By Katie Sutton (ANutr), EBPP Public Health Nutritionist
Stunting is the most prevalent form of undernutrition today, and an estimated 165 million children below 5 years are affected globally.[i] The World Health Assembly 2012 Global Targets ambitiously promote a 40% reduction in the number of stunted children, globally, by 2025.
- Young boy enjoying his formula milk supplement at posyandu
Indonesia is one of 54 countries signed on to the Scaling Up Nutrition Movement, a multi-sector initiative aimed at reducing global levels of stunting. Stunting is a result of chronic malnutrition, leading to short stature and impaired brain development, and negatively impacts the health and intelligence of individuals and subsequently their future economic earning potential. Stunting, in turn therefore, negatively impacts the communities in which people live, and also the economic health of the nation.
Since the 1980s, the Indonesian government has been running monthly health posts, led by community volunteers trained by local health departments. With over 260,000 posyandus nationwide, they serve as a ‘one-stop shop’, which families can attend to receive immunisations, contraception, healthcare, and education and advice. When East Bali Poverty Project started working in Desa Ban, there were just 3 active posyandus because road access was so poor, or non-existent. With this in mind, EBPP began to establish posyandus for the 19 hamlets of Desa Ban. Attending women would often be pregnant, and/or have small children with them, and both the terrain, and the vast distances between residences rendered it impractical to have just one posyandu per hamlet. EBPP set the standard that no woman should walk more than 45 minutes to get to posyandu, and by the end of 2003, through sheer determination, 27 posyandus facilitating this standard were active. Because local Puskesmas (government health centre) staff did not have suitable transport to navigate the terrain and attend, EBPP transported them on their trail bikes. These 27 posyandus have been operating in partnership with local government health staff ever since.
We have recently identified, through comprehensive data collection at posyandu, a high level of stunting in the communities in which we work. It is important that families attend posyandu, where children are monitored for malnutrition, but it is not always easy due to poor roads and work and family commitments. In order to reinforce the importance of attending posyandu to address this issue, the EBPP Health Team had the idea to produce a video resource that can teach children, parents, and parents to be, about good nutrition, health, and hygiene.
In February, we were fortunate enough to have our second visit from Ross Green, Founder of grassroots charity Music Seeds International, to realise our idea, and we set to work creating a video called ‘Scale Up Nutrition’. Children from 3 of our 6 EBPP schools were involved in the story-making, music, singing, and acting. The video was designed to communicate the key messages about good nutrition, health, and hygiene practices that are the foundation on which the posyandu is based.
[i] UNICEF, WHO, World Bank. Levels and Trends in Child Malnutrition. Joint Child Malnutrition Estimates. New York, NY: United Nations International Children’s Fund; Geneva: WHO; Washington, DC: World Bank, 2012. Available from: http://www.who.int/nutgrowthdb/estimates/en/