Improving Food and Nutrition Security in Indonesia (Story of Change)

The Netherlands Development Organisation (SNV) leads the Voice for Change Partnership (V4CP) in collaboration with the International Food Policy Research Institute (IFPRI), and in partnership with the Dutch Directorate-General for International Cooperation (DGIS).

V4CP is working with 51 locally-based civil society organisations (CSOs) around the world to bridge the gap between the United Nation’s Sustainable Development Goals (SDGs) and their implementation within society, especially amongst low-income and marginalised communities. It does so by strengthening the capacity of CSOs to influence stakeholders and decision-makers with solid and contextualised evidence in order to get the interests of communities embedded into government and business policies and practices.

This story illustrates the value of gathering solid evidence to support advocacy and how working collaboratively can amplify voices for change. In this case the V4CP’s CSOs coordinated dialogue across a variety of stakeholders to tackle stunting, one of the health impacts of poor nutrition.

Tackling stunting

Globally, almost one in four children under the age of five have a condition called stunting (low height-for-age). In Indonesia, this rises to an average of one in three (30.8%)[1], and affects as many as eight million of the country’s children.

Stunting is the impaired growth and development that children experience as a result of malnutrition, repeated infection, and inadequate psychosocial stimulation. Stunting in early life - particularly in the first 1,000 days from conception until the age of two - has adverse functional consequences including poor cognition.

V4CP’s local CSOs have claimed the space and are supporting the district-level implementation of the Country Strategic Plan on Food and Nutrition Security, as well as the National Strategy to Accelerate Stunting Prevention 2017-2021, in order to contribute towards the fulfilment of the United Nation’s Sustainable Development Goal (SDG) 2.2, and to end all forms of malnutrition by 2030. They are focusing on two Provinces - West Nusa Tenggara (NTB) where stunting rates are the seventh highest in the country and East Nusa Tenggara (NTT) where they are highest, at a staggering 42.6%[2].

This story focuses on East Lombok in West Nusa Tenggara, where stunting rates used to be the third highest in the country[3], yet have improved. Here, exemplary work by one V4CP CSO - Consortiums for the Study and Development of Participations (KONSEPSI) - has led it to become a successful pioneer in evidence-based advocacy for stunting. Today, it is widely regarded as one of the most reputable organisations in the country on the issue, and is the only CSO frequently asked by the District Government to manage stunting-related issues in East Lombok.

This is their story.

Voice for Change: Moh Taqiuddin, Director at KONSEPSI

On his way to work in Mataram, East Lombok, every day Moh Taqiuddin passes dozens of children that are too short for their age. Yet, because stunting has not been regarded as a serious public health issue by the district’s leaders, nothing much has ever been done about it in West Nusa Tenggara - or in any of the country’s 34 provinces for that matter.

Having worked with communities across the province for many years, Taqi knows the human cost of the condition only too well. He is determined to transform the government’s national ambitions into effective interventions amongst villages, yet given that the causes of malnutrition are so diverse, he is aware that instigating change will take monumental effort by a wide range of district government departments, as well as social and religious leaders.

Looking out over the city square, Taqi reflects on how to win the support of district leaders. Given the district’s limited resources and wide-ranging agendas, he knows that inspiring them will be an enormous challenge – one that KONSEPSI cannot undertake alone. He decides that the way forward is for KONSEPSI to collaborate with other organisations and to start looking for partnership opportunities.

Pioneering evidence-based advocacy

In 2016, KONSEPSI teamed up with SNV for the V4CP programme. Taqi was keen to build his team’s capacity so together they attended a series of training programmes to increase their skills on policy development, nutrition issues, and on best practice for conducting research. With greater insight into policy processes, Taqi realised the key to convincing district leaders to prioritise stunting reduction lay in presenting them with hard facts – yet those were lacking.

Taqi and his colleagues asked IFPRI to help them by analysing reliable sources of publicly available research. By combining these analysed facts with their increased knowledge of policy development and their first-hand experience of working with communities, KONSEPSI was able to create an evidence-based case for the need to prioritise stunting reduction. Taqi felt confident that they were now ready to amplify their voices on the issue, and to become involved in a policy making process for the first time.

Collaboration for progress

In July 2017, KONSEPSI initiated a meeting with the local district and provincial governments, who were impressed by the quality of their evidence-based advocacy case. Yet, in order to ensure that Food and Nutrition Security (FNS) issues were included in policies and budgets, they required more district FNS data and a budgetary analysis.

KONSEPSI (with support from IFPRI) assembled a team of stakeholders from the government and social sectors. They applied the research skills gained through the V4CP programme’s capacity training to conduct a FNS Household Survey in 20 sub-districts of East Lombok, interviewing 20 households in each district. In addition, in June 2018, IFPRI - in collaboration with the Regional Information Center (PATTIRO) and five V4CP CSOs[4] -  tracked and analysed the FNS budget in five districts including East Lombok, so that adequate financial resources could be assigned to nutrition in the future.

Pressure on the district government to step up efforts to reduce stunting grew when, later that year, it transpired that - of the 100 villages across the country identified for priority action on stunting by the Indonesian National Team of Poverty Reduction Acceleration – 10 were in East Lombok. In response, the Regent of East Lombok District established the Regent’s Regulation of East Lombok Number 31 Year 2017 (Perbup Nomor 31 Tahun 2017) to decrease stunting. The Regent also set up two task forces to accelerate progress: one to formulate and develop a District Food and Nutrition Action Plan (2018 – 2023), and another task force to accelerate stunting alleviation. Both task forces are legalised by the East Lombok Regent Decree. As the quality of KONSEPSI’s evidence has increased its credibility, the district head invited the CSO to facilitate both of the task forces.

To engage civil society participation in the stunting task force, Taqi and his colleagues organised what is known locally as a Rembuk, or gathering, that included a wide range of stakeholders, from academics and researchers to religious and village representatives. Four significant commitments were made at the gathering: to accelerate efforts to reduce stunting; to ensure the FNS Action Plan included stunting issues; to initiate and establish a Village Movement for Stunting Reduction (called the Gerdes Penting); and to collect additional, integrated village-level data so that all institutions in East Lombok could develop a collaborative Stunting Reduction Programme.

The need for more village-level data on nutrition was given priority so, in July 2018, IFPRI and KONSEPSI conducted further research into stunting rates, as well as access to water, sanitation, and food, amongst 2,725 households (with children under five) in the 10 priority villages. These results were disseminated to all related stakeholders in East Lombok and KONSEPSI advised the district government to use the results as a source of data for FNS policy.

Pioneering evidence-based advocacy

As a direct result of this teamwork between the CSOs and local governmental and social sectors, the first ever research platform for a collaborative Stunting Reduction Programme was established. By integrating the research results on stunting and the Household Survey with other key government data, such as poverty statistics, the critical links between stunting, poverty and nutrition could be identified and the most strategic intervention priorities into stunting-related issues formulated. The data is currently used to underpin policy decisions and to devise guidelines for village authorities on mapping and monitoring stunting reduction plans.

KONSEPSI and the Local Development Planning Board (BAPPEDA) used the research results on stunting to initiate an Integrated Baseline Data system (called SISTARI). In early October 2018, district government departments agreed to use the results as a baseline for implementing a stunting-related programme in the 10 priority villages, and they also committed to set up a Roadmap for Stunting Reduction 2019-2023, based on SISTARI.

“Being a change maker is not easy. For our work to stimulate change required us to have sufficient knowledge, commitment, confidence and patience. Through this experience, I learned that change emerged when people started to trust KONSEPSI-SNV to provide them with a new energy. Thanks to the East Lombok district authorities for their excitement and cooperation in working hand in hand with us for the emergence of evidence-based policies.” - Moh Taqiuddin, Director at KONSEPSI.

KONSEPSI is rapidly growing as an organisation and a voice for civil society. Although the challenge to implement the SDGs amongst communities across Indonesia remains great, there is progress. The provincial government aims to use the positive results of the stunting initiative in East Lombok as an example for other districts across Indonesia and, through the V4CP programme, KONSEPSI is sharing its experiences with government and civil society at international fora.

Lastly – and perhaps most importantly – KONSEPSI’s journey has helped convince the district government of East Lombok of the benefits of working with CSOs to establish a multi-stakeholder approach to tackling FNS issues. It has demonstrated the value of using evidence as the basis for action plans and as a model to scale up efforts to reduce stunting. Together, these advances can lead to significant progress, not only on FNS but other critical development issues.

“Thank you KONSEPSI for facilitating this process and helping us to become more aware of the stunting issue. Sometimes, we as the government need external people to help facilitate the thinking process that involves various stakeholders and brings us out of comfort zone to implement the programme collaboratively.” - Maryani, ST., ME, Head of Social-Cultural Division Bappeda of East Lombok.

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Reference:  
[1] Stunting Prevalence in Provinces of Indonesia according to the Indonesia Basic Health Research (Riskesdas) 2013-2018.

[2] Riskesdas 2018