Nutrition for Growth (N4G) commitment
Based on the Summary of Ministries Detailed Output in 2022 Supporting the Acceleration of Stunting Reduction published in January 2022, the budget allocation on Nutrition Intervention in Indonesia increased from IDR 29.26 T in 2019 to IDR 50.03 T in 2020. However, the budget declined to IDR 31.74 T in 2021. The budget allocation for nutrition-specific, nutrition- sensitive, and coordination were IDR 1.87 T, IDR 29.56 T, and IDR 0.32 T respectively.
Similar to the previous years, the central government provided Special Budget Allocation (DAK) for districts government as a fiscal transfer to support accelerate stunting reduction within their jurisdiction. The fiscal transfers also act as an incentive to the districts government to ensure they will implement nutrition programs. We started the fiscal transfers scheme specifically for stunting in 2019 working hand-in-hand with the Ministry of Finance. In addition, Indonesian government through the Ministry of Village, allocated village funds (Dana Desa) as a source of fund for implementing interventions to reduce stunting prevalence
Reported progress suggests commitment is on course.
Reduce stunting prevalence from 35.6% (2010) to 32% (2015) and further reduction 40% by 2025.
The stunting prevalence in Indonesia dropped from 30.8% in 2018 to 27.7% in 2019. In 2020, we had to postpone the National Survey on Nutrition Status. Thus, we were unable to report our progress on the impact commitment. However, the Ministry of Health proceeded the National Survey on Nutrition Status in 2021 and the results showed that the stunting prevalence among children under 5 had decreased further to 24.4%.
We aim to continue reducing the stunting prevalence to 14% by 2024 which translates to 10.4% drop within 3 years. The Presidential Decree Number 72 on the Acceleration of Stunting Reduction was released in August 2021 to strengthen this commitment by appointing the National Population and Family Planning Board as the leading implementation agency. The National Population and Family Planning Board is responsible to ensure that the targeted populations receive all interventions across ministries. These actions included to assure the delivery and compliance of the interventions to the targeted populations.
Assuming a linear rate of reduction, the stunting prevalence in 2019 (27.7%) is greater than the required prevalence by this stage (25.8%) to remain on course with the target of a further 40% reduction by 2025.
Stakeholders at provincial and district levels will prioritize well-conceived nutrition efforts in their development plans and budgets.
In terms of triple burden of malnutrition, Indonesian Government has released 6 documents on the National Action Plan on Food and Nutrition (RAN-PG) since 2001 to scale up nutrition interventions at the provincial and district levels. The most recent National Action Plan on Food and Nutrition 2021-2024 was published through ministerial decree in October 2021 by the Ministry of National Development Planning. The sub-national governments use this document as one of the references in writing their development plans and budgets related to nutrition.
Specifically for stunting reduction, it was assigned as one of the major projects in the National Medium Term Development Plan (RPJMN) 2020-2024. This is an important policy because it pushes ministries across sectors to be involved in efforts to reduce stunting. In February 2021, the Minister of National Development Planning announced that all 514 districts in Indonesia becomes prioritized locations for stunting reduction. It was the final increment after 260 districts in 2020 to 360 districts in 2021. Furthermore, the Presidential Decree Number 72 on the Acceleration of Stunting Reduction released in August 2021 was also crucial to push district governments to incorporate nutrition programs in their development plan. As of September 2021, the Office of Vice President reported that head of every district has signed a commitment to accelerate stunting reduction.
Another pivotal policy that went on in 2021 was fiscal transfers scheme for stunting reduction – a joint strategy by Ministry of National Development Planning, Ministry of Finance, and line ministries. Since Indonesia uses decentralization governance, the districts government have the authority to manage their local funds. Therefore, to ensure that stunting reduction and other national priorities are implemented at the sub-national level, the central government has to arrange financial policies such as fiscal transfers. In addition, the disparity of fiscal capacity among districts remains high especially when we compare districts in Java and outside of Java. The fiscal transfers would be an incentive for all district despite the fiscal disparity.
There are 2 types of fiscal transfers which are infrastructure and operational. In 2021, the central government allocated a total of IDR 6.8 trillion of fiscal transfers for stunting reduction. It included IDR 2.7 trillion for infrastructure fiscal transfers and IDR 4.1 trillion for operational fiscal transfers. In Indonesia, fiscal transfer activities are integrated with the budget from the ministries. By doing so, we are able to ensure that national priorities are implemented at the sub-national level. Also, we can monitor whether the district governments do the convergence actions or not.
Reported progress in previous Global Nutrition Reports indicates that commitment has been achieved.
Reinforce the implementation of specific evidence-based nutrition interventions including promotion of maternal and IYCF, improvement of micronutrient intake through supplementation and food fortification, and management of severe acute malnutrition.
In 2022, there are 17 ministries/agencies that explicitly mentioned programs addressing malnutrition in their planning and budgeting document. The programs include nutrition specific intervention, nutrition sensitive intervention, and coordination./p>
The promotion of maternal and IYCF emphasized the training of health workers on IYCF counselling. In 2022, government target 231.428 health workers are trained on improving the quality of life for mother and under-5 children. Similarly, the government with the support of development partners had done efforts towards improving the management of severe acute malnutrition. Government commits to perform Global Action Plan on Child Wasting aligned with stunting reduction program. The development of local ready-to-use therapeutic food was a partnership between MoH, Unicef, IPB, and Indofood. The results will be disseminated in near future with a possibility to be scaled up.
In addition, the appointment of the National Population and Family Planning Board as the leading implementation agency for Presidential Decree on the acceleration of stunting reduction was a concrete step to ensure that beneficiaries receive the intended nutrition interventions. Family companion team (tim pendamping keluarga) consisted of 1 health worker, 1 cadre, and 1 family planning field officer is created to ensure all the interventions are utilized by the families with the 1,000 days of life group. The family companion team is also expected to emphasize on social behavioral change communication
Reported progress suggests commitment is on course