More than one in four children in Indonesia under the age of five suffers from stunting. That’s more than the population of Jakarta, or equivalent to almost two Singapores.

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Stunted growth is caused by a lack of adequate nutrition and results in life-long health problems, from reduced IQ to greater susceptibility to diabetes and cancer. There is also a huge economic cost, with Indonesia’s Ministry of Health estimating that the prevalence of stunting costs the country 2-3% of GDP, or as much as US$27 billion each year.

The good news is that the condition is easily preventable, but a lot of work remains if Indonesia is to achieve its target of bringing stunting down from 27.7% in 2019 to 20% by 2024.

That’s why Tanoto Foundation, an independent family philanthropy organisation founded by Sukanto Tanoto and Tinah Bingei Tanoto in 1981, is holding Stunting Awareness Month, to raise awareness of this condition, how to prevent it, and how to treat it in kids who are already stunted.

What is stunting?

Stunting is when a child fails to grow to the proper height for his or her age. The main cause is poor nutrition in pregnant women, babies and toddlers.

Stunting is a form of malnutrition, but it’s more accurately described as under nutrition. Few people in Indonesia lack sufficient calories, but low awareness of balanced nutrition means that meals are often heavy on rice, with little protein or vegetables. Many parents also don’t understand the importance of breastfeeding, relying instead on formula which is not as nutritious for a baby.

In some areas, lack of clean water for sanitation and personal hygiene as well as limited access to health services can exacerbate the problem.

Stunting often begins in the womb due to a poor maternal diet, but symptoms typically don’t manifest themselves until the child is around two years old, when it becomes clear that the child is not growing as quickly as he or she should.

Why does stunting matter?

Stunting has huge costs for the child and for the economy. Stunted children have weakened immune systems, are more susceptible to diseases like diabetes and cancer, and are likely to die earlier than non-stunted individuals.

Brain development is affected too, resulting in lower IQs and reduced income in adult life. According to research by the WHO children who were stunted at age two completed a year less of schooling than non-stunted individuals, and were likely to earn 20% less as adults.

This impacts the country’s economy. The government has set a target of becoming the fifth largest economy in the world by 2045, buoyed in part by a demographic dividend from a ‘youth bulge’ entering the workforce in the coming decades. But if stunting remains at current levels, more than one quarter of those new workers will be less healthy and less productive than they should be, holding back the nation’s growth and condemning millions to poverty unnecessarily.

What can parents do?

Stunting is easily preventable with proper nutrition.

Mothers need to follow a balanced diet before pregnancy starts to ensure that the proper nutrients are passed on to the fetus.

Indonesia’s Ministry of Health recommends that a healthy meal should consist of around one third fruits and vegetables, one third carbohydrates like rice, and one third protein like meat, fish or vegetarian protein sources.

You should also practice proper hygiene, including washing your hands with soap and water before preparing or eating food.

Experts recommend exclusive breastfeeding for the first six months of a baby’s life, and husbands can play a role by supporting their wife’s decision to breastfeed.

And once the baby starts weaning, introduce fruit and vegetables into his or her diet.

How do you know if a child is stunted?

Children suffering from stunting typically weigh less than 2.5kg at birth, and grow more slowly than they should. They also often start teething later than non-stunted children.

The good news is that some of these effects can be reversed by following a balanced diet within the first 1,000 days of life, or up to the age of two.

If you think that your child may be stunted then you should seek advice from a medical professional.

What is the government doing?

The government launched the First 1,000 Days of Life Movement in 2013 which focused on fulfilling nutrition for children from the pregnancy phase (270 days) to two years old (730 days).

The government also launched the National Strategy to Accelerate Stunting Prevention in 2017, gathering 22 ministries and around US$14.6 billion commitments to implement various nutritional interventions. In 2018, this strategy targeted 100 districts with high stunting prevalence. The number of districts was increased to 160 in 2019, 360 districts in 2020, and finally all 514 districts and cities in 2021.

In the National Medium-Term Development Plan (RPJMN) 2020-2024, efforts to accelerate stunting reduction are one of the priorities.

The government is aiming to get stunting under 20% in 2024, and some progress has been made. In 2007 36.8% of children were stunted, compared to 27.7% in 2019.

What is Tanoto Foundation doing?

Through our Early Childhood Education and Development program, we’re actively supporting the government’s efforts to prevent stunting. We invest in research that enables data-based decision making, and are working to strengthen care-giving in Indonesia to support children’s development.

We are also a founding donor of the World Bank’s Multi Donors Trust Fund for the Indonesian Human Capital Acceleration, which provides US$2 million to help the government’s stunting prevention strategy.

Together with the Smeru Research Institute, Tanoto Foundation is conducting a pilot study in Rokan Hulu, Riau, to map the prevalence of stunting down to the village level. These data will help inform future prevention strategies.