The double burden of malnutrition, which comprises under-nutrition and over-nutrition, has become one of key development challenges faced by Indonesia. Under-nutrition in children usually occurs during their first 1,000 days of life, beginning from pregnancy until their second birthday. This is a critical period of brain development in children because any failure in this stage cannot be corrected.

Under-nourished children will suffer physical growth disorders and metabolism problems. Once children live in a condition with easier access to nutritious foods during their adulthood, they will be very susceptible to obesity because of their inability to properly digest the nutritional elements of food such as carbohydrates, proteins and fats. This will make them prone to non-infectious diseases such as diabetes and heart disease.

As it leads to illness, disability and even death, the double burden of malnutrition has become a crucial problem in Indonesia, and one that demands a greater degree of attention.

Malnutrition remains a serious challenge for Indonesia despite ongoing efforts to tackle nutrition-related problems. According to the 2013 Basic Health Research (Riskesdas) released by the Health Ministry, the prevalence of underweight children under five years of age in Indonesia stands at 19.6 percent, up from 17.9 percent in 2010 and 18.4 percent in 2007. With such a figure, the research report concludes that undernourished children under the age of five remains a major public health concern in Indonesia.

The 2013 Riskesdas further reveals that the prevalence of fat children aged under five years of age stands at 11.9 percent, down by 2.1 percent from 14 percent in 2010. Nationally, however, the percentage of fat children aged between 5-12 years stands at 18.8 percent, which is quite high.

'€œWhile under-nutrition has not yet been completely tackled, Indonesia is facing a growing problem of obesity,'€ said Soekirman, a professor of nutrition from the Bogor Institute of Agriculture (IPB) in Bogor, West Java, recently in an interview.

Soekirman said Indonesia'€™s improved incomes, which led people to a wider access of food, had triggered a higher consumption of foodstuffs that were high in fats and carbohydrates. There has been a higher consumption of processed food as well, especially among people in urban areas. A lack of physical exercises and a sedentary lifestyle, in which children go to schools by private vehicle or public transportation instead of by walking, have worsened the situation.

'€œWhat our country has to deal with now is much more complicated. Over-nutrition, which emerges simultaneously with under-nutrition, is an old problem that is not yet completely resolved,'€ the expert on nutrition said.

Soekirman said many government policies were not precise enough to address nutrition-related problems. '€œThe problem of underweight children is often perceived as merely a food problem, although wasting can also be a sign of infection,'€ he said.

The nutritionist further said that it was unfortunate to see that in Indonesia, malnutrition was still perceived as a problem in the health sector. In fact, according to the 2014 Global Nutrition Report, the health sector contributed only 30 percent to the overall effort conducted by stakeholders from all developmental sectors, including clean water and sanitation, he added.

'€œAs long as people live with poor access to safe water, nutrition problems will easily occur,'€ said Soekirman.

Combating all forms of malnutrition is one of 17 goals (SDGs) to be achieved in the post 2015 development agenda, adopted last year during the UN Sustainable Development Summit in New York, the US, from Sept. 25 to 27.

Indonesian Women'€™s Coalition for Justice and Democracy (KPI) general secretary Dian Kartikasari said unlike MDGs, civil societies had participated actively in identifying key issues countries must highlight in the post 2015 development agenda.

'€œWe do hope that the government has a policy framework on how best to implement SDGs. The most important thing is to ensure that both government and local administrations can include SDGs in national and regional development planning documents,'€ said Dian in an interview.

She said there should be a mechanism to monitor the government work plan, including on how it involved local administrations in the implementation of SDGs.

'€œAmong serious problems that have hampered the implementation of MDGs was local administrations'€™ poor capacity in integrating the global development agenda into their mid-term regional development plans,'€ said Dian, adding the government also needed to help local administrations to involve civil society groups in implementing SDGs from the very beginning.

International NGO Forum on Indonesian Development (INFID) executive director Sugeng Bahagijo said there should be non-state efforts to accelerate Indonesia'€™s progress toward achieving its SDG targets.

The involvement of citizens and civil society groups could ensure that the post-2015 development agenda would put forward inclusive economic growth, social protections and environment sustainability, all important for Indonesia today and into the future, he said.

'€œThere is one key word needed in the implementation of SDGs, and that is accountability. It is accountability, including in the implementation of public participation, which will bring pressure on the government to work to achieve the SDG targets,'€ said Sugeng.

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