Reducing Stunting in Rural Areas
Broadly speaking, there are three causes of stunting: inability, ignorance and unwillingness. The incapacity of the population is usually associated with poverty.
One of the challenges in developing Indonesia's human resources, including in rural areas, is overcoming stunting, locally known as tengkes. Data shows the prevalence of stunting in Indonesia in 2021 amounts to 24.4 percent, still above the standard figure of 20 percent set by the World Health Organization (WHO).
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Stunting is the impaired growth and development that children experience from poor nutrition, repeated infection and inadequate psychosocial stimulation from the time they are in the womb until the first 1,000 days of life. Stunting not only results in poor quality of physical health, but also interferes with intellectual development when the children are adults. In short, stunting has a negative impact on the quality of human resources.
The ministry has also published several pocket books of guidelines for dealing with stunting or tengkes, which contain a quite detailed list of activities and indicators of the success of the treatment program.
The management of stunting is one of the priorities of the Villages, Development of Disadvantaged Regions and Transmigration Ministry, which is reflected in the continued increase in the village funds to overcome stunting since 2018. The ministry has also published several pocket books of guidelines for dealing with stunting or tengkes, which contain a quite detailed list of activities and indicators of the success of the treatment program.
Ability and knowledge
Broadly speaking, there are three causes of stunting: inability, ignorance and unwillingness. The incapacity of the population is usually associated with poverty. The poor are not able to provide nutritious food for pregnant women and their children under five, and are not able to provide adequate sanitation facilities so that they are vulnerable to disease which, in the end, causes stunting.
Data from the Statistics Indonesia (BPS) shows that poverty in rural areas is higher than poverty in urban areas. In 2021, 7.6 percent of the urban population fell into the poor category, while in rural areas the figure reached 12.52 percent. The poverty depth and severity index data also show that the problem is graver in rural areas than urban ones.
All activities are listed in the Villages, Development of Disadvantaged Regions and Transmigration Ministry’s guidebook.
Various programs to improve the welfare of the population have been implemented to help cope with stunting caused by economic incapacity. In addition, village administrations have a program to provide nutritious food and vitamins at certain times for pregnant women and children under five. All activities are listed in the Villages, Development of Disadvantaged Regions and Transmigration Ministry’s guidebook.
The second cause is ignorance. To prevent stunting, it is necessary to provide children with balanced nutrition: not only carbohydrates, but also protein, vitamins and minerals. In terms of protein consumption, for example, data from the 2021 BPS National Socio-Economic Survey (Susenas) shows that the average protein consumption of Indonesians (all ages) is 22 grams per day (equivalent to 237 kcal). The protein sources are fish and other seafood, milk and eggs, meat and nuts. If based on urban and rural areas, the figure is 257 kcal for urban and 211 kcal for rural.
The consumption level of 22 g per day is only ideal to meet the protein needs of the 4- to 6-year-old group. The need for protein increases with age. Adults of productive age (19-65 years) need 60 g to 65 g per day. From these figures, it can be concluded that the protein requirement for children under five, especially children under five in rural areas, is far below the ideal figure.
Will
Various policies to overcome stunting have been and are being implemented. Nevertheless, it is necessary to think about the sustainability of the policy in the long term when all government interventions have been removed. It means that residents must be able to make their own efforts to prevent stunting independently and voluntarily.
Making people aware that preventing stunting is for their own good, not for the interest of the government, requires the expertise of human development cadres (KPM) in villages providing assistance.
When a healthy lifestyle is within the reach of the people and their knowledge of a healthy lifestyle is also adequate, the sustainable efforts to prevent stunting depend on the will of the people. Perhaps this stage is the most challenging: instilling the idea that prevention of stunting is the need of the people and therefore they should do everything they can to achieve it. Making people aware that preventing stunting is for their own good, not for the interest of the government, requires the expertise of human development cadres (KPM) in villages providing assistance.
The willingness of the population to make efforts to prevent stunting is also influenced by the level of ease of doing so. Providing adequate food nutrition, for example, is easier and cheaper if you use local food sources in the area. If Mr. Kobayashi (the principal character in Totto-chan's book) hypothesizes that a nutritionally balanced diet is a combination of those foods from the sea and those taken from the mountains, nutritious-food sources for the villagers, on the contrary, can be obtained from local sources.
In coastal areas, the source of marine protein is from the sea; but in land and mountainous areas, far from the coast, it is necessary to explore sources of plant and animal protein that can be produced locally. Here, knowledge of the nutritional content of various food sources is required. Overcoming stunting does require the cooperation of various parties.
SIWI NUGRAHENIis a lecturer at the Parahyangan Catholic University School of Economics.
(This article was translated by Hendarsyah Tarmizi).
