Five ways Indonesia is tackling under-nutrition in children

Faced with global crises and rising food prices people on low incomes are reducing or skipping meals.

As the problem grows, it’s likely many will suffer deficiencies in macronutrients, including energy and protein. For countries with a young population like Indonesia, the flow-on effects could deliver a heavy burden.

Children are one of the most vulnerable groups; malnutrition poses a significant threat to their growth size, intellectual ability, economic productivity, reproductive performance, and sometimes survival.

The irreversible educational and economic losses this could cause are motivating leaders to come up with better strategies and monitoring systems.

While there are several types of undernutrition found in Indonesia, the government has targeted a reduction of stunting – low height for age – to 14 percent by 2024.The city of Surakarta wants to go further with the ambition of reducing stunting to 0 percent in 2024.

Women are likely to play a key role in Surakarta’s pilot programme. There are several risk factors in antenatal care that can affect the incidence of stunting in children, including the age of pregnant women, anemia and depression during pregnancy, nutritional status of pregnant women and health literacy.

The government and health department also have an important role in orchestrating the program which extends to planning, financing, logistics and condition monitoring of toddler nutrition.

To pursue its goal of eliminating stunting, Surakarta is focusing efforts in five areas.

First, it plans to raise awareness and knowledge about stunting, seeking to change people’s behavior by encouraging stunting prevention efforts. It’s doing this through health facilities and health workers who can provide accurate information regarding stunting.

Second, Indonesia’s Ministry of Health is monitoring the development of the fetus during pregnancy at the household level. If pregnancy problems occur, appropriate early action can then be taken.

During pregnancy, many mothers in Indonesia are unaware or unable to access adequate nutrition due to poor education or poor access. Also, for families with a poor education level, dealing with administrative procedures can sometimes be intimidating and take too much work. Personal assistance from health cadres could help expectant women access healthcare facilities (e.g. Posyandu – integrated health care and Puskesmas – public health center).

Third, Surakarta has a focus on adequate pregnancy nutrition. This can be aided by Indonesia’s Pemberian Makanan Tambahan (PMT) Program to help optimise a child’s development process. The PMT program distributes several nutritious foods, such as fish, milk, yogurt, nuts, fruit and vegetables. To prove effective, the availability and distribution of the PMT programme must be stable both in terms of quality and quantity.

Fourth, it is encouraging exclusive breastfeeding. The high nutritional content of breast milk can prevent babies from developing various diseases and can help support the baby’s brain and physical development. Health workers actively provide education about nutrition and support mothers with breastfeeding including by monitoring the nutritional adequacy rate.

Fifth, it’s promoting a clean and healthy lifestyle. Stunting can also be caused by poor environmental conditions so efforts from parents and family members to always maintain hand cleanliness by washing with soap, before touching food and after eating can help.

Reducing the prevalence of undernutrition is not only the responsibility of the mother, but the whole community. Addressing the problem has the potential to influence the physical and intellectual quality of a generation.

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* Valid Hasyimi is pursuing his PhD (Cand) in School of Business Management in Bandung Institute of Technology (ITB) Indonesia.

* Dr. Agung Hendriadi is a former Head of National Food Security Agency. Currently, he is a senior researcher at Agroindustry Research Center in National Research and Innovation Agency (BRIN), Indonesia.

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