1000 First Days of Life As An Effort to Prevention and Prevention Stunting in Rw 08 North Margahayu

Chronic malnutrition can lead to stunting. Stunting is caused by insufficient nutritional intake for a long time due to feeding that is not in accordance with nutritional needs during pregnancy, infancy and toddlerhood. Prevention of stunting through the first 1000 days of life (HPK) as an effort to overcome and prevent stunting was carried out in RW 08 North Margahayu Village, Caringin Subdistrict, Bandung City with lecture and question and answer methods and provision of additional food. The tools and materials used were Power point, leaflets and examples of nutritious food or the contents of my plate and examples of food for MP - breastfeeding children. The implementation of this counseling activity was carried out on September 22, 2022 starting at 08.00 until completion at Posyandu RW 08 North Margahayu Village. The targets of this activity are pregnant women, mothers of infants and toddlers and Posyandu cadres. The results of these activities obtained distribution based on the age of counseling activities mostly in the age range of 20-30 years as much as 73, 53%, and the results on the level of knowledge at Posyandu RW 08, namely the level of knowledge about the First 1000 Days of Life is in the moderate category, namely 38.23%, in the Good category, namely 35.29%, and the category is less, namely 26.47%.


A. Introduction
Health is one aspect of community life, quality of life, productive labor, high morbidity and mortality rates in infants and children, decreased work capacity and disruption of mental development are direct or indirect consequences of malnutrition. Improving public health is the main thing in supporting the creation of a healthy and prosperous nation. Therefore, health during growth is very important, because the health of a child not only determines the direction of his own life and future, but will also affect the direction of the life of the nation and state in the future.
Indonesia faces multiple nutrition problems, namely undernutrition and overnutrition. Malnutrition in general causes disturbances in the growth process, body defenses, and brain function. While overnutrition causes overweight or obesity [1]. This is caused by children's activities that are quite heavy and irregular eating patterns can lead to an imbalance between the intake and adequacy of nutrients in children. diet can result in an imbalance between intake and nutritional adequacy in children [2].
Malnutrition affects the quality of human resources and gradually leads to high maternal mortality, infant mortality, under-five mortality, and low life expectancy [3]. Malnutrition during pregnancy is associated Vol 1 No 1 2023 (11-16) ISSN : 2987-6052 Publisher with fetal growth retardation, stunting, wasting, and was the cause of 3 million child deaths each year or 45% of all child deaths in 2011 [4].
stunting is a condition where a person's height is shorter than the height of other people in general (of the same age) [5]. according to [6] stunting is a condition of malnutrition associated with past nutrient inadequacies so that it is included in chronic nutrition problems. Stunting is a condition of failure in growth and development due to long-term malnutrition, which is caused by lack of nutritional intake, recurrent infectious diseases and suboptimal parenting [7]. Stunting can be a predictor of low quality human resources that affect the productivity and economic growth of a nation, so that prevention and control of stunting is very important [8]. Globally, about 162 million children under the age of 5 are stunted [9]. Based on the results of the 2021 Indonesian Nutrition Status Survey (SSGI) conducted by the Ministry of Health, the stunting prevalence rate in Indonesia in 2021 was 24.4%, or a decrease of 6 . 4% from the 30.8% rate in 2018 [10]. Based on the Ministry of Health's Riskesdas data, the prevalence stunting in Java West Java amounted to 29.2% [11]. In 2020, Bandung City experienced an increase in stunting rates by 2.40% compared to 2019 with 9,567 under-fives identified as stunted. In 2021 this dropped to 7,568 under-fives.
Stunting is a condition of growth failure in children due to chronic malnutrition over a long period of time long period of time [12] Another factor that affects nutritional status is the mother's level of education, mothers whose education is high will better understand the right foods so that the higher the education, the better the knowledge. A person's level of knowledge about nutrition will be better. Someone who does not have enough nutritional knowledge, will choose food ingredients that appeal to the senses and not make choices based on the nutritional value of food. On the other hand, those with higher nutritional knowledge use more rational consideration of the nutritional value of the food [13].
Four impacts of stunting on children and the Indonesian state, 1) Cognitively weak and psychomotorly inhibited; 2) Difficulty mastering science and excelling in sports; 3) More susceptible to degenerative diseases; and 4) Low quality human resources [14] One of the efforts to prevent stunting is to improve nutrition. The government has established a stunting prevention policy, through Presidential Decree No. 42 of 2013 on the National Movement for the Acceleration of Nutrition Improvement with a focus on the first 1000 days of life [15]. The presidential regulation contains the following, 1) Pregnant women receive Blood Addition Tablet (TTD) at least 90 tablets during pregnancy; 2) Provision of Supplementary Food (PMT) for pregnant women; 3) Nutrition fulfillment; 4) Delivery with a skilled doctor or midwife; 5) Provision of Early Breastfeeding Initiation (IMD); 6) Exclusive breastfeeding for infants up to 6 months of age; 7) Providing complementary foods (MP-ASI) for infants over 6 months to 2 years of age; 8) Providing complete basic immunization and vitamin A; 9) Monitoring toddler growth at the nearest posyandu; 10) Implementation of Clean and Healthy Living Behavior (PHBS) [16].
North Margahayu Village is one of the sub-districts in Babakan Ciparay Bandung, according to data from Puskesmas Caringin, 2022 in RW 08 North Margahayu Village has 8 toddlers who are declared stunted, 7 toddlers fall into the category of malnutrition, and 1 toddler falls into the category of malnutrition.
Based on the description above, it is considered important to carry out activities to increase knowledge in the RW 08 community of North Margahayu village, Caringin sub-district about nutritional adequacy in the 1000 HPK range.

B. Methods
This community service activity is carried out in the form of health counseling with the title of the activity "First  [17]. What happens during this period, including the nutrition received by the baby while in the womb and receiving breast milk, has a long-term impact on adult life. The implementation of community service activities uses the Lecture and Discussion Method. The speaker provides material in the form of lectures with the help of Power Point which contains material on the first 1000 days of life as an effort to overcome and prevent stunting. Furthermore, discussions were held with participants regarding the material provided, ending with an evaluation of the material provided.

C. Result and Discussion
Community service activities on "1000 Days First Life as an Effort to Combat and Prevent Stunting" in RW.08 North Margahayu on 22 nd September 2022 coincides with the implementation of Posyandu in RW.08 North Margahayu , can be carried out well. The service activity was attended by almost all mothers and toddlers who participated in Posyandu activities in RW.08 North Margahayu with more than 34 people.
The stages of service activities that have been carried out are as follows: 1. Service Preparation a. Survey of service locations through visits to RW.08 Margahayu Utara Tenggela Village and Tilango Health Center b. Application for permission for activities in writing or unwritten to the Head of RW.08 Margahayu Utara which had previously been socialized in the opening ceremony of community service at the Immanuel Institute of Health. c. Coordination with members of the community service working group related to problems, making proposals, preparing materials, preparing equipment. d. Preparation of the posyandu place that will be used for community service activities in coordination with the head of the posyandu.  Publisher c. Discussion/Interview After the material was presented, the participants were given the opportunity to ask questions. There were 5 participants who asked questions. The discussion and question and answer session was held for ± 15 minutes. Based on the results of the evaluation by giving questionnaires to community service participants, the following results were obtained: 1. Characteristics by Age Knowledge is one of the keys to behavior change. The level of knowledge is influenced by several factors, including exposure to health information, age, and the role of health workers in providing health information. In addition, the level of education also affects the level of knowledge, the level of education is a social factor that influences how he will behave and behave [18]. In the results of the community service evaluation, it can be seen from the age characteristics of the respondents that the respondents are in the age range of 20-30, which means that this age range is the age range of advanced adulthood, so that the respondents' thinking and understanding are more responsive to the information provided.
If knowledge about the First 1000 Days of Life is lacking, one of the impacts that will arise is that there will be malnutrition during this period which will result in physical growth disorders such as stunting, wasting, low birth weight (LBW), as well as disruption of brain development, intelligence, and will also cause metabolic disorders that can increase the risk of non-communicable diseases such as stroke, obesity, diabetes, disability, and coronary heart disease [9].
According to [13], knowledge is the result of knowing. Obtained by someone from the results of sensing a particular object. Knowledge is very important which can affect a person's behavior. Behavior that is based on by knowledge will be better than those that are not based on knowledge [13]. Good knowledge is very important because it is hoped that good knowledge will form a good attitude for both prospective mothers and fathers later on the importance of the first 1000 days of fetal life, especially nutritional problems in that period [13].
According to [13], conducting health education can produce changes or increase knowledge with the right method. There are various methods and media that can be used in conducting health education, such as electronic media (TV, Radio) printed media such as leaflets, banners, posters, newspapers, including media cards that can be adjusted to the target and number of targets to be achieved. In the community service activities carried out, the method used, namely lectures and questions and answers, is the right method to use for targets in the community.

D. Conclusion
Community service activities carried out in the form of counseling with the theme "The first 1000 days of life as a prevention and control of stunting" in RW.08 North Margahayu , can be carried out well. The expected output can be achieved well where there is an increase in knowledge from the participants of the service activities.

E. Acknowledgement
The community service team would like to thank LP2M Immanuel Institute of Health for providing support, and coordination to the community in RW.08 North Margahayu village. Thank you to the Caringin Health Center, Head of Sub-district, Head of RT, RW and RW 8 cadres of North Margahayu village, and the community and all lectures of the S1 faculty of health at Immanuel Institute of Health.