Mixed progress on reducing child malnutrition

While Indonesia in relative terms is cutting the number of malnourished children under the age of five, wasting and stunting - especially in certain pockets of the country - remain a major concern, say health experts.

Based on national statistics, Indonesia is one of 15 countries making the fastest gains in cutting child malnutrition among 165 developing countries, according to a recent ranking from NGO Save the Children.

In 2010, the government estimated some 18 percent of under-five children nationwide weighed too little for their age, a sign of malnutrition, compared to 31 percent in 1989.

However, the absolute number of malnourished under fives between 1989 and 2010 has probably increased, given that the country’s population has grown from 179 to 237 million during this period, and that the proportion of under-fives in the population is also probably greater now than 20 years ago.

On the plus side, the government has taken steps to improve breastfeeding rates and promote timely complementary feeding in young children, hygiene, and Vitamin A, iron and zinc supplements, said Minarto, the director of nutrition promotion at the Health Ministry, who like many Indonesians goes by only one name.

Nevertheless, stunting and wasting, or acute malnutrition - when a child weighs too little for their height, which can result from a sudden lack of access to food or illness - still affect a “significant” proportion of children in Indonesia, said Nuraini Razak, a spokeswoman with the UN Children’s Fund (UNICEF).

National statistics for an archipelago nation made up of over 17,000 islands (about 900 of them permanently inhabited) hide wide regional disparities, said Minarto.

In East Nusatenggara Province, some 2,000km east of the capital of Jakarta, the prevalence of underweight children was 34 percent - similar to neighbouring West Nusatenggara’s rate of 30 percent - versus the national average of 18 percent, according to the government’s 2010 National Health Survey.

“These areas are vulnerable to food scarcity, especially during dry spells,” Minarto said, noting the government has emergency reserves.

UNICEF warns that though the country has attained the first Millennium Development Goal to halve the percentage of people living on less than US$1 a day and suffering from hunger in 1990, malnutrition remains “of great concern”.

One in three Indonesian children under the age of five suffers from malnutrition - both acute and chronic - according to the 2010 Health Survey.

Some 13 percent of the same group is acutely malnourished. Health experts consider 15 percent as the threshold of a health “emergency”.

From 1990-2010, the country reduced its rate of chronic malnutrition - also known as stunting when children are too short for their age groups - by more than 2 percent, still leaving more than three out of 10 children stunted.

Malnutrition contributes to half the deaths of Indonesian children before they reach age five, UNICEF estimates. For those who survive, malnutrition can impair brain development and hobble learning capacity, weaken a child’s immunity and increase the risk of diabetes, obesity, heart disease and strokes.