Impact Pandemic Covid-19 and Limitation Foods Pregnant Mothers Rural Papua Province of Indonesia

Background Pandemic infectious diseases cause morbidity and deaths to increase over time globally. Corona virus disease-19 (Covid-19) is an infectious disease found in China in Wuhan City, and spread very quickly to Indonesia and Papua Province. The aims of the study was to determine the impact of the covid-19 pandemic and food limitations for rural pregnant mothers in Indonesia's Papua Province. Methods A cross sectional study design, is type research to see the relationship of the impact covid-19 pandemic and food limitations for rural pregnant mothers in Papua Province. Place of research Jayapura and Jayawijaya Regencies, which represents all the Regencies of Papua Province. The population ware all pragnant mothers in Papua Province. Samples were living in rural areas Jayapura and Jayawijaya Regencies. Data analysis using the Chi-Square test (χ2). Results Covid-19 pandemic and food limitations of rural pregnant mothers in March - June 2020 in Papua Province. Food transportation was very less 33,7% and very good 26,7%. Government helps was less 25,7% and good 36,6%. Work of the head families were less 27,7% and good 24,8%. Household heads income were very less 27,7% and very good 25,7%. Limited of vitamins mineral source were very less 24,8% and very good 30,7%. Protein sources (10-15%) were less 38,6% and good 36,6%.Carbohydrates source (60-75%) less 27,7% and very good 37,6%. Fats Source (10-20%) were very less 37,6% and good 16,8%. Energy sources (2150 to 2250 kcal + 300 kcal) were less 24,8% and good 28,7%. Limitations food consumption of rural pregnant mothers were not significant with government helps, work of the head families, and the limitations mitamins mineral source.Limitations food consumption of rural pregnant mothers were significant with restrictions on food transportation, household heads income, limited of protein sources, carbohydrates, fats, and energy source. There were no restrictions on government helps, work of the head families, and limited vimtamin mineral source. Impact pancemic covid-19 were limited to foods transportation, household head income, protein sources, carbohydrates, fats and energy. Covid-19 and limited nutritional resources of pregnant mothers rural. The results showed that the limitation foods consumption of pregnant mothers was significant with protein sources (10-15%), carbohydrates (60-75%), fats (10-20), and energy source (2150 to 2250 kcal + 300 kcal). This means that nutritious food source was very important to improve the nutritional status of pregnant mothers in the pandemic covid-19. The immune system of pregnant mothers against infectious diseases and the status of the baby in the womb, very depends on the intake nutritious food trimesters 1, 2, and 3, and the health status of pregnant mothers were good.


Results and Discussion
Foods security was basically divided into three parts that were beneficial to society namely food availability, food consumption, food accessibility. Food availability is quite meaningful, the average amount and quality of food nutrition available in the community and market, sufficient the consumption needs of all households [9].
Foods were basic need for human life. Food is one of the basic needs that the body needs every day in a certain amount. Food as source of energy and human health. The amount of foods less or more consumed in a long time, can adversely affect the health status of the community [10]. Limitations of the Nutrition Sources pregnant mothers in rural Papua Province of Indonesia. Limited of vitamins mineral source was very less 24,8% and very good 30,7%. Protein source (10-15%) were less 38,6% and good 36,6%. Carbohydrates source (60-75%) less 27,7% and very good 37,6%. Fats source (10-20%) was very less 37,6% and good 16,8%. Energy source (2150 to 2250 kcal + 300 kcal) less 24,8% and good 28,7%. Health protocol in the social restrictions of the community with social distancing, physical distancing, work from home, large-scale eradication, and regional quarantine, adversely affect household food availability in Papua Province.
A person's health condition depends on the level food consumption. Level consumption was determined by the quality and quantity of nutritious food. The quality of food shows the fulfillment of all nutrients needed by the body. While the quantity indicates the amount of each nutrient to the body's needs. If the composition of food dishes, meet the needs of the body both in quality and quantity, then the body will get adequate nutrition [11].
Indonesia Law number 18 of 2012. Food security is a condition of fulfilling foods for the country to the individuals, reflected by the availability of sufficient food, both in quantity and quality, safe, diverse, nutritious, evenly distributed, and affordable and not contrary to religion, beliefs, and community culture, for a healthy, active and productive sustainable life. The description shows that food security is one of the primary human needs, which must be realized for human life [12]. Nutritional status is foods security outcome that description a person's quality of life. The number of children under five experiencing malnutrition and malnutrition is an indicator of nutrient prone. Many toddlers and pregnant mothers suffer from malnutrition and malnutrition is an indicator of nutritional vulnerability [13]. While poor nutrition is influenced by many interrelated factors. The reason is the consumption of unbalanced food and infectious diseases, inadequate food supplies and inadequate parenting, as well as sanitation/clean water, and basic health services are inadequate [14].
Based on Republic of Indonesia Government Regulation number 21 year 2020, about large-scale social restrictions, in order to accelerate the handling of corona virus disease 2019 (Covid-19). Covid-19 pandemic with number of cases and/number of deaths, has increased and expanded across regions cross country and impact on the political, economic, social, cultural, defense and security aspects, as well as the welfare of the peoples in Indonesia [15]. Explanation : 1. Consumption food of pregnant mothers rural (a. Less ≤ eat 1 time a day, b. Good = eat 2-3 times a day) 2. Significant (*** <0,001, ** <0,05. * <0,1) Relationship between covid-19 pandemic and food limitations for rural pregnant mothers in March -June 2020 Papua Province. Covid-19 pandemic caused limited community activities every day to get food. Government applies social distancing, physical distancing, work from home, quarantine areas, leaving the house using masks. This restriction has an impact on the limited availability of household food.
Foods consumption limitations of rural pregnant mothers were not significant with restrictions on government helps and the work of the head of the family. This means that at the covid-19 pandemic in Indonesia, President of the Republic Indonesia gave instructions for helps to the community, so that peoples can survive in difficult times the covid-19 pandemic. 39 Covid-19 pandemic in Papua Province, peoples in urban areas had more restricted working hours. Whereas rural communities work hours were not restricted. Results showed that the food consumption limitations of rural pregnant mothers were not significant with government helps, work of the head families, and vitamins mineral sources. This means that restrictions on rural communities in working as farmers, fishermen, unskilled laborers, the private sector are not restricted. Because covid-19 prevalence in Papua Province was higher in urban areas compared to very small in rural.
Foods consumption limitations of rural pregnant mothers were significant with restrictions on food transportation and family head income. This means with implementation of regional quarantine during the covid-19 pandemic in Papua Province, the transportation relationship between urban and rural areas was limited, in order to prevent covid-19 transmission.
In addition, the limitation food consumption of rural pregnant mothers were significant with restriction of the household's head income. This means that agricultural products, fisheries, unskilled laborers and the private sector do not work, causing family head to not had income to meet the family's living needs. Thus of the head families in rural has a limited income and it was very difficult to make ends meet.
Covid-19 and it's impact on agriculture and global food security. In the agricultural sector, employment declined from 40,2% to 26,8%. Counting 60,4% were families with low income [16]. The covid-19 pandemic, Europe's workforce has decreased drastically, as a result of job losses in hundreds thousands of seasonal workers. This happened in France, Germany, Italy, Spain and Poland. Thus, many peoples do not work, do not had income, and do not had sufficient food supplies [17].
Improving the country's food security was very important by way of community empowerment. Because the community is empowered by the government, it is very important in maintaining the food and nutrition vigilance system in the region [18].
Food-insecure families, basically having children under five are more at risk of malnutrition, whereas families that were not food insecure have children who are not malnourished. One of the problems related to the problem of public food insecurity is the worldwide covid-19 pandemic. One of the problems related to community food insecurity was worldwide covid-19 pandemic [19]. Foods availability in an area was a major factor in preventing cases of malnutrition in the community. One problem of malnutrition that needs special protection is the first 1000 days of live birth. Starting from pregnant women to children less than 2 years in regencies/Cities in Indonesia [20].
Limited of nutrition sources for rural pregnant mothers in the pandemic covid-19 Papua Province. The results showed that the foods consumption limitations of rural pregnant mothers were not significant with government helps, work of the head families, and limited of vitamins mineral sources. This means that peoples who live in rural Papua province in general, had sources food ingredients and the availability sufficient food ingredients. Thus there were no limitation foods ingredients for rural pregnant mothers, for the adequacy of nutrient intake during the covid-19 pandemic.
Foods were very important for pregnant mothers, one of the functions foods was to provide endurance and prevent infectious diseases. This is very related to family behavior and habits. Eating habits of pregnant mothers will follow the family behavior in every meal. Family behavior of providing food for pregnant mothers and toddlers were very influential on the nutritional status was more, less, and normal [21].
Nutritionally aware families play a huge role in providing nutritious food for family members. Nutrition aware families research in Yapen Islands Regency, The results show that the nutritional status of children were very dependent on the behavior of families providing nutritious food for family members. Where toddlers less nutrition is found in families who were not aware of nutrition [22]. Impact pandemic covid-19 and limited nutritional resources of rural pregnant mothers in Papua Province. The food consumption limitations of rural pregnant mothers were significant with restrictions food transportation and families head income. This means that pregnant mothers living in rural Papua Province, in the pandemic covid-19 caused the government to restrict transportation and employment, so that the head family works as unskilled laborers, the private sector, farmers and fishermen do not had income. Thus the needs of pregnant mothers were not fulfilled during the covid-19 pandemic in Papua Province.
Pandemic Covid-19 and limited nutritional resources of pregnant mothers rural. The results showed that the limitation foods consumption of pregnant mothers was significant with protein sources (10-15%), carbohydrates (60-75%), fats (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20), and energy source (2150 to 2250 kcal + 300 kcal). This means that nutritious food source was very important to improve the nutritional status of pregnant mothers in the pandemic covid-19. The immune system of pregnant mothers against infectious diseases and the status of the baby in the womb, very depends on the intake nutritious food trimesters 1, 2, and 3, and the health status of pregnant mothers were good.
Changes in the nutritional status of the community, is one of the important behavioral changes, in utilizing food, according to the social outlook of the community. Thus the growth and development of nutritional status in pregnant women, breastfeeding mothers, and toddlers are closely related to the community's view, provide nutritious food for theirs family [23]. Cultural knowledge in social relations greatly influences the degree of public health. This relates to how to provide food for the family, and ways to prevent infectious diseases in public Food Science and Quality Management www.iiste.org ISSN 2224-6088 (Paper) ISSN 2225-0557 (Online) Vol.100, 2020 culture [24].
Pathogenesis of malnutrition consists of 5 stages. First, the inadequacy of nutrients lasts for a long time. Second, the nutrient reserves in the tissues are used to meet inadequacy. This situation lasts a long time, will be a deterioration of tissue, which was characterized by weight loss. Third, there was biochemical change that can be detected by laboratory examination. The fourth was occurrence of changes in bodily functions in the presence of distinctive signs. The fifth is the occurrence of anatomic changes, which can be seen from the appearance of classical signs, so that it has an impact on malnutrition [25].
Nutritional status of pregnant women and children under five is very important in building quality Human Resources in the countries of the world. Nowadays, developing countries, especially Asia and Africa, public health nutrition issues that fear stunting children, is the main problem that causes low human resources. so that the government prepares more collaborative or cross-sectoral programs that can reduce stunting [26].
Covid-19 in Papua Province increased from March to June 2020. Causing decreased food security in Papua Province Regency/City. In addition there are limited differences in food supply between urban and rural areas. Thus the covid-19 pandemic caused an economic crisis and food security was greatly felt in urban communities.
Covid-19 has a big influence globally. Much damage to the economies of the world countries. So many people do not work, do not have money, it is difficult to get food, and state income falls. Covid-19 is one of the diseases that kills the world economy, causing unemployment to rise, people losing jobs, and poverty is increasing widely throughout the world. Thus covid-19 caused an economic recession to increase from December 2019 to June 2020 as a whole in the world, including peoples in Papua Province.
High risk groups, the community must get good protection by the Government of the Papua Province. One of the nutrition-prone groups, in the co-19 pandemic in Papua Province is the group of pregnant women, breastfeeding mothers, and toddlers. This group needs special negotiations from the Provincial Government of Papua, so that this group is protected from poor nutrition and malnutrition. Regencies/City Region in Papua Province is a threat of poor nutrition and malnutrition, due to the covid-19 pandemic.
Thus the role of nutrition workers in the community health center, and the Regencies/City Health Office of the Papua Province, many needed support in community nutrition surveillance. To find out the poor nutrition of mothers and childrens in the community, and preventive action early. If not found early, can be an iceberg phenomenon that causes the prevalence of Less Chronic Energy. and Low Birth Weight (LBW) increased in Papua Province. Thus the First 1000 Days of Life or Window off Oppotunity will fail, and cannot be fixed in the future, and is permanent(irreversible).
Suggestions to the Government of the Papua Province are every pregnant woman, breastfeeding mother, and child under five. Minimum of every meal 2 times and a maximum of 3 meals. Do not pregnant women, breastfeeding mothers and toddlers eat 1 time a day or do not eat in one day. This can cause the nutritional status of pregnant women, breastfeeding mothers, and children under five worsening from day to day in Papua Province.
Food should be pregnant women, breastfeeding mothers, and toddlers containing enough 3 substances, namely (1) energy substances: sago, taro, banana, cassava and others), (2) Builders: freshwater fish, sea water fish and chicken eggs, (3) regulating substances: cooked papaya, watermelon, star fruit, mango, cooked banana, spinach, mustard greens, vegetable wax, papaya leaves, kale, cabbage, carrots and others. In order for adequate intake of nutrients in pregnant women, breastfeeding mothers, and toddlers in Papua Province can achieve normal nutritional status.
Nutritious food is a priority for pregnant women. Consumption of foods low in nutrients, adversely affects anemia in pregnant women. The resulting output is babies born with low birth weight (<2500 grams). Thus, pregnant women who give birth to low birth weight children, have low quality human resources. In addition, children born with low body weight <2500 grams, have poor development [27].
Based on the basic issues of the theory human development, that nutritious food is very influential on increasing human resources. Peoples who have good intelligence were born to mothers who have normal nutritional status. This is a measure in increasing the human resources of countries in the world. Thus the normal nutritional status of pregnant women, breastfeeding mothers, infants and toddlers becomes an important part in the quality of life of the nation [28].
nutrition is a process of organisms using food that is consumed normally through the process of digestion, absorption, transportation, storage, metabolism, and removal of substances that are not used. Nutritional functions are sourced from food to maintain life, growth, and normal functions of the body's organs, and produce energy. Nutritional state is a result of the balance between consumption and absorption of nutrients and use of nutrients. While malnutrition is a pathological condition due to deficiency or excess, both relative and absolute nutrition [29].
Food and Agriculture Organization (FAO), reported that between 2010 -2012, there were almost 900 million peoples or as many as 12,5% of the total world population experiencing malnutrition. This problem is high in middle and low income countries. Most malnutrition occurs in women and childrens [30]. Under the nutritional food supplementation program for pregnant women and children under five in the United States, the results show that nutritional food supplementation in pregnant women and children under five even though it has not reached Food Science and Quality Management www.iiste.org ISSN 2224-6088 (Paper) ISSN 2225-0557 (Online) Vol.100, 2020