Jakarta, Aug 25, 2021 - Indonesia's children are its future and its most valuable asset. In fact, the present condition of children under the age of five is a reflection of Indonesia’s future.
Therefore, the government is eager to make sure that the younger generation grows healthy and becomes a golden generation by prioritizing and accelerating a drastic reduction in stunting rate among Indonesian children.
The national stunting rate, recorded at 37 percent in 2013, declined to 30.8 percent in 2018, and 27.6 percent in 2019. Currently, the stunting rate is around 27.7 percent. The government has set a target of reducing the stunting rate to 14 percent by 2024.
Four Indonesian districts have continued to report a very high number of cases of stunting, a growth disorder caused by chronic malnutrition in children — Jeneponto (41.3 percent) and Bantaeng districts (21 percent) of South Sulawesi, Minahasa district (38.6 percent) of North Sulawesi, and South Nias district (57 percent) of North Sumatra.
However, the government has been facing a huge challenge in the implementation of the stunting reduction program owing to the COVID-19 pandemic that started in early 2020.
"The COVID-19 pandemic has posed a challenge in reducing the stunting rates. Achievements from the last seven years must be maintained to achieve the 14-percent target by the end of 2024," Vice President Ma'ruf Amin noted at the virtual National Coordination Meeting on stunting prevention on August 23, 2021.
The government is determined that despite the ongoing COVID-19 pandemic, the stunting reduction program continues and is expedited, and has asked all regional heads to assess all work programs, activities, and local government budgets.
Earlier, the National Population and Family Planning Board (BKKBN), which has been tasked to coordinate the implementation of the stunting prevention program, confirmed that the COVID-19 pandemic has contributed to the increase in the prevalence of stunting.
"It is a reality we cannot deny; the study of 118 low- and middle-income countries has shown a decrease in gross national incomes. This has been associated with the magnitude of the prevalence of stunting," BKKBN chief Hasto Wardoyo remarked recently.
Economic problems caused by the pandemic have gradually slowed down people's purchasing power and the staple nutrient intake of families.
The pandemic has even disrupted harmony in families. In a survey conducted by BKKBN of 20,400 childbearing-age couples, 2.5 percent said they were under pressure. The survey also reported scuffles between husbands and wives.
In addition, the number of child marriage dispensations tripled in Indonesia in 2020 compared to the previous year, according to the Ministry of Women's Empowerment and Child Protection (PPPA). The number of child marriages in 2020 increased to 63,383, compared to 23,145 in 2019 .
BKKBN has outlined three program strategies to accelerate the reduction of stunting in Indonesia.
The first program, the National Action Plan for the Acceleration of Stunting Reduction (Ran Pasti), aims to sharpen all forms of intervention activities at the upstream level to prioritize the prevention of stunting.
The second program is an incubation program called Critical Success Factor, which seeks to ensure that families are able to prepare for family life.
And the third program aims to develop an accurate information data collection system, surveillance assistance for families at risk of stunting, and conduct an auditing of stunting cases.
Intensive interventions
President Joko Widodo has issued Presidential Regulation No. 72 of 2021 concerning the acceleration of the Stunting Reduction Program.
His administration has allocated Rp255.3 trillion, or 9.4 percent of the total planned state expenses of Rp2,708.7 trillion, for the health sector in the 2022 State Budget draft.
"We will use the budget to continue the handling of the pandemic, reform the health system, reduce the stunting rate, as well as (ensure the) sustainability of the National Health Insurance (JKN) program," the President said in his state budget speech before the Parliament on August 16, 2021.
For the stunting reduction program, in particular, the government will expand the program coverage to all districts and cities of Indonesia by strengthening the collaboration of various institutions, he informed.
Meanwhile, Health Minister Budi Gunadi Sadikin said he is optimistic that Indonesia's stunting prevalence rate would reduce to 14 percent by 2024 through evidence-based and intensive interventions.
"Intensive efforts will be taken to accelerate the reduction in stunting prevalence in Indonesia until the stunting prevalence rate in our country reaches a negligible level," Minister Sadikin stated in his opening remarks during the national coordination meeting on stunting prevention, broadcast by the Vice President Secretariat on Monday.
The interventions will target toddlers, teenagers, future brides and grooms, and pregnant and breastfeeding mothers, he said.
Specific and sensitive nutritional interventions will be prioritized in the first one thousand days of a child's growth, as such interventions could contribute over 70 percent to reducing stunting among children, he added.
Specific nutritional interventions are actions related to improving nutrition and health, while sensitive nutritional interventions are supportive interventions, such as the provision of clean water and sanitation, he said.
Furthermore, Coordinating Minister for Human Development and Culture, Muhadjir Effendy, said that the prevalence of stunting cases is affecting the development of human resources in Indonesia.
"This stunting disorder will determine whether Indonesian human resources will develop well, or fail to develop. If we are free from the potential for stunting, Indonesian human resources will be superior and competitive," he remarked.
He cited a survey conducted by the World Bank in 2020 which ranked Indonesia 115th out of 151 countries that are experiencing stunting problems.
The high number of stunting cases in Indonesia has been caused by a chronic lack of nutritional intake and poor sanitation of the population due to lack of access to quality water and drinking water, he said. In addition, low level of parental education and wrong parenting has also affected the national stunting rate, he added.
Hence, stunting prevention in Indonesia should be prevented by optimizing family functions, according to IPB University lecturer Dr. Tin Herawati.
The occurrence of stunting is linked to suboptimal family function, she said. A lot of research has shown that low-quality breast milk, complimentary food, premature feed of complimentary food, lack of exclusive breastfeeding, as well as incomplete immunization, and infrequent visits to a community health center (Posyandu) can also contribute to the prevalence of stunting among children, she added.
The failure of families to protect their offspring is also evident by the prevalence of child marriage that can increase the number of cases of stunting, she noted. Poverty is also one factor that may cause stunting, Herawati pointed out.
Hence, family functions must be optimized as proper family functions and parenting will boost a child's welfare, health, growth, and quality of living, she added. (INE)
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