Dr. Dini Latief MSc., SpGK. Grand Sahid Jaya Hotel, 13 14 December - - PowerPoint PPT Presentation

INTERNATIONAL CONFERENCE ON CSR AND COMBATING MALNUTRITION: OBTAINING MILLENNIUM DEVELOPMENT GOALS (MDGs) IN INDONESIA

Grand Sahid Jaya Hotel, 13 – 14 December 2010

Session 1: Prevention & Intervention in Improving The National Nutrition Status in Indonesia

• Dr. Dini Latief MSc., SpGK.

Maternal and Child Nutrition for Preventing and Improving the Nation’s Nutritional Status Indonesia’s Experience

Dr Dini Latief, MSc, SpGK

Dr Dini Latief, MSc, SpGK

Nutritional Status of Children Under-5

(RISKESDAS, 2010)

17,9 35,6 13,3 14,2 5 10 15 20 25 30 35 40 GIZI KURANG PENDEK KURUS GEMUK Prevalensi (%)

3

Prevalence of Stunting by Province

Riskesdas, 2010

0.0 5.0 10.0 15.0 20.0 25.0 30.0 35.0 40.0

NAD Sumut SumBar Riau Jambi SumSel Bengkulu Lampung BaBel KepRi Jakarta Jabar Jateng DI Yogya Jatim Banten Bali NTB NTT KalBar KalTim KalSel KalTim SulUt SulTeng SulSel SulTera Gorontalo SulBar Maluku MalUt PapBar Papua INDONESIA

2007 2010

Prevalence of Underweight by Province

2007 and 2010 (Riskesdas)

Mapping of severe underweight (gizi buruk )

Riskedas, 2010 MGDs target 2015 ≤ 3.5 %

≤ 3.5 % 3.6-7.0 % > 7.0 %

Percentage of Population with Energy Intake <1400 Kkal/cap/day, by Province

Susenas, 2009

Child growth failure Low birthweight baby Low weight & height in teenagers

Early pregnancy

Small adult woman Small adult man

The intergenerational transmission of growth failure: When to intervene in the life cycle?

(ACC/SCN, 1992)

Critical Period of Child’s Growth

Abas, 2009

10

Critical Period of Child’s Growth

(Indonesia’s data)

Window of Opportunity

• Maternal and birth outcomes
• Newborn babies
• Infants and children under two years old

The Womb. Your Mother. Yourself.

What makes the way we are?

• 1. Our genes: the DNA we inherited at

conception

• 2. Our childhood experiences: how we were

treated and what we took in, especially the first three years

• 3. Our health and well-being stem from the

lifestyle choices: kind of diet and how much exercise

• 4. Powerful source of influence:

Our life as a fetus

(David Baker et al, 1990)

a) The kind and quantity of nutrition received in the womb b) The pollutants, drugs and infections exposed to during gestation c) The mother’s health, stress level and state of mind while she was pregnant

Sufficient evidence of interventions that affect maternal and child undernutrition in Indonesia

• 1. Maternal and birth outcomes: Ante-natal care incl.

iron-folate/calcium supplementation and TT immunization, consumption of iodized salt, reduce tobacco consumption and indoor air pollution, maternal supplement of balanced energy and protein, insecticide-treated bednets.

• 2. Newborn babies: Promotion of breastfeeding

(individual and group counseling) and immunization.

Sufficient evidence of interventions that affect maternal and child undernutrition

• 3. Infant and children: Promotion of

breastfeeding, Behavior change communication for improved complementary feeding, completed immunization, Zn in management of diarrhea, Iron-Vitamin A fortification and supplementation, Universal iodized salt, hand washing or hygiene interventions, treatment of severe malnutrition, insecticide-treated bednets.

INDONESIA National Plan of Actions on Food and Nutrition

Policy on Food and Nutrition

• 1. Strengthen poverty reduction for increased impact on

child and maternal undernutrition.

• 2. Focusing key nutrition interventions targeted at

vulnerable group of pre-pregnant, pregnant and lactating women and children under two years of age.

• 3. Improve food security at local level and increase

accessibility of the poor to adequate nutritious and safe food. 4. Healthy and Clean Life-style behaviour

• 5. Strengthen Food and Nutrition Institution at all level

Strategy of Plan of Actions for Food and Nutrition

• 1. New initiatives for more effective interventions

at selected Provinces/Districts (prevalence of underweight > 15.5%, stunting >32% and daily energy intake <2000 Kkal/cap/day).

• 2. Gold standard of infant feeding incl. promotion
• f breastfeeding and complementary feeding
• 3. Hygiene and sanitation
• 4. Identify deployment gaps and competencies of

human resources for health and nutrition.

Target: Universal Access to Food and Nutrition in 2015 All Kabupaten/Kota:

• 1. Prevalence of underweight of children under

five years of age: <15.5%

• 2. Prevalence of stunting of children under five

years of age: <32%

• 3. Energy intake <2000Kkal/cap/day: 35.32% of

population

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