Food-Price Disparity Worsens Stunting

Food-price disparity worsens the risk of stunting among children in Indonesia. It is believed that the stunting risk can be reduced if the cost of nutritionally balanced food in regions is lowered.

KOMPAS/SATRIO PANGARSO WISANGGENI

Aldianus (2.5) opened his shirt when nutritionist Imelda Tamo Inya tried to record the toddler's weight during a home visit on Thursday (10/11/2022). Aldi is one of the toddlers who is classified as severely malnourished in Kawango Hari Village, Kodi, Southwest Sumba, East Nusa Tenggara.

JAKARTA, KOMPAS — There is strong correlation (0.6) between the proportion of people incapable of buying nutritionally balanced or healthy food and the prevalence of stunting in the province where they live. The smaller the number of people who can afford to meet their daily balanced nutritional needs in the region, the higher the risk of child stunting will be.

In East Nusa Tenggara (NTT) province, for instance, the cost of balanced food in the Recommended Dietary Allowance (RDA) version is Rp 19,173 (US$1.23) per day or Rp 575,192 per month. At this cost, 78 percent or 4.37 million of its people cannot afford to buy nutritionally balanced food.

At the rate of 78 percent, NTT is the province with the largest population incapable of buying nutritionally balanced food in Indonesia. NTT also has the highest prevalence of stunting in Indonesia based on a survey of the Indonesian Nutritional Status Study (SSGI) in 2021, at the rate of 37.8 percent.

Also read: The Root Problems of the People’s Unbalanced Nutrition

However, if the cost of nutritionally balanced food in NTT can be lowered, many more people will be able to buy healthy food. For example, if the food commodity prices in NTT can be reduced to that of Yogyakarta province -- one of the provinces with the lowest commodity prices -- to Rp 15,997 per day, there will be 593,690 more NTT people who can afford to buy nutritionally balanced food every day.

The vulnerability of NTT people to malnutrition, as the price of nutritious food is beyond their reach, is reflected in their daily life. Relying on her job as a dry-field worker with a monthly income of Rp 100,000 and cash aid from the government, Paulina Bebe, 50, a resident of Kodi, Southwest Sumba, NTT, and her husband can only afford to buy protein sources like chicken eggs once a week for their six children.

Their youngest child, Aldianus, 2.5, has been ailing since his birth. Until June, he suffered from lymph gland tuberculosis (TB). Now that he has recovered from TB, Aldianus frequently has a cold and fever.

KOMPAS/SATRIO PANGARSO WISANGGENI

Nutritionist Imelda Tamo Inya (left) measures Aderensi's (4) weight during a home visit on Thursday (11/10/2022) in Kodi, Southwest Sumba, East Nusa Tenggara.

Imelda Tamo Inya, a local nutritionist, said limited economic capacity constituted a major challenge to the fulfillment of infant nutrition in her village. “The carbohydrate source may be met, but vitamins, minerals and protein are lacking. An undernourished two-year-old should eat eggs twice daily. Although I have told them, if the parents have no money, they can’t buy anything,” added Imelda.

The relatively high food price in North Maluku also poses a crucial problem to the lower-middle income group. Head of the Community Health Center of Labuha, South Halmahera, Kartini Dalle, said poor people only consumed rice and fish. But even so, according to her, the price of fish was relatively high. “A small dish of eight fish costs Rp 20,000,” she said.

The Kompas data journalism team has analyzed that if the average cost of nutritionally balanced food in the RDA version in Indonesia worth Rp 18,409 per day is lowered by Rp 1,000, 9.1 million more Indonesian people will be able to buy healthy food. The 57 percent of Indonesian people unable to buy healthy food would thus be reduced to 54 percent.

Also read: Over Half of Population Unable to Consume Nutritious Food

The risk of stunted children can also be lowered with an increasing number of families capable of buying nutritionally balanced food.

Head of the Population and Family Planning Agency (BKKBN), Hasto Wardoyo, described the effort to reduce the cost of and increase people’s accessibility to nutritionally balanced food as crucial to lowering the prevalence of stunting in Indonesia.

“It’s important, we agree. We should facilitate the expansion of access to nutritious food,” said Hasto. The BKKBN has a vital role in the handling of stunting because Hasto has been named Chief Coordinator of National Stunting Reduction Acceleration.

People think of how to eat enough food. Thus the victims are children.

Hasto said the long-term impact of stunting could end in a low level of intelligence in Indonesian society.

National Coordinator of People’s Coalition for Food Sovereignty, Ayip Said Abdullah, said the factor of food-price accessibility correlated closely to food resilience and stunting.

In his view, when food accessibility was low, some long-term impacts would arise. First, the food resilience of families would grow weak. Then the quality and quantity of people’s consumption would also decline.

“When poverty sets in, they no longer think of fulfilling diverse sources of nutrition. People think of how to eat enough food. Thus the victims are children,” added Said.

MARGARETHA PUTERI ROSALINA

Jasman Abdul Rahim (1.5), a malnourished toddler in Wayaua Village, South East Bacan District, South Halmahera. The parenting style of parents who do not provide nutritious food for their children is one of the causes of stunting in South Halmahera..

Availability

The availability of food commodities also challenges the nutritional fulfillment of infants and children under five in North Maluku, the province with the costliest nutritious food in Indonesia. Head of the North Maluku Food Resilience Office, Dheni Tjan, said markets were only located in regency capitals rather than evenly distributed in villages.

The geography of North Maluku as an island group also complicates the distribution of food, noted Dheni. The areas prone to food shortage, according to Dheni, are those with difficult transportation access like Taliabu Island and South Halmahera.

The difficulty in access makes the prevalence of stunting in Taliabu Island and South Halmahera regencies quite high. Based on 2021 SSGI data, their rates reached 35.2 and 33.7 percent, above the North Maluku average.

Solution

The North Maluku regional administration, said Dheni, had formed provincial and regency Stunting Reduction Acceleration Teams with members from relevant institutions. The South Halmahera regency administration has also issued the regent’s Regulation No.19/2020 on the management of stunting. As its realization, according to South Halmahera Deputy Regent Hassan Ali Bassam Kasuba, a Family Guidance Team has been set up at the village level. The team has 477 members comprising village midwives, chairs of village-family welfare associations and family-planning cadres.

Head of the NTT Agriculture and Food Crops Office, Lecky Frederich Koli, acknowledged stunting as the problem of his region. He attributed its root cause to poverty, with its impact on limited access to nutritious food.

Also read: Food Diversity Marginalized

The NTT provincial administration has also formed a special stunting-management team with all regional offices participating. One of its activities is the distribution of kelor (horseradish) plants to be grown in residents’ house yards, believed to help overcome stunting.

The management of stunting, in the opinion of a public-nutrition lecturer at IPB University, Hardinsyah, should be sustainable, rather than only an intervention of extra food for three successive months. It should also go along with a change of parents’ behavior.

“Otherwise, after three months’ monitoring, [and then] three months with no more management, the stunting would remain,” he said.

This article was translated by Aris Prawira.