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View all search resultsStunting in Indonesia: Winning the battle but losing the war?
The strategy of keeping highly stunted communities on life support through constant food and supplement donations is risky and unsustainable.
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bout 27.7 percent (1 out of 4) Indonesian children under 5 years of age remain stunted, despite massive efforts by the government. This figure from the Health Ministry's 2019 Basic Health Research (Riskedas) indicates an improvement from the 2018 national average of 31.8 percent. But with a stunting prevalence of 42.6 percent, East Nusa Tenggara – one of the archipelago's most deprived and neglected regions – is perhaps a better gauge of the nation's success, if not trials and tribulations, in its ongoing battle against this scourge.
Stunting, a term that conjures up images of film doubles engaged in death-defying moves, actually refers to a condition where undernourished children suffer reduced growth of body and brain. The more conspicuous sign is a shorter stature or low height for age, or a low weight for age in the case of extreme undernourishment, a condition called wasting. Less apparent, though more serious, is the deleterious effect on the nervous system, impairing cognitive and learning abilities.
Stunted and wasted children are inexorably condemned to a life of protracted pain and suffering, if they manage to avoid a premature death. A weakened immune system exposes them to a litany of diseases such as diarrhea and pneumonia. A compromised brain drastically lowers their academic achievement.
Further hurdles await them later in adult life in the form of chronic diseases such as diabetes, hypertension, coronary heart disease and obesity, lowering their productivity and earnings potential, and putting them at a greater risk of extreme poverty. Indeed, the estimated 10.5 percent gross domestic product loss to the Indonesian economy as a result of unachieved productivity and development is nothing short of an exaggeration.
Over the years, the Health Ministry has delivered a host of anti-stunting programs. The bulk of these programs consists of nutritional correction among mothers in the form of iron tablets (against anemia) while they are expecting, with micronutrient supplementation after they give birth until the child is 2 years of age (1000 days).
The ministry has also actively promoted best practices related to breastfeeding, complementary feeding, therapeutic feeding and basic hygiene. Undoubtedly, these large-scale measures have been effective. From 2007 to 2013, the nationwide stunting rate for children below 5 hovered around 37.2 percent (9.5 million children). This figure was first reduced to 30.5 percent in 2018 and then to 27.7 percent in 2019 – a downward trend suggesting that Indonesia is on course to achieve its noble but ambitious goal of eradicating stunting in 2030.
The government needs to be applauded for its Herculean efforts to reach out to nearly 268 million people scattered across 17,508 islands. However, an unbridled optimism about the eradication of stunting within the next 10 years is potentially dangerous, for a few reasons.
