Stunted growth in children is a major problem in Indonesia. Valid Hasyimi and Utomo Sarjono Putro of the Bandung Institute of Technology and Agung Hendriadi of the National Research and Innovation Agency in Indonesia look at one municipality that aims to eliminate the problem in 2024.
Surakarta schoolchildren: Women are playing a key role in the city's pilot program to counter stunted growth (Credit: DonniYudhaPerkasa / Shutterstock.com)
Faced with global crises and rising food prices, people on low incomes are reducing or skipping meals. As the problem grows, it is likely that many will suffer deficiencies in macronutrients, including energy and protein. For countries with a young population such as Indonesia, the flow-on effects could deliver a heavy burden.
Children are one of the most vulnerable groups, with malnutrition posing 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 a child’s age – to 14 percent by 2024.The city of Surakarta on the island of Java wants to go further. Its ambition is to reduce stunting to zero by 2024.
Women are playing a key role in Surakarta’s pilot program. 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 city government, particularly the health department, also has an important role in orchestrating its 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 is 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 time and effort. Personal assistance from health cadres could help expectant women access healthcare facilities (e.g., Posyandu – integrated healthcare – and Puskesmas – public health centers).
Third, Surakarta has a focus on adequate pregnancy nutrition. This can be aided by Indonesia’s Pemberian Makanan Tambahan (PMT) program to help optimize a child’s development process. The PMT initiative distributes several nutritious foods such as fish, milk, yogurt, nuts, fruit and vegetables. To prove effective, availability and distribution of the foods must be stable both in terms of quality and quantity.
Fourth, Surakarta 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, the city is 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 – especially as food insecurity has risen due to the pandemic, global food-supply stress, rising prices and climate change – has the potential to influence the physical and intellectual quality of a generation.
This article is published under Creative Commons with 360info.
Mutunga, Mueni. (September 15, 2022) “Wasting in the East Asia and Pacific region: Preventing, identifying and treating acute malnutrition”, UNICEF East Asia and Pacific, Bangkok, Thailand.
World Food Programme (WFP). (January 2023) “The Global Food Crisis: Impact on the Asia Pacific Region”, WFP, Rome, Italy.
World Health Organization (WHO). (2018) “Reducing Stunting in Children: Equity considerations for achieving the Global Nutrition Targets 2025”, WHO, Geneva, Switzerland.
Bandung Institute of Technology (ITB)
Utomo Sarjono Putro
Bandung Institute of Technology (ITB)
National Research and Innovation Agency (BRIN)