The Difference Between Giving Iron Syrup and Vitamin C with Leaflet Media Education on Hemoglobin Levels in Stunted Toddlers Aged 2–5 Years in Perdana Village, Kembang Janggut District
Main Article Content
Abstract
Stunting remains a health problem in toddlers, often accompanied by low hemoglobin levels due to iron deficiency. This condition can disrupt children's growth and development, requiring effective intervention. This study aims to analyze the differences in the provision of iron syrup and vitamin C with leaflet media education on hemoglobin levels in stunted toddlers aged 2–5 years in Perdana Village, Kembang Janggut District. The study used a quantitative method with a quasi-experimental design through a pretest-posttest control group design approach. The study population was 67 stunted toddlers with a sample of 36 respondents divided into experimental and control groups using a purposive sampling technique. The research instrument used the Easy Touch GCHb hemoglobin test and observation sheets. Data analysis was performed using the Wilcoxon Signed Rank Test and Mann-Whitney test. The results showed that the average hemoglobin level in the experimental group increased from 10.256 g/dL to 11.278 g/dL with a p-value <0.001, while the control group increased from 10.450 g/dL to 10.489 g/dL with a p-value of 0.088. The conclusion of the study showed that providing Fe syrup and vitamin C was more effective than leaflet media education in increasing hemoglobin levels in stunted toddlers aged 2–5 years.
Article Details
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
References
Achjar, K. A. H., Marni, N. K., Lestari, A. S., & Ribek, I. N. (2023). Health education with leaflet media on the level of knowledge of mother's about toddler rearing partners in stunting prevention. Journal of Education Research and Evaluation, 7(2), 197–203. https://doi.org/10.23887/jere.v7i2.61560
Aghniya, R. (2022). Dampak stunting terhadap perkembangan kognitif dan motorik anak stunting: Systematic literature review. Scientia Journal, 11(2), 178–189.
Andersen, C. T., Marsden, D. M., Duggan, C. P., Liu, E., Mozaffarian, D., & Fawzi, W. W. (2023). Oral iron supplementation and anaemia in children according to schedule, duration, dose and cosupplementation: A systematic review and meta-analysis of 129 randomised trials. BMJ Global Health, 8(2), e010745. https://doi.org/10.1136/bmjgh-2022-010745
Anjani, S., Rohmawati, N., Oktafiani, L. D. A., & Handayani, O. R. (2024). Hubungan antara tingkat pendidikan, pengetahuan ibu, dan pendapatan keluarga dengan pola makan balita stunting. ARTERI: Jurnal Ilmu Kesehatan, 6(1), 8–16.
Ariani, D., Septiani, H., & Srinayanti, Y. (2024). The effects of using e-leaflet and lecture methods on maternal knowledge regarding stunting prevention in toddlers. Genius Journal, 5(1), 6–11. https://doi.org/10.56359/gj.v5i1.329
Armitage, A. E., & Moretti, D. (2019). The importance of iron status for young children in low-and middle-income countries: a narrative review. Pharmaceuticals, 12(2), 59. https://doi.org/10.3390/ph12020059
Arulparithi, C. S., Arunbabu, T., & Manjani, S. (2023). Iron preparations in the management of iron deficiency anemia in infants and children: A systematic review and meta-analysis. Indian Pediatrics, 60(9), 752–758.
Aulia, B., Notarianti, R., Larasati, A. Q., & Sitorus, N. L. (2025). Optimizing iron absorption in children through vitamin C supplementation and fortification: A review. Journal of Indonesian Specialized Nutrition, 3(3). https://doi.org/10.63953/jisn.v3i3.55
Bhutta, Z. A., Guerrant, R. L., & Nelson III, C. A. (2017). Neurodevelopment, nutrition, and inflammation: the evolving global child health landscape. Pediatrics, 139(Supplement_1), S12-S22. https://doi.org/10.1542/peds.2016-2828D
Danianto, A., Cholidah, R., Amalia, E., & Purnaning, D. (2024). The relationship between stunting and anemia in toddlers in Malaka Coastal Area, North Lombok. Jurnal Biologi Tropis, 24(4), 1097–1103. https://doi.org/10.29303/jbt.v24i4.7990
Deng, J., Ramelli, L., Li, P. Y., Eshaghpour, A., Li, A., Schuenemann, G., & Crowther, M. A. (2024). Efficacy of vitamin C with Fe supplementation in patients with iron deficiency anemia: a systematic review and meta-analysis. Blood Vessels, Thrombosis & Hemostasis, 1(4), 100023. https://doi.org/10.1016/j.bvth.2024.100023
Dianna, Septianingsih, N., & Pangestu, J. F. (2020). Perbedaan pengetahuan ibu balita sebelum dan sesudah diberikan penyuluhan tentang stunting melalui media video dan leaflet di wilayah kerja Puskesmas Saigon Kecamatan Pontianak Timur. Jurnal Kebidanan Khatulistiwa, 6(1), 7.
Eliati, Handayani, S., Nidia, W. H., Rohani, Susanti, D., & Rahliadi, R. (2021). Faktor-faktor yang berhubungan dengan kejadian stunting pada balita usia 3–5 tahun di Kecamatan Badar Kabupaten Aceh Tenggara. Nasuwakes: Jurnal Ilmiah Kesehatan, 14(2), 123–135.
Febriyanti, C. E. K., & Setiyadi, N. A. (2023). Differences in the effectiveness of audiovisual media and leaflets on the knowledge and attitudes of mothers of toddlers in Bogorejo Village about stunting. Gaster, 21(2), 267–278. https://doi.org/10.30787/gaster.v21i2.1192
Herawati, D. M. D., & Sunjaya, D. K. (2022). Implementation outcomes of national convergence action policy to accelerate stunting prevention and reduction at the local level in Indonesia: A qualitative study. International Journal of Environmental Research and Public Health, 19(20), 13591. https://doi.org/10.3390/ijerph192013591
Iolascon, A., Andolfo, I., Russo, R., Sanchez, M., Busti, F., Swinkels, D., ... & from EHA‐SWG Red Cell and Iron. (2024). Recommendations for diagnosis, treatment, and prevention of iron deficiency and iron deficiency anemia. Hemasphere, 8(7), e108. https://doi.org/10.1002/hem3.108
Kailola, N. E., Seimahuira, T. N., Soumena, R. Z., & Siahaya, P. G. (2025). Anemia Screening and Health Education on Stunting Reduction Efforts. Unram Journal of Community Service, 6(4), 1100-1106. https://doi.org/10.29303/ujcs.v6i4.1196
Kartika, D., Zoelkarnain, I., Illiandri, O., Adhani, R., & Musafaah, M. (2024). Analysis of Factors Associated with the Incidence of Stunting in Toddlers: Factor Analysis of Family Support, Health Worker Support, Insurance Participation, and Income. Journal La Medihealtico, 5(5), 1112-1117. https://doi.org/10.37899/journallamedihealtico.v5i5.1742
Khair, A., Rahayu, S. F., & Muhsinin, M. (2021). Faktor Yang Mempengaruhi Status Gizi Anak Prasekolah. DINAMIKA KESEHATAN: JURNAL KEBIDANAN DAN KEPERAWATAN, 12(1), 210-220. https://doi.org/10.33859/dksm.v12i1.632
Laksono, A. D., Wulandari, R. D., Amaliah, N., & Wisnuwardani, R. W. (2022). Stunting among children under two years in Indonesia: Does maternal education matter? PLoS ONE, 17(7), e0271509. https://doi.org/10.1371/journal.pone.0271509
Leung, A. K., Lam, J. M., Wong, A. H., Hon, K. L., & Li, X. (2024). Iron deficiency anemia: an updated review. Current pediatric reviews, 20(3), 339-356. https://doi.org/10.2174/1573396320666230727102042
Liu, Y., Ren, W., Wang, S., Xiang, M., Zhang, S., & Zhang, F. (2024). Global burden of anemia and cause among children under five years 1990–2019: Findings from the Global Burden of Disease Study 2019. Frontiers in Nutrition, 11, 1474664. https://doi.org/10.3389/fnut.2024.1474664
Mardani, R. A. D., Wu, W. R., Hajri, Z., Thoyibah, Z., Yolanda, H., & Huang, H. C. (2024). Effect of a nutritional education program on children's undernutrition in Indonesia: A randomized controlled trial. Journal of Pediatric Health Care, 38(4), 552–563. https://doi.org/10.1016/j.pedhc.2024.02.006
Milman, N. T. (2020). A review of nutrients and compounds, which promote or inhibit intestinal iron absorption: making a platform for dietary measures that can reduce iron uptake in patients with genetic haemochromatosis. Journal of Nutrition and Metabolism, 2020(1), 7373498. https://doi.org/10.1155/2020/7373498
Mulyani, A. T., Khairinisa, M. A., Khatib, A., & Chaerunisaa, A. Y. (2025). Understanding stunting: impact, causes, and strategy to accelerate stunting reduction—a narrative review. Nutrients, 17(9), 1493. https://doi.org/10.3390/nu17091493
Munir, Z., & Audyna, L. (2022). Pengaruh edukasi tentang stunting terhadap pemgetahuan dan sikap ibu yang mempunyai anak stunting. Jurnal Keperawatan Profesional, 10(2), 29-54. https://doi.org/10.33650/jkp.v10i2.4221
Mustakim, M. R. D., Irwanto, I., Irawan, R., Irmawati, M., & Setyoboedi, B. (2022). Impact of stunting on development of children between 1–3 years of age. Ethiopian Journal of Health Sciences, 32(3), 569–578. https://doi.org/10.4314/ejhs.v32i3.13
Ningsih, D. D. R., Panunggal, B., Pramono, A., & Fitranti, D. Y. (2018). Hubungan Asupan Protein dan Kebiasaan Makan Pagi terhadap Kadar Hemoglobin pada Anak Usia9–12 tahun di Tambaklorok Semarang Utara (Doctoral dissertation, Diponegoro University).
Nugroho, R. F., & Wardani, E. M. (2022). Habit of consumption of tea, coffee and Fe tablets with the incidence of anemia in pregnant women in Sidoarjo. Pancasakti Journal of Public Health Science and Research (PJPHSR), 2(1), 51-56.
Oktarina, C., Dilantika, C., Sitorus, N. L., & Basrowi, R. W. (2024). Relationship between iron deficiency anemia and stunting in pediatric populations in developing countries: A systematic review and meta-analysis. Children, 11(10), 1268. https://doi.org/10.3390/children11101268
Orsango, A. Z., Loha, E., Lindtjørn, B., & Engebretsen, I. M. S. (2021). Co-morbid anaemia and stunting among children 2–5 years old in southern Ethiopia: a community-based cross-sectional study. BMJ Paediatrics Open, 5(1), e001039. https://doi.org/10.1136/bmjpo-2021-001039
Pettoello-Mantovani, M., Bali, D., Sevketoglu, E., Pastore, M., Vural, M., & Giardino, I. (2025). The first thousand days: nourishing the developing brain for a lifetime of mental well-being. Narrative review. Global Pediatrics, 100270.
Prasetyo, Y. B., Permatasari, P., & Susanti, H. D. (2023). The effect of mothers’ nutritional education and knowledge on children’s nutritional status: a systematic review. International Journal of Child Care and Education Policy, 17(1), 11. https://doi.org/10.1186/s40723-023-00114-7
Ramadhani, L. N., & Kuswandi, F. D. (2025). Edukasi gizi melalui media Leaflet terhadap peningkatan pengetahuan ibu balita di Kota Depok, Jawa Barat tahun 2023. Jurnal Pengabdian Gizi dan Kesehatan Masyarakat, 2(2), 155-161. https://doi.org/10.53823/jpgkm.v2i2.105
Ramlan, P., Sukri, P., Abdullah, M. T., Ibrahim, M. A., Ahmad, J., & Adri, K. (2025). A Systematic Review of Maternal and Child Health Policies in Addressing Stunting: Trends and Challenges. Journal of Public Health and Pharmacy, 5(1), 119-130. https://doi.org/10.56338/jphp.v5i1.6001
Safitri, L., Suhrawardi, S., Kristiana, E., & Isnaniah, I. (2025). Efektivitas pendidikan kesehatan melalui media leaflet terhadap tingkat pengetahuan anemia remaja putri di SMPN 8 Satap Mantewe Kabupaten Tanah Bumbu tahun 2024. Jurnal Penelitian Multidisiplin Bangsa, 1(8), 1432-1437. https://doi.org/10.59837/jpnmb.v1i8.297
Samosir, O. B., Radjiman, D. S., & Aninditya, F. (2023). Food consumption diversity and nutritional status among children aged 6–23 months in Indonesia: The analysis of the results of the 2018 Basic Health Research. PLoS ONE, 18(3), e0281426. https://doi.org/10.1371/journal.pone.0281426
Skolmowska, D., & Głąbska, D. (2022). Effectiveness of dietary intervention with iron and vitamin C administered separately in improving iron status in young women. International journal of environmental research and public health, 19(19), 11877. https://doi.org/10.3390/ijerph191911877
Suleman, Y., Tasnim, T., & Wahab, H. (2021). Analysis of the influence of health education to improve mother’s knowledge in preventing stunting in Masolaka Raya Sub-District, Bombana District. Indonesian Journal of Health Sciences Research and Development, 3(1), 129–135. https://doi.org/10.36566/ijhsrd/vol3.iss1/65
Sumanti, S., & Risnawati, R. (2025). Hubungan Pemberian FE Terhadap Kadar HB Pada Anak Stunting Dengan Anemia Di Wilayah Kecamatan Babulu. Innovative: Journal Of Social Science Research, 5(2), 4136-4149. https://doi.org/10.31004/innovative.v5i2.18683
Sunardi, D., Bardosono, S., Basrowi, R. W., Wasito, E., & Vandenplas, Y. (2021). Dietary determinants of anemia in children aged 6–36 months: A cross-sectional study in Indonesia. Nutrients, 13(7), 2397. https://doi.org/10.3390/nu13072397
Suryawan, A., Jalaludin, M. Y., Poh, B. K., Sanusi, R., Tan, V. M. H., Geurts, J. M., & Muhardi, L. (2022). Malnutrition in early life and its neurodevelopmental and cognitive consequences: A scoping review. Nutrition Research Reviews, 35(1), 136–149. https://doi.org/10.1017/S0954422421000159
Sutinbuk, D., Nugraheni, S. A., Rahfiludin, M. Z., & Setyaningsih, Y. (2024). Effectiveness of ERKADUTA model to increase stunting prevention behaviors among mothers with toddlers in Indonesia: A quasi-experiment. Narra J, 4(1), e688. https://doi.org/10.52225/narra.v4i1.688
Thamrin, H., & Sharief, S. A. (2020). Perbandingan Pemberian Tablet Fe dan Vitamin C dengan Tablet Fe dan Vitamin A terhadap Peningkatan Kadar Hemoglobin pada Mahasiswi Kebidanan. Jurnal Penelitian Kesehatan" SUARA FORIKES"(Journal of Health Research" Forikes Voice"), 11(1), 1-5. http://dx.doi.org/10.33846/sf11101
Widyaningsih, V., Mulyaningsih, T., Rahmawati, F. N., & Adhitya, D. (2022). Determinants of socioeconomic and rural-urban disparities in stunting: Evidence from Indonesia. Rural and Remote Health, 22(1), 7082. https://doi.org/10.22605/RRH7082
Yakoob, M. Y., & Lo, C. W. (2017). Nutrition (micronutrients) in child growth and development: a systematic review on current evidence, recommendations and opportunities for further research. Journal of developmental & behavioral pediatrics, 38(8), 665-679.
Yushananta, P., & Ahyanti, M. (2022). Risk factors of stunting in children aged 6–59 months: A case-control study in horticulture area. Open Access Macedonian Journal of Medical Sciences, 10(E), 1–5.