Factors Affecting the Implementation of Measles Immunization

1. Mother education
Education is the process of changing attitudes and code of conduct a person or group of people in a mature business people through teaching and training efforts. (Alwi H, 2001).

The role of a mother to the immunization program is essential. Hence an understanding of this program is essential for these circles. Understanding of the mother or maternal knowledge of immunization is strongly influenced by the level of maternal education.

The higher level of education or knowledge of someone getting needed health care centers as a place to seek treatment for themselves and their families. Based on several studies concluded that the higher level of education a mother the more likely to immunize their infants. (Slamet, 2002, p.45).

Education can be categorized low levels of initial education if the first nine years of schooling up to secondary education (junior high). Categorized higher education where secondary education (high school) education program that includes diploma, undergraduate, masters, doctors and specialists was held college. (Http://Wikipedia.org online.com / Date Accessed May 26, 2010).

2. Number of children
Children are People who were born (Descendants) / belongs to a family group. (Alwi H, 2001).
The amount is the amount (number or something that is gathered into one). (Ministry of National Education, 2002.hal 11).

So the Son is the number of offspring in one family. (Ministry of National Education, 2002, p.11).
Number of children in single-family lots will result in reduced attention and affection that is received, especially if the distance is too close to children in families with less economic and social conditions, the number of children will result in much less than affection and attention in children, is also a primary need such as food, and housing and child health conditions are not met (Notoatmodjo, 2003, p.. 56).

Results showed that most mothers who carry out child labor by the number of at least 3 people (79.7%) which indicates that the mother has applied a small family norm as a happy and prosperous one form of health development programs in order to improve the welfare of the community. High number of children will have an impact on the incidence of various health problems for both mother and baby is born like the state of health of children primarily immunized children (http://.blog.spot.com/ Accessed on 24 April 2010).

3. Age infant
Age is one characteristic trait of a very major. Age infants that age infants are calculated from birth up to receive measles immunization. (Http://Syehaceh. Wordpress. Com / Accessed on 25 April 2010).
WHO recommends immunization at age 9 months for routine immunization programs in developing countries. In areas with risk of mortality of infants aged less than 9 months of a very high recommended the administration of two doses of measles vaccine at age 6 and 9 months. In developed countries, which have a risk of contracting measles at an early age is much lower, given measles vaccine at age 12-15 months, when all children have lost maternal antibody so that an optimal immune response can be achieved (Wahab, 2002, p.60 - 61).
Actually measles immunization can be given before the baby was 9 months, for example, at the age between 6-7 months when the passive immunity acquired from the mother began to disappear. But then he should get a one-time injection was repeated after 15 months (Markum, 2002, p.28).

4. Mother Age
Age is one characteristic trait of the primary parent. Age has a relationship with the level of exposure, the magnitude of risk and resistance properties. Different experiences of health problems / diseases and decision makers are influenced by the age of the individual. (Notoatmodjo, 2003, p. 40).
From research it was found that maternal age-related knowledge and their attitude towards immunization. This study found that the main factors associated with measles immunization is the maternal age. Namely maternal age maternal age, calculated from birth until the time of the study. (Http://Syehaceh. Wordpres.com / DiaksesTanggal 25 April 2010).

5. Socioeconomic status
Socioeconomic levels proved highly influential on health problems in a family. In families with a good socioeconomic level, will automatically get a good well-being as well. Nutritional status will increase Because nutritional quality obtained. Because the primary needs are met then any health problems get attention in the family. (Sulistyawati, 2009, hal.104).

The presence of the spread of different health problems based on socioeconomic status in general is influenced by two things: because there are differences in economic capability in preventing disease or health services and because there are differences of life and behavior of living sikaf owned. Various variables are very closely related to socioeconomic status that is characteristic. Socioeconomic status is closely connected with the work / type, family income, region, place of residence / geographic, living habits and so forth. Socioeconomic status is also closely associated with psychological factors in society. (Http://Syehaceh. Wordpress. Com / Accessed on 25 April 2010).

The results showed that the factors that influence dropout or incomplete immunization status of infants among the distance factor is home to the place of immunization service. Mom will seek health care that is closest to his home due to considerations other activities that must be resolved is forced to be postponed. (Http://Syehaceh. Wordpress.com / Accessed on 25 April 2010).

Overview About the Measles Immunization

1. Definition
a. Measles immunization is given to receive immunization against measles immunity actively (Markum, 2002, p.26).
b. Immunization against measles is the act of giving measles vaccine to children which aims to establish immunity against measles (Hidayat, 2005, hal104).

2. Measles Vaccine
Measles vaccines containing live measles virus which has been attenuated. Measles vaccine circulating in Indonesia can be obtained in the form of dry packaged singly or in combination with a dry pack mumps vaccine / goitre (mumps) and rubella (German measles). In the United States last package is known as the MMR vaccine Measles-Mumps-Rubella Vaccine. (Markum, 2002, p.26)

In developing countries, measles immunization is recommended given early with the intention of providing immunity as early as possible, prior to exposure to natural measles virus infection. Early immunization apparently hit by the innate immune anti originating from the mother (maternal antibodies), it can inhibit the formation of a substance the body immune to measles in children, so that repeat immunization was given 4-6 months later. Then to Indonesia vaccines campak.diberikan start child was 9 months. (Http://syehaceh.wordpress.com/Diakses On 25 April 2010).
Measles vaccine should be refrigerated at the appropriate temperature (2-8 0C) due to sunlight or heat can kill the virus measles vaccine. When the virus died before it is injected, the vaccine is not able to induce an immune response (Wahab, 2002, p.60).

3. Measles immunization
WHO recommends immunization at age 9 months for routine immunization programs in developing countries. In areas with risk of mortality of infants aged less than 9 months of a very high recommended the administration of two doses of measles vaccine at age 6 and 9 months. In those countries, which have a risk of contracting measles at an early age is much lower, given measles vaccine at age 12-15 months, when all children have lost maternal antibody so that an optimal immune response can be achieved (Wahab, 2002, p.60 - 61 ).
Timing of immunization against measles at age 9 -12 months. How to measles immunization subcutaneously with a dose of 0.5 ml. (Hidayat, 2005, hal.104).
Actually measles immunization can be given before the baby was 9 months, for example, at the age of 6-7 months when the passive immunity acquired from the mother began to disappear. But then he should get a one-time injection was repeated after 15 months. (Markum, 2002, p.. 28)

4. Immunity and Immunization Reactions
Power protection measles immunization is very high, namely 96-99%. According to the study, acquired immunity is lifelong, as the staying with immunity acquired when children infected with measles naturally (Markum, 2002, p.. 29)
Immunizations that are common reactions include high fever (temperature over 39.4 º C), which occurs 8-10 days after vaccination and lasts for about 24-48 hours (approximately 2% incidence) and skin rash for about 1-2 days 2 incidence % (Wahab, 2000, p.61).

5. Side Effects and Contra Indications
Side effects are very rare, possibly a mild seizures can occur and are not dangerous on day 10-12 after injection. Moreover, it can occur in the form of brain inflammation or ansefalopati ansefalitis within 30 days after immunization. But it happened very rarely, namely 1 in a million shot. This figure is much lower than the incidence of brain inflammation due to natural measles disease of 1 in 250 cases. Thus the risk for the occurrence of brain inflammation caused by natural infection 2500 times greater than the result of immunization. (Markum, 2002, hal.29).

According to WHO, contra indications only applies to terminally ill children, suffering from tuberculosis (tuberculosa) without treatment, or who suffer from severe malnutrition in degrees. Measles vaccination should also not be given to children suffering from malignant disease or is in the treatment of malignant disease. Since not enough scientific information gathering, measles immunization should be deferred in pregnant women. In children who have suffered seizures, measles immunization can be given as usual, provided with medical supervision (Markum, 2002, hal.30).

Immunization Program Objectives

Immunization program goal is to reduce mortality and morbidity caused by diseases - diseases that can be prevented by immunization (PD3I). So to achieve this has been a lot of things done by the government through policies, strategies and activities through the funding of domestic and foreign aid (MOH, 2007, p.1).

According to the MOH (2001) The goal of immunization is to prevent illness and death of infants and children - children that is caused by epidemics that often arise. The Indonesian government strongly encourages the implementation of immunization programs as a way to reduce morbidity and mortality in infants, toddlers / children - pre-school children. (Http://syehaceh.wordpres. Com / Accessed on 25 April 2010).

Type of immunization, vaccines and usefulness

a. Immunization is divided into two:
1) Active Immunization
Active immunization is immune from any person's body that is actively forming agent anti-bodies. Active immunization is divided in two:
a) Active immunization of natural
Active immunization is the natural immune system that automatically obtained after recovering from an illness.
b) artificial active immunization
Artificial active immunization is obtained immunity from vaccinations given to protection from a disease (IGN Ranuh, et al, 2005, p.23).
2) Passive immunization
Passive immunization is immune to a person who acquired immune substances obtained from the outside. Passive immunization is divided in two:

a) Passive immunization of natural
Passive immunization is a natural antibody from any person's inherited by the mother who is a direct biological parents while in the womb.
b) Passive immunization of artificial
Artificial passive immunization is obtained because the immune serum injections to prevent certain diseases (IGN Ranuh, 2005, p.24).
b. Kind - kind of vaccine development program entry immunization (PPI) and its usefulness:
1) BCG (Bacillus Calmatte Guerin)
BCG vaccine is made from the bacterium tuberculosis (TB) who have been living in weaken. (MOH, 2009, p. 29).
The purpose of this vaccine to create immunity that is active against tuberculosis. (MOH, 2005, p. 5).
2) DPT (Dipteri Pertussis Tetanus)
Vaccine DPT vaccine called "Triple" which consists of:
a) diphtheria vaccine: diphtheria bacteria that has been attenuated.
b) pertussis vaccine: pertussis bacterium that has been attenuated
c) tetanus vaccine: tetanus bacteria that have been weakened.
DPT vaccine goal is to provide the same active immunity against diphtheria, whooping cough and tetanus. (MOH, 2005, p. 6).
3) Polio
Recognized two types of polio vaccine dead vaccine (Salk) and live vaccine that has been in the weaken (Sabin). (MOH, 2009, p. 29).
The purpose of this immunization is to prevent paralysis in infants and toddlers wilt. (MOH, 2005, p. 9).
4) Measles
Measles virus measles-containing vaccine that has been weaken. (MOH 2009, p. 29).
The purpose of this vaccine to provide immunity against measles. (MOH, 2005, p.10).
5) Hepatitis B (HB)
HB vaccine derived from virus in weaken. (MOH 2009, p. 29).
The purpose of HB vaccine is to give immunity to the infant and toddler jaundice. (MOH, 2005, p.11).

Understanding of the immunization program

The immunization program is an activity aimed at an area that requires quick handling to prevent the occurrence of outbreaks (Extraordinary Events). (MOH 2009, page.2).

In Indonesia, the immunization program has been started since the 19th century to eradicate smallpox in Java. Indonesia's last case of smallpox was discovered in 1972 and in 1974 Indonesia was officially declared smallpox-free country. 1977 to the year 1980 was introduced immunization BCG, DPT and TT respectively to give immunity to the diseases of children tuberculosis, diphtheria, pertussis and tetanus neonatorum. In 1981 and 1982 respectively was introduced antigen polio and measles which started in 55 districts and sub-districts known as the Development of Immunization (PPI). (MOH, 2005, p.. 27).

In 1987 the immunization program was first introduced PWS (Local Area Monitoring) as a tool monitor coverage. PWS actually very useful for monitoring the trend of achieving coverage of the program within a certain period and can take immediate corrective action and follow-up. By utilizing the PWS and its follow-up in late 1990 by the National UCI can be achieved early, then followed UCI propensi and district level the following year (MOH, 2007, p.58).

The immunization program is a program that is very effective and efficient and proven by its success eradicate smallpox in the world. In order to target the national and global commitment to achieve eredikasi, elimination, and reduction of Cosmos, the disease can be prevented by immunization (PD3I) can be achieved, immunization activities need to be improved and maintained both the quantity and quality (MOH, 2007, p.58).

Definition of Immunization

Immunization derived from the word immune, immune or resistant. So the immunization is an act to provide vaccine immunity by entering into the human body. While invulnerable is a condition in which the body has the ability to conduct disease prevention in order to face the attacks of certain germs. (Http: / / Infeksi.com / Accessed date 14 April 2010).

Immunization is a business that is done in giving the vaccine in a person's body so that it can lead to immunity to certain diseases (MOH, 2004 Page 1).

Immunization is the provision of immunity to a disease by inserting something into the body so the body resistant to the disease being endemic or harmful to seseorang.Imunisasi to a disease will only provide immunity or resistance to the disease course, so as to avoid other diseases is required immunizations other (http://organisasi.org/ Date Accessed May 26, 2010).

Immunization is a vaccine to prevent certain diseases. The vaccine is a biological product made ​​from the germs, kompenen germs, germs or toxins that have been attenuated or turned off and are useful to stimulate one's immune. (MOH, 2005, p.4)

Overview About the Research Variables

1. Age
Age is one factor that determines the selection of contraceptive methods. Healthy reproductive period is known that pregnancy and childbirth are the 20-35 years it has been ready to get pregnant while the risk of high risk pregnancies occur in the young maternal age is <20 years and gestational age> 35 years. Thus age greatly affect the research methods of contraception to avoid complications that may occur in the mother or fetus (Wiknjastro H, 2006).
In choosing a suitable contraceptive devices, and both are things tricky. All must be tailored to the age and purpose of the female partner of childbearing age. In medicine, there are three time periods used as the basis for the normal use of contraception, namely the delaying fertility / pregnancy, regulate the fertility / spacing of fertility and the end of fertility.
a. Delaying Pregnancy
In times of delaying fertility / pregnancy is a time for women infertile couples who are married by age <20 years. In women that age, the means of reproduction is still not stable, so that fear can happen things that are not desirable when she was pregnant.
b. Spacing pregnancies
The best age for mothers to give birth according to the science of reproductive health between the ages of 20-30 years, but recently started to move up to the age of 35 years, the necessary condition of contraception for women this age of high effectiveness, the ability to restore fertility is also quite high because the acceptor is still expects to have more children, age 3-4 years can be used with the desired spacing, and do not hinder milk production.
c. Ending fertility / stop
This period is when women aged over 30 years and already has 2 children. Contraception is needed is a high effectiveness, and can be used for long-term. (Anonymous, 2002).
2. Parity
To save the mother and child it is necessary to adjust the spacing births. Parity 1-2 is the most secure parity minimize complications that may occur in the mother. Parity ≥ 3 have a high risk obstetric and can be dealt with better with family planning (Wiknjastro H, 2006).
Parity is the number of babies are born, whether born alive or stillborn. Mothers who give birth often have a high risk of child mortality compared with mothers who gave birth to a little more. Safe delivery for mother is the second and third childbirth (Royston, 1994). Parity is the parity 2-3 safest from the standpoint of maternal deaths. The higher the parity is also higher maternal mortality (Wiknjosastro H, 2005).
3. Education
The higher the education level attained reflects an acceptor level of intellectual, educated people are generally easy to understand about this new, easy to follow and can change bad habits in the form of attitude so that an educated mother is more concerned with the welfare of the family.
Education can be categorized as low if early education first 9 years of schooling up to secondary education (junior high). Categorized as high education levels of education when at least secondary education (high school) which includes courses pandidikan diploma, undergraduate, masters, doctors and specialists who held college. (Anon: 2007)
4. Work
Work on the general activity that takes time, work for mothers will have an influence on the work of family planning participants and the husband will affect income and economic status of families. A family with economic status on fertility behavior are encouraging the formation of a large family. Employment status may affect the participation in family planning because of factors influence the work environment that encourages a person to participate in family planning, so it will indirectly affect the status of the use of contraceptives. (Gungde, 2008).
5. Culture
Current trends concerning the number of families; impact the number of families in which individuals grow and develop to the individual; importance of having a son in the eyes of society because it will continue the family name; whether the public connects directly between the number of children who possessed a man and his manhood; values ​​in the community about being a "woman" only if he can "give" the child to her partner. (H Varney, 2006)

Weight according to height

The study of 61 children aged 4-6 years based on weight according to height high index gained as many as 12 people (19.67%), normal index as many as 47 people (77.05%) and low index of 2 people (3.28 %).

Based on the theory that the measurement of body weight according to height is a very good indicator to assess the nutritional status of the current weight which has a close relationship with height. Under normal circumstances, the development of weight will be in line with growth in height with a certain speed.

Height by age

The results of the study 61 children aged 4-6 years based on height for age obtained a high index of 2 people (3.28%), normal index as many as 52 people (85.25%) and low index of 7 people (11.47%) . Based on the theory that the height of the child - children are expressed in percentage of the standard shows whether the child has a stunt. Dwarfs are the result of malnutrition a very long time.

However, from the height data alone can not provide clarity whether the child in a state of malnutrition or not. Perhaps once the child is now growing well, but have not been able to pursue a standard size. Many chronic malnutrition in children - children never able to achieve the standard measure of height for age.

Weight loss by age

The study of 61 children aged 4-6 years based on the age-weight high index gained as many as 11 people (18.03%), normal index as many as 47 people (77.05%) and low index of 3 people (4.92% ).

On the basis of the theory to determine the child's nutritional weight measurements were taken which gives an overview of body mass. Because body mass is very sensitive to changes - sudden changes, such as infectious diseases,

decreased appetite or decrease in the amount of food consumption, body weight is a parameter that is very unstable. Based on these properties then the index weight for age better describe the current nutritional status.

Assessment of Nutritional Status in the Public About Anthropometry

One way of assessing nutritional status in the community is by measurement of the human body, known as Anthropometry. In use for the assessment of nutritional status, antropomteri presented in the form of an index that is associated with other variables. The variables are as follows (Arsad, RA. 2006):

a. Age
Age really plays a role in determining nutritional status, determination of fault will cause an incorrect interpretation of nutritional status. The results of weighing and accurate height, become meaningless if not accompanied by the determination of the appropriate age. Errors that often arises is the tendency to choose the number that is easy as 1 year, 1.5 years; 2 years. Therefore the determination of the child's age should be calculated carefully. Its provisions is one year is 12 months, one month is 30 days. So the calculation of age is the moon is full, meaning that the remaining life in days not taken into account (MOH, 2004).

b. Weight Loss
Weight loss is one measure that provides a mass of tissue, including body fluids. Weight loss is very sensitive to sudden changes either due to infectious diseases and food consumption declined. Body weight is expressed in index form MM / N (Weight Loss by Age) or assessment by looking at changes in body weight at the time of measurements carried out, which in its use provides a state now.

c. Height
Height growth function gives an overview of state visits and short little scrawny. Height is expressed in index form of TB / U (height for age), or also indexes BB / TB (Weight Loss by Height) is rarely done because the height changes are slow and usually only done once a year. Circumstances of this index generally gives the situation of the environment, poverty and unhealthy due to a chronic (MOH, 2004).

Body weight and height is an important parameter to determine the status of human health, especially those related to nutritional status. Usage Index BB / U, TB / U and BB / TB is an indicator of nutritional status to see any malfunctioning of growth and body composition. (Arsad, RA. 2006)

The use of weight and height will be more clear and sensitive / sensitive in showing the state of malnutrition when compared with the use of BW / U. Expressed in the BB / TB, according to WHO standards when the prevalence of underweight / wasting <-2SD above 10% indicates an area having a very serious nutritional problems and deal directly with morbidity. (Arsad, RA. 2006)

About General Nutrition Status Assessment indirectly

Assessment of nutritional status indirectly divided into 3 namely (Arsad, RA. 2006):
a. Survey of food consumption
Is a method of determining nutritional status indirectly by looking at the number and types of nutrients consumed.

b. vital Statistics
Is to analyze the data some health statistics like mortality rates by age, morbidity and mortality due to certain causes and other data relating to nutrition.

c. ecology
Based on the expression of Bengoa said that malnutrition is a problem of ecology as a result of interaction of several physical factors, biological, and cultural environments. The amount of food available is dependent on ecological circumstances such as climate, soil, irrigation, etc..

About General Nutrition Status Assessment is directly

Assessment of nutritional status is directly divided into four assessments are (Arsad, RA. 2006):
a. anthropometry
Anthropometry is the measure of the human body. While the nutritional anthropometry is associated with a variety of body dimensions and measurements of body composition and age levels and nutrient levels. Anthropometry is generally used to see a balance of protein and energy intake.

b. clinical
Clinical examination is a method to assess nutritional status based on the changes - changes that occur associated with insufficiency of nutrients, such as skin, eyes, hair, and oral mucosa or organs that are close to the surface of the body such as the thyroid gland.

c. biochemistry
Assessment of nutritional status with biochemical examination of the specimens are tested by laboratories that performed on various tissues. Body tissues that are used among others blood, urine, feces and also some body tissues such as liver and muscle.

d. biophysical
Assessment of nutritional status in biophysics is the method of determining the nutritional status by involving kemamapuan function and see the changing structure of the network ..

Nutrition Disorders Causes

1. Ignorance of the relationship between food and health
In everyday social life - the day is often seen that even though the family earn enough but the food is served potluck only. (Moehji, Sjahmin. 2002)

2. Prejudiced against certain foods
Many foods are actually high nutritional value but not used or used only on a limited basis due prasangkaan bad to the food ingredients. Use of food ingredients that are considered lower the dignity of the family. Types of vegetables such as genjer, turi leaves, cassava leaves even the rich in iron, vitamin A and protein, in some areas are still considered a food that lowers the dignity of the family. (Moehji, Sjahmin. 2002)

3. The existence of adverse habits or abstinence
The various customs associated with eating certain foods abstinence is still frequently encountered, especially in rural areas. Habits of pregnant women to eat certain foods that are not of the prohibition of the doctor, actually would be detrimental to the mother's own health. (Moehji, Sjahmin. 2002)

4. Excessive passions against certain types of food
Excessive favorite food of a certain type of food (Food Faddisme) will result in less varied diet and will result in the body does not obtain all the necessary nutrients. (Moehji, Sjahmin. 2002)

5. Limited family income
There is no denying that the family income will also determine the meals for a family day - the day, both quality and quantity of food. Knowledge of the levels of nutrients in various foodstuffs, food ingredients for health usefulness family can help mothers choose foodstuffs whose prices are not so expensive but high nutritional value. (Moehji, Sjahmin. 2002)

6. Birth spacing is too tight
Many research results that prove that many children who suffer from nutritional disorders because his mother was pregnant again or a new sister is born, so do not take good care of her mother. (Moehji, Sjahmin. 2002)

Nutritional needs of the child

Nutrients are divided into six main classes, namely: water (called an organic substance), Proteins, Fats, Carbohydrates, Vitamins, (referred to as organic substances, since substances that contain carbon arranged) and Minerals. (Yuniastuti, Ari. 2008)

1) Water
Water is the nutrient that serves a nutrient medium for the other

2) Protein
Proteins are the building blocks of the main body. Proteins are substances made up of various amino acids. Based on the source of protein is divided into two kinds, namely animal protein and vegetable protein. Animal protein comes from meat, eggs, milk, cheese and fish while vegetable proteins derived from seeds - grains, beans, wheat and vegetables.

3) Fat
Is the main source of energy for the body and as a food reserve. Based on the source can be divided into two, namely vegetable fats and animal fats. Animal fats found in fish flesh, fish oil, milk, cheese and eggs while vegetable fat found in peanuts, red beans, palm oil, hazelnut, avocado and sesame.

4) Carbohydrates
Carbohydrates are divided into two, namely:
a. Simple carbohydrates like white sugar and brown sugar
b. Complex carbohydrates such as flour, rice, wheat and corn.

5) Vitamins
a. Vitamin A is needed for bone growth, eyes, hair, and skin, also to prevent congenital abnormalities. Vitamin A is divided into 2 of vitamins derived from animal and vegetable. Animal vitamins contained in milk, liver, egg yolks, cheese, whereas that derived from the vegetable vegetables - fresh vegetable and fish oils.
b. Vitamin B is needed to maintain the nervous system to function normally, which is derived from bread, rice, milk, meat's temped.
c. Vitamin C is needed for tissue formation and spread of iron. Vitamin C is widely available in the fruit - fruit that brwarna such as oranges, tomatoes, papaya, and green vegetables that are still fresh.
d. Vitamin D plays a role in bone formation, regulate calcium and phosphorus levels in the blood, increasing the absorption in the intestine, and regulate the exchange of substances in the blood and bone. Vitamin D is widely available in fish liver, egg yolks, butter, meat, oily fish and nuts - nuts.
e. Vitamin E act to prevent bleeding and regulate cell proliferation. Vitamin E is widely available in the apple, celery, lettuce, spinach, sprouts, egg yolks, milk, and meat.
f. Vitamin K plays a role in blood clotting process, affect the making protombin in the liver. Vitamin K found in green vegetables, beans - whole grains and liver. Vitamin K is also produced by the bacterium Escherichia Coli in the colon.
6) Minerals
Used to improve the health condition of the human body, if given a decent amount contained in iron, calcium, zinc and iodine.

A person is healthy and normal child will grow according to its genetic potential. But growth will also be influenced by the intake of nutrients consumed in the form of food. Deficiency or excess nutrients will be manifested in the form of a distorted pattern of growth standards. (Suhardjo. 2001)

Growth and development of children

Growth and development is a process that occurs in every creature. Humans, especially in childhood - childhood experience this growth process quickly. (BOHKASIM, 2009)
Developments experienced by children is a regular series of changes or stages of development to the next stage of development policies in general, such as the ability to crawl, jump and run. (BOHKASIM, 2009)
On the physical growth process, there is a change - change in size and maturation functions starting from simple molecular phase at the beginning of the womb, until the teenager with a complex metabolic process. (BOHKASIM, 2009)

From the point of nutritional science, according to Ahmad Djaeni Sediaoetama (2000), growth is the increasing body of material, while the development is the progress of physiological function or capacity of the body or body organs. (Soegeng, Santoso. 2008)

1) Growth in children
There are various ways to follow the growth of children on a regular basis, one way that can readily be done is to monitor the child's weight according to height. The measurement results matched according to weight table height so that the child's nutritional status can be known. (BOHKASIM, 2009)
2) The development of children
The development of a child according to his ability can be grouped in four aspects, namely (BOHKASIM, 2009):

a. Basic motor skills
The ability to perform its apparent movement such as walking, standing, and jumping.
b. Fine motor skills
Namely the ability to do subtle movements that give the precision and coordination of small muscle movements such as buttoning clothes, and winks.

c. Speech, language and intelligence
Namely the ability to express feelings, desires and opinions through words - words, understand and comprehend the words of others, as well as the ability to think.

d. Social skills and self-
The ability to make friends, to know good manners, and follow the rules.

Understanding Children's Health

Healthy can be interpreted as a good state of all bodies and parts - parts or something this good. Health itself can be defined as good health (free from disease) and the good of the state (or other entity). In other words, health can be interpreted as healthy a state free of the disease so that it can do all activists without physical barriers. Someone said to be healthy if it has both physical health (body organs) and psychological (mental, emotional, social, and spiritual). (Soegeng, Santoso. 2008)

A healthy child is a child who is physically and psychologically healthy. Health of a child starting a healthy lifestyle. Healthy lifestyle can be applied from the smallest start from maintaining personal hygiene, the environment to a healthy diet and regular. (Soegeng, Santoso. 2008)
According to the Ministry of Health (1993) characteristic of a healthy child is growing well, the level of development according to age level, appear to be active / agile and cheerful, clean and shining eyes, good appetite, lips and tongue seemed fresh, odorless respiratory, skin and hair looks clean and not dry, and easily adjust to the environment. (Soegeng, Santoso. 2008)
A preschool child is experiencing a period of very rapid growth and rapid. At this time, the process of physical changes, emotional, and social development take place quickly. This process is influenced by various factors from the child's own self, nutrition, health care and the environment both physically and socially. Kindergarten age child development can be monitored through physical measurements and via observation of the attitude or behavior. (Soegeng, Santoso. 2008)

Kindergarten - childhood is the beginning of the introduction of a child with a social environment that is in the general population, outside the family. Nursery - child (TK) is an institution that besides giving a chance to play while learning to children, educating children to be independent, sociable, and acquire various skills of children. One aspect that fostered the child's Nursery - Schools are maintaining health through eating healthy foods. In the Nursery - Schools, children are also taught the correct procedure for eating behaviors in addition to choosing foods that are useful for him. (Soegeng, Santoso. 2008)

Children's Nursery - Kanak (TK) has a characteristic, which is currently in the process of growth and development. Kindergarten children did a lot of physical activity and began to actively interact with the surrounding social and natural environment. They are a group of pre-school children aged 3-6 years who are sensitive to education and the cultivation of healthy living habits. (Soegeng, Santoso. 2008)

understanding Nutrition

The word nutrition comes from the Arabic of Ghidza which means food. Food is anything that is worn or used by humans to be alive. (Yuniastuti, Ari. 2008)

Nutritional status (manutrition status) is a picture of a state of balance between the needs of substance intake - nutrient for the growth process. The imbalance between the intake to the needs of substances - nutrients will lead to disruption of metabolic processes in the body which in turn affects the growth process of physical and non physical. Real picture of the imbalance caused by the need for intake of nutrients will be visible on the physical growth that is taking into account height, weight, and body size. (BOHKASIM. 2009)

Nutritional science is the study of processes occurring in living organisms, including retrieval and processing of solid and liquid substances from food (digestion, transport and excretion) are needed to maintain life, growth, proper functioning of body organs and produce energy. (Yuniastuti, Ari. 2008)