Effectiveness of an Integrated Nutrition Rehabilitation on Growth and Development of Children under Five Post 2018 Earthquake in East Lombok, Indonesia

Abstract: Background: In August 2018 Lombok Island in Indonesia was hit by a 7 Richter scale earthquake. This study aimed to assess the effectiveness of comprehensive nutrition disaster rehabilitation,
based on the holistic integrated early child development concept, on the growth and development
of children under five. Methods: A community-based intervention was performed in the East Lombok district; four villages in two sub-districts were randomly allocated into intervention or control
groups. Mothers of 6–49-month-old children in the intervention group (n = 240) attended parenting
classes (twice weekly) and received shredded fish/liver/anchovy and optimized complementary
feeding/food-based recommendations, developed using linear programming. Health staff from the
public health center and teachers from early childhood education (ECE) centers delivered parenting
sessions on health–nutrition and care–education. The control group (n = 240) received existing
health services. Indicators measured at baseline and the end line point were weight, length/height,
hemoglobin, feeding practices, psychosocial care (HOME) and maternal stress (SRQ). At the end line
point, child development was assessed using BSID-III. Results: At the end line point, maternal stress
and child morbidity (cough) were lower and dietary diversity (+1) in 6–23-month-old children, and
weight-for-age Z-score (+0.26) and social emotional score (+10 points) in ≥24-month-old children
were higher in the intervention group. Conclusions: The nutrition rehabilitation intervention delivered through ECE centers has a positive effect on the growth and development of children under five
in post-disaster conditions