What are the consequences of double burden of malnutrition in Indonesia context? What would you suggest to minimize the consequences?
It is important to first understand what the double burden of malnutrition (DBM) is. Essentially, DBM is when both overnutrition and undernutrition exists within the same population at the same time. Indonesia faces this issue not only within its population but overnutrition and undernutrition can be seen within the same household or even in one individual. The issue can be seen in both poor and rich countries and likelier in women than men (Shrimpton & Rokx). The term was coined in 1992 at the International Conference on Nutrition (ICN) because countries, like Indonesia, were facing both overnutrition and undernutrition simultaneously.
Malnutrition in Indonesia Indonesia has a population of 237 million people making is the largest member of the Association of Southeast Asian Nations (ASEAN) economy. It is an emerging low middle-income country and one of Asia’s most decentralized democracies. Furthermore, it is the largest in Muslim population (Martini). Most of the nutritional issues occur in the eastern part of Indonesia where 18% are underweight, 35.6% are stunting and 14.3% are wasting. In these statistics, underweight and stunting are defined as being two deviations below the median of weight and height for that age respectively. Wasting is defined as being extremely thin also by two or more deviations below the median weight for that height (Shrimpton & Rokx). There are 25 million Indonesians that are food insecure (Martini). Malnutrition affects more than the individual facing it. Undernourished children are likelier to be short adults as well and thus birth smaller children. Furthermore, stunting negatively effects cognitive development thus hindering proper school performance (Martini). Education is such a vital part of the development of a village, country and the world and so this hindrance affects the society as a whole. Moreover, fetuses that undergo stunting in the first 2 years leads to “reduced economic productivity in adulthood” (Martini). The opportunity to prevent stunting is within the first 24 months of living.
Food Security Food security is defined by when the population has access to safe, adequate and nutritious food that allows for a healthy and active life at all times (Martini). Furthermore, it is also about having economic access to food that meets people’s needs and preferences (Martini). Access to food, availability and utilization are three key foundations to achieving food security. Access to food is defined by having a consistent amount of necessary food, access is defined by having enough resources and utilization is defined by properly using food based on nutritional needs and ensuring that it is all being handled in a sanitary way (Martini). A huge problem is that the supply of food is not meeting the continuously increasing demand for it leaving countries in shortages. Indonesia in particular has a high rate of population growth which makes food access such a relevant issue. The International Food Policy Research Institute (IFPRI) reported that food supply increases 1-2% annually while the world population increases by 4% (Martini).
How does DBM happen?
There are four main causes at to why DBM occurs and they relate to changes in nutrition transition (Shrimpton & Rokx). Causes include changes to the health/biological environment, changes in the economic/food environment, the physical environment itself and the socio/cultural environment (Shrimpton & Rokx). First, the health and biological environment have to do with how the population has grown by three times and a decrease in fertility as NCDs are becoming more common than infectious diseases which were the main cause of death. Those who do survive NCDs become more susceptible to being overweight, diabetes and CVD, common in Asians, (Shrimpton & Rokx). Young children that suffer
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