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Emo-Demo, empowering mothers to fight stunting

Visual campaign: Dozens of mothers attend a campaign event on the importance of healthy food intake for babies at an integrated health services post (Posyandu) in Sumber village, Probolinggo regency, East Java, coorganized by the local regency administration and a Swiss-based foundation, the Global Alliance for Improved Nutrition (GAIN), on Oct

Wahyoe Boediwardhana (The Jakarta Post)
Probolinggo, East Java
Mon, December 23, 2019

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Emo-Demo, empowering mothers to fight stunting

V

isual campaign: Dozens of mothers attend a campaign event on the importance of healthy food intake for babies at an integrated health services post (Posyandu) in Sumber village, Probolinggo regency, East Java, coorganized by the local regency administration and a Dutch-based healthcare NGO, the Global Alliance for Improved Nutrition (GAIN), on Oct. 29. The poster reads: “Ibu hamil, makan ATIKA” (Pregnant women should eat ATIKA [an acronym for chicken, liver, eggs and fish]). (JP/Wahyoe Boediwardhana)

The yard of the Dahlia integrated health services post (Posyandu) in Sumber village, Sumber district, Probolinggo regency, was crowded with dozens of mothers carrying their babies and sitting on plastic mats, on the morning of Oct. 29.

In the Posyandu yard of the village some 30 kilometers south of Probolinggo city, located at an altitude of 2,500 meters beside Mount Bromo, Sumiati, 43, a Sumber villager, kept gazing at the midwife standing before her.

The village midwife was holding two glasses of white liquid. The left-hand glass contained pure breast milk (ASI) and the right one formula milk powder dissolved in water. Then she put some cooking oil into both glasses while stirring.

The gathering of mothers attentively observed what happened next. In the glass of formula milk, the cooking oil gradually accumulated on top and the milk sank below it. In the other glass with ASI no cooking oil was left, meaning that the oil entirely merged into the ASI.

“I used to misunderstand how to feed infants for their growth. The simple explanation about ASI and mother-and-child ties has made me and the other women here get a better idea of the matter,” said Sumiati.

Sumiati finally got a full grasp of the importance of breastfeeding her babies. Through Emotion Demonstration (Emo-Demo), a method of educational campaigning about the significance of nutritional intake for children introduced by the Global Alliance for Improved Nutrition (GAIN), Sumiati witnessed the difference between ASI consumption and formula milk feeding.

“Everything was explained in a simple and easily understood way. Now I’ve got the point after my second child and my participation in this counseling,” added Sumiati.

The same was revealed by Wulan, 28, a Sumber resident. She hoped the local administration would continue to arrange this nutritional education for her and the other women in the village.

“We need a broader horizon about nutrition. My first baby is six months old. I want the best for my child so that he will grow healthily, physically and mentally,” said Wulan while caressing the baby boy she was carrying.

From the Emo-Demo nutritional education, Wulan claimed to have gained knowledge about how to nurse and take care of her child correctly, including how to maintain a pattern of nutritious food consumption as well as the child’s mental and emotional well-being.

“Especially ASI, it turns out to be of far higher quality than formula milk. I’ve just learned this after being guided by staff of this Posyandu,” added Wulan.

In the case of Sukarti, the mother of two with a two-year-old child also came to understand that children need the attention of their parents.

“Most mothers and I often leave the children to play on their own. Their mothers are chatting or shopping and the children are playing without being accompanied. Malnutrition and parents’ incorrect behavior toward children turn out to cause stunting,” said Sukarti at the Emo-Demo program monitoring session of the Health Ministry and GAIN.

Emo-Demo programs have four main themes. The first is about the sufficiency of giving ASI alone; the second about foods complementary to ASI; the third relates to the consumption of chicken, liver, eggs and fish (ATIKA) by expectant mothers; and the fourth is about washing hands with soap and other messages for pregnant women.

Today GAIN is also preparing 12 new modules, still with the theme of infant and child feeding (PMBA). The second-phase Emo-Demo with 12 ideas will be further developed to make it more complete. All the modules deal with entertaining games that are educative and with an emphasis on the emotional touch.

Financed by the Netherlands government, GAIN with its headquarters in Switzerland, has made Probolinggo regency one of its program targets for Indonesian people’s nutritional education.

“The nutrition issue is vital. Poor nutritional intake can cause stunting. Malnutrition and the environment where children live are some of the factors in stunting,” country director of GAIN Indonesia, Ravi K. Menon, said when visiting the GAIN program site in Probolinggo.

In Probolinggo regency there are 12 public health centers (Puskesmas) scattered over seven districts, which have become Emo-Demo program targets. The programs have reduced the rate of stunting by 10 percent. “This will be evaluated to determine whether or not we will continue the activity in the next period,” added Ravi.

Probolinggo Regent Puput Tantriana Sari on a separate occasion said she herself was among those who had recently learned what stunting was. Four years ago she had no knowledge of this condition. Only after an outbreak of stunting cases did she pay more intense attention to public nutrition in her region.

“In Probolinggo, human resources and lifestyle are the factors causing stunting. Local people are ignorant about the right food and nutrition, resulting in malnutrition. The poor nutrition turns out to involve the middle- and upper-income group. It’s because of random food consumption. For instance, some parents allow their children to eat rice with cilok [cassava snacks] or other instant food, with no nutritional value,” the regent pointed out.

The other thing affecting the issue is women’s awareness of the need to prevent stunting, which should precede pregnancy, particularly the understanding of nutritional intake. The problem is that most women only begin to realize that they are pregnant about three months after conception.

Tantri hoped GAIN would carry on its Emo-Demo programs in her regency to strengthen the public’s nutritional outlook. “This is the hope of the people. I’m going to prepare the program areas. It’s important for the community in Probolinggo to remain healthy,” she said.

In Probolinggo regency the stunting rate in 2013 stood at 49.9 percent, decreasing in 2018 to 39.9 percent. In East Java province, the rate was 35 percent in 2013 and declined to 32 percent in 2018.

Besides Probolinggo, GAIN has also implemented Emo-Demo programs in three regencies and a city in East Java, namely Surabaya and the regencies of Jember, Bondowoso and Trenggalek.

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