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    JFCC Soekirman

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    Eva Oretla
    This document discusses stunting in children in Indonesia. It begins by defining stunting as children being shorter than average for their age. It then provides data showing that Indonesian children are on average 6.7 cm (boys) and 7.3 cm (girls) shorter than the WHO standard. The document later discusses that stunting occurs when children fail to reach their genetic growth potential due to prolonged inadequate nutrition and frequent infections. It provides context on the global burden of stunting and undernutrition in children under five years old.

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    JFCC Soekirman

    Uploaded by

    Eva Oretla
    56 views32 pages
    This document discusses stunting in children in Indonesia. It begins by defining stunting as children being shorter than average for their age. It then provides data showing that Indonesian children are on average 6.7 cm (boys) and 7.3 cm (girls) shorter than the WHO standard. The document later discusses that stunting occurs when children fail to reach their genetic growth potential due to prolonged inadequate nutrition and frequent infections. It provides context on the global burden of stunting and undernutrition in children under five years old.

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    This document discusses stunting in children in Indonesia. It begins by defining stunting as children being shorter than average for their age. It then provides data showing that Indonesian children are on average 6.7 cm (boys) and 7.3 cm (girls) shorter than the WHO standard. The document later discusses that stunting occurs when children fail to reach their genetic growth potential due to prolonged inadequate nutrition and frequent infections. It provides context on the global burden of stunting and undernutrition in children under five years old.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    56 views32 pages

    JFCC Soekirman

    Uploaded by

    Eva Oretla
    This document discusses stunting in children in Indonesia. It begins by defining stunting as children being shorter than average for their age. It then provides data showing that Indonesian children are on average 6.7 cm (boys) and 7.3 cm (girls) shorter than the WHO standard. The document later discusses that stunting occurs when children fail to reach their genetic growth potential due to prolonged inadequate nutrition and frequent infections. It provides context on the global burden of stunting and undernutrition in children under five years old.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    of 32

    What is Stunted, Why and

    How
    Soekirman,
    Prof (Em), Dep. Community Nutriton, IPB, Bogor/
    Director, Foundation of Food Fortification Indonesia
    (KFI), Jakarta

    10/8/14 Soekirman JFCC Jkt 8 Okt 14 1


    Stunting : Same Age/Older but Smaller

    11 th

    10/8/14 Soekirman JFCC Jkt 8 Okt 14 2


    10/8/14 Soekirman JFCC Jkt 8 Okt 14 3
    Stunting : Fail to achieve Genetic Potential
    (Height of Under Fived Children Indonesia vs Standard WHO 2005

    Beda:6.7cm Beda: 7.3 cm

    Anak laki-laki: Anak Perempuan:

    Source
    10/8/14 : Riskesdas 2010 Soekirman JFCC Jkt 8 Okt 14 4
    STUNTED
    Normal Growth

    Stunted

    Retarded Growth

    4 Maret 2005 Normal up toProf.Soekirman


    6 UKI Sem.12 9
    10/8/14 Soekirman JFCC Jkt 8 Okt 14 6
    m
    WHO 2007

    10/8/14 Soekirman JFCC Jkt 8 Okt 14 7


    WHO 2007

    10/8/14 Soekirman JFCC Jkt 8 Okt 14 8


    Progress on Nutritional Problem
    (Indonesia)
    Controlled
    Problems VAD and IDD

    un-finished
    problems Stunting,
    underweight, IDA

    Emerging problems
    Overweight
    4
    Prevalence of Stunting in Indonesia
    by Province (Riskesdas 2010)

    Laut Sulawesi

    Laut Jawa Laut Banda

    Lautan Hindia Laut Arafuru


    Laut Timor

    Indonesia : 35,6 %
    0 200 400 km < 20 % (0 province) 30-39,9 % (18 province)
    0 200 400 mm
    20-29,9 % (8 province) >= 40 % (7 province)
    10/8/14 Soekirman JFCC Jkt 8 Okt 14 11
    10/8/14 Soekirman JFCC Jkt 8 Okt 14 12

    GLOBAL SITUATION

    10/8/14 Soekirman JFCC Jkt 8 Okt 14 13


    Global Burden of Undernutrition
    on Children Under Five

    Child and maternal undernutrition is


    the underlying cause of 3.5 million child
    deaths worldwide per year and 35% of
    the disease burden for children under 5

    The vast majority of deaths are due to


    increased susceptibility to infectious
    disease. Only 140,000 deaths are directly
    attributed to starvation (i.e. insufficient
    intake of calories and/or protein), less
    than 4% of the total deaths due to
    undernutrition

    Vitamin A and zinc deficiencies have


    the largest disease burden among
    micronutrients

    Stunting and iron deficiency anemia


    account for over 20% of maternal
    10/8/14 Soekirman JFCC
    mortality
    Source : Black
    Jkt 8 Okt 14 et al. The Lancet (2008) 14

    178 Million Children Under 5 Suffer from Stunting

    Prevalence of
    Stunting

    PAPER
    Source 1 Lancet Maternal and Child Undernutrition Series
    : The
    (2008)
    Prevalence of Stunting : Indonesias position

    Prevalence of Stunting in countries part of ASEAN


    (2003-2008) World Average 26,9

    Prevalence of Stunting in 50 Countries


    (Tahun 2003-2008) Indonesia rank 42 (37 percent)
    World Average26,9

    Sumber : UNICEF 2009


    10/8/14 Soekirman JFCC Jkt 8 Okt 14 16
    Why Stunted ?

    10/8/14 Soekirman JFCC Jkt 8 Okt 14 17


    LOGICAL FRAMEWORK OF THE CAUSES OF NUTRITIONAL
    PROBLEMS

    Source: World Bank 2011, adapted from UNICEF 1990 & Ruel 2008
    10/8/14 Soekirman JFCC Jkt 8 Okt 14 18
    Unmet Genetic Potential

    10/8/14 Soekirman JFCC Jkt 8 Okt 14 19


    Long-term consequences :
    Short-term consequences : Adult size, intelectual ability,
    Mortality, morbidity, disability, economic productivity,
    weakness, discomfort, pain reproductive performance,
    metabolic and cardiovascular
    disease

    Immediate
    Inadequate
    Disease
    Causes dietary intake

    Food : Care : Health :


    Underlying Household food Inadequate care of Unhealthy household
    insecurity children and
    Causes (access and
    environment and lack
    women of health services
    availability)

    Poverty

    Basic Causes Lack of capital :


    financial, human,
    social, natural

    Social, economic
    and political context

    Analytical frame work : Poverty, Food, Care and Health


    Source
    10/8/14 : Unicef, 1998 Soekirman JFCC Jkt 8 Okt 14 20
    Intergenerational cycle of growth failure

    Child growth
    failure

    Low-birth- Early
    Low weight and
    weight baby pregnancy height in teens

    Small adult
    women

    Source :ACC/SCN (1992)


    10/8/14 Soekirman JFCC Jkt 8 Okt 14 21
    10/8/14 Soekirman JFCC Jkt 8 Okt 14 22
    FIRST 1000 DAYS OF LIFE
    (MARTORELL-IDB-1012)

    2 YRS

    0 DAYS BIRTH 365 DAYS 1000 DAYS


    10/8/14 Soekirman JFCC Jkt 8 Okt 14 23
    The causes of malnutrition are
    interconnected
    Insufficient access Lack of good
    to affordable, Inadequate access to
    nutritious CARE HEALTH
    FOOD for mothers & children
    & support for mothers
    sanitation & clean
    water services
    throughout the on appropriate child
    feeding practices
    year

    ROOTED IN
    Political & Cultural Disempowerment
    Poverty
    Environment Soekirman JFCC Jkt 8 Okt 14 of women
    10/8/14 24
    Chi Impact of being Stunted
    ldr
    en Co
    be m
    co
    me
    pe Lo
    ea tin w
    sil g Low prmotoric skills
    y ca od
    sic pa development
    Physical uc is not optimal
    k/ bil tiv
    he
    alt
    ity ity
    h Lo
    pro
    Stunting can lead tow sub-optimal child development, both
    ble
    physically and mentally. In the long term, productivity will
    ms
    10/8/14 not be JFCC
    Soekirman optimal.
    Jkt 8 Okt 14 25
    Nutrition Status Productive Age
    Demographic Bonus? (Riskesdas 2010)

    10/8/14 Soekirman JFCC Jkt 8 Okt 14 26


    HOW ?

    10/8/14 Soekirman JFCC Jkt 8 Okt 14 27


    TYPES OF INTERVENTION

    NUTRITION SPECIFIC INTERVENTION NUTRITION SENSITIVE INTERVENTION


    Efforts to prevent and reduce
    the nutrition problems directly. Efforts to prevent and
    reduce the nutrition
    These activities are generally
    problems indirectly.
    carried out by the health sector.
    The activities such as
    These activities are
    immunization, complementary generally carried out by
    feeding for pregnant mother non-health sectors.
    and under-5 children, growth The activities such as:
    monitoring for under-5 at provision of clean water,
    Posyandu poverty alleviation and
    target: the group of The first gender mainstreaming
    1000 days of life (pregnant Target: community
    mother, lactating mother and
    Contribution: 70%
    children 6-23 moths old)
    Contribution: 30%
    10/8/14 Soekirman JFCC Jkt 8 Okt 14 28
    Cost Effective Nutrition Interventions
    List of cost effective
    nutrition intervention
    Specific intervention There are strong scientific evidence of
    Maternal dietary supplementation the most cost effective nutrition
    Micronutrient supplementation or intervention (Lancet 2008; 2013), i.e.
    fortification for mother and children
    Breastfeeding and complementary specific intervention, and a sensitive
    feeding
    Feeding - behavior and stimulation.
    intervention
    Case management of Acute Malnutrition The government has set a policy of
    Diseases prevention and management
    prevention of stunting , through
    Sensitive intervention Presidential Decree No. 42 of 2013 of
    Water and sanitation the National Movement Acceleration
    Agriculture and Food security
    Social Safety Net
    Nutrition Improvement with a focus on
    Family Planning the age group of the first 1000 days of
    Women Empowerment
    life .
    Why nutrition? SUN - MOVEMENT
    Because
    when.. Children receive
    Girls & women are proper nutrition,
    well-nourished, they will develop
    they will have strong bodies &
    healthy newborn brains/intelligence
    babies

    The world is a
    Adolescents learn
    Communities & safer, more better & achieve
    nations are resilient & higher grades
    productive & stronger place in school
    stable

    Young adults are


    Families &
    better able
    communities
    to obtain
    emerge out of
    work & earn more
    poverty

    10/8/14 Soekirman JFCC Jkt 8 Okt 14 30


    Sumber: SUN Movement Secretariat, 2013
    PPP - SUN MOVEMENT

    PROF GOVERNME
    ESSIO NT
    inisiator,
    NAL fasilitator,
    DEVELOPM
    And motivator
    ORGA ENT
    PARTNER
    NISATI (bilateral-
    multilateral)
    ON & Fostering
    collaboration
    ACAD NATIONAL and inclusion
    EMIA MOVEMENT ON
    ACCELERATING
    Think NUTRITION
    Tank
    DEVELOPM
    ENT
    IMPROVEMENT
    PRIVATE
    PARTNERS SECTOR
    (UN SYSTEM) Product
    To support CIVIL developme
    and scale up SOCIETY nt
    the activities ORGANISATI
    ON
    Policy
    analysist and
    implementers
    in mitigating
    10/8/14 Soekirman JFCC Jkt 8 Okt 14
    under- 31
    nutrition
    THANK YOU

    10/8/14 Soekirman JFCC Jkt 8 Okt 14 32

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