Kecamatan : Habinsaran Desa : Tanggal Wawancara : No. Responden : B. Riwayat Kehamilan :

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Inge Utami Yuwono
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1 KUESIONER PENELITIAN FAKTOR-FAKTOR YANG BERHUBUNGAN DENGAN KEJADIAN ANEMIA GIZI BESI PADA IBU HAMIL DI WILAYAH KERJA PUSKESMAS PARSOBURAN KECAMATAN HABINSARAN KABUPATEN TOBA SAMOSIR TAHUN 2011 Kabupaten : Toba Samosir Kecamatan : Habinsaran Desa : Tanggal Wawancara : No. Responden : A. Data Responden : 1. Nama : 2. Alamat : 3. Umur : tahun 4. Pendidikan : a. Tidak Tamat SD/Tidak Sekolah b. SD c. SLTP d. SLTA e. Akademi/PT B. Riwayat Kehamilan : 5. Usia Kehamilan : 6. Jumlah Persalinan yang pernah dialami: 7. Jumlah anak : 8. Sudah berapa kali ibu memeriksakan kehamilan : kali 9. Kemana saja ibu memeriksakan kehamilan : a. Posyandu b. Praktek Bidan c. Puskesmas d. Lainnya, 10. Hal apa saja yang dilakukan saat pemeriksaan a. Penimbangan berat badan dan pengukuran tinggi badan b. Pemeriksaan tekanan darah c. Pengukuran tinggi fundus d. Pemberian imunisasi Toxoid e. Pemberian tablet Fe

2 C. Aktivitas Fisik 11. Pekerjaan : 1. Ibu Rumah Tangga 2. Petani 3. PNS 12. Kegiatan Sehari-hari di rumah : a. Memasak b. Mencuci c. Mengasuh anak d. Lainnya, D. Tablet Tambah Darah (Fe) 4. Lainnya, Apakah ibu mengkonsumsi tablet tambah darah? a. Ya b. Tidak (lanjut ke pertanyaan 17) 14. Pada umur kehamilan berapa ibu pertama kali mengkonsumsi tablet tambah darah?... bulan 15. Sampai sekarang sudah berapa kali (bungkus) ibu menerima tablet tambah darah? Berapa lama ibu minum tablet tambah darah setiap hamil? Mengapa tidak mengkonsumsi tablet tambah darah? a. Mual/muntah setelah meminum tablet tambah darah b. Baunya tidak enak c. Rasanya tidak enak d. Lainnya,. D. Penghasilan 18. Penghasilan tetap perbulan : Rp. /bulan 19. Penghasilan tidak tetap : 20. Pengeluaran : a. Keperluan sehari-hari : Rp. b. Rekening listrik : Rp. c. Biaya sekolah anak : Rp. d. Lainnya : Rp. E. Pengukuran 1. Kadar Hb Darah : mg/dl 2. Lingkar Lengan atas : cm

3 Frequencies Frequency Table <20 & >35 (resiko tinggi) (resiko rendah) Umur Ibu Frequency Percent Percent Percent Trimester I Trimester II Trimester III Usia Kehamilan Frequency Percent Percent Percent Paritas Ibu >=4 <4 Frequency Percent Percent Percent Pendidikan Ibu Dasar Menengah Atas Frequency Percent Percent Percent Penghasilan Keluarga Rendah(<Rp ) Tinggi (>= Rp ) Frequency Percent Percent Percent

4 Bekerja Tidak Bekerja Pekerjaan Ibu Frequency Percent Percent Percent Tidak pernah Non-Program Program Konsumsi Tablet Fe Frequency Percent Percent Percent Tidak Normal Normal Lingkar Lengan Atas Ibu Frequency Percent Percent Percent Ante Natal Care Tidak Baik Baik Frequency Percent Percent Percent Anemia Tidak Anemia Frequency Percent Percent Percent

5 s Umur Ibu * Usia Kehamilan * Paritas Ibu * Pendidikan Ibu * Penghasilan Keluarga * Pekerjaan Ibu * Ante Natal Care * Konsumsi Tablet Fe * Lingkar Lengan Atas Ibu * Umur Ibu * Case Processing Summary Cases Missing N Percent N Percent N Percent Umur Ibu <20 & >35 (resiko tinggi) (resiko rendah) % within Umur Ibu % within % of % within Umur Ibu % within % of % within Umur Ibu % within % of Anemia Tidak Anemia % 17.9% 100.0% 61.3% 33.3% 53.3% 43.8% 9.5% 53.3% % 40.8% 100.0% 38.7% 66.7% 46.7% 27.6% 19.0% 46.7%

6 Value df (2-sided) Pearson Chi-Square b Continuity Correction a Fisher's Exact Test N of Cases a. Computed only for a 2x2 table (2-sided) (1-sided) b. 0 cells (.0%) have expected count less than 5. The minimum expected count is Odds Ratio for Umur Ibu (<20 & >35 (resiko tinggi) / (resiko rendah)) For cohort = Anemia For cohort = Tidak Anemia N of Cases 95% Confidence Interval Value Lower Upper

7 Usia Kehamilan * Usia Kehamilan Trimester I Trimester II Trimester III % within Usia Kehamilan % within % of % within Usia Kehamilan % within % of % within Usia Kehamilan % within % of % within Usia Kehamilan % within % of Anemia Tidak Anemia % 54.5% 100.0% 13.3% 40.0% 21.0% 9.5% 11.4% 21.0% % 19.0% 100.0% 45.3% 26.7% 40.0% 32.4% 7.6% 40.0% % 24.4% 100.0% 41.3% 33.3% 39.0% 29.5% 9.5% 39.0% Value df (2-sided) Pearson Chi-Square a N of Cases a. 0 cells (.0%) have expected count less than 5. The minimum expected count is Value Odds Ratio for Usia a Kehamilan (Trimester I / Trimester II) a. statistics cannot be computed. They are only computed for a 2*2 table without empty cells.

8 Paritas Ibu * Paritas Ibu >=4 <4 % within Paritas Ibu % within % of % within Paritas Ibu % within % of % within Paritas Ibu % within % of Anemia Tidak Anemia % 22.2% 100.0% 18.7% 13.3% 17.1% 13.3% 3.8% 17.1% % 29.9% 100.0% 81.3% 86.7% 82.9% 58.1% 24.8% 82.9% Pearson Chi-Square Continuity Correction a Fisher's Exact Test N of Cases Value df (2-sided).429 b a. Computed only for a 2x2 table (2-sided) (1-sided) b. 0 cells (.0%) have expected count less than 5. The minimum expected count is Odds Ratio for Paritas Ibu (>=4 / <4) For cohort = Anemia For cohort = Tidak Anemia N of Cases Value Lower Upper % Confidence Interval

9 Pendidikan Ibu * Pendidikan Ibu Dasar Menengah Atas % within Pendidikan Ibu % within % of % within Pendidikan Ibu % within % of % within Pendidikan Ibu % within % of % within Pendidikan Ibu % within % of Anemia Tidak Anemia % 16.0% 100.0% 28.0% 13.3% 23.8% 20.0% 3.8% 23.8% % 33.8% 100.0% 57.3% 73.3% 61.9% 41.0% 21.0% 61.9% % 26.7% 100.0% 14.7% 13.3% 14.3% 10.5% 3.8% 14.3% Value df (2-sided) Pearson Chi-Square a N of Cases a. 1 cells (16.7%) have expected count less than 5. The minimum expected count is Value Odds Ratio for a Pendidikan Ibu (Dasar / Menengah) a. statistics cannot be computed. They are only computed for a 2*2 table without empty cells.

10 Penghasilan Keluarga * Penghasilan Keluarga Rendah(<Rp ) Tinggi (>= Rp ) % within Penghasilan Keluarga % within % of % within Penghasilan Keluarga % within % of % within Penghasilan Keluarga % within % of Anemia Tidak Anemia % 23.1% 100.0% 66.7% 50.0% 61.9% 47.6% 14.3% 61.9% % 37.5% 100.0% 33.3% 50.0% 38.1% 23.8% 14.3% 38.1% Pearson Chi-Square Continuity Correction a Fisher's Exact Test N of Cases Value df (2-sided) b a. Computed only for a 2x2 table (2-sided) (1-sided) b. 0 cells (.0%) have expected count less than 5. The minimum expected count is

11 Odds Ratio for Penghasilan Keluarga (Rendah(<Rp ) / Tinggi (>= Rp )) 95% Confidence Interval Value Lower Upper For cohort = Anemia For cohort = Tidak Anemia N of Cases Pekerjaan Ibu * Pekerjaan Ibu Bekerja Tidak Bekerja % within Pekerjaan Ibu % within % of % within Pekerjaan Ibu % within % of % within Pekerjaan Ibu % within % of Anemia Tidak Anemia % 25.5% 100.0% 93.3% 80.0% 89.5% 66.7% 22.9% 89.5% % 54.5% 100.0% 6.7% 20.0% 10.5% 4.8% 5.7% 10.5%

12 Pearson Chi-Square Continuity Correction a Fisher's Exact Test N of Cases Value df (2-sided) b a. Computed only for a 2x2 table (2-sided) (1-sided) b. 1 cells (25.0%) have expected count less than 5. The minimum expected count is Odds Ratio for Pekerjaan Ibu (Bekerja / Tidak Bekerja) For cohort = Anemia For cohort = Tidak Anemia N of Cases Value Lower Upper Ante Natal Care * % Confidence Interval Ante Natal Care Tidak Baik Baik % within Ante Natal Care % within % of % within Ante Natal Care % within % of % within Ante Natal Care % within % of Anemia Tidak Anemia % 23.3% 100.0% 88.0% 66.7% 81.9% 62.9% 19.0% 81.9% % 52.6% 100.0% 12.0% 33.3% 18.1% 8.6% 9.5% 18.1%

13 Value df (2-sided) Pearson Chi-Square b Continuity Correction a Fisher's Exact Test N of Cases a. Computed only for a 2x2 table (2-sided) (1-sided) b. 0 cells (.0%) have expected count less than 5. The minimum expected count is Odds Ratio for Ante Natal Care (Tidak Baik / Baik) For cohort = Anemia For cohort = Tidak Anemia N of Cases 95% Confidence Interval Value Lower Upper

14 Konsumsi Tablet Fe * Konsumsi Tablet Fe Tidak pernah Non-Program Program % within Konsumsi Tablet Fe % within % of % within Konsumsi Tablet Fe % within % of % within Konsumsi Tablet Fe % within % of % within Konsumsi Tablet Fe % within % of Anemia Tidak Anemia % 15.9% 100.0% 49.3% 23.3% 41.9% 35.2% 6.7% 41.9% % 32.1% 100.0% 25.3% 30.0% 26.7% 18.1% 8.6% 26.7% % 42.4% 100.0% 25.3% 46.7% 31.4% 18.1% 13.3% 31.4% Pearson Chi-Square N of Cases Value df (2-sided) a a. 0 cells (.0%) have expected count less than 5. The minimum expected count is Odds Ratio for Konsumsi Tablet Fe (Tidak pernah / Non-Program) a Value a. statistics cannot be computed. They are only computed for a 2*2 table without empty cells.

15 Lingkar Lengan Atas Ibu * Lingkar Lengan Atas Ibu Tidak Normal Normal % within Lingkar Lengan Atas Ibu % within % of % within Lingkar Lengan Atas Ibu % within % of % within Lingkar Lengan Atas Ibu % within % of Anemia Tidak Anemia % 21.4% 100.0% 29.3% 20.0% 26.7% 21.0% 5.7% 26.7% % 31.2% 100.0% 70.7% 80.0% 73.3% 50.5% 22.9% 73.3% Pearson Chi-Square Continuity Correction a Fisher's Exact Test N of Cases Value df (2-sided).955 b a. Computed only for a 2x2 table (2-sided) (1-sided) b. 0 cells (.0%) have expected count less than 5. The minimum expected count is 8.00.

16 Odds Ratio for Lingkar Lengan Atas Ibu (Tidak Normal / Normal) For cohort = Anemia For cohort = Tidak Anemia N of Cases Value Lower Upper % Confidence Interval

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