Today is National Children’s Day here in Indonesia, so the 1000 Days Fund wanted to do something tangible to help fight stunting throughout the country.
Stunting, or low height for age, is caused by insufficient nutrient intake, poor hygiene, and frequent infections — is associated with terrible disadvantages. On average, stunted kids will surrender 10 IQ points, and miss half a year of schooling due to illness.
“Stunting is arguably the most heartbreaking and avoidable crisis facing Indonesia today,” said Sisi Arawinda, the Deputy Director of the 1000 Days Fund. “Over the last 2 years, the 1000 Days Fund has distributed 25,000 height charts across 25 islands, but more important than that, we have trained 500 frontline health volunteers (kader).”
Beyond the height charts and related to kader training to reduce stunting, the 1000 Days Fund has a bevy of tools, including smart blankets, flip charts, smart cards, and an innovative Instagram filter.
In a world where stunting is often seen as “complex,” most NGOs shy away from tangible interventions, but the 1000 Days Fund prides itself on providing solutions rather than simply pointing out problems. Across 300,000 Posyandu (village health posts), 1.5 million kader stand at the ready to respond to stunting and chronic malnutrition at the village level.
Click here to see a video of the height charts in action.
“The height charts are easy to install, and the most effective way to get them to the people who need them most—without sacrificing sustainability or impact—is through trusted yayasans and Puskesmas,” said Sisi. “The height charts are actually tools to train kader. We encourage NGO and Puskesmas partners to take advantage of grassroots opportunities and train kader to install the height charts in homes of pregnant women and women with children under 2.”
The 1000 Days Fund believes that innovation is not only about new technological tools, but also about simple tools delivered differently and specially adapted to the end-users. The height chart – or as we refer to it in the field poster – consists of height measurements for children between 9-24 months and practical ways to prevent stunting. It went through several design revisions by listening to and gathering inputs from mothers and health workers. We know the height charts work, stunting rates have dropped 9% in Labuan Bajo after 2 years with the height charts and training.
More importantly, the height charts lead to behavior change. With funding from the World Bank, the 1000 Days Fund ran a pilot testing the height charts alongside kader training in Manggarai Barat, NTT and found that after roughly six months of implementation, 65% of caregivers were able to define stunting and 48% were able to explain why stunting is important – a major increase from a baseline of 4%. More importantly, 62% of caregivers said that having the height chart in the household led to positive behavioral changes. On the village health workers’ side, while at the baseline only 35% felt confident explaining key aspects of stunting and stunting prevention, this figure doubled to 73%. In addition, the continuous follow-up and community level meetings convened by village heads and the project team contributed to all three villages rendering additional budget allocations to finance activities aligned with the prevention and reduction of stunting.
The height charts are the most comprehensive and cost-effective solution on the market. But the height charts are not a panacea. They are just one piece of the menu proposed by the 1000 Days. Our interventions center around the height chart but nudge the entire community toward change.
The problem now is that some 50% of frontline health facilities in Indonesia are either not running or have suffered some form of disruption. This means that women are not getting vital antenatal care, and children are not getting vaccines, deworming meds, or Vitamin A, not to mention birth control for moms. All these services have been disrupted, so experts expect that all the hard-fought wins made in stunting over the last 5 years maybe for not.
In the face of the baby boom and the pandemic, the 1000 Days is doing its part to get tangible stunting solutions out to those who need them most.