Post on 13-Jul-2019
multi-stakeholder approach in reducing malnutrition problem
in Indonesia
BotswanaComoros
Djibouti Egypt
Libya
MozambiqueSao Tome &
Principe
Sierra Leone
Zambia
Benin
Albania
IraqSyria Arab Rep.
Bhutan Azerbaijan
INDONESIA Papua
New Guinea
17 countries of 117
countries, have 3 kind of nutrition problem:
STUNTING,
WASTING , Anemia
and OVERWEIGHT
TRIPLE BURDEN
ECONOMIC GROWTH IS NOT ENOUGH: STUNTING PERSISTS IN INDONESIA AS A
MIDDLE-INCOME COUNTRIES
The Benefit-cost Ratio for Nutrition Specific Intervention Packages with ≥ 90% coverage to Reduce Stunting
Indonesia: 48
Every dollar invested to reduce stunting will be returned 48 dollar
Investing in Nutrition for Human Development
World economists identified that investing in Community Nutrition is the most Smart way to address the top 10 world’s challenges
Investing in nutrition can help to cut off poverty cycle and increase GDP between 2 – 3% per year
The Benefit-cost Ratio for Nutrition specific Intervention packages with ≥ coverage to Reduce Stunting
For every dollar invested in nutrition will be returned about 48 dollar in Improvement of health, education, and economy productivity
The Copenhagen Consensus 2012
What Causes Undernutrition in Indonesia?
Only 36% children 6-23 months consume a “minimum acceptable diet”
(IDHS, 2012)
14% of children have suffered diarrhea in the last 2 weeks
(IDHS, 2012)
• 24% defecated in the open (JMP, 2013)
• 14% do not have access to an improved water source (JMP, 2013)
Only 42% children less than 6 months are exclusively
breastfeed(IDHS, 2012)
12% are below the national poverty line(SUSENAS, 2012)
NUTRITION STRATEGIES OF INDONESIA
1. Nutrition improvement, focusing on the first 1000 days of life (pre-pregnancy, pregnant woment, child)
2. Improving access to food diversification 3. Improving control on food quality and food safety4. Improving Healthy and Hygiene Lifestyle5. Strengthening food and nutrition institution
1. Iron-Folic Supplementation2. Promotion of Exclusive Breastfeeding 3. Adequate Complementary feeding 4. Protection to energy malnutrition
1. Access to improved sanitation2. Food and Nutrition Security3. Family Planning4. Universal Health Coverage5. Food Fortification6. Nutrition Education7. Women empowerment8. Poverty Reduction Program
Women of Reproductiv
e AgePre-pregnancy
Pregnant mother
Lactating mother
Infant and young child
( 0 – 23 month)
5 PILLARS OF ACTION PLAN
SPECIFIC INTERVENTION SENSITIVE INTERVENTION
1. 40% reduction in the number of children under-5 who are stunted
1. 50% reduction of anemia in women of reproductive age
1. 30% reduction in low birth weight
1. No increase in childhood overweight
1. Increase the rate of exclusive breastfeeding in the first 6 months up to at least 50%
1. Reduce and maintain childhood wasting to less than 5%
TARGET 2025
Presidential Decree
No. 42.2013 on
National Movement to
Accelerate Nutrition
Improvement within the
Framework of the First
1000 Days of Life
Bringing work together
a. Decrease of MMR & IMR (Mother & Child Health
including Immunization
b. Nutrition improvements especially stuntingc. Infectious Disease Control (ATM: HIV / AIDS,
Tuberculosis & Malaria
d. Control of Non Communicable Diseases (Hypertension,
Diabetes Mellitus, Obesity & Cancer)
Family
Approach
Healthy
Community
Movement
Priorities Are Important:Indonesia Case:
National Midterm Planning 2015-2019
THE MAIN ACTIVIES TO REDUCE STUNTING 2015-2019
Reduction of stunting in childrenunder 2 years
Improvement Nutritionfor Adolescent girl andmarried women:1.delayed marriage2.Iron tablet
supplementation3.nutrition balance diet
campaign
Supplementary Feeding for School Children• Nutrition balance diet Campaign• Education Behavior Clean and Healthy
Nutrition Improvement for
The First 1000 days of life:
1.Supplementary feeding for
pregnant women
2.Promotion and counseling
Early Initiation of
Breastfeeding and
Exclusive breastfeeding
3.Growth Monitoring and
Promotion
4. Infant and Young Child
Feeding
5.Management of Children
with severely Acute
Malnutrition
6.Vitamin A Supplementation
7.Home fortification (Taburia)
4. School Age
3.Infant and Children
5. Adolesence and Reproductive women
2. Lactating Mother
1.Pregnant Women6. Elderly People
• Promotion 0f Exclusive
breastfeeding
• Breastfeeding counseling
▪ Growth monitoring & Promotion
▪ Vitamin A supplementation
▪ Provision of iodized salt
▪ Complementary Feeding
▪ Iron fortification and provision of Taburia
▪ Zinc for diarrhea management
▪ Controlling of Deworming
• Nutritional counseling
• Nutrition services
• Reproductive health
• Nutrition counseling
• Iron folate tablet
supplementation
• Health Screening
• Monthly Immunization
• School Health Improvement
• Supplementary feeding
• Controlling school food
vendor
▪ Iron folate tablet
supplementation
▪ Supplementary feeding
▪ Prevention of Deworming
▪ Supplementation of
Calcium
GOVERNMENT
PrivateSector
Academia &Civil Society
Shared
Social Value
of communities
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SYNERGY AND HARMONIZATIONIN NUTRITION AND HEALTH DEVELOPMENT
Health Program Multisectoral
Family ApproachHealthy Community
Movement (GERMAS)
Implementation of Healthy Paradigm
a systematic collective action from all stakeholders to raise awareness, capacity
and ability of the community to live healthy for better quality of life
STRENGTHENING OF PROMOTIVE-PREVENTIVE MEASURES THROUGH
HEALTHY LIFE COMMUNITY MOVEMENT
(GERMAS)
Goals
Nudging the
community
behavior to
Live Healthy
Be Productive
Create Healthy Environment
Minimizing Health Care Cost
GOVERNMENT LEADERSHIP ON NUTRITION
• SUN Movement in Indonesia
• Indonesia joined the Global SUN Movement in 2011
• Policy Framework and Implementation Guidelines developed in 2012
• Presidential Decree on 1000 Days of Live in 2013 and launching of the National Movement (1000 HPK)
• Multi-sector and multi-stakeholder coordination structures established, and stakeholder networks
• Tracking of budget allocations for nutrition.
MULTI-SECTORAL APPROACHES TO SYNERGIZE EFFECTS AND MULTIPLY CHANNELS FOR NUTRITION IMPROVEMENT
MULTI-SECTOR NUTRITION POLICY FRAMEWORKS & PLANS reflect International Commitments
NUTRITION-SENSITIVE SOCIAL PROTECTION PROGRAMMES(PKH AND PNPM)
• Infant & Young Child Feeding (IYCF) COUNSELLING PACKAGE WASH/IYCF INTEGRATION
• IYCF PACKAGE FOR AGRICULTURAL EXTENSION WORKERS FOCUSING ON COMPLEMENTARY FEEDING
• INTEGRATED ECD PACKAGE (EDUCATION, CHILD PROTECTION, HEALTH AND NUTRITION)
• Integration of the
first 1000 days of
live Movement
into CSO
program
• Strengthening
CSO
engagement with
the government
• Advocacy to
support the
Movement of first
1000 days of life,
• Supporting
nutrition as a
national and
local government
priority issue
• Encourage
cooperation
between
countries
• Cooperation and
technical
assistance
Development
Partners
Social
institutionsBusiness
sectorProfessional
Organizations & Academics
• Implementation of
“Tri Dharma
Perguruan Tinggi”
in improving
nutrition
• Increasing the
quality of the
ProfesSional
Nutrition Service
• Provide input
based on research
results
• Facilitating the
business sector in
the Movement of
1000 HPK
• CSR for Nutrition
improvement
• Exchange
experiences
including the use
of innovation
technology
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THE ROLE OF STAKEHOLDERS IN
ACCELERATION OF NUTRITION IMPROVEMENT
Collaboration with Development Partners in NTT:
• Nutrition International (NI) Indonesia : Micronutrient Supplementation for Reducing Morbidity and Mortality in
Indonesia program (MITRA) by anemia prevention activities for young women through Fe tablets.
• UNICEF : Community-Based
Nutrition Program (PGBM)
• Program in Gorontalo
District to reduce Stunting
which is funded by village
cooperatives and self-
supporting communities
such as Posyandu,
Posbindu & Saung germas
• PKPU's support in the
Ambassador Program of
1000 HPK through
monitoring program
activities (by Midwives and
Posyandu cadres) to
mothers and children during the first 1,000 days of life
• APPNIA & GAPMMI:
Support the Ministry
of Health in
Adolescent Nutrition
Campaign
• Faculty of Medicine, Hasanuddin University: 1 student accompanies 1 pregnant mother program, until the baby is born and the baby reaches the age of 2 years
• Poltekkes students in Gorontalo District, accompanies and educate mother from the beginning of pregnancy until giving birth and “Arisan Donor Darah” (Si DORA)
THE ROLE OF STAKEHOLDERS IN
ACCELERATION OF NUTRITION IMPROVEMENT
Development Partners Social Institutions Business sector Professional Organizations & Academics
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TERIMA KASIH – THANK YOUTHANK YOU –KOB KHUN KRAB
15
SALAMINDONESIA
Working together for Indonesia prosperity