Two children in face masks at the Mekar Sari Integrated Health Service Post (Posyandu), South Karangasem, Batang on August 15, 2020. (Antara Photo/Harviyan Perdana Putra)

Educating Vulnerable Groups on Stunting Crucial to its Prevention

DECEMBER 02, 2021

Jakarta. Helping the vulnerable group, which includes pregnant women and future brides, to better understand the risks of stunting is crucial to prevent the low height for age condition affecting their children.

The Covid-19 pandemic has posed a number of new challenges. Among others is stunting.  Main factors leading to stunting include poor access to healthy nutrition, sanitation or clean water by low-income families and those who lose their jobs due to the coronavirus outbreak.

But one cannot combat stunting alone. It takes a multi stakeholder collaboration, especially during this pandemic. 

Agus Suprapto, the health quality improvement and population development deputy at the Coordinating Ministry Human Development and Cultural Affairs, said that theoretically, the pandemic has led to an increase in stunting in the country.

“But we need to take a look at the most recent survey first.” Agus said on Tuesday.

The government has made efforts to help improve people’s prosperity and food security, including distributing food packages for those in need. Indonesia has also set the goal of lowering its stunting rate to 14 percent by 2024.

Education on stunting, however, should not only focus on infants and children. But also the vulnerable groups, namely anemic teens, future brides and grooms, fertile age couples, pregnant mothers, and newborns. 

“To achieve that 14 percent [reduction] target, [we must direct] our education orientation to the upstream again,” Agus said. 

And with local culture’s great influence on nutritional education, Agus suggested that “it is best that the [educational campaigns] are done by the local communities.” 

According to Agus, the nutritional status of the future brides and pregnant mothers have an effect on the baby’s health. He recommends that the mentoring of pregnant mothers be done individually, as each individual has their own uniqueness and problems.

Kartini Rustandi, the Health Ministry’s acting director general of public health, underscored the people’s worry wh visit community health facilities (puskesmas) amid the Covid-19 pandemic.

There are a number of ways to make sure children grow up healthy, including taking them to integrated health services posts (posyandu) while also paying attention to the health protocols.

“In certain regions, there are cadres and health workers that go door-to-door,” Kartini said.

Nowadays, telecounseling can be an option. Pregnant women can also visit the public health facility by making appointments and implementing health protocols at all times. 

According to Kartini, pregnant mothers should have regular health check-ups to give birth to a healthy baby.

She also advised pregnant women to maintain their health, eat a healthy diet, as well as keep their environment healthy and cigarette smoke-free.

But nutrition is not the only factor that can lead to stunting, Kartini said.

Parenting, eating habits, and local culture can cause stunting in children. For instance, local misconceptions that eating fish can be detrimental to one’s health. Such hoaxes can affect the children or pregnant women’s nutritional intake.

Indonesian Doctor Association (IDI) chairman Adib Khumaidi highlighted the importance of education as a preventive and promotive effort in health, including in preventing stunting.

"The main problem in overcoming health [issues] is with promotive preventive efforts, not curative efforts," he said. 

We should be able to identify cases of malnourished children first before waiting for them to visit the puskesmas. To this end, Adib hopes for a revitalization in the puskesmas’ role.

“Puskesmas is the regional manager and the regional representative of the Health Ministry. This is the role that must be pushed forward,” Adib said.

Gorontalo Regional Development Planning Agency head Cokro R. Katilie said his team is working alongside multiple stakeholders to double down education on stunting. Among these stakeholders include the Religious Affairs Ministry, who help raise the future bride and groom’s awareness on stunting through the local religious affairs offices.

Tackling stunting requires seamless coordination with various parties because stunting is not only a health issue. But it is also an issue of infrastructure, sanitation, culture, food security, among others.

According to Cokro, thanks to this collaboration —also with the help of the National Population and Family Planning Board’s family companion teams, the stunting rate in his region has dropped drastically from 37 percent to 9 percent.