nutritional out since adolescence. Fulfillment of micronutrient
status. This condition was stated by the research of intake, balanced nutritional food habits, fulfillment of
Nasriyah, Kulsum, and Tristanti that 8 Elementary School high calcium milk intake, and school feeding programs
(SD) children aged 8-14 years who consumed poor snacks can support optimal growth and development during
had more nutrition36. In this case, school feeding adolescence. Intervention through MMN
programs can fulfill the balanced nutritional food needed supplementation for female adolescents is considered
by school-age children to support physical growth, brain more effective in tackling the incidence of anemia as a
maturity, and increased productivity. According to the trigger for LBW events which has a high chance of
researcher's analysis, the school feeding intervention was triggering the birth of stunted children. Various efforts to
right on target according to the age of the research prevent stunting since adolescence, especially for young
respondents, namely the ages of 5-15 years. When women, can potentially reduce the population of stunted
entering the age of 5-9 years, an increase in nutritional children born in the future.
status significantly reduces the risk of infectious disease.
At the age of 10-14 years, there is relatively fast growth ACKNOWLEDGEMENT
and development that adolescents will experience due to The author would like to thank all those who
puberty, and at the age of 15-21 years, there is a process have contributed and helped so that this journal can be
published correctly.

p-ISSN: 2580-9776 (Print) 305
Conflict of Interest and Funding Disclosures for Class Xi Bdp at SMKN Mojoagung. J. Educator.
All authors have no conflict of interest, and Commerce 8, (2020).
private funds funded this research. 15. Sukraniti, DP, Ambartama, IW & Arwati, KL The
Effectiveness of Counseling with Media Booklets
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e-ISSN: 2580-1163 (Online)

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Literature Review: Intervention on Adolescent Girls in 8000 First

INTRODUCTION are estimated at IDR 96 billion - IDR 430 billion or around

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stunting prevention effort from 1000 HPK plus 7000 METHODS

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Author, Title Intervention Research methods Research result Conclusion

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Author, Title Intervention Research methods Research result Conclusion

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Author, Title Intervention Research methods Research result Conclusion

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DISCUSSION decision-making, and actions of young women to plan the

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