Sunday, March 3, 2024 | 09:31 WIB

Foster Father in Stunting Prevention?

Dr. Ni Ketut Aryastami, MCN, MSc
Dr. Ni Ketut Aryastami, MCN, MSc, Researcher from Research Center for Public Health and Nutrition, National Research and Innovation Agency.

Stunting impact and budget considerations

Coinciding with National Family Day 2022, BKKBN launched a new program, namely, Fostering Stunting Children. The Stunting Fostering Father program carries a concept of mutual cooperation or ‘gotong royong’ through the provision of assistance funds to improve the nutritional quality of children, a concept that still needs to be pursued in detail. According to the Head of the BKKBN (quoted from m.antaranews.com), the provision of healthy food to children under the age of two-year will be carried out by the Family Assistance Team (TPK) in the village. With a fairly large budget allocation of Rp. 500,000/month/stunted child (or Rp. 15,000/day), when multiplied by the number of babies born with stunting (1.2 million/year), Rp600 billion/year is required. And this does not include babies who born until and up to the age of 2. 

The concept of the program of Stunting Fostering Father is a worthwhile, effort by inviting donors, but it needs to be reviewed, considering how the public’s understanding of the risks of stunting is still not optimal. The potential risk of stunting threatens with lower cognitive abilities during schooling, in spite of linear growth retardation, so that they become less competitive at a reproductive age. The greater risk, according to Barker’s hypothesis, is succumbing to non-communicable diseases in adulthood, dueto delayed development of body organs during the fetal period, so that organ function as an adult, especially with improper nutrition, can run a high risk of diabetes, heart disease, hypertension and kidney disorders, which are classified as catastrophic diseases that require high treatment costs. 

Causes of stunting and foster father intervention 

Stunting as a chronic malnutrition problem can start from the fetal period (in the womb) is a mother is malnourished. The baby may be born with a low birth weight (LBW). Disrupted fetal growth results in impaired brain development and fetal organs. Physically, stunting is indicated by non-optimal growth, called “stunted” or “of short stature”. However, not everyone who is short is stunted. According to Gluckman, about 17-20% of children who grow up short are that way because of genetic or hereditary factors. 

The fundamental key in efforts to accelerate stunting reduction is a prior understanding of the problem by stakeholders and the wider community. Provision of food by the TPK requires basic socialization of stunting-related problems. Fulfillment of nutritional needs for stunted children is somewhat different from the needs of a healthy toddler. Children born with LBW must be exclusively breastfed. In order to get good quality of breast milk, the first thing is to intervene with optimal nutritional intake by the mother, both in the form of macro and micro nutrients. Efforts to improve maternal nutrition must be accompanied by outside assistance. 

For the baby, the provision of complementary feeding by TPK must refer to an IYCF standard, namely, the fulfillment of macro and micro nutrients, according to age growth. The nutritional needs of b a b i e s a f t e r b r e a s t f e e d i n g exclusively are very few and gradually increase according to age. An understanding of low nutritional needs, while still meeting nutritional requirements must be given to the TPK if a foster care program is implemented, to avoid suboptimal feeding, which can trigger other health hazards. 

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