Indonesia’s upcoming presidential election carries high stakes, demanding strong leadership to address long-standing challenges in child malnutrition and stunting at this pivotal moment. The issue of child stunting has become a flash point among the numerous campaign pledges for health and nutrition repeatedly declared by all the candidates. But without real leadership, commitment, and grounded policy implementation, promises to secure the future of nutrition programs and to address child stunting in Indonesia may remain lip service. Indonesia’s next president has a watershed opportunity to transform rhetoric into reality, reaping the demographic bonus and achieving lasting progress for Indonesia’s next generation.
Child stunting—the failure to reach full growth potential—is a pernicious form of chronic undernutrition during the most critical periods of growth and development, particularly in the first 1,000 days of life. Although influenced by many factors, such as maternal health, inadequate dietary intake, infection, and suboptimal care practices, the persistence of child stunting is underpinned by deeper social and environmental determinants such as access to healthcare, education, and income. In Indonesia, child stunting is a major obstacle to human development, posing irreparable physical and neurocognitive impacts. This issue threatens to significantly undermine Indonesia’s potential to reap the demographic dividend by 2045, a crucial period where the number of working-age population will surpass the number of dependents, positioning the country for an era of optimal economic growth and societal advancement.
The challenge of national leadership and organizational fragmentation
The Indonesian government is implementing the National Strategy to Accelerate Stunting Prevention, with 22 ministers committed and approximately US$14.6 billion allocated to converge priority nutrition intervention. But critically, the initiative is hampered by a lack of clear and unified leadership. Currently, the authority is fragmented vertically at the national level and horizontally by the unequal capacity of local governments.
As an example, even a shared operational definition of child malnutrition differs between the ministries, resulting in different benchmarks and indicators of progress. No entity has the mandate to firmly lead and synchronize the efforts of all stakeholders, which complicates the effective mobilization and harmonization of resources. Each ministry and local government operate their own programs separately, leading to a landscape where strategies are not cohesive and collective impact is diminished.
Major reforms in the health workforce need strong leadership
To address child malnutrition in Indonesia, major reforms are needed in the health workforce and human resources, both health cadres and nutritionists. Both types of health workers require significant leadership to navigate inter-ministry politics, bureaucracies, and red tape.
Health cadres play an essential role in community health, including nutritional status monitoring and much more. Yet they lack adequate compensation and incentives, have an enormous workload, are poorly regulated, and do not competitively recruit next-generation cadres—all factors hindering their effectiveness. Inter-ministry ping-ponging of the responsibility and authority to upgrade health cadres has left health cadres in the lurch.
Professional nutritionists remain underutilized, are often reassigned to non-nutritional roles, and are unable to renew professional licenses under the new regulation, further reducing their employment.
Refrain from grandiose campaign pledges and prioritize feasible, evidence-based commitments
The campaign pledges offered by the presidential candidates warrant a critical evaluation as to whether they will truly combat stunting, with an eye on sustainability and value for money. Take one of the pledges to offer free milk and meal programs in schools. This pledge has an estimated daily cost of Rp 1 trillion (US$64.46 million) for 82.9 million beneficiaries; the yearly expenditure would soar to Rp 365 trillion (US$23.5 billion). By comparison, the entire health budget of Indonesia is Rp 186.4 trillion per year.
In addition to sustainability, value for money are other key considerations. There are more cost-effective interventions—meaning more health at lower cost—that should be prioritized if reducing stunting is the goal. Worse, if this pledge for free milk and school meals does not pass nutritional standards, it could potentially promote ultra-processed food and increase the risk of non-communicable diseases in the long term.
What’s needed from all the candidates are detailed plans that address the root causes of child stunting by offering feasible, sustainable, long-term solutions for addressing the nutritional challenges faced by Indonesian children. Meanwhile, voters need a critical eye to carefully evaluate each campaign’s pledges and not blindly believe in populist promises.
Design a rigorous result framework
The current monitoring and evaluation approach to nutritional problems in Indonesia is too narrowly focused on stunting as an outcome rather than other process indicators that address stunting. Further, subnational authorities are incentivized to underestimate stunting prevalence in order to prevent their budgets from being cut.
The next president has an opportunity to bring strong leadership that addresses the theory of change and processes that address stunting while creating subnational accountability and designing a better incentive system. Strong leadership is needed to address these questions of accountability and incentive compatibility.
As Indonesia approaches political renewal, the collective gaze of its citizens and leaders must not only be on the present but on creating a robust foundation for future generations. The strategy for reducing stunting should not be based on short-term pledges but rather a vision for nurturing the next generation to seize the maximum demographic dividend in 2045 and set a strong foundation for Indonesia’s human development. The next administration must transcend political rhetoric and control the power of informed policy, dedication, and concerted action to ensure lasting progress in addressing Indonesia’s stunting problem.
CGD blog posts reflect the views of the authors, drawing on prior research and experience in their areas of expertise. CGD is a nonpartisan, independent organization and does not take institutional positions.
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