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 Session 1: Prevention & Intervention in Improving The National Nutrition Status in Indonesia Dr. Dini Latief MSc., SpGK. Grand Sahid Jaya Hotel, 13 – 14 December 2010

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) 40 35,6 35 30 Prevalensi (%) 25 17,9 20 14,2 13,3 15 10 5 0 GIZI KURANG PENDEK KURUS GEMUK 3

Prevalence of Stunting by Province Riskesdas, 2010

Prevalence of Underweight by Province 10.0 15.0 20.0 25.0 30.0 35.0 40.0 0.0 5.0 NAD Sumut SumBar Riau Jambi SumSel Bengkulu Lampung 2007 and 2010 (Riskesdas) 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 2010 2007

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

The intergenerational transmission of growth failure: When to intervene in the life cycle? (ACC/SCN, 1992) Child growth failure Low birthweight Low weight & Early pregnancy baby height in teenagers Small adult woman Small adult man

Critical P eriod of Child’s Growth

Critical Period of Child’s Growth (Indonesia’s data) 10 Abas, 2009

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 of 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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