Complementary Feeding and Maternal Nutrition in Indonesia

A partnership between UNICEF Indonesia and Indonesia’s Ministry of National Development Planning

Elizabeth Drummond
Foni, 25, holds her 14-month-old daughter Juriska outside their home.
UNICEF/2017/van Oorsouw
Foni, 25 with her daughter Juriska, 14 months, outside their home in a remote village in Kupang District, Nusa Tenggara Timur Province, Indonesia. In this province, more than 15% of children have moderate or severe acute malnutrition, while 51% are stunted, meaning they suffer from chronic malnutrition and are too short for their age.
23 December 2019

Fifty-nine per cent of children in Indonesia are not growing up well, they are either stunted (too short for their age), wasted (too thin for their height) or overweight (too heavy for their height)[1].

Among women, 44 per cent of women of reproductive age are overweight.[2] Improving the quality and quantity of the foods mothers and young children eat is essential to reduce the high burden of malnutrition in Indonesia.

UNICEF Indonesia in partnership with Bappenas (Indonesia’s Ministry of National Development Planning) launched the Complementary Feeding and Maternal Nutrition Frameworks for Action in Jakarta on December 11. The Frameworks for Action, developed by UNICEF and contextualized for Indonesia, highlight how food, health, water and sanitation, social protection and education systems come together to influence behaviours that determine what women and children eat.

20-month-old Danu plays with a ball in a dirt road in Indonesia
UNICEF/2017/van Oorsouw
Danu, 20 months old, lives in a remote village in Kupang District, Nusa Tenggara Timur Province, Indonesia. A few months ago, Danu’s weight stopped increasing after he fell sick, had a fever and lost his appetite. His mother Nurlina took him to the local Health Post where he was monitored and later found to be severely acutely malnourished (SAM).
A Systems Approach to ensuring Healthy Diets

UNICEF worked with the Government, donors and implementing partners to determine specific recommendations for each system. The Event was moderated by Latief Siregar, a journalist and familiar face to the audience. Dr.Ir Subandi Sardjoko, MSc, Deputy for Human and Societal Development and Cultural Affairs, Bappenas, opened the meeting with an overview of the nutrition situation in Indonesia and reminded the audience of the commitment needed to meet the Government of Indonesia’s nutrition targets. Dr Kirana Pritasari, MQIH, Director General for Public Health, Ministry of Health, provided an overview of current priority programmes in the Public Health Nutrition Directorate. UNICEF Indonesia Representative, Debora Comini urged government officials, academicians, professional organizations, development partners, the private sector – to take immediate and urgent action to recommit themselves to improve the quantity and quality of children’s diet and nutritional status of pregnant and lactating mothers and women of reproductive age.

Many women and children in Indonesia are not eating a wide variety of foods

Less than half of all Indonesia children consume a diet that is diverse, meaning they are missing out on vital nutrients.[3] For maternal nutrition, there isn’t much data about what mothers are eating. Still, we know that only 5 per cent of women eat the recommended servings of fruit and vegetables per day, and 50 per cent of pregnant women are anaemic.3

Technical presentations highlighted the key findings of the Landscape Analysis on Maternal Nutrition and Complementary Feeding in Indonesia. Presented by two Indonesian nutrition experts, Dr. Umi Fahmida from SEAMEO-RECFON and the Faculty of Medicine, University of Indonesia’s Dr. Rina Agustina, the findings highlighted that there are significant gaps in maternal and child diets.

Dr. Jee Hyun Rah, Nutrition Chief, UNICEF Indonesia, wrapped up the session, presenting the 11 Recommended actions to Improve Complementary Feeding and Maternal Nutrition. UNICEF developed these recommendations in discussion with partners, and they will be used to develop specific measures for implementation across Indonesia. The recommendations covered a broad set of drivers of poor diets and nutrition practices, from restricting the marketing of unhealthy foods and improving nutrition labelling, to ensuring that health workers have the skills they need to provide nutrition advice to mothers and families.

UNICEF Nutrition Officer, Blandina Bait, speaks with a child who is being checked as part of monthly nutrition screening at a village Health Post in Indonesia
UNICEF/2017/van Oorsouw
A UNICEF Nutrition staff speaks with a child who is being checked as part of monthly nutrition screening at a village Health Post in Kupang District, Nusa Tenggara Timur Province, Indonesia. In this province, more than 15% of children have moderate or severe acute malnutrition, while 51% are stunted, meaning they suffer from chronic malnutrition and are too short for their age.
Skills, Advocacy and Social and Behaviour Change are needed to make progress

The frameworks for action (included below) engage multiple systems to ensure improved diets for all. Panelists from the Ministry of Health, Ministry of Social Affairs, Bappenas, Ministry of Villages, and the Vice President’s Office discussed specific actions that their sector could take to improve maternal and child diets. All panelists mentioned the importance of improving capacity and knowledge among service providers, district planning bodies and the community on the importance of good nutrition, highlighting the need for a comprehensive advocacy, social and behaviour change and better training for government staff.

Frameworks for Action

Frameworks for Action

Maternal Nutrition

Maternal Nutrition Framework

The event was the first step in building consensus, support and defining actions that can be adopted across the health, water and sanitation, social protection and education systems to improve the diets of mothers and children. 

All panelists agreed that while Indonesia has made significant progress, commitment from all sectors is needed to reach National and Sustainable Development Goal Targets for Nutrition. 

 

Elizabeth Drummond is a Nutrition Consultant at UNICEF East Asia and Pacific

 

[1] UNICEF, State of the Worlds Children, 2019

[2] Riskesdas, 2019

[3] Indonesia DHS, 2017

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