THE INFLUENCE OF HEALTH EDUCATION USING VIDEO MEDIA ON THE KNOWLEDGE AND SKILLS OF PUBLIC WOMEN REGARDING CORRECT BREASTFEEDING TECHNIQUES AT PMB MURNIYATI

ABSTRACT


INTRODUCTION :
Breastfeeding is a natural process, but in many cases mothers cannot breastfeed properly and need help to make the breastfeeding process successful.In World Breastfeeding Week activities organized by UNICEF and WHO, data obtained from Basic Health Research (RISKESDAS 2021), there were 52.5% or only half of the 2.3 milion infants under the age og six months are reportedly exclusively breastfed in Indonesia, this means a decrease of around 12% from 2019.The figure for Early Initiation Of Breastfeeding (IMD) additionally dropped to 48.6% in 2021, which was previously 58.2% in 2019 (Dinkes, 2021).
In KEPMENKES 320, 2020 concerning Professional Standards for Midwives which is explained in CHAPTER IV with a List of Topics, Problems and Skills, it is explained that medical professionals provide care to postpartum mothers in the form of clinical skills in midwifery practice regarding early initiation of breastfeeding, and quality breastfeeding processes and techniques.proper breastfeeding (Kementerian kesehatan, 2020) The breastfeeding process often fails because a problem arises either with the mother or with the baby itself.This problem that is often encountered or often occurs is due to the baby being in the wrong position when breastfeeding or errors in the way he breastfeeds.Usually this happens because the baby can only suck on the nipple and most of the areola does not enter the baby's mouth.Correct breastfeeding technique is important to start the breastfeeding process for the baby.Because mothers do not understand and are not skilled in correct breastfeeding techniques, for example how to latch on and how to remove the nipple after the baby has finished breastfeeding, it can cause the nipples to feel sore (Endah Artati, 2023).
Breastfeeding knowledge and skills relate to a mother's ability to nurse her baby with breast milk in the correct position.Correct breastfeeding technique has a significant part in overcoming this problem and in making the exclusive breastfeeding program a success.So it is very necessary to provide health education regarding correct breastfeeding techniques which aims to increase the postpartum mothers abilities and competence in breastfeeding.This effort can be provided by providing education and guidance to postpartum mothers regarding correct breastfeeding techniques (Sari Dewi, Mutoharoh and Rahmadhani, 2021).
The dissemination of health education through the media information can have a significant influence on the absorption of information.Providing health education media is used to help the audience understand the health education being delivered (Sari Dewi, Mutoharoh and Rahmadhani, 2021).The provision of health education through video about correct breastfeeding techniques can have a big influence on the absorption of information.Using

Journal of Advanced Nursing and Health Sciences
Vol . 5, No. 1, Februari 2024, pp. 20~30 ISSN: 2774-5821.video media can involve all learning senses, as the greater the degree of sense, the simpler it is to absorb and process information which allows health education to be understood and stored in memory (Supliyani et al., 2021).
According to the findings of an initial investigation at the Murniyati Independent Midwife Practice (PMB) which carried out a preliminary study on 17-20 October 2023, the results of interviews with 8 postpartum mothers aged 0-40 days.From the interviews that were conducted, it was found that 6 out of 8 postpartum mothers aged 0-40 days did not understand correct breastfeeding techniques and did not know what impacts could occur if breastfeeding techniques were incorrect, so the author was very interested in conducting health education about appropriate breastfeeding techniques.true for postpartum mothers.
Seeing this phenomenon, researchers were interested in researching the consequences of video based health education on postpartum mothers knowledge and abilities at PMB Murniyati.

METHOD :
Pre-experimental research with a single group pretest-posttest research design is this kind of study; it uses a research design that only uses one group of subjects and carries out assessments before (pretest) and after (posttest) giving treatment to the subjects (Hilamuhu et al., 2023).

Respondent Characteristics
The description of based on their age, education, occupation, and parity, the research participants' characteristics are outlined..

Picture of Knowledge
The degree of expertise of breastfeeding mothers.The accompanying table compares the appropriate breastfeeding approaches before and after receiving health education through video media:  4.2 shows that before being given health education on correct breastfeeding techniques using video media, the majority of those surveyed knew quite a bit, namely 17 people (56.67%) and a sufficient level of knowledge, 13 people (43.33%).4.5, it can be seen that after being given health education using video media, the majority of respondents experienced an increase in their breastfeeding skills.most recent mothers are proficient in their field, namely 29 respondents (96.66%) and a sufficient level of skill is 1 respondent (3.34%).Considering the outcomes of Wilcoxon calculations, the z value was -4.805 with a pvalue of 0.00 which is less than 0.05 so that Ha is accepted.The knowledge of postpartum moms differs before and after they get health education through video media, it can be concluded.

The Impact of Postpartum Mothers' Skills on Correct Breastfeeding Techniques through Video Media Health Education
Considering the outcomes of Wilcoxon calculations, the z value was -4.786 with a pvalue of 0.00 which is less than 0.05 so that Ha is accepted.The competence level of postpartum moms differed before and after they received health education through video media, it can be determined.

DISCUSSION
The research results show the age characteristics of postpartum mothers.The research results show that the most common age characteristics of respondents are in the 21-35 year age category with 26 respondents (86.67%).Ages 21-35 years are included in women of reproductive age (women of childbearing age) according to the National Population and Family Planning Board that fertile women are women aged 15-49 years, at this age women have a great opportunity to get pregnant (Prasetya, 2022).
Based on the educational characteristics of postpartum mothers, the study's findings indicated that most of postpartum mothers had education at the high school level, 19 respondents (63.33%).A person's education will greatly influence the abilities and knowledge they have.The more information you get, the better your abilities will be, especially behavior regarding breastfeeding.Mothers who are breastfeeding have a need to maintain the health of themselves and their babies, so that they can breastfeed their babies with good and correct techniques (Pasiak, Pinontoan and Rompas, 2019).
Job characteristics: The study's findings show that the job characteristics of most respondents are in the private sector employee category, with 14 respondents (46.66%).The employment status reveals that the vast majority of responders are employed by private companies.. Working mothers have less free time than non-working mothers (housewives).Working long hours prevents moms from having adequate time to breastfeed and learn how to breastfeed or how to breastfeed properly.This research is comparable to the results of research by Pasiak, et al (2019) which states that ineffective breastfeeding processes are more common in working mothers.This can be caused by insufficient information and therefore knowledge about breastfeeding techniques is also lacking.

Parity characteristics:
The results of this study showed that the parity characteristics of mothers were mostly multiparous mothers, totaling 16 respondents (53.34%).Good and correct breastfeeding techniques were found in the group of multiparous mothers, this could be influenced by having previously breastfed.This is consistent with studies carried out by (Pasiak, Pinontoan and Rompas, 2019) which states that a mother who already has experience in breastfeeding influences breastfeeding success, because previous experience can be a reflection of current breastfeeding.
The results of this study show that postpartum mothers have different levels of knowledge and skill levels which are caused by the characteristics of postpartum mothers.This is influenced by several factors such as the age of the postpartum mother, education, employment and previous breastfeeding experience.
According to (Aeni and Yuhandini, 2018) Knowledge is the outcome of human senses, such as the eyes, nose, hearing, and so forth.In observations made before the intervention, the majority of respondents with good knowledge were 17 people (56.67%), and the minority of respondents with sufficient knowledge was 13 people (43.33%).After being given health education, the majority of participants reported having more knowledge.In observations made after the intervention, the number of respondents with a good level of knowledge was 30 people (100%), there were no respondents with a sufficient level of knowledge, and there were no respondents with a poor level of knowledge.
According to studies carried out by (Hindiarti and Khofifah, 2021)  This is proven by research results which show that the majority of respondents have poor knowledge regarding correct breastfeeding techniques, this is due to mothers' lack of understanding about the importance of breastfeeding babies properly, apart from that, the majority of postpartum mothers have poor knowledge regarding appropriate breastfeeding techniques.
The majority of respondents' postpartum mothers' skills have a sufficient skill level, 27 respondents (90%), and 1 respondent (10%) has a poor skill level.According to Notoatmodjo, S (2010), quoted from research by Aprilia (2021), explains that an attitude is not automatically realized in an action or it can be said that a person's skills are the same as behavior.
After being given health education on correct breastfeeding techniques using video media, the research results showed that the majority of respondents' skills following receiving health instruction, had improved.There were 29 respondents (96.66%) with a good skill level and 1 (3.34%) with a sufficient skill level.
In accordance with research that has been conducted (Supliyani et al., 2021) with the title The Effectiveness of Video Tutorial Media for Exclusive Breastfeeding Management on Mothers' Breastfeeding Skills, the research results showed an increase in the average skills of postpartum mothers after being given health education on correct breastfeeding techniques using video tutorial media on how to breastfeed correctly, how to express breast milk and how to store breast milk.
The Wilcoxon test findings with an error rate of 5%, the p-value significance value is 0.000, after which Ha is approved and Ho is denied, indicating that the use of audiovisual media in health education has an impact about correct breastfeeding techniques on the knowledge of postpartum mothers.
According to research (Hindiarti and Khofifah, 2021) health education can have an influence on knowledge of correct breastfeeding techniques and the impact of increasing this knowledge can improve breastfeeding skills for the better.
Based on the research results, it shows that postpartum mothers' knowledge about breastfeeding techniques has increased after being given health education using video media.
From the data obtained from research before being given health education, the majority of respondents had a good level of knowledge, 17 respondents (56.67%), 13 respondents (43.33%) had a fair level of knowledge.Those with a decent degree of education showed an improvement in knowledge after receiving health education, as many as 30 respondents (100%).
The results of the Wilcoxon test with an error rate of 5%, the p-value significance value is 0.000, then Ha is accepted and Ho is rejected, so it can be concluded that there is an influence of health education using video media about correct breastfeeding techniques on the skills of postpartum mothers.This is in line with research conducted by (Endah Artati, 2023), the test results showed that there was an increase in the breastfeeding skill scores of respondents before being given the intervention, the majority of breastfeeding techniques were poor (78.3%) and the breastfeeding skills of respondents after being given the intervention had increased, namely good breastfeeding techniques.(95.7%).In data analysis, significant results were obtained with a Sig (2-tailed) value of 0.000 < 0.05.Health education is a series of experiences that influence an individual's attitudes and knowledge related to healthy living at the individual, community and racial levels (Amalia and Susanti, 2020).
The use of media in health education can have a big influence on the absorption of the information conveyed.Health education media is used to help audiences receive information provided using their five senses.The more senses are used, the better the reception of the learning material.Types of media that involve several senses include film or video screenings (Sari Dewi, Mutoharoh and Rahmadhani, 2021).The research's data analysis results indicate that there was an increase in breastfeeding practices both before and after receiving health education through video medium.the breastfeeding skills of postpartum mothers.It is known that before being given health education, the majority of postpartum mothers' skill level was at a sufficient skill level with 27 respondents (90%) and a poor skill level with 3 respondents (10%), whereas after being given health education the respondent's skill level increased, namely good skill level with the number of 29 respondents (96.66%) and the skill level was sufficient with 1 respondent (3.34%).

CONCLUSION
Based on the research results and discussions explained in the previous chapter, several things can be concluded from this research as follows: 5.1 The majority of respondents in this study were aged 21-35 years with a total of 26 respondents (86.67%), while the smallest number of respondents was aged < 21 with a total of 1 respondent (3.33%).The majority of respondents had a high school education with a total of 19 respondents (63.33%), while the lowest level of education was junior high school with 2 respondents (6.67%).The majority of respondents' jobs are private employees with 14 respondents (46.66%) and at least 4 respondents as civil servants (13.34%).The majority of parity respondents were multipara with 16 respondents (53.34%), while the fewest were primipara with 14 respondents (46.66%).
5.2 The level of knowledge before being given health education interventions, namely the majority of respondents had a good level of knowledge, 17 respondents (56.67%), and those with a sufficient level of knowledge were 13 respondents (43.33%).The skill level before being given the health education intervention was that the majority of respondents had a sufficient skill level, 27 respondents (90%), and 3 respondents (10%) had a poor skill level.
5.3 Level of knowledge after being given health education intervention, namely the majority of respondents had a good level of knowledge, 30 respondents (100%).The skill level after being given the health education intervention was that the majority of respondents had a good skill level, 29 respondents (96.66%), and 1 respondent (3.34%) had a fair skill level.Practice Murniyati with a P-value of 0.000 (p<0.05).5.5 There is an influence of health education on correct breastfeeding techniques on the skills of postpartum mothers at Independent Midwifery Practice Murniyati with a P-value of 0.000 (p<0.05).
with the title The Relationship between Mothers' Knowledge of Appropriate Breastfeeding Techniques and Health Education via Android-Based Video Media in the Cigayam Health Center Work Area in 2020: The findings of this study indicate a connection between postpartum mothers' increasing knowledge of proper breastfeeding techniques and health education via Androidbased video media.

5. 4
There is an influence of health education on correct breastfeeding techniques on the knowledge of postpartum mothers at 8403 Colesville Road, Suite 1550, Silver Spring, MD 20910-6374 240.485.1800fax: 240.485.1818www.midwife.orgIndependent Midwifery The job category is dominated by mothers who work as private employees, namely 14 respondents (46.66%).And the parity category was dominated by 16 multiparous mothers (53.34%).

Table 4 .
2 Frequency Distribution of Knowledge Levels of Postpartum Mothers Before Being Given Health Education on Correct Breastfeeding Techniques Using Video Media

Table 4 .
3 Distribution of Knowledge Levels at Frequencies of Postpartum Mothers AfterBeing Given Health Education on Correct Breastfeeding Techniques Using Video Media Based on table 4.3, it can be seen that after being given health education on correct breastfeeding techniques using video media, postpartum moms today possess a higher It is evident that prior to receiving health instruction on appropriate breastfeeding techniques using video media, most of the participants have an adequate degree of expertise., namely 27 respondents (90%).

Table 4
, the outcomes of the data normality test with the Sapiro-Wilk test showed results with a p-value <0.05, hence it may be said that the research's data is not regularly distributed.So the researchers carried out the Wilcoxon test.

Table 4
, the results of the data normality test using the Sapiro-Wilk test showed results with a p-value <0.05, so it can be concluded that the data used in this research is not normally distributed.So the researchers carried out the Wilcoxon test.