Procurement of Health Equipment Facilities and Assistance in Efforts to Improve the Quality of Posyandu Aster Wanujoyo Lor Services

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Introduction
Posyandu is an Indonesian term that refers to integrated healthcare centres in the community.It is a form of Community-Based Health Efforts managed and organized by, for, and with the community in implementing health development to empower the community and provide convenience to the community in obtaining essential health services, primarily to accelerate the reduction of mortality: mother and baby [1].Because Posyandu is organized for the benefit of the community, it is hoped that the community members will actively form, organize, utilize, and develop Posyandu as well as possible.
One of the critical tasks of Posyandu is to prevent stunting.Stunting is a condition of growth and development of a child who experiences failure caused by prolonged malnutrition in the first 1000 days of life [2].Stunted children mostly have a shorter height than children of their age [3,4].Their intelligence levels are also lower compared to normal children [5].Stunting is a nutritional problem that concerns the world, especially in poor and developing countries [6].In Indonesia itself, stunting is a severe problem for the government.In 2021, cases of stunting in Indonesia ranked fourth in the world and second in Southeast Asia.Based on survey data on the Nutritional Status of Toddlers in Indonesia, one in four children in Indonesia is stunted Factors causing stunting in Indonesia are influenced by, among others, 1) household and family factors, 2) inadequate solid food, 3) breastfeeding, and 4) infection factors.The first factor is household and family, consisting of maternal and environmental factors [7,8].Maternal factors include malnutrition during pregnancy and breastfeeding, infection, hypertension, mental health, etc.Then, inadequate stimulation and activity of infants, caregivers who lack education, lack of sanitation and clean water, and the family economy are examples of environmental factors that affect the risk of stunting.The second factor is inadequate feeding of solid food.This can be in the form of low-quality food given to infants, less frequency of giving solid food, as well as food and water safety.The next factor is the breastfeeding process, such as delaying initiation, not giving exclusive breastfeeding, and weaning too early.The last factor is an infectious factor, including Enteric Infections, Respiratory Infections, Malaria, decreased appetite caused by infection, and receiving only partial or no vaccines.
In preventing stunting, Posyandu is referred to as the front guard in efforts to reduce stunting cases in Indonesia [9].Posyandu is a health service centre for mothers and babies through Community-Based Health Efforts [10].This means that the implementation process is from the community, by the community, for the community, and with the community.In the implementation process, Posyandu is carried out by cadres from hamlet-level Family Welfare Movement (PKK) members, community leaders, or cadres.The Posyandu cadres have received basic health training organized by Puskesmas (public health center).Posyandu cadres are tasked with creating and implementing programs that can support the health of mothers and babies.One of the programs routinely carried out by Posyandu every month is to collect data on the weight and height of the babies of Posyandu members.These data will be used as a report to detect early stunting cases that can occur so that interventions can be carried out.
Posyandu ASTER Wanujoyo Lor is one of the health service facilities for toddlers at the sub-village level in the village of Srimartani.This posyandu is one of a total of 23 posyandu in Srimartani Village, Piyungan District, Bantul Regency.In carrying out its function as a health service facility for mothers and toddlers, Posyandu Aster Wanujoyo Lor has five cadres from family welfare movement and cadres from the community.These cadres collect data on the weight, height, and head circumference of the members of Posyandu every month.Because Posyandu is a meeting point that accommodates health professionals and the role of the community, Posyandu Aster Wanujoyo Lor actively organizes programs aimed at mothers and babies who participate in Posyandu.The Posyandu is attended by around 80 mothers with 1 to 2 children aged 0 to 5 years.Most Posyandu participants are housewives, followed by civil servants, teachers, staff, and lecturers.

Methodology
The implementation of community service is carried out in several stages.The stages in implementing this community service program are shown in Figure 2.

The implementation of this service program began with coordinating with Posyandu
Aster Wanujoyo Lor cadres.This activity was aimed to gather information about the needs and problems faced by Posyandu Aster Wanujoyo Lor and conveyed the aims and objectives of implementing this community service program.Then,it was continued by identifying the problems faced by Posyandu Aster Wanujoyo Lor.In this case, the cadres of Aster Wanujoyo Lor Posyandu as community service program partners, participate in providing information and statements regarding the needs and problems faced by the healthcare facilities and participants.After identifying the problems, coordination was carried out regarding the schedule for implementing community service activities.
The next step was preparing the equipment and materials needed for community service activities.After this step was completed, the next stage was the implementation of community service activities by providing health-measuring equipment assistance to the Posyandu in the form of digital baby scales equipped with toddler digital length measuring devices which were the result of research work from lecturers and students.Then, an assistance in using and maintaining medical devices and equipment calibration health was given.Furthermore, the last activity was monitoring and evaluation.This activity aims to assess whether this community service activity program's objectives have been achieved or not.

Results and Discussion
Based on the interviews conducted with the head of Posyandu Aster Wanujoyo, this health centre has several obstacles/problems in carrying out its function as the front guard in preventing maternal and infant mortality in Indonesia.The main problem faced by Posyandu Aster Wanujoyo Lor is the need for weight and height measurement tools for infants and toddlers.Currently, the measuring instruments owned by Posyandu Aster Wanujoyo Lor are: • an analogue baby scale • a lift scale, and The cadres complained that the equipment used was inadequate to carry out a monthly routine program to record the weight and height of infants and toddlers and the weight and blood pressure of pregnant and postpartum women.Especially for measuring a baby's body length, Aster Wanujuyo Lor Posyandu still needed to get a special measuring tool for a baby's length.In fact, the baby scales they used now had been donated by residents who no longer used them.Previously, the baby scales owned by the Posyandu were damaged and could no longer be used, so the babies' weight was not measured directly.The cadres only asked the mothers.Posyandu Aster Wanujoyo Lor had submitted equipment assistance, but until now, there has yet to be an answer as to when the government will provide the proposed equipment.Besides that, another problem faced by the Posyandu cadres was the need for more knowledge in the use and maintenance of the medical equipment.This can be seen from the absence of standard operational procedures (SOPs) for the use of medical devices and the knowledge regarding when these devices should be calibrated minimal, thus, the potential for making measurement errors was still immense.
Therefore, based on the problems faced of Posyandu Aster, the solutions that had been done through the Yogyakarta Muhammadiyah University community service program were in the form of; 1. Providing health measuring instruments for Posyandu Aster in the form of digital baby scales equipped with toddler digital length measuring devices which were the output of research work by lecturers and students.
2. Aiding programs in using and maintaining excellent and correct health equipment for Posyandu cadres.
3. Provide a calibration program for health equipment owned by Posyandu Aster.
The following was community service that had been done in Posyandu Aster Wanujoyo Lor.

Conclusion
This community service activity aims to help improve the services provided by Posyandu Aster Wanujoyo Lor.This service activity is in the form of providing medical equipment assistance needed in examining the nutritional status of infants and toddlers of Posyandu participants and accompanying them in the use and care of the health equipment they have.The Posyandu cadres and participants welcomed this service activity, and it was carried out successfully.Posyandu Aster Wanujoyo has sufficient equipment to check the nutritional status of Posyandu participants.

Figure 2 .
Figure 2. The stages of community service activities.

Fig. 3 .
Fig. 3.The assistance in the use of the infant height measuring devices