title: Factors influencing mother's participation in Posyandu for improving nutritional status of children under-five in Aceh Utara district, Aceh province, Indonesia.
abstract: BACKGROUND
  Posyandu, or pos pelayanan terpadu (integrated service post), is a community-based activity for health services in Indonesia. According to the Indonesian Basic Health Survey, the prevalence of children under five in Indonesia who suffered from being underweight was 19.6 %. The wasting was 12.1 % and the stunting was 37.2 % in 2013, and these values have not changed greatly from 2007; much greater than the WHO targets of, less than 10 % underweight, 5 % wasting, and 20 % stunting. In Aceh were 26.6, 16.8, and 43.3 %, respectively. Also, the participation percentages of mothers to Posyandu was about 45 %, far below the national target of 100 %. In Aceh Province, the percentage was even lower (34 % in 2013). This study aimed to investigate the factors influencing participation of mothers in Posyandu.
  
  
  METHODS
  This research used a cross-sectional design with sample of mothers who had children under five. They were chosen by multistage random sampling. Sample size was determined by the WHO formula. Face-to-face interviews were carried out using a questionnaire. The questionnaire consisted of items about socio-demographic characteristics, satisfaction with Posyandu services, attitude towards Posyandu benefits, and intention to attend Posyandu. The collected data were analyzed by using EZR (version 1.21). Fisher's exact test was performed to examine the associations between the socio-demographic factors, attitude, satisfaction, and intention covariates with participation. Logistic regression was used to describe the strength of the relationship between the predictor variables and participation.
  
  
  RESULTS
  There were no significant differences in age, marital status, education level, occupation, family size, and distance to Posyandu between low participation group except for the monthly household income. Among the socio-demographic factors, only monthly household income had a significant association with the frequency of mothers' participation. Satisfaction, attitude, and intention were associated with participation. The logistic regression showed that monitoring the nutritional status of children under five was the main reason that mothers participated in Posyandu. Mothers who were satisfied with the Posyandu services were more likely to attend than those who were dissatisfied. Respondents with intention to participate in Posyandu every month were more likely to attend than those who did not intend to attend every month. Households with low income were more likely to participate in Posyandu than households with high income.
  
  
  CONCLUSIONS
  Household income, mothers' satisfaction with Posyandu services, attitude towards Posyandu benefits and intention to attend Posyandu affect the participation frequency of the mother. In addition, monitoring the nutritional status of children under five was the main reason respondents attend Posyandu. Improving the quality of Posyandu services and providing qualified resources are needed to promote mothers' participation.
authors.affiliation: Department of Public Health, Gunma University Graduate School of Medicine, Maebashi, Japan. cutnazri@gmail.com.|Faculty of Medicine, Universitas Padjajaran, Jatinangor, Indonesia. cutnazri@gmail.com.
authors.forename: Cut
authors.initials: C
authors.lastname: Nazri
authors.affiliation: Department of Public Health, Gunma University Graduate School of Medicine, Maebashi, Japan.
authors.forename: Chiho
authors.initials: C
authors.lastname: Yamazaki
authors.affiliation: Department of Public Health, Gunma University Graduate School of Medicine, Maebashi, Japan.
authors.forename: Satomi
authors.initials: S
authors.lastname: Kameo
authors.affiliation: Faculty of Medicine, Universitas Padjajaran, Jatinangor, Indonesia.
authors.forename: Dewi M D
authors.initials: DMD
authors.lastname: Herawati
authors.affiliation: Faculty of Medicine, Universitas Padjajaran, Jatinangor, Indonesia.
authors.forename: Nanan
authors.initials: N
authors.lastname: Sekarwana
authors.affiliation: Faculty of Medicine, Universitas Padjajaran, Jatinangor, Indonesia.
authors.forename: Ardini
authors.initials: A
authors.lastname: Raksanagara
authors.affiliation: Department of Public Health, Gunma University Graduate School of Medicine, Maebashi, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Koyama
mesh_terms: D000328:Adult; D000367:Age Factors; D001290:Attitude; D002648:Child; D015362:Child Nutrition Disorders / Q000517:prevention & control*; D002675:Child, Preschool; D003153:Community Health Services / Q000706:statistics & numerical data*; D003258:Consumer Behavior; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D007214:Indonesia / Q000453:epidemiology; D007223:Infant; D007231:Infant, Newborn; D033182:Intention; D007407:Interviews as Topic; D009035:Mothers / Q000523:psychology*; D011203:Poverty; D015995:Prevalence; D012959:Socioeconomic Factors