Indonesia has been facing the serious problem of stunting. Basic Health Research conducted in 2007, 2010 and 2013 shows that the prevalence of stunted toddlers was respectively 36.8 percent, 35.6 percent and 37.2 percent.
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Kompas/P Raditya Mahendra Yasa
Children from various rural districts are still undergoing treatment for malnutrition and measles in Agats General Hospital, Agats district, Asmat regency, Papua, on Thursday (25/1). Long-term government programs are currently needed to deal with health problems for the people in rural areas of Papua.
JAKARTA, KOMPAS – The high prevalence of stunting cases is threatening the quality and productivity of the future generation. If the issue is not resolved soon, Indonesia will reap a productivity problem in conjunction with a population boom at the peak of the nation’s projected demographic bonus in 2020-2040.
“Stunting indicates a more serious problem than malnutrition,” nutrition and public health science professor Endang L Achadi of the University of Indonesia said on Tuesday (27/3) at the Stunting Conference in Jakarta.
Children with stunted development are shorter than the typical height of children their age. Meanwhile, children suffering from malnutrition are generally described as having lower weight than is normal for their age, without specifically defining their physical condition or nutritional status.
Developmental issues from the formation of the fetus to the first 1,000 days of an infant’s life may affect a child’s growth and lead to stunting. Stunting is closely related to the development of an infant’s brain and other organs.
“Stunting has a serious effect on intelligence, and it increases the risk of non-communicable diseases in adulthood, including diabetes, kidney failure, heart disease and stroke,” said Endang.
Indonesia has been facing the serious problem of stunting. Basic Health Research conducted in 2007, 2010 and 2013 shows that the prevalence of stunted toddlers was respectively 36.8 percent, 35.6 percent and 37.2 percent. This means that of the approximately 24 million toddlers in 2013, nine million experienced stunted growth. This is almost equal to twice the entire population of Singapore (Kompas, 26/2/2014).
The Global Nutrition Report 2014 placed Indonesia among the top five countries in the world with the highest prevalence of stunting cases. Indonesia was also included among the 17 out of 117 countries – along with a number of South Asian and African countries – that faced the dual nutritional burdens of having stunted, underweight children and obese children.
“When these stunted children reach adulthood at a time when we expect to enjoy our demographic bonus, Indonesia will have a population of low-quality, productive-age people,” said human, community and cultural development deputy Subandi Sardjoko of the National Development Planning Ministry.
Villages, Disadvantaged Regions and Transmigration Minister Eko Putro Sandjojo said that this could hinder Indonesia from becoming an advanced nation, despite the country expecting to have the world’s largest gross domestic product in 2030.
“Resolving stunting is a huge job for us. If we don’t deal with this immediately, we will have an unprepared workforce,” Eko said.
The issue of stunting is not just a health problem. Stunted children are a result not only of poor behavioral patterns and low nutritional intake among children and pregnant women; social and infrastructure problems can also lead to stunting.
Endang said that stunting in children could also be the result of infectious diseases, which were caused by poor sanitation and healthcare infrastructure, including the lack of clean water facilities.
Meanwhile, Subandi highlighted the trend of preferring thin bodies among female teenagers. Poor nutrient intake during adolescence could lead to a woman’s inability to supply enough nutrients to support fetal development when they become pregnant, and thus lead to stunted babies.
Economic burden
Apart from the poor quality of human resources, productivity will also be poor; apart from diminished intelligence, the higher risk of disease could also hinder performance. As a result, it will be increasingly difficult for such adults to compete within the global workforce.
In addition, non-optimal organ development in stunted children may increase their risk of infection from degenerative diseases in adulthood. Of the five non-communicable diseases with the highest fatality rate in 2014, four are related to nutrition, namely strokes, cardiovascular diseases, diabetes and hypertension.
These conditions will certainly increase Indonesia’s healthcare costs. The financial burden of the National Health Insurance program, which is managed by the Healthcare and Social Security Agency (BPJS Kesehatan) and is currently in deficit, will continue to rise.
Nevertheless, Subandi said, “Those suffering from stunting come from not just poor families. Those with higher financial capacity can also be exposed to this condition if they have a low awareness of nutrition and health.”
The condition reflects the similar prevalence of hypertension and coronary disease among the 20 percent poorest and 20 percent richest Indonesians.
Therefore, the government launched an integrated measure in 2017 to tackle the problem of nutritional intake. The program involves 12 ministries and state institutions. Interventional measures include healthcare programs, the development of clean water facilities and training for young couples before marriage.
"The village funds can also be used for infrastructure development to lower stunting [figures]," said Eko.
