IMPACT PANDEMIC COVID-19 AND LIMITATION FOODS PREGNANT MOTHERS URBAN 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. Conclusion: 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. Keywords : Impact pandemic  covid-19,  and limited foods pregnant mothers DOI: 10.7176/FSQM/100-06 Publication date:August 31st 2020

Limitation of vitamins mineral source were very less 26,7% and very good 35,6%. Protein source (10-15%) less 37,8% and very good 17,8%. carbohydrates source(60-75%) less 35,6% and good 22,2%. Fats source(10-20%) were very less 31,1% and good 26,7%. Energy sources (2150 to 2250 kcal + 300 kcal) were very less 24,4% and very good 26,7%. The government made health protocol in social restrictions on the community by social distancing, physical distancing, work from home, large-scale extermination, and regional quarantine, adversely affects the availability of household food 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 urban (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 pandemic covid-19 and food limitations for urban pregnant mothers in March -June 2020 Papua Province. Pandemic Covid-19 causes peoples to do activities every day to get limited food. The 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. But with the transportation foods and government helps to urban communities, it was very helpful for peoples who were not civil servants, to get food.
Covid-19 and its 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]. Results of the study limited the socioeconomic status of urban pregnant mothers in Papua Province. Results showed no significant limitation food consumption for pregnant mothers with the government help of the urban pregnant mothers. This means that underprivileged families who were not civil servants, and do not had fixed income, receive government helps. Thus there is no limitation of the government in helping the community in the pandemic covid-19 in Papua Province.
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].
Food consumption limitations of urban pregnant mothers were significant with restrictions on foods transportation, work of the head families, and families head income in the pandemic covid-19 Papua Province. Where urban community activities are restricted in trading, unskilled laborers, the private sector and motorcycle taxis. Thus the community their not have enough income to buy foods. In addition to this limited income, the impact on food consumption of pregnant women is less than 2 times a day.
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].
Impact pandemic covid-19 and limited nutrition sources for urban pregnant mothers in Papua Province. Limitations foods consumption of pregnant mothers Significant with limited vitamins mineral source, protein sources (10-15%), carbohydrate sources (60-75%), fats sources (10-20%), and energy sources (2150 to 2250 kcal + 300 kcal). In addition, mothers who live in urban only consume less than 2 times a day. This was found in the head families who had a non-permanent job. Such as trading, unskilled laborers, private sector, and motorcycle taxi of urban Papua Province. Thus the head families who does not had permanent job in Papua Province, pregnant mothers were limited in nutrient intake. Whereas the head family has a permanent job such as civil servant, consumption of pregnant mothers were still sufficient, because their had fixed income every month.
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].
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 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 100%, but only by 20% -40%, but can reduce the prevalence of malnutrition children from 1976 -1980 [31].
Poor nutrition when pregnant women and malnutrition when children aged 0-24 months, can not be corrected if the child has become an adult [32]. The results of the study (Aryastami, 2015), that the role of maternal nutrition is very important for the health status of the baby [33]. Whereas Marotz (2012) states that early growth and development of infants can be stunted, because the baby receives essential nutrients is very little compared to what should be needed [34].
Malnutrition is still a special concern, and its handling is step by step, and sustainability by the government, so that children in Indonesia can grow up healthy to be the nation's golden generation that is free from chronic nutritional disorders (stunting). Collaboration with other sectors, is one of the strategies to realize the highest changes for the quality of a healthy, prosperous and independent life, for all Indonesian peoples in the future [35].

Conclusion:-
Pandemic covid 19 March-June 2020 in Regencies/City of Papua Province. Impact pandemic of limited food consumption in urban pregnant mothers were not significant with the government helps.