The decline in health workers slows down, the number of health workers only falls by 0.1 percent

Tengkes figures tend to stagnate, only decreasing by around 0.1 percent from the previous year. Problem identification is required.

ARSIP BKKBN

The Head of the National Population and Family Planning Agency (BKKBN), Hasto Wardoyo, measured the height of a child in Soe, Central South Timor District, East Nusa Tenggara on Tuesday (22/3/2022). Out of 100 toddlers there, 48 of them suffered from stunting.

JAKARTA, KOMPAS — Figures stunting or tengkes tend to stagnate. The latest data shows that the number of tengkes only fell 0.1 percent over one year. Factors causing the slowdown in this decline must be immediately identified. Apart from that, interventions are also encouraged to focus on super-priority groups.

The government has targeted the tengkes figure to fall to 14 percent by 2024. To achieve this target, ideally every year the tengkes figure must fall by around 3.8 percent. However, from data from Indonesian Health Survey in 2023, the figure of stunting is still 21.5 percent. That means, it only fell 0.1 percent from the previous year when referring to the 2022 Indonesian Nutrition Status Survey (SSGI) data.

Vice President Ma'ruf Amin stated that the decrease in the poverty rate has been slowing down in the past two years. Therefore, identification needs to be conducted to find out the factors causing the deceleration of the poverty rate's decline.

"I ask that the factors that have caused the achievement of stunting reduction to slow down in the last two years be identified and navigated," he said at the opening of the National Working Meeting of the Proud of Kencana and Acceleration Program Decreasing Stunting 2024 at the Population and Family Planning Agency (BKKBN), Jakarta, Thursday (25/4/2024).

The factors that have caused the achievement of stunting reduction to slow down in the last two years need to be identified and navigated,

In addition, the Vice President also encouraged policy interventions to be focused on things that have leverage in accelerating the reduction of air pollution. The commitment and vision of leaders towards the program to reduce air pollution must be maintained, especially during the transition and change of leadership this year.

According to him, the programs that have been implemented so far need to be evaluated, both in terms of achievements, learning, and recommendations. This evaluation is crucial so that the programs that have been carried out can be ensured to continue and remain a priority for the next government.

Tengkes should be prevented early on by ensuring that each family member receives adequate nutrition, providing exclusive breastfeeding for babies aged 0-6 months, access to safe sanitation and drinking water, healthy hygiene practices, and proper parenting. Families also need to be encouraged to be more proactive in accessing healthcare services, such as regular prenatal check-ups, immunizations, and monitoring of child development periodically.

Also read: Running to Pursue the Target of Reducing Tengkes

Previously, President Joko Widodo stated during the National Health Work Meeting 2024 that the target of reducing air pollution by 14 percent is not easy to achieve. The efforts to reduce air pollution must be done in an integrated manner by all parties.

"Indeed, the 14 percent target is very ambitious. But, if not, we won't work hard to achieve that.” he said.

Quoting tengkes data from the 2023 Indonesian Health Survey which was presented at the National Working Meeting of the Bangga Kencana Program and the Acceleration of Stunting Reduction 2024, the tengkes figure was 21.5 percent. When compared with the previous year, the tengkes figure only fell 0.1 percent.

From the data provided, it is also mentioned that the highest decrease in smoky kitchens prevalence occurred in West Papua, West Nusa Tenggara, Papua, and South Papua. However, an increase in smoky kitchens prevalence actually occurred in other areas with an increase of more than 5 percent, namely in DKI Jakarta, Bangka Belitung Islands, Banten, Gorontalo, Maluku, and Southeast Sulawesi.

The Head of the National Population and Family Planning Agency (BKKBN), Hasto Wardoyo, stated that the alignment of tengkes data still needs to be carried out between the data from the Indonesian Health Survey (SKI) and data from electronic nutrition recording and reporting based on community (E-PPGBM). Therefore, body weight and height measurements for every child conducted in E-PPGBM must be maximized up to 100 percent.

KOMPAS/HENDRA A SETYAWAN

An awareness campaign regarding the handling of children under five who are stunted was seen in the Pondok Pinang area, Jakarta, Wednesday (17/4/2019). Nationally, according to Basic Health Research (Riskesdas), 30.8 percent of children under five years old (toddlers) experienced short stature in 2018.

"E-PPGBM is like a real count, while SKI is like a quick count due to surveys. "If E-PPGBM is verified, I am sure the figure (stunting) will be far below 20 percent, so I am sure that if we use E-PPGBM the data will even be below 14 percent," he said.

Hasto said that the data collection related to families at risk of poverty has reportedly experienced a significant decrease. In 2021, the number of families at risk of poverty was 21.9 million, which decreased to 11.9 million in 2023.

However, concerning indicators related to basic needs, such as the large number of uninhabitable houses reaching 8 million, poor sanitation remains about 6.3 million points unchanged. This also applies to sources of drinking water that are still inadequate, around 2.6 million.

Also read: Reducing Tengkes Must Be Sustainable

This condition needs to be paid attention to because a study in 137 countries shows that environmental factors, including poor water and sanitation conditions, contribute greatly up to 21.7 percent to mortality rates. This is the largest contributor after factors from maternal health during pregnancy.

JOHANES GALUH BIMANTARA

Lead Strategist of the 1000 Days Fund, Zack Petersen, provided education on preventing stunting through a smart poster to a pregnant woman in the Gorontalo Village of Komodo District, West Manggarai, East Nusa Tenggara on Sunday (22/11/2020).

Hasto believes that changing behavior in society is the biggest challenge in reducing the number of malnourished individuals in Indonesia. Behavioral changes include poor nutrition in dietary habits and awareness of reproductive health. In addition, the challenge of changing sanitation behavior in society is also a difficult task.

Superpriority goals

The Secretary Manager of the National Stunting Acceleration Team 2024, Sudibyo Alimoeso, who is also the Chairman of the Indonesian Practitioners and Experts Association of Demography, stated that the target of reducing stunting rates in Indonesia is becoming increasingly difficult to achieve. This is because, from the experience of several countries, the achieved decrease in stunting rates is only about 1.5 percent per year. If Indonesia targets a reduction in stunting rates to 14 percent by 2024, the reduction must reach 7.5 percent this year.

"If it's just business as usual, our stunting rate will only be 19 percent in 2024. If we want 14 percent, we have to have the courage to prevent new stunting from happening . The key is to preventnew stunting. Upstream must be intercepted first," he said.

According to Sudibyo, the target in reducing stunting should be more focused on the super-priority groups, namely pregnant women and children under two years old. The prevalence of stunting jumps occur in the age groups of 0-5 months and 6-23 months. This group should be wary if malnutrition is found.

DEONISIA ARLINTA

A child is having his head circumference measured while receiving services at Posyandu Mawar Merah, Klangon Hamlet, Sedayu, Bantul. Yogyakarta, Friday (10/2/2023). In the posyandu service, monitoring of children's growth and development is carried out, giving vitamin A, and providing healthy food with animal protein to each child. This service is to prevent and handle stunting (stunting) more precisely.

The slow decrease in malnutrition can also be evaluated based on specific indicators in malnutrition interventions. Out of the nine specific malnutrition intervention indicators, only three have reached their targets, namely the percentage of pregnant women consuming iron supplements, adolescent girls consuming iron supplements, and malnourished toddlers receiving treatment.

Meanwhile, six other indicators have not yet reached their targets. These include pregnant mothers with chronic energy deficiency given additional nutrition, infants aged less than 6 months being given exclusive breastfeeding, children aged 6-23 months receiving complementary feeding, and malnourished toddlers receiving additional nutrient intake.

Sudibyo added that interventions to reduce air pollution are currently expected to be carried out through real and more convergent, holistic, and integrated actions. Interventions from stakeholders, both at the central and regional levels, as well as other stakeholders, must target the same targets in the same place. If it is still done sporadically, interventions will not be targeted. In addition, convergence at the family level is a priority.

Also read: Tengkes, Between Definitions and Numbers

"The budget is also very large, up to IDR 30 trillion with IDR 20 trillion through PKH (Family Hope Program) and social assistance (social assistance). "I think in the future there is a need for tagging a special budget for stunting and ensuring compliance in implementation," he said.