SURABAYA, INDONESIA – The Micronutrient Initiative (MI) and the Government of Indonesia launched a new nutrition program designed to improve the health of over one million pregnant women and children below the age of five in two high burden provinces.
“MI is honored to be part of this innovative partnership between the governments of Australia, Canada and Indonesia to enhance the nutritional status of vulnerable women and young children in East Java and East Nusa Tenggara,” said John McCullough, MI’s regional director for Asia.
Through investments from both the Australian and Canadian governments, the MITRA program aims to improve health and nutrition services in 20 high priority districts of Indonesia’s East Java and East Nusa Tenggara provinces, including improving access to needed vitamins and minerals for healthy development, as part of the Indonesian government’s efforts to increase the health and well-being of its most vulnerable populations.
“Human capital is central to improving the productivity and mobility of Indonesia’s labour force, and poor nutrition could impose on long-term economic costs through impaired cognitive function,” said Jon Burrough Counsellor for Heath and Rural Development at the Australian Embassy in Jakarta.
Since 1990, Indonesia has halved its under-five mortality rates, thanks to investments in health care. However, progress in improving the health of pregnant women has been slower, with an estimated 17,000 women dying every each due to complications in pregnancy and childbirth.
“In Indonesia, Canada has been supporting MI since 2009 with over $11 million in funding. Through the MITRA program, Canada is very pleased to collaborate with Australia to support MI in its work with the Indonesian Ministry of Health to increase healthcare workers’ capacity,” said Melissa Cardinal, First Secretary for Development, Government of Canada. “This program will promote and ensure that micronutrient supplements – such as vitamin A, zinc, iron and folic acid – reach those in greatest need.”
The MITRA program will be implemented at national, provincial and district levels by the Indonesia’s Ministry of Health, with support from MI. Funding for the program’s implementation will be provided by the governments of Australia and Canada.
“Through improving access and consumption of key micronutrients, the MITRA program will ensure pregnant women and young children get the right start in life,” John McCullough said. “MITRA will pave the way for a new generation of healthy and productive Indonesians, who will ultimately contribute to building a stronger and more resilient society.”
The MITRA program launch took place under the auspices of the Government of Indonesia’s Ministry of Health, represented by Ir. Doddy Izwardi, MA, Director of Community Nutrition; Naning Nugrahini, SKM, MKM, Head of Hepatitis and Gastrointestinal Infection Disease Sub Directorate; and Dr. Harsono, Head of Provincial Health Office, in Surabaya, East Java province. The event was attended by Jon Borrough, Counsellor for Health and Rural Development from the Australian Embassy Jakarta; Melissa Cardinal, First Secretary Development from the Government of Canada; along with MI Asia’s Regional Director, John McCullough; MI Asia Deputy Regional Director, Dr. Deepika Nayar Chaudhery; and MI Indonesia Country Director, Dr. Elvina Karyadi.
Quick facts on MITRA
MITRA is a unique multi-government collaboration to improve the survival and wellbeing of women and children through better nutrition, including:
Reduce iron deficiency anaemia in pregnant women by increasing healthcare worker capacity to promote the distribution and consumption of iron and folic acid (IFA) supplements by pregnant women. This intervention will benefit around 180,000 pregnant women. IFA helps to prevent complications related to anemia during pregnancy and avoid neural tube defects, like spina bifida, in newborns. MI will work with the Ministry of Health to build healthcare worker capacity in counseling pregnant women on the need to take IFA during the length of their pregnancy. In addition, MI will provide technical support to the government to ensure IFA supplements are provided as per global recommendations. Currently, 37 percent of pregnant women in Indonesia are anaemic, so consumption of at least 90 IFA tablets will help to ensure a healthier pregnancy.
Reduce the impact of diarrhoea in young children by increasing the use and consumption of zinc and oral rehydration salts (ORS) to treat diarrhoea. This intervention will target approximately 160,000 children under the age of five suffering from diarrhoea through the use of zinc and ORS via skilled health workers. ORS rehydrates a child suffering from diarrhoea while zinc helps reduce the severity of the episode and can build the immunity of children against future episodes. In addition, MI will work with the government to train healthcare workers in the distribution of zinc and ORS to caregivers, including increasing their capacity to counsel caregivers on the correct dosage as well as appropriate continued feeding of a child during the illness. In addition, MI will support the government supply chain system to reduce “stock outs” at health centers. Currently, only 15 percent of children with diarrhoea receive zinc and ORS in the two provinces (RISKESDAS 2013).
Increase the number of children below the age of five receiving two doses of vitamin A supplementation (VAS) to build immune systems and reduce blindness. This intervention aims to ensure 770,000 children in the two provinces receive two annual doses of vitamin A, which will provide a needed immune system boost and reduce the risk of nutritional blindness in children. In addition, MI will work closely with the national network of integrated health posts – the Posyandu – where children will receive VAS twice a year; support the government to procure and distribute VAS to the provinces; and increase capacity of government staff to capture and analyze VAS data. The percentage of children receiving two doses of vitamin A decreased from 71.5% in 2007 to 69.8% in 2010 (Basic Health Research Data), well below the national target of 85% coverage (National Plan of Action on Food and Nutrition of the Ministry of Development Planning, Indonesia, 2010).
The Micronutrient Initiative (MI) in Indonesia
The MITRA program builds on the Micronutrient Initiative’s previous successful collaboration with the Government of Indonesia over the last 10 years, with the financial support of the Government of Canada. Concurrent with the MITRA program, MI also implements programs to reduce iodine deficiency through iodization of salt; as well as increase the use of zinc and ORS by children with diarrhoea and bi-annual vitamin A supplementation for children under the age of five, in six other provinces. In addition, MI has initiated a program to reduce anemia levels of 3.5 million school-going adolescent girls through IFA supplements in schools in West Java and Banten. MI will work closely with the Government of Indonesia to scale up this initiative across other provinces in the coming years.