Dr. Dini Latief MSc., SpGK.

Transcription

1 INTERNATIONAL CONFERENCE ON CSR AND COMBATING MALNUTRITION: OBTAINING MILLENNIUM DEVELOPMENT GOALS (MDGs) IN INDONESIA Session 1: Prevention & Intervention in Improving The National Nutrition Status in Indonesia Dr. Dini Latief MSc., SpGK. Grand Sahid Jaya Hotel, December 2010

2 Maternal and Child Nutrition for Preventing and Improving the Nation s Nutritional Status Indonesia s Experience Dr Dini Latief, MSc, SpGK Dr Dini Latief, MSc, SpGK

3 Prevalensi (%) Nutritional Status of Children Under-5 (RISKESDAS, 2010) ,6 17,9 13,3 14,2 GIZI KURANG PENDEK KURUS GEMUK 3

4 Prevalence of Stunting by Province Riskesdas, 2010

5 NAD Sumut SumBar Riau Jambi SumSel Bengkulu Lampung BaBel KepRi Jakarta Jabar Jateng DI Yogya Jatim Banten Bali NTB NTT KalBar KalTim KalSel KalTim SulUt SulTeng SulSel SulTera Gorontalo SulBar Maluku MalUt PapBar Papua INDONESIA Prevalence of Underweight by Province 2007 and 2010 (Riskesdas)

6 Mapping of severe underweight (gizi buruk ) Riskedas, 2010 MGDs target % 3.5 % % > 7.0 %

7 Percentage of Population with Energy Intake <1400 Kkal/cap/day, by Province Susenas, 2009

8 The intergenerational transmission of growth failure: When to intervene in the life cycle? (ACC/SCN, 1992) Child growth failure Low birthweight baby Early pregnancy Low weight & height in teenagers Small adult woman Small adult man

9 Critical Period of Child s Growth

10 Critical Period of Child s Growth (Indonesia s data) Abas,

11 Window of Opportunity Maternal and birth outcomes Newborn babies Infants and children under two years old

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13 The Womb. Your Mother. Yourself.

14 What makes the way we are? 1. Our genes: the DNA we inherited at conception 2. Our childhood experiences: how we were treated and what we took in, especially the first three years 3. Our health and well-being stem from the lifestyle choices: kind of diet and how much exercise

15 4. Powerful source of influence: Our life as a fetus (David Baker et al, 1990) a) The kind and quantity of nutrition received in the womb b) The pollutants, drugs and infections exposed to during gestation c) The mother s health, stress level and state of mind while she was pregnant

16 Sufficient evidence of interventions that affect maternal and child undernutrition in Indonesia 1. Maternal and birth outcomes: Ante-natal care incl. iron-folate/calcium supplementation and TT immunization, consumption of iodized salt, reduce tobacco consumption and indoor air pollution, maternal supplement of balanced energy and protein, insecticide-treated bednets. 2. Newborn babies: Promotion of breastfeeding (individual and group counseling) and immunization.

17 Sufficient evidence of interventions that affect maternal and child undernutrition 3. Infant and children: Promotion of breastfeeding, Behavior change communication for improved complementary feeding, completed immunization, Zn in management of diarrhea, Iron-Vitamin A fortification and supplementation, Universal iodized salt, hand washing or hygiene interventions, treatment of severe malnutrition, insecticide-treated bednets.

18 INDONESIA National Plan of Actions on Food and Nutrition

19 Policy on Food and Nutrition 1. Strengthen poverty reduction for increased impact on child and maternal undernutrition. 2. Focusing key nutrition interventions targeted at vulnerable group of pre-pregnant, pregnant and lactating women and children under two years of age. 3. Improve food security at local level and increase accessibility of the poor to adequate nutritious and safe food. 4. Healthy and Clean Life-style behaviour 5. Strengthen Food and Nutrition Institution at all level

20 Strategy of Plan of Actions for Food and Nutrition 1. New initiatives for more effective interventions at selected Provinces/Districts (prevalence of underweight > 15.5%, stunting >32% and daily energy intake <2000 Kkal/cap/day). 2. Gold standard of infant feeding incl. promotion of breastfeeding and complementary feeding 3. Hygiene and sanitation 4. Identify deployment gaps and competencies of human resources for health and nutrition.

21 Target: Universal Access to Food and Nutrition in 2015 All Kabupaten/Kota: 1. Prevalence of underweight of children under five years of age: <15.5% 2. Prevalence of stunting of children under five years of age: <32% 3. Energy intake <2000Kkal/cap/day: 35.32% of population

22 Terima Kasih