Strategy for Stunting Reduction & Prevention: Clean and Healthy Lifestyle

Transcription

1 Strategy for Stunting Reduction & Prevention: Clean and Healthy Lifestyle

2 Indonesia: 5 th highest number of stunted children

3 What is stunting? Children s failure to achieve their growth and development potential because of the cumulative effects of persistent nutrition deprivation

4 Long-term consequences of stunting in early childhood Survival Linear growth Cognitive development School achievement Economic productivity Birth weight Source: Dewey K, 2011

5 Stunting and Brain Development Normal Stunting Source: Cordero E et al, 1993 Typical brain cells Extensive branching Impaired brain cells Limited branching Abnormal, shorter branches

6 Stunting and Development Context

7 Stunting: A marker of national development Poverty Infant and young child feeding practices Protection Prevention and treatment of infections Women and mothers Prenatal nutrition and growth Equity

8 Source: Torlesse et al., 2016; Riskesdas, 2013

9 What can be done?

10 Indonesia: Poor feeding practices in children undertwo 0 6 mo mo Early Initiation Months Exclusive Breastfeeding Breastfeeding Provision of Timely & Quality Complementary Food with Breastmilk Complementary feeding OPTIMAL FEEDING * * Early Initiation Exclusive Breastfeeding Introduction to solid, semi-solid or soft foods Minimum meal frequency Minimum Diet Diversity Minimum Acceptable Diets Continued BF at one year Continued BF at two years Source: SUSENAS (2015); IDS (2012)

11 Continued Breastfeeding Source: IDHS months months

12 Food and Diets as the Center Bring back food and diets to the center of our advocacy and programming. Ensure food security 12 Strengthen our ability to ensure that food systems deliver healthy diets for children.

13 Timely Appropriate Complementary Feeding Start when the child reach 6 months Feed 4-5 times a day (3 +1-2) Feed 4 food groups

14 Quality Counseling Skills of Community Workforce Reduced Stunting in Indonesia

15 Quality Counseling Improves Mother s Knowledge & Feeding Practices Children in the lowest quintile

16 Intrapersonal determinants: Knowledge Literacy Beliefs, perceptions Perceived risk, susceptibility Perceived severity Attitudes Perceived self-efficacy, agency, fatalism Behaviour routine. Policy/ Enabling Environment Organizational/ Institutional Community Interpersonal Intrapers onal

17 Policy/ Enabling Environment Interpersonal determinants: Social networks Social support groups Social norms, including gender norms Peer influence Power relations. Organizational/ Institutional Community Interpersonal Intrapers onal

18 Risk Factors for Low Birthweight

19 Adequate Nutrition for Mothers 180 Iron & Folic Acid supplements during pregnancy Improved dietary consumption

20 Adequate Nutrition for Adolescents 52 weekly iron & folic acid supplements Improved dietary consumption Prevention of overweight & obesity

21 Adolescent Nutrition Intervention Package Education Nutrition Specific Iron-folic acid supplements Nutrition education / BCC WASH Nutrition Specific Health Nutrition Sensitive Vocational & life skills training Handwashing & hygiene Reproductive health & HIV Child marriage & bullying Child Protection

22 Adolescent Nutrition Intervention Strategies Advocacy Behavioral Change Communication Coordination Monitoring & Evaluation Health Systems Strengthening Capacity Building

23 Wasting Increases the Risk of Stunting

24 Effective Treatment for Severely Undernourished Early detection and referral Inpatient care for cases with medical complications Community-based care for cases with no complications

25 Multi-sectoral Response & Coordination

26 Scaling up Water, Sanitation, and Hygiene Interventions

27 Stunting Free Indonesia is Possible