Under Nutrition Causes Stunting

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The article starts by quoting the WHO global data on stunting and the Indonesian national prevalence. Among 556 million children under-five years in developing countries, 178 million (32%) are stunted due to chronic under nutrition. In Indonesia, based on Ministry of Health statistics, 7.6 million (32%) U5Children are stunted. Indonesia has the fifth largest number of stunted children in the world after India, China, Nigeria, and Pakistan.
Indonesia, as in many other developing countries, is also witnessing a double burden of malnutrition.  People, especially the poor, are suffering both under nutrition and infection, as well as over nutrition (overweight) that leads to high risk of Non-Communicable Diseases (NCD), such as heart disease, diabetes, hypertension, stroke and cancer. Currently according to WHO and MoH , NCD is the number one cause of mortality in developing countries (60% of all deaths) in developing countries and in Indonesia (64% of all deaths).

Stunting has short and long term negative effects. First, retarded physical growth of the fetus during pregnancy is irreversible. Stunted children are likely to have smaller stature as adult. Second, stunted children are more susceptible to illness both at young age as well  as in adult especially for NCD.  In developing countries NCD is related to under nutrition in children. Third, they tend to have lower education achievement and productivity. Fourth, they tend to earn lower income as adults. Fifth, stunted girls , tend to deliver smaller infants when they become pregnant mothers. Stunting becomes an inter-generation issue if there is no significant improvement in the nutrition status of pregnant women.

The article also described the causes of stunting. Most people believe, especially from medical professionals, that stunting is a function of genetic (heredity).  However, most current scientific studies suggest that the most important risk factors for stunting are environmental that does not promote favorable growth and development of a fetus in the womb during pregnancy. Malnourished and unhealthy pregnant women are susceptible to producing malnourished fetus and delivering low birth weight (LBW) babies. LBW is the first step in the beginning of child under nutrition. If it is continued until the age of 2 years, the child would have retarded growth and be stunted. Unfavorable environments for pregnancy; such as nutritionally unbalanced daily food intake, unhealthy environment, poor household sanitation, pollution, parental smoking, gender inequality, low education, etc. are all rooted in poverty and low education of women.

To prevent and to cope with the stunting problem, the UN Secretary General Ban Ki Moon,  has established a Global Movement on Scaling Up Nutrition (SUN) at a high level meeting on nutrition at the  UN New York in September 2011.  Ban Ki Moon encouraged governments and UN agencies, to establish multi sectorial efforts, not only under the health sector,  to accelerate nutrition programs in achieving the MDGs and eradicate stunting. In this context, BKM reminds developing countries not to neglect nutrition in their  development policy.   In conclusion the article wishes that the Indonesian government would reposition nutrition as integral part of development policy, as it was applied to the national five-year development plan (Repelita) in 1970s to 1990s. According to the author of the article,  WHO suggests that Indonesia is the 5th top country in terms of number of stunted children in the world , could eventually constrain the current relatively high economic growth of the country.

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