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Stunting stunts Indonesia’s demographic dividend
The prevalence of childhood stunting in Indonesia has remained high over the past decade
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he prevalence of childhood stunting in Indonesia has remained high over the past decade. According to the Health Ministry, the prevalence of stunted children rose from 35.6 percent in 2010 to 37.2 percent
in 2013. Anything above 20 percent indicates a high severity of malnutrition, according to the World Health Organization (WHO).
There are also large disparities among Indonesia’s provinces: 15 have a stunting prevalence of more than 40 percent, while the rest are between 25 and 40 percent. Children are defined as stunted if their height for their age is below the WHO Child Growth Standard. They suffer from poor nutrition, infections and inadequate psychosocial stimulation, which hampers their mental development.
According to Basic Health Research (Riskesdas), children suffering from stunting are born of both the poorest families and the wealthy. However, the prevalence among the poorest is almost twice as high as it is among the richest. Economically, they are also likely to suffer more.
Stunting remains a major challenge for Indonesia, yet few people understand that it can lead to losses in both human and economic potential.
Most Indonesians think of stunting simply as shortness and consider it normal due to hereditary reasons. This, says Endang Achadi, a professor of nutrition at the University of Indonesia, is one of the main challenges in overcoming stunting in Indonesia.
Indonesia is entering a period of demographic productivity that is expected to peak between 2030 and 2035. This so-called demographic dividend, where the number of citizens in their productive age is far greater than the number of children and elderly, is expected to contribute significantly to economic growth.
Indonesia is projected to have a population of 306 million in 2035, of which the working-age population will be 207 million. Twenty-three percent of them will be in the 15 to 24 age bracket.
But making the most of the demographic dividend critically depends on the population achieving high productivity, without which contribution to economic growth will be limited.
Under the government’s Medium-Term Development Plan 2015-2019, the demographic dividend will have a significant impact on the country’s economic development only if young people’s work skills and knowledge are developed. This cannot happen if many children today continue to suffer from stunted growth.
Children who are currently 2 to 5 years old will be 19 to 22 years old in 2035. This age group is categorized as young adult, ready to enter the job market and drive the economy. From 2030 to 2035, this group will account for the biggest portion of Indonesia’s population.
However, for the large number of these children suffering from stunting, as adults they will be more susceptible to chronic diseases. This will lead to low productivity and income attainment, leaving them economically vulnerable.
In contrast to the bonus expected for Indonesia’s economy, this scenario would be disastrous. It would add pressure to the national budget to cover millions of potentially unemployed and newly poor citizens, through expansion of antipoverty and social protection programs.
Based on a study from the World Bank (2015), stunting reduces IQ scores by five to 11 points, resulting in lower grades among school children.
Stunted girls from poor families are more likely to give birth to babies who are also stunted. This perpetuates a vicious cycle of poverty that is difficult to break and reduces human capital potential in the future.
The World Bank (2016) estimates that a 1 percent reduction in adult height due to stunting correlates with a 1.4 percent loss in economic productivity.
Based on a study from the World Bank (2015), stunting reduces IQ scores by 5 to 11 points.
Studies also show that stunted children earn 20 percent less in lifetime earnings as adults compared to their non-stunted peers, and are 30 percent more likely to live in poverty.
Potential economic losses from stunting range from US$6.7 trillion to $43.4 trillion per year, depending on the country, according to research from the Department of Economics and Sociology and the Population Studies Center at the University of Pennsylvania. Through the study, researchers attempted to understand the pathways through which stunting causes economic losses from, among other things, diminished labor productivity and the cost of medical treatment resulting from health problems.
As such, the losses for each country will be dependent upon the respective medical systems, markets and policies in place.
The economic benefits of having better nutrition are substantial for individuals as well as a country. According to the World Bank, stunting can cause economic losses of 2 to 3 percent of a country’s gross domestic product (GDP) per year. For Indonesia, whose GDP in 2017 was about Rp 13,000 trillion ($873 billion), that would mean losses of around Rp 260 trillion to Rp 390 trillion per year.
Investing in better nutrition could increase productivity, fuel economic growth and reduce poverty. Better nutrition can improve cognitive development, school performance, physical work capacity and health by reducing the risk of chronic diseases. Healthy populations spend less on health care, which frees up resources for investment.
Public awareness campaigns about good nutrition and healthy lifestyles are really important, enabling the production of more competitive human capital.
A healthy and productive working-age population will also positively affect the aged population in the future. Eradicating stunting will have multiple benefits over the course of an individual’s lifetime, and will double the demographic.
More than just a health issue, stunting is a cross-cutting problem that calls for multisectoral responses. Action to reduce stunting requires long-term interventions to improve quality of life, including health, economic, environmental and social conditions at various stages of a person’s life.
It is a challenging task for policymakers to formulate policies that can minimize the risks and provide opportunities for the country’s economy in the future.
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The writer works at the Directorate of Poverty Reduction and Social Welfare at the National Development Planning Agency (Bappenas). The views expressed are her own.
