Drivers of Stunting Reduction in Yogyakarta, Indonesia: A Case Study

Abstract

Background: Chronic malnutrition in children is a severe global health concern. In Yogyakarta, the number of children who are too short for their age has dropped dramatically over the past few decades. Objective: To perform an analysis of trends, policies, and programs; and an assessment of government, community, household, and individual drivers of the stunting reduction in Yogyakarta, Indonesia. Method: Using a mixed-methods approach, there were three types of research: (1) analysis of quantitative data, (2) evaluation of stunting policy, and (3) focus group discussions and in-depth interviews to collect qualitative data. Results: The prevalence of stunting has decreased from year to year. Mean height-for-age z-scores (HAZ) improved by 0.22 SDs from 2013 to 2021. Male and female toddlers aged <20 months have relatively the same body length as the WHO median, but it is lower for children >20 months old. The COVID-19 pandemic has contributed to an increase in stunting-concurrent wasting. Nutrition-specific and -sensitive interventions have been carried out with coverage that continues to increase from year to year, although in 2020, or at the beginning of the COVID-19 pandemic, the coverage of specific interventions decreased. The government has committed to tackling stunting by implementing the five pillars of stunting prevention and the eight convergent stunting actions. As the drivers of stunting reduction, national and community stakeholders and mothers, at the village level, cited a combination of poverty reduction, years of formal education, prevention of early marriage, access to food, enhanced knowledge and perception, and increased access to sanitation and hygiene. Conclusions: Nutrition-specific and -sensitive sector improvements have been crucial for decreasing stunting in Yogyakarta, particularly in the areas of poverty reduction, food access, preventing child marriage, sanitation, education, and increasing knowledge and perception.

Determinant factors of stunting incidence in Muara Enim Regency, South Sumatra Province

“…If short toddlers do not acquire adequate nourishment, they will be unable to compensate for normal age-related growth, resulting in youngsters who are smaller than other teenagers [8]. It is an irreversible physiological, physical, and cognitive syndrome caused by poor nourishment and repeated bouts of infection beginning at conception [1], [9].…”

“…Stunting is a disorder that results from persistent malnutrition in children from an early age [1]. Chronic undernutrition during growth and development from the beginning of life is called stunting.…”

“…Chronic undernutrition during growth and development from the beginning of life is called stunting. If a child's height is less than minus two standard deviations from the length or height of a child his age, that youngster is considered stunted [1]. The detrimental consequence of inadequate dietary intake during pregnancy and the early years is stunting, which impacts children's maximum height and cognitive capacity [2].…”

Audiovisual Media Increases Stunting Prevention Knowledge Among Pregnant Women in The Working Area of Wani Health Center: Pretest, Posttest 1 dan Posttest 2

“…The highest prevalence of stunting under five is Sigi Regency (36.8%) and Donggala ranks fourth (32.4%) out of 13 regencies/cities 6 . In the working area of the Wani Health Center, the stunting toddler data for 2020 was 28.2% and 2021 decreased to 21.7% 10,11 . Pregnant women are one of the target groups for stunting reduction interventions 12,13 .…”

Effectiveness of Stunting Prevention Programs in Indonesia : A Systematic Review

“…National policymakers and the World Bank have discussed these five pillars, developed based on Indonesian knowledge and global best leadership, national media campaigns, integration of national programs with regional and community initiatives, nutrition and food security policies, and monitoring and evaluation. The implementation of convergent actions to reduce stunting is carried out through 8 convergent actions, which include situation analysis (business planning), action planning, stunting discussions, village role regulations, human development, staff development, data management systems, measuring and publishing stunting data, and evaluating performance annually (Siswati et al, 2022a).…”