Improving child nutrition in Indonesia

by Because I am a Girl

Here's a great post by Wahdini Hakim, Health Specialist for Plan Indonesia, about a Child Nutrition Project implemented from 2008-2010. The project was such a success that it has been used as a base for our current Food Security and Nutrition Project in Indonesia, which you can learn more about here!

By Wahdini Hakim

I visited Dompu once again - a little, beautiful place in Sumbawa island, in the eastern part of the country. Sitting on the sand, enjoying the beautiful painting of sky above the Dompu beach, and smelling of local seaweed. The atmosphere brought me back to memories of enthusiasm when health cadres, village midwives and traditional leaders gathered to develop their action plan to improve the nutrition situation for boys and girls in one of the villages.

The long journey to implement the plan involved all efforts and commitments to happen. There were times where female cadres needed to climb trees just to be able to send short messages so that health staff knew that there were undernourished children that needed referral to health facilities - the Puskesmas (and yes, mobile phone signal is a precious thing that we can hardly find there). There were also times when childrens groups worked hard to develop messages for their community radio, to make sure that growth monitoring schedules were in local community health posts - the Posyandu were broadcasted on time, and health staff were informed to oversee the sessions. These were only some of experiences the villagers faced in the Food and Nutrition Project implemented in Dompu, Sikka and Lembata districts from 2008 to 2010.

But I guess the community hard work eventually brought rewards. The implemented community plan managed to improve the quality of the services provided by Posyandu through extensive training on nutrition and caring practices to cadres. Almost all Posyandu reached the level of Purnama, categorization acknowledging of the quality of health services provided to the communities. As a result, the attendance of children under five in Posyandu increased: in Sikka, the proportion of children being regularly weighted increased from 69 to 79%, in Lembata, the proportion of children not gaining enough weight also decreased from 31% to 27%.

When necessary, Posyandu organized nutrition rehabilitation sessions for undernourished children and their caregivers/parents. Among undernourished children reached, 75% were rehabilitated. Also, parents and caregivers learned to use good caring practices (active feeding, greater diversity of food provided to children, exclusive breastfeeding for infants under 6 months, etc) in the sessions. Further, the project introduced the concept of home gardening, to impact the diversity of food offered to young children. While almost no household had a home garden in the beginning of the project, an average of 82,1% of the households surveyed had a home garden in 2010. The FNS project managed to reduce prevalence of underweight children among under 5 year olds by 5%.

Despite results achieved, many more needs to be done. I just realized that too many adolescent girls have become pregnant in Dompu alone (I just met at least 7 of them this week!). This situation brings unnecessary health and nutrition risk for themselves, their children, and thus their communities, now and in the future. Special attention should be given to adolescent girls, for them to avoid becoming pregnant at young age, be prepared for reproductive roles they may take in the future, and be equipped with knowledge and skills around women's and children's health and nutrition. Adolescent girls have the power to bring more impact to nutrition situation of future infant and young children in the communities.