3. MCC in 2 minutes
Reducing poverty through economic growth
•Competitive selection
– Good governance
– Economic freedom
– Investment in citizens
•Country-led solutions
– Economic and social analysis
•Country-led implementation
– The MCA and implementing partners
– 5-year Compacts and Threshold Program
•Focus on results
4. Indonesia
• 246.9 million people
• 17,000 islands across 3200 miles
• Largest Muslim democracy (86% Muslim)
• 140 million people live on less than $2/day
• Over one-third of children under five years
of age experience stunted growth
5. This chart uses WHO data from different years as available and is presented for comparison purposes only
Children Under 5 Years Stunted (%)
6. 37% of all Indonesian children
under age 5 are stunted
7. Why focus on stunting
Stunting affects:
•Survival
•Long-term health
•Cognitive development
•Family resource utilization
•Long-term productivity
9. Project Overview
• The Indonesian government’s implementation of
Scaling Up Nutrition (SUN)
• Aims to reduce and prevent low birth weight,
childhood stunting, and malnourishment of children
• Targets approximately 5400 villages in 11 provinces
where stunting and low birth weight are higher than
national averages
• $129.5 million
• 16.5% ERR
• In Year 2 of 5-year Compact
10. Project Activities
• Component 1 (Demand Side): block grants and
participatory planning technical assistance to
communities ($81.6 M)
• Component 2 (Supply Side): training and capacity
building for health and sanitation providers,
anthropometric equipment, micronutrient provision,
and private sector response ($34 M)
• Component 3: national stunting awareness
campaign and project management support
($13.9M)
14. PNPM Generasi Indicators as a
Community Incentive
1. Each pregnant women attends four prenatal care visits
2. Each pregnant woman receives iron supplements during pregnancy
3. Each delivery assisted by trained professional
4. Each mother attends two postnatal care visits
5. Each infant is fully vaccinated
6. Each child under 5 is given vitamin A supplements
7. Each child under 5 years of age is weighed once a month
8. Each child increases their weight
9. Each child aged 6-59 months receives Vitamin A two times per year
10.Each mother and father attends a monthly nutrition counseling session
11.Each primary-school-age child attends school
12.At least 85 percent of secondary-school-age children attend school
15. – Supply Side –
Supplying Services and
Resources Demanded by
Communities
16. Capacity Building
• Ministry of Home Affairs, Ministry Health
and Sanitation
• Training
– Over 20,000 staff and volunteers
– Cascaded training model
– Didactic and on-the-job
– Maternal, child, and young child feeding;
growth monitoring; sanitation and hygiene
17. Sanitation and Hygiene
Helping Communities to Become
Open Defecation-free
•Community-led Total Sanitation (CLTS)
– Sanitation triggering
– Community action plan
– Monitoring and technical assistance
– ODF declaration
•Service provider incentives (RBF)
18. Micronutrient Powders and the
Private Sector
• Government of Indonesia policy to provide
MMN powders to bottom 2 quintiles
• Supplemental feeding and nutritious food
options
• Role of the private sector
20. Impact Evaluation
• Random assignment to treatment and
control
• Testing entire package
• Reduction of stunting as a key outcome
• Public availability of data
21. Challenges and Opportunities
• Number of stakeholders
• “The Handshake”
• Budget tradeoffs
• Geographic scope
• On-the-job performance
• Distribution and compliance
Our second project is Community-Based Nutrition to Reduce Stunting.
It is an alarming statistic that over one third of Indonesian children under 5 are stunted – this means low height for age.
After 2 years of age, the effects of stunting are practically irreversible and have a life-long impact on an individual’s productivity. Stunting leaves children at a higher risk of experiencing chronic disease, delayed cognitive development, delayed enrollment in school, reductions in academic achievement, thus future earning potential.
Given Indonesia’s desire to become one of the 10 largest economies in the world by 2030, it needs to do more now to support a population that can reach its full economic potential.
The good news is that the causes and remedies for stunting are well understood. The challenge for Indonesia is that there remains a lack of access to these remedies, especially in places where they are most needed.