Child Stunting Reduction in Aceh Province: Challenges and a Way Ahead.
Aceh province
Child stunting
Indonesia
reduction and prevention
regulations
Journal
Maternal and child health journal
ISSN: 1573-6628
Titre abrégé: Matern Child Health J
Pays: United States
ID NLM: 9715672
Informations de publication
Date de publication:
May 2023
May 2023
Historique:
accepted:
18
01
2023
medline:
21
4
2023
pubmed:
3
2
2023
entrez:
2
2
2023
Statut:
ppublish
Résumé
Indonesia ranks the fifth highest in child stunting among Asian countries. Aceh, a westernmost province in Indonesia recorded the highest prevalence of stunting in children under two years old in the nation. Our study investigated the current government efforts on child stunting reduction activities since the introduction of Governor Regulation No. 14/2019. The study investigated the current efforts of Aceh governments and relevant actors on child stunting reduction using in-depth interviews, document reviews and focus group discussions. Thirty-five (35) respondents including policy makers were interviewed, four focus group discussions (15 each group) were conducted, and various official documents were reviewed. Various challenges for reducing child stunting in Aceh were identified: inadequate knowledge and skills of Posyandu cadres on child stunting; reluctance to consume iron and folic acid (IFA), and supplementary foods (PMT Bumil) by many pregnant women due to perceived annoying effects and unappetizing taste; work engagement, insufficient breast milk production and inadequate support from husbands failing to achieve exclusive breastfeeding among nursing women; inadequate provision of complementary fortified foods for children 6-23 months; lack of clean water, waste management and WASH practices. The intervention on both nutrition-specific and nutrition-sensitive factors was found to be insufficient in Aceh. Although WASH (water, sanitation and hygiene) practices are the most important contributors to child stunting, only the health agency plays a singular role in reduction efforts by focussing on specific factors. Coordination between relevant agencies to address both factors is required to achieve the effectiveness of child stunting reduction and prevention in Aceh.
Identifiants
pubmed: 36732463
doi: 10.1007/s10995-023-03601-y
pii: 10.1007/s10995-023-03601-y
pmc: PMC9894663
doi:
Substances chimiques
Water
059QF0KO0R
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
888-901Informations de copyright
© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
Références
Aceh Governor. (2019a). Peraturan Gubernur Aceh No. 14 Tahun 2019 Tentang Pencegahan dan Penanganan Stunting Terintegrasi di Aceh. Aceh Government.
AL-Rahmad, A. H., Miko, A., & Hadi, A. (2013). Kajian stunting pada anak balita ditinjau dari pemberian ASI eksklusif, MP- ASI, status imunisasi dan karakteristik keluarga di Kota Banda Aceh. Journal Kesehatan Ilmiah Nasuwakes, 6(2), 169–184.
Alam, M. A., Richard, S. A., Fahim, S. M., Mahfuz, M., Nahar, B., Das, S., Shrestha, B., Koshy, B., Mduma, E., Seidman, J. C., Murray-Kolb, L. E., Caulfield, L. E., & Ahmed, T. (2020). Impact of early-onset persistent stunting on cognitive development at 5 years of age: Results from a multi-country cohort study. PLoS One, 34, 21.
Arshiya, S., Rahman, K. U., & SMS, M. S. (2013). Clinical update and treatment of lactation insufficiency. Medical Journal of Islamic World Academic of Science, 21(1), 19–28.
doi: 10.12816/0000207
Bakrie, A. (2019). 900 Ribu Penduduk Aceh belum Terakses Air Bersih. https://aceh.tribunnews.com/2015/04/08/900-ribu-penduduk-aceh-belum-terakses-air-bersih
Bazeley, P., & Jackson, K. (2013). Qualitative Data Analysis with NVivo (2nd ed.). Sage. https://crasglobal.org/wp-content/uploads/2020/08/Qualitative-Data-Analysis-with-NVivo-PDFDrive.com-.pdf
Bryman, A. (2012). Social research methods (4th ed.). Oxford University Press.
Edemba, P. W., Irimu, G., & Musoke, R. (2022). Knowledge attitudes and practice of breastmilk expression and storage among working mothers with infants under six months of age in Kenya. International Breastfeeding Journal, 17(33), 1–8.
Engle-Stone, R., Kumordzie, S. M., Meinzen-Dick, L., & Vosti, S. A. (2019). Replacing iron-folic acid with multiple micronutrient supplements among pregnant women in Bangladesh and Burkina Faso: Costs, impacts, and cost-effectiveness. Annals of the New York Academy of Sciences, 1444(1), 35–51.
doi: 10.1111/nyas.14132
pubmed: 31134641
pmcid: 6771790
Hendri, S. (2019). Angka Stunting di Aceh Timur Capai 8.467, Ini Faktor Penyebabnya. https://aceh.tribunnews.com/2019/09/05/angka-stunting-di-aceh-timur-capai-8467-ini-faktor-penyebabnya
Herwanto, H. (2021). Dinkes Simeulue Bersama Unicef dan PKBI Gelar Penanggulangan Malnutrisi Stunting. Serambi. Com. https://aceh.tribunnews.com/2021/03/26/dinkes-simeulue-bersama-unicef-dan-pkbi-gelar-penanggulangan-malnutrisi-stunting
Husna, M. (2020). September 25). Jumlah Balita Pendek dan Gizi Buruk di Aceh Berada di Atas Nasional. Serambi. Com.
Ikeda, N., Irie, Y., & Shibuyac, K. (2013). Determinants of reduced child stunting in Cambodia: analysis of pooled data from three demographic and health surveys. Bulletin of the World Health Organization, 91(5), 341–349. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3646343/ .
doi: 10.2471/BLT.12.113381
pubmed: 23678197
pmcid: 3646343
Kakute, P. N., Ngum, J., Kroll, K. A., & Mitchell, P. (2015). Cultural barriers to exclusive breastfeeding by mothers in a rural area of cameroon, Africa. Journal of Midwifery and Women’s Health, 50(4), 324–328.
doi: 10.1016/j.jmwh.2005.01.005
Kumara, S., Vidanapathirana, S., Gihani, U., & Hushara, S. K. (2021). Multiple micronutrient supplementation programme of Sri Lanka: does it deliver the goods? Experience from the Central Province - A preliminary study. Sri Lanka Journal of Child Health, 50(3), 393–400.
doi: 10.4038/sljch.v50i3.9686
Kurniawan, M. A. (2022). Understanding open defecation practices in rural Aceh, Indonesia. WASH Technical Paper Report No: WASH/TP/19/2021. https://www.susana.org/_resources/documents/default/3-4884-7-1646729264.pdf
Kusnandar, V. B. (2021). Ini wilayah Aceh dengan prevalensi balita stunting terbesar pada 2021. Prevalensi Balita Stunting di Kabupaten/Kota Provinsi Aceh (2021). https://databoks.katadata.co.id/datapublish/2022/07/14/ini-wilayah-aceh-dengan-prevalensi-balita-stunting-terbesar-pada-2021
Mara, D., Lane, J., Scott, B., & Trouba, D. (2010). Sanitation and health. Plos, 2(44), e1000363.
doi: 10.1371/journal.pmed.1000363
Mates, E., Shoham, J., Khara, T., & Dolan, C. (2017). Emily Mates, Jeremy Shoham, Tanya Khara and Carmel Dolan. https://www.ennonline.net/attachments/2716/Stunting-Brief-2017_WEB_2.pdf
Mayimbo, S., Haruzivishe, C. M., Kwaleyela, C., Phoebe, B., Chirwa, E., Kaonga, P., & Ngoma, C. (2020). Assessing malnutrition in pregnant women using the Dietary Diversity score and the Mid-Upper Arm circumference: A cross-sectional study, Zambia. Food and Nutrition Sciences, 11, 712–725.
doi: 10.4236/fns.2020.117051
Mustinda, L. (2020). Cara Cuci Tangan yang Benar Menurut Kemenkes dan WHO. https://health.detik.com/berita-detikhealth/d-4903337/cara-cuci-tangan-yang-benar-menurut-kemenkes-dan-who
Riski, P. (2017). Surabaya, Kota Percontohan Pengolahan Sampah Terbaik Indonesia. https://www.mongabay.co.id/2014/02/27/surabaya-kota-percontohan-pengolahan-sampah-terbaik-indonesia/
Semba, R. D., Moench-Pfanner, R., Sun, K., De Pee, S., Akhter, N., Rah, J. H., & Kraemer, K. (2011). Consumption of micronutrient-fortified milk and noodles is associated with lower risk of stunting in preschool-aged children in Indonesia. Food and Nutrition Bulletin, 32(4), 406.
doi: 10.1177/156482651103200406
Susiloretni, K. A., Hadi, H., Prabandari, Y. S., Soenarto, Y. S., & Wilopo, S. A. (2015). What works to improve duration of exclusive breastfeeding: lessons from the exclusive breastfeeding promotion program in rural Indonesia. Matern Child Health Journal., 19(7), 1515–1525.
doi: 10.1007/s10995-014-1656-z
Tampah-NaahI, A. M., Kumi-Kyereme, A., & Amo-Adjei, J. (2019). Maternal challenges of exclusive breastfeeding and complementary feeding in Ghana. PLoS One, 14(5), e0215205.
Thet, M. M., Khaing, E. E., Diamond-Smith, N., Sudhinaraset, M., Oo, S., & Aung, T. (2016). Barriers to exclusive breastfeeding in the Ayeyarwaddy Region in Myanmar: Qualitative findings from mothers, grandmothers, and husbands. Appetite, 6, 62–69.
doi: 10.1016/j.appet.2015.08.044
Tong, A., Sainsbury, P., & Craig, J. (2007). Consolidated criteria for reporting qualitative research (COREQ): A 32-item checklist for interviews and focus groups. International Journal for Quality in Health Care, 19(6), 349–357.
doi: 10.1093/intqhc/mzm042
pubmed: 17872937
Tracy, S. J. (2014). Qualitative research methods: Collecting evidence, crafting analysis, communicating impact. John Wiley & Sons.
UNICEF. (2021). Southeast Asia regional report on maternal nutrition and complementary feeding. Nutrition and Complementary Feeding Regional Report.pdf. https://www.unicef.org/eap/media/9466/file/Maternal .
Aceh Bureau of Statistics (2019). Aceh in Figure, 2019. https://aceh.bps.go.id/quickMap.html
Aceh Governor (2016). Aceh governor regulation No. 49/2016 on exclusive breastfeeding.
Aceh Governor (2018). Circulation letter No 440/23856 on healthy life community movement (GERMAS).
Aceh Governor (2019b). Tabloit Aceh sehat sejahtera: mewujudkan masyarakat sehat dan berintegrasi.
AJNN (2019). Kawasan rumah kumuh Lhokseumawe dibanjiri sampah. https://www.ajnn.net/news/kawasan-rumah-kumuh-di-lhokseumawe-dibanjiri-sampah/index.html
CNBC Indonesia (2020). Cegah Stunting, Pertagas Latih Kader Posyandu Di Aceh Timur. https://www.cnbcindonesia.com/news/20201008133348-4-192826/cegah-stunting-pertagas-latih-kader-posyandu-di-aceh-timur
East Aceh District (2020). Profile program penanggulangan stunting di Aceh Timur.
East Aceh District (2022). EPPGBM update in East Aceh 2022.
East Aceh Regent (2019). Peraturan Bupati No. 61 tahun 2019 tentang pencegahan dan penanganan stunting terintegrasi di gampong. http://jdih.acehprov.go.id/dih/view/c0ee077b-4444-4c00-8abd-771c543d7267
Global Nutrition Report (2020). Indonesia: The burden of malnutrition at a glance. https://globalnutritionreport.org/resources/nutrition-profiles/asia/south-eastern-asia/indonesia/
Ministry of Health (2016). Ministry of Health Regulation on Nutrition supplement Standards.
Ministry of Health (2017). Nutrition surveilance. http://bppsdmk.kemkes.go.id/pusdiksdmk/wp-content/uploads/2017/11/SURVAILANS-GIZI-FINAL-SC.pdf
Ministry of Health (2021a). Circulation letter No. DP.02.01/2/0334/2021 on conducting research during Covid-19 pandemic.
Ministry of Health (2021b). Launching hasil Studi Status Gizi Indonesia (SSGI).
Ministry of Village (2020). Peraturan menteri desa, pembangunan daerah tertinggal, dan transmigrasi RI No. 6 tahun 2020 tentang perubahan atas peraturan menteri desa,pembangunan daerah tertinggal, dan transmigarsi No. 11 tahun 2019 tentang prioritas penggunaan dana desa tahun 2020.
NAWASIS (2010). STBM: Sanitasi Total Berbasis Masyarakat. http://nawasis.org/portal/digilib/read/stbm-sanitasi-total-berbasis-masyarakat/4750
Portalsatu (2020). Angka Pemberian ASI Eksklusif di Aceh Rendah.
Provincial Health Office (2019). Aceh province report on basic health research. https://www.litbang.kemkes.go.id/laporan-riset-kesehatan-dasar-riskesdas/
SinarPost.com (2019). Perilaku BAB Sembarangan Masyarakat Aceh Masih Tinggi, Pidie Terbanyak.
SUN (2019). Nutrition-Specific and Nutrition-Sensitive Interventions. https://www.karger.com/Article/Pdf/452392
UNICEF (2020a). Levels and trends in child malnutrition.
UNICEF (2020b). UNICEF Data: Monitoring the situation of children and women. https://data.unicef.org/topic/nutrition/malnutrition/
UNICEF (2022a). Handwashing helps schools safely reopen across Indonesia:UNICEF and the Government of Indonesia are installing handwashing facilities and promoting hand hygiene in schools during the COVID-19 pandemic https://www.unicef.org/indonesia/stories/handwashing-helps-schools-safely-reopen-across-indonesia
UNICEF (2022b). Malnutrition. https://data.unicef.org/topic/nutrition/malnutrition/
UNICEF (2022c). Maternal nutrition: Prevention of malnutrition in women before and during pregnancy and while breastfeeding.
United Nations (2016). Transforming our world: The 2030 agenda for sustainable development.
WFP (2015). Nutrition sensitive programming: what and why. https://www.humanitarianresponse.info/sites/www.humanitarianresponse.info/files/documents/files/OMD Nutrition Bulletin 1 - July 2014.pdf
WHO (2014a). Childhood stunting: challenges and opportunities.
WHO (2014b). Global Nutrition Targets 2025: Policy Brief Series. https://apps.who.int/iris/bitstream/handle/10665/149018/WHO_NMH_NHD_14.2_eng.pdf?ua=1
WHO (2014c). WHA Global Nutrition Targets 2025: Stunting Policy Brief.
WHO (2018). Reducing stunting in children: Equity considerations for achieving the Global Nutrition Targets 2025.
WHO (2020). WHO Antenatal Care Recommendations for a Positive Pregnancy Experience. Nutritional Interventions Update: Multiple Micronutrient Supplements during Pregnancy https://www.who.int/publications/i/item/9789240007789