The Indonesian government has been fighting against stunting, which is characterized by growth failure in children under the age of two due to long periods of malnutrition, for decades.
The prolonged fight has been crucial for the fate of the nation because stunting poses a long-term danger for the future of children as it hinders brain development, causes mental degradation, and reduces studying capability.
Other impacts of stunting on children include a decline in cognitive capability, suboptimal body posture during adulthood, and increased risk of chronic disease with age such as diabetes, hypertension, and obesity, Professor Rini Sekartini from the University of Indonesia's Faculty of Medicine noted during a webinar on stunting recently.
Stunting eradication efforts have involved various ministries, institutions, and relevant stakeholders. The fight, however, has been disrupted by the COVID-19 pandemic over the past two years.
"COVID-19 has a big contribution in delaying stunting eradication. Several regions such as East Nusa Tenggara (NTT) have experienced a drastic increase in stunting cases," Coordinating Minister for Human Development and Culture, Muhadjir Effendy, said while accompanying President Joko Widodo (Jokowi) to a visit to NTT province on March 24, 2022.
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Data from the 2021 Indonesia’s Nutrition Status Study (SSGI) place 15 districts in NTT in red status, with the stunting prevalence rate of more than 30 percent.
The districts comprise South Central Timor, North Central Timor, Alor, Southwest Sumba, East Manggarai, Kupang, Rote Ndao, Belu, West Manggarai, West Sumba, Central Sumba, Sabu Raijua, Manggarai, Lembata, and Malaka.
Five of these districts are in the top 10 regions with the highest stunting prevalence in Indonesia out of 246 districts or cities in 12 provinces that are being prioritized for accelerating stunting reduction.
Of the 12 prioritized provinces, 7 provinces have recorded the highest rate of stunting in the country: East Nusa Tenggara (37.8 percent), West Sulawesi (33.8 percent), Aceh (33.2 percent), West Nusa Tenggara (31.4 percent), Southeast Sulawesi (30 percent), West Kalimantan (29.8 percent), and Central Sulawesi (29.7 percent).
Hence, Effendy said that his ministry and BKKBN have been carrying out the mandate of President Widodo to conduct interventions for families who are at risk of having stunted children, either through the provision of nutritious food, improvement of clean water and sanitation, as well as health monitoring, especially for prospective brides and grooms.
Widodo’s visit to Kesetnana village, South Mollo sub-district, South Central Timor district, NTT, demonstrated that NTT is a priority province for stunting handling, as it had the highest prevalence of 37.8 percent in 2021 in the country. Nationally, the prevalence rate is pegged at 24.4 percent, according to the head of BKKBN (National Family Planning Agency), Hasto Wardoyo.
The stunting prevalence in Kesetnana village is 48.3 percent, based on data from the 2021 Indonesian Nutritional Status Study (SSGI).
Kesetnana’s residents have poor access to clean water and healthcare facilities, do not have proper toilet facilities, and are now aware of the importance of health education. Other factors that have triggered high stunting prevalence in the area include a high poverty rate, low education level, and poor parenting knowledge.
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While reviewing stunting handling in NTT, President Widodo drew attention to the fact that uninhabitable houses have become one of the factors causing stunting.
"From my direct visit today, we know that on average, people suffering from stunting usually live in uninhabitable houses," Widodo told ANTARA in South Central Timor.
In addition to the problem of uninhabitable houses, he highlighted the importance of nutritional intervention in children to reduce the stunting rate.
He urged the central government, local governments, and the community to work together to reduce stunting prevalence to reach the national target of 14 percent by 2024.
"Without the integrated work of the district/city government, city government, central government, and the entire community, I think it will be very difficult to achieve the targets we have set," Widodo remarked.
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Collaboration with universities
In the meantime, BKKBN is planning to work with 340 universities in Indonesia to carry out several programs to accelerate efforts to reduce childhood stunting in the country.
One of the programs that will be implemented this year will be a Kedaireka fund-matching program, deputy for population control at BKKBN, Dwi Listyawardani, said.
The program is to be carried out with the cooperation of the Directorate General of Higher Education (Dikti) at the Ministry of Education, Culture, Research, and Technology (Kemendikbudristek).
"It is hoped that more than 340 universities in Indonesia can get funding from Dikti to support the acceleration of stunting reduction," Listyawardani said.
BKKBN has proposed a minimum budget of Rp110 billion for the fund-matching program, she added.
The agency is planning to assist as many as 318 districts and cities in the country through the program in 2022, she disclosed.
University students will go to ten priority villages in each region under the compulsory community work (KKN) and the freedom to learn and independent campus (MBKM) programs, she added.
"This is a very real form of thinking. Each party is carrying out its duties and functions by using its own funding source, but running in synergy," she remarked.
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Meanwhile, as many as 3,355 ultrasound (USG) devices will be distributed to community health centers (Puskesmas) to avoid stunting in babies during pregnancy, according to Health Minister Budi Gunadi Sadikin.
"Hopefully, we would be able to catch up in 2022. We plan to distribute 3,355 USG devices to all Puskesmas," Sadikin informed at the kick-off of the Stunting Cases Audit.
The 3,355 USG devices will be provided in Puskesmas to help health workers monitor fetuses with body weight below average, he said.
He further said his ministry will also cooperate with BKKBN to conduct a campaign for reminding pregnant women to always get their condition checked by health workers.
Monitoring of stunting before birth will also be continued by distributing at least 90 blood-supplement tablets to pregnant women to prevent anemia, and digital monitoring of tablet consumption will be conducted digitally.
Additional food will also be provided to a target of 847,351 pregnant women, who suffer from chronic energy deficiency (KEK). The food will contain animal proteins, such as eggs, fish, meat, and milk, for daily consumption.
"We will hold discussions with the Ministry of Home Affairs, Ministry of Villages, Development of Disadvantaged Regions, and Transmigration, and Ministry of Social Affairs to support animal protein intake for our middle-lower class people," Sadikin said.
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