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Length Mats: An Innovation to Reduce Stunting in Indonesia

Tuesday, Apr 24, 2018 Author: Hera Diani Co-author: Intan Oktora Megha Kapoor

Length Mats "Aku Tumbuh Tinggi dan Cerdas"
Length Mats "Aku Tumbuh Tinggi dan Cerdas"

 

The atmosphere was festive as staff at the Permata Bunda integrated health post (posyandu) in Manahan, Surakarta awaited Vice President Jusuf Kalla on Monday, 12 March. The posyandu is a key component of the national stunting prevention program led directly by President Joko Widodo and Vice President Jusuf Kalla. The one in Manahan serves 42 under-five-years-old children and four pregnant women.

At Permata Bunda health post, Vice President Kalla witnessed the launch of an innovative tool -- a portable “Length Mat” -- initiated by Generasi, the Ministry of Health and the Ministry of Villages, Disadvantaged Regions and Transmigration to measure the height of children under two years of age.

Between 6-15 February 2018, this innovative tool was trialed in 13 villages in four priority districts – Cianjur, Gorontalo, Maluku Tengah, and Ketapang. The trial involved 232 people, including parents of children under two years of age, health post workers, and human development workers. Generasi and the Ministry of Villages will expand the pilot to 3,105 villages in 31 districts in 2018.

Height, a critical benchmark of child growth, must be measured every three months for children less than two years old. The Length Mat gives health workers and parents a visual cue to see if a child is the right height for her/his age, and can be used to differentiate between female and male children. It is used by posyandu to detect stunting early and rapidly identify children who need special attention.

 

Length Mat "Aku Tumbuh Tinggi dan Cerdas"

Markings on each half of the length mat indicate expected lengths of children aged 3 to 18 months, as defined by the WHO Growth Chart Standard.
 

 

 

The Length Mat is made from durable plastic and is practical as it can be carried door to door by community health workers in remote areas, making it easier for them to detect stunting, and promote better health and nutrition practices. The mat is expected to motivate caregivers to change behaviors to promote child growth. Since community level height measurements may not be highly accurate, measurements taken with the length mat should primarily be used to raise awareness for behavioral change, not as hard data.

The length mat has been introduced in stunting prevention initiatives in Bolivia, Guatemala, Zambia and Cambodia. The use of growth charts in Zambia has reportedly helped reduce stunting by 22 percent over a one year period. Initial reviews of length mat use in Cambodia and Guatemala showed that mothers felt the height visualization on the mat has helped them understand their children’s growth.

The VP reiterated the urgency of addressing malnutrition and stunting in Indonesia. “Without sufficient nutrition and a healthy environment, our young generation is in peril,” the Vice President said in a written statement on March 12th.  He explained that if the situation persists, it would affect the country’s development performance in economic growth, poverty, and inequality. According to the VP, “Indonesia is in critical situation in terms of stunting, as warned by the WHO. Therefore, people must play (an) active role to protect our children”.

The National Report on Basic Health Research (RISKESDAS) 2013 estimates that almost 9 million children in Indonesia or a third of all children under five years of age are stunted. The Government of Indonesia is committed to reducing the prevalence of stunting through cross-ministerial, national and subnational anti-stunting programs.

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