Strategy for Stunting Reduction & Prevention: Clean and Healthy Lifestyle

Strategy for Stunting Reduction & Prevention: Clean and Healthy Lifestyle

Indonesia: 5 th highest number of stunted children

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

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

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

Stunting and Development Context

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

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

What can be done?

Indonesia: Poor feeding practices in children undertwo 0 6 mo 23-24 mo Early Initiation 100 6 Months Exclusive Breastfeeding Breastfeeding Provision of Timely & Quality Complementary Food with Breastmilk Complementary feeding OPTIMAL FEEDING 90 80 91 70 60 66 50 *52 58 55 40 30 *42 37 20 10 0 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)

Continued Breastfeeding 100 90 80 70 60 50 40 30 20 10 0 1997 2002 2007 2012 2017 Source: IDHS 1997 2017 12-15 months 20-23 months

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.

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

Quality Counseling Skills of Community Workforce Reduced Stunting in Indonesia

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

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

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

Risk Factors for Low Birthweight

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

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

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

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

Wasting Increases the Risk of Stunting

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

Multi-sectoral Response & Coordination

Scaling up Water, Sanitation, and Hygiene Interventions

Stunting Free Indonesia is Possible