Factors Related toThe Incidence of Nutritional Deficiencies in Children Under Five

The nutritional deficiencies cases for under five can be caused by poverty, food supply, poor environmental sanitation, lack of community knowledge about nutrition, and the existence of poor areas of iodine and infectious diseases. The result of weighing at posyandu of Sekip Village, Lubuk Pakam Subdistrict, Deli Serdang Regency, shows that of the 1,712 below five year-old children with the weighing coverage of 1,404 below five year-old children (82%), 1,372 of them (80.1%) had good nutrition, 339 of them (19.8%) had nutritional deficiency, and 1 of them (0.06%) had malnutrition. Based on this, it is necessary to analyze the relationship between the characteristics and parenting factors for children to the amount of malnutrition in children in the area.The m0ethod used in this study is a survey with a cross sectional approach. The population in this study were mothers with under fives as many as 1,712 people and a total sample of 100 people. Data collection through questionnaires. The method of data analysis with univariate and bivariate using the chi square statistical test at a significance level of 5%.The results showed that there was a relationship between maternal characteristics of education, income, knowledge, and parenting factors about the practice of feeding and health practices with the incidence of malnutrition in under five.The conclusion of the study is that under five experiencing malnutrition are caused by education, income and low knowledge and poor diet and health patterns.


INTRODUCTION
Nutritional problems are one of the main problems of public health in the world, especially for under fives because they are closely related to general health indicators such as increased morbidity and mortality. Poor nutrition also affects growth, intellectual development and productivity. Under fives who are malnourished will grow short and experience disorders of brain growth and development that affect low levels of intelligence (1)(2)(3).
The death of children under 5 years reached 6.6 million in 2012 or nearly 18,000 people every day. The risk of a child dying before reaching the age of 5 for the European region is 12 per 1000 live births and in Africa about 8 times higher than the European region (95 per 1000 live births). While the Asia region, especially South Asia reaches 50 per 1000 live births (4)(5)(6).
Under-five mortality rates in Indonesia are still relatively high compared to other member countries of the Association of South East Asia Nations (ASEAN). Based on the Indonesian Health Data Profile in 2012, the Under five Mortality Rate (AKABA) in Indonesia is 40 per 1,000 live births, still higher than Malaysia, which is 6.5 per 1,000 live births, the Philippines is 25.4 per 1,000 live births and Thailand 12, 3 per 1,000 live births (7)(8)(9). The next stage determines the households that are used as sample members (10). the number of samples used can be seen in table 1. Data collection is based on the type of research data, namely primary data and secondary data. Primary data in this study included maternal characteristics (age, education, occupation and knowledge), parenting (feeding practices and health practices). Secondary data in this study are the results of weighing under fives registered in integrated service posts (Posyandu??). The variables in this study are independent variables in the form of maternal characteristics (education, opinions and knowledge), and the dependent variable is parenting (feeding practices and health practices).
The variable measurement method in this study is to observe the relationship between research variables as in Table 2. The data obtained will be analyzed using the univariate method to explain and describe all the independent variables that will be presented in the frequency distribution table.
Bivariate analysis was performed to analyze the relationship of independent variables with dependent variables using the chi square correlation test using a significance level of 5% (α = 0.05).

Characteristics of Mother and Under five
The results of data collection on the characteristics of mothers and children under five who live in Sekip Village, Lubuk Pakam District, Deli Serdang Regency in 2017 can be seen in tables 3 and 4. The frequency of malnutrition in children under five, the level of knowledge and practice of mothers in under five feeding, and health practices in infants can be seen in table 5. The relationship between education level and total income to the incidence of under fivemalnutrition can be seen in Table 6.

No
Tabel 6. The relationship between education level and total income to the incidence of malnutrition The results of the study that show the relationship between the level of knowledge of mothers in food descriptions for children under five, the feeding practices and the practice of seeing children under five on the incidence of malnutrition can be seen in table 7. Penulisan tabel hasil tidak lazim

DISCUSSION
Health status is one aspect of parenting that can affect children's nutritional status towards improving.
Health status is things that are done to maintain the nutritional status of children, keep away and avoid diseases and that can cause a decline in the state of health of children. This health status includes the treatment of diseases in children when the child is suffering from illness and preventive measures against the disease so that the child does not get an illness. Children's health status can be taken by paying attention to the state of nutrition, the completeness of the immunization, the child's personal hygiene and the environment in which the child is located, and the mother's efforts in seeking treatment for children when the child is sick. If the child is sick, the mother should take him to the place of health services such as hospitals, clinics, health centers and others (11,12).
Parenting about health is very important for children's development. The better the health management carried out by the mother, the better the pattern of family health. So that in an effort to protect children from disease because it will affect the family nutritional status (13)(14)(15).
Mothers who do not implement good health practices in the case of mothers not bathing their children 3 times a day, brushing their teeth, not always throwing garbage into a garbage dump and burning it to avoid contamination and clean children's beds. The low sanitation and cleanliness of the environment also triggers a disturbance in the digestive tract, which makes energy for growth diverted to the body's resistance to infection. A study found that the more often a child has diarrhea, the greater the likelihood of stunting (16)(17)(18)(19)(20).

CONCLUSION AND RECOMMENDATION
The incidence of malnutrition in children under five is as much as 34%, generally aged 37 -<60 months occur in families with incomes below Rp. 2.5 million. The relationship between the level of education, family income, mother's knowledge and practice in providing nutrition to infants, and health practices to the incidence of malnutrition in infants in Sekip Village, Deli Serdang Regency, Sumatera Utara.
The results of the study need to be further developed by examining the nutritional status of less / more or adding variable items from this study to be able to find out what can be done to avoid children under five not experiencing the incidence of undernutrition in growth and development.