Menu ENN Search

Stunting prevention in Indonesia: Raising awareness at the sub-national level

View this article as a pdf

Lisez cet article en français ici

Akim Dharmawan (PhD) is the SUN Movement secretariat manager at the Ministry of National Development and Planning (Bappenas) in Indonesia. He has worked as a nutritionist and public health practitioner for more than 15 years, with experience in programme planning and management, behaviour change intervention, community development and monitoring and evaluation.

Pungkas Bahjuri Ali (PhD) is the Director for Public Health and Nutrition at the Ministry of National Development and Planning (Bappenas), and secretary of the technical team for the SUN Movement Indonesia. He works closely with both national and sub-national governments in aligning health and nutrition programmes.

Dr Entos Zainal is the Deputy Director for Community Empowerment and Public Nutrition at the Ministry of National Development and Planning (Bappenas). He is an expert in public health and nutrition programme planning and implementation.    

Ardhianti has an MSc in public health and is part of the team responsible for the planning and technical coordination of Healthy Lifestyle Community Movement and integrated nutrition intervention for accelerating stunting reduction.

Evi Nurhidayati has worked as a programme assistant in the SUN Movement Secretariat of Indonesia at the National Development Planning Agency since 2016.   

Nur Akbar Bahar has worked as a programme assistant in the SUN Movement Secretariat of Indonesia at the National Development Planning Agency since 2016. 


Indonesia is a lower-middle income country and the largest economy in Southeast Asia1.  Rapid economic growth over the past ten years, coupled with government investments in social development, have led to the poverty rate being halved since 1999, to 10.9% in 20161. However, the benefits of economic growth do not align with an improvement of social and health indicators, and 36% of children under five (CU5) are stunted (low height for age), while 14% are affected by wasting (low weight for height)2.

The national prevalence of stunting (affecting nearly 9 million children under five) has been slowly decreasing for the last decade. However, the reduction of stunting was less than expected (it was 40% in 2007 and 37.2% in 2013)3. Although prevalence is similar across the 34 provinces of Indonesia, east Nusa Tenggara Timur province has a prevalence of 70%, whilst Jambi province has the lowest prevalence at 37.9%3. Children affected by stunting are found among both rural and urban populations (42.1% and 32.5%, respectively)3. Additionally, almost a third (29%) of CU5 among the wealthiest households are stunted, which suggests that stunting is not heavily influenced by location and economic status3.

Figure 1: Geographical distribution of stunting prevelance in Indonesia

Coordinating stunting efforts

Stunting prevention efforts have not been effectively implemented for many years, initially because nutrition was only associated with the health sector (Ministry of Health) and nutrition-specific interventions. Failure to address malnutrition may be costing the Indonesian economy an estimated 17.5–26 million USD (260-390 billion IDR) per year of Gross Domestic Product (GDP). Nutrition-specific and sensitive interventions do not appear to be fully coordinated at all levels in terms of planning, budgeting, implementation, and monitoring and evaluation, and this has been recognised as a key challenge for stunting prevention. Additionally, lack of local capacity at district, sub-district and village levels are constraints that still need to be addressed.

In recognition of the need to tackle stunting, the country launched a national strategy called Integrated Nutrition Interventions (INI) for Stunting Reduction and Prevention in August 2017. None of the activities in INI are ‘new’ activities, but the strategy (backed by the President, Joko Widodo) sets out guidelines for national and sub-national stakeholders to accelerate stunting prevention and reduction. The INI consists of five pillars: 1) commitment and vision of the state’s highest leaders; 2) National campaign focusing on behaviour change; 3) Convergence, coordination and consolidation; 4) Food security policy, and 5) Monitoring and evaluation.

To improve the quality of multi-sectoral interventions (such as those involving agriculture, education and social protection), a geographically-focused plan was designed to create awareness and commitment for INI in 100 districts (out of 514 districts in Indonesia) in 34 provinces in 2018. The choice of districts was based on a number of criteria, including number of CU5 and prevalence of stunting and wasting in CU5 and prevalence of poverty. There are plans to expand the coverage to a further 160 districts in 2019.

Strengthening sub-national action

The first pillar of INI aims to strengthen sub-national government’s commitment and capacity and a National Rembuk Stunting event (a type of ‘stunting bootcamp’ or summit) was held in November 2017 in Jakarta with the active participation of eight districts. Nineteen government ministries/institutions came together for the event, including development partners, civil society, academia and professional organisations, and the media. The event focused on sharing best practices at global and national level, as well as village experiences on how to strengthen coordination between national and local governments for programme effectiveness. A workshop with key leaders from the districts to develop an integrated action plan. The second and third National Rembuk Stunting events were held in March 2018 in Jakarta. In total, 26 districts participated in the second and third Rembuk (with 13 districts at each one).

Platform for district-level events

Rembuk Stunting has provided a new platform (to which SUN Movement networks have also been invited) for information sharing and learning between national and sub-national governments with a focus on planning and budgeting for INI. The national-level Rembuk Stunting events were followed by similar events at provincial and district level, with funding coming from the government budget and development partners/donors. So far, five districts out of 34 from the national event have conducted district and/or village level Rembuk Stunting. These were attended by local private sector, local academia, professional organisations, and local civil society organisations who have all contributed to discussions on stunting reduction and prevention at the district/village level.

Bappenas, with support from the World Bank, has developed a Rembuk Stunting curriculum along with facilitator guidelines, which includes stunting and other related health data for each district for discussion among district key leaders, a work plan with an activity and timeline template, and a health and nutrition dashboard. District government have learnt how to use and analyse health and nutrition data, developed recommendations with an evidence-based approach, chosen priority actions based on local problem analysis, and ensured adequate budget to fund selected priority actions. Villages have been urged to use Village Funds (from central government) to reduce stunting by investing in infrastructure, such as health clinics and water and sanitation facilities, and there are reports from the Ministry of Villages that health and nutrition activities have increased among focus districts.

Addressing challenges

It has been noted that capacity gaps between districts need to be properly assessed, with a follow up district planning session performed by either central or provincial government after a Rembuk Stunting event. Local universities/experts also need to be more widely included to provide technical advice for district governments. Coordinating working with sub-national governments is challenging due to lack of staff and heavy workloads at this level. Selecting a focal point for each Dinas (sub-national government organisations for health, education, village development, public work and housing, etc) and setting/agreeing regular meetings is crucial to ensure everyone is on board. Finally, advocacy tools and communication strategy should be developed to ensure the sustainability of the commitment. In addition, specific governor/mayor regulations are needed to justify and sustain the implementation of the INI.

Lessons learned and next steps

Rembuk Stunting is shaping up to be an effective advocacy tool for sub-national government leaders and has already provided opportunities for direct learning from field visits between focal districts to increase ownership of INI. Moreover, it has built capacity at sub-national level through improved knowledge and skills in planning, coordinating and monitoring INI, and the initial 34 targeted districts have now developed action plans. Further Rembuk Stunting events are planned to cover the remaining focal districts, and the monitoring and evaluation framework (including visits to each village) is being finalised so that progress can be reported.



3Basic Health Survey (Riskedas) 2013, Ministry of Health, Republic of Indonesia

More like this

NEX: La prévention du retard de croissance en Indonésie : Éveiller les consciences au niveau infranational

Read an English version of this article here Akim Dharmawan (Docteur) est le responsable du Secrétariat du Mouvement SUN au Ministère national du...

FEX: SUN Movement experiences in Indonesia

By Nina Sardjunani and Endang L. Achadi Lisez cet article en français ici Nina Sardjunani is the SUN Lead Group member and was previously Deputy Minister of Ministry...

FEX: Scaling up child wasting prevention and treatment in the context of stunting prevention in Indonesia

View this article as a pdf Leveraging efforts for joint wasting and stunting programming in Indonesia This article outlines how wasting treatment was integrated into stunting...

NEX: SUN Movement experiences in Indonesia

Nina Sardjunani is SUN Lead Group member, and Endang L. Achadi, Professsor in the Faculty of Public Health, University of Indonesia. Background Undernutrition rates in...

FEX: Scaling up child wasting prevention and treatment in the context of stunting prevention in Indonesia

Lisez cet article en français ici This is a summary of a Field Exchange field article that was included in issue 67. The original article was authored by Blandina...

NEX: Meeting the global nutrition targets 2025: Nepal’s unfinished agenda

View this article as a pdf Lisez cet article en français ici Kiran Rupakhetee is Division Chief/Joint Secretary of the Good Governance and Social Development Division,...

NEX: Multi-sectorality comes of age in the Philippines: Rollout at sub-national level

View this article as a pdf Lisez cet article en français ici ENN's SUN Knowledge Management team Introduction The Philippines is an archipelago in Southeast Asia...

NEX: Putting communities at the heart of improving nutrition: Experiences from Bénin

View this article as a pdf Lisez cet article en français ici Professor Roch Mongbo is Chief Executive of the Food and Nutrition Council of the Republic of Bénin...

FEX: Experiences of multi-sector programming in Malawi

By Felix Pensulo Phiri Lisez cet article en français ici Felix Pensulo Phiri is Director of Nutrition in the Department of Nutrition, HIV and AIDS, Ministry of Health,...

FEX: A journey to multi-sector nutrition programming in Nepal: evolution, processes and way forward

By Pradiumna Dahal, Anirudra Sharma and Stanley Chitekwe View this article as a pdf Lisez cet article en français ici Pradiumna Dahal is a nutrition specialist with...

NEX: El Salvador: the road from national nutrition strategy to local implementation

View this article as a pdf Lisez cet article en français ici Dáysi de Marquez is Executive Director of the National Council for Food Security and Nutrition...

FEX: Inter-sectoral coordination for nutrition in Zambia

Summary of research1 Location: Zambia What we know: The level of inter-sectoral coordination needed to address underlying causes of malnutrition is difficult to achieve and...

NEX: Providing district-level coverage for nutrition programming in Balochistan, Pakistan province

Hassan Hasrat is the Chief Executive Officer of the Society for Community Action Process (SCAP-Balochistan), a local NGO. He has ten years' experience in health, nutrition and...

NEX: South-to-south SUN collaboration: A Tajikistan learning group visit to Nepal

Savita Malla is the Advocacy and Communication Advisor at the National Nutrition and Food Security Secretariat at the National Planning Commission in Nepal. Stanley Chitekwe is...

NEX: Strengthening sub-national capacity in Yemen to provide life-saving treatment

View this article as a pdf Lisez cet article en français ici Majid Hammed Alhaj is head of the Taybah Foundation for Development's Hodeida office, Yemen. He has...

NEX: Moving towards multi-sector programming in Mauritania

Moving towards multi-sector programming in Mauritania Mohamed Ould Saleck is the coordinator of the National Nutrition Programme at the Ministry of Social Affairs, Childhood...

NEX: Developing the second National Plan of Action for Nutrition in Bangladesh

Dr Md. M. Islam Bulbul is the Deputy Programme Manager with National Nutrition Services and a technical specialist in the Public Health and World Health Wing of the Ministry of...

FEX: Bangladesh Nutrition Cluster: A case in preparedness

By Andrew Musyoki and Anuradha Narayan Andrew Musyoki is a Nutrition Specialist with UNICEF Bangladesh Anuradha Narayan is the Chief of the Nutrition Section, UNICEF...

FEX: Scaling up nutrition services and maintaining service during conflict in Yemen: Lessons from the Hodeidah sub-national Nutrition Cluster

By Dr. Saja Abdullah, Dr. Rasha Al Ardi, and Dr. Rajia Sharhan Lisez cet article en français ici Dr. Saja Abdullah is Chief of Nutrition with UNICEF Yemen Dr. Rasha...

FEX: Assessing progress in implementing Uganda’s Nutrition Action Plan: District-level insights

Summary of Research1 Agaba E, Pomeroy-Stevens A, Ghosh S and Griffiths JK. Assessing Progress in Implementing Uganda's Nutrition Action Plan: District-Level Insights. Food and...


Reference this page

Akim Dharmawan, Pungkas Bahjuri Ali, Dr Entos Zainal, Ardhianti, Evi Nurhidayati and Nur Akbar Baha (). Stunting prevention in Indonesia: Raising awareness at the sub-national level. Nutrition Exchange 11, January 2019. p8.



Download to a citation manager

The below files can be imported into your preferred reference management tool, most tools will allow you to manually import the RIS file. Endnote may required a specific filter file to be used.