Indonesia - Indonesian ministry soldiers on with nutrition programmes for poor families

The emergence of a number of cases of stunted growth and obesity in children suggests that the majority of people in Indonesia are not aware of the importance of a healthy diet, especially during pregnancy.

Although there has been progress in improving child nutrition of late, the last decade has seen an overall escalation in the majority of nutrition-related diseases.

“It’s a fact that there’s a decreasing number of children with nutrition-related health problems, such as low-birth weight, vitamin A deficiency, iodine-deficiency disorders and even anemia. But, that doesn’t necessarily mean that the problem is over,” Minarto, the

Health Ministry’s nutrition management director, told journalists on Friday at a press briefing on the ministry’s newly launched programme “The First 1,000 Days of Life for the Country”.

Amid progress in tackling malnutrition in children under five years old, a new pattern of nutrition-related problems, such as obesity in children, has emerged due to poor awareness of a healthy diet.

According to Basic Health Research (Riskesdas), Indonesia’s malnourishment rate among children under five years of age has declined from 31 per cent in 1990 to 17.9 per cent in 2010.

Sufficient levels of micronutrients among children and mothers have also improved quite significantly.

As about 62.3 per cent of total households have achieved sufficient levels of iodine, for example, the government has now stopped its programme of distributing iodine capsules, a key measure to avoid disorders related to iodine deficiency.

Although vitamin A deficiency has declined, however, vitamin A and other micronutrient supplementations are still among the core nutritional improvement programmes the government will continue to develop to tackle nutrition-related health problems.

Since the government began its vitamin A supplementation programme in the 1980s, about 81.7 per cent of newborns have achieved sufficient levels of vitamin A, along with 81.4 per cent among children under five years old and 72.5 per cent of mothers.

“Yet, we will continue distributing vitamin A capsules due to its effectiveness not only at ensuring healthy eyesight, but also to support physical growth and to strengthen the immune system,” Minarto said.

Iron supplementation, he said, would also remain a key strategy, although anemia had declined to 24.5 per cent, far lower than in previous years.

“Providing iron capsules for pregnant women is important not only to protect them against nutritional anemia, but also to prevent infant deaths. Thus, we will continue iron supplementation and even include it in standardized antenatal healthcare services,” Minarto said.

Iron supplementation for pregnant women is one of the programmes, including balanced-diet promotion, provided by the government in its “First 1,000 Days of Life for the Country” programme, which is aimed at providing better nutrition intake for children during their first 1,000 days of life, starting from when they are still in the womb up until two years of age.

According to Riskesdas, stunting in children reached 35.6 per cent of children below five years as of 2010. About 14.2 per cent of children under five years old suffer from obesity, which can lead to non-communicable disease in adulthood.

Minarto said that poor nutritional intake during pregnancy would affect the fetus’ organ development.

“Eighty per cent of brain and other vital organ development occurs during pregnancy and will end when children are two years old. Nutrition intervention conducted after this golden period will not be useful,” he said, adding that people would be encouraged to use more protein and mineral-rich local food sources in the programme’s malnutrition management.

Subagyo Partodiharjo, a member of Commission IX overseeing health, labor and social issues at the House of Representatives, said that most Indonesians had adopted the wrong eating patterns.

Many pregnant women, he said, avoided protein-rich food, such as eggs and fish, on the grounds that it could give lead to infection during childbirth.

“Breast-feeding women are even encouraged to consume only katuk [edible leaves], which is deemed as an effective way to increase their breast milk supply, whereas protein-rich foods such as meat, egg and fish are the best food sources of omega 3 and fatty acid, for example, needed in children’s brain development,” said Subagyo, who also chairs the House’s caucus for health issues.

Six provinces, namely East Java, East Nusa Tenggara (NTT), Gorontalo, West Nusa Tenggara (NTB), West Java and West Sulawesi, will receive nutrition intervention delivered under the programme.

Elly Burhaini Faizal

The Jakarta Post

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