World Food Programme Fighting Hunger Worldwide

Cost of the Diet (CoD) tool: First results from Indonesia and applications for policy discussion on food and nutrition security

the paper was published on Food and Nutrition Bulletin, vol. 34, no. 2 (supplement) © 2013, The United Nations University.

Authors:

Baldi, Giulia; Martini, Elviyanti; Catharina, Maria; Muslimatun, Siti; Fahmida, Umi; Jahari, Abas Basuni; Hardinsyah; Frega, Romeo; Geniez, Perrine; Grede, Nils; Minarto; Bloem, Martin W.; de Pee, Saskia

The Minimum Cost of a Nutritious Diet (MCNut) is the cost of a theoretical diet satisfying all nutrient requirements of a family at the lowest possible cost, based on availability, price, and nutrient content of local foods. A comparison with household expenditure shows the proportion of households that would be able to afford a nutritious diet.
Objective. To explore using the Cost of Diet (CoD) tool for policy dialogue on food and nutrition security in Indonesia.

Methods. From October 2011 to June 2012, market surveys collected data on food commodity availability and pricing in four provinces. Household composition and expenditure data were obtained from secondary data (SUSENAS 2010). Focus group discussions were conducted to better understand food consumption practices. Different types of fortified foods and distribution mechanisms were also modeled.

Results. Stark differences were found among the four areas: in Timor Tengah Selatan, only 25% of households could afford to meet the nutrient requirements, whereas in urban Surabaya, 80% could. The prevalence rates of underweight and stunting among children under 5 years of age in the four areas were inversely correlated with the proportion of households that could afford a nutritious diet. The highest reduction in the cost of the child's diet was achieved by modeling provision of fortified blended food through Social Safety Nets. Rice fortification, subsidized or at commercial price, can greatly improve nutrient affordability for households.

Conclusions. The CoD analysis is a useful entry point for discussions on constraints on achieving adequate nutrition in different areas and on possible ways to improve nutrition, including the use of special foods and different distribution strategies.

Tujuan Rencana Aksi Daerah Pangan dan Gizi (RAD-PG) Nusa Tenggara Barat 2011-2015 adalah: (1) meningkatkan status gizi masyarakat dengan target penurunan prevalensi balita gizi buruk dan kurang menjadi 18.8 persen, dan penurunan prevalensi balita pendek dan sangat pendek menjadi 36.6 persen, serta menurunkan proporsi penduduk rawan pangan menjadi 10 persen pada tahun 2015, (2) mempertahankan dan meningkatkan produksi pangan berbasis kemandirian untuk menyediakan  ketersediaan energi perkapita minimal 2,200 kkal/hari, dan penyediaan protein perkapita minimal 57 gram/hari, (3) meningkatkan keragaman konsumsi pangan rata-rata perkapita untuk mencapai gizi seimbang dengan kecukupan energi 2,000 kkal/hari dan protein sebesar 52 gram/ hari dan cukup zat gizi mikro, serta meningkatkan keragaman konsumsi pangan dengan skor Pola Pangan Harapan (PPH) menjadi 84 pada tahun 2015, dan (4) meningkatkan keamanan dan mutu pangan yang dikonsumsi masyarakat dengan menekan dan meminimalkan pelanggaran terhadap ketentuan keamanan pangan.

Pelaksanaan pembangunan di Provinsi Nusa Tenggara Timur (NTT) tahun 2009-2013 didasarkan pada Rencana Pembangunan Jangka Menengah Daerah (RPJMD). Dokumen perencanaan tersebut merupakan acuan bagi semua pemangku kepentingan yang terlibat dalam proses pembangunan. Pelaksanaan pembangunan di Provinsi NTT telah memberikan hasil yang cukup baik, hal ini ditandai dengan menurunnya jumlah penduduk miskin pada tahun 2008 sebanyak 25.65 persen menjadi 20.48 persen pada bulan september tahun 2011. Selain keberhasilan tersebut, masih terdapat sejumlah permasalahan yang perlu mendapatkan perhatian dari semua pihak. Di bidang ketahanan pangan dan gizi, pembangunan di Provinsi NTT masih dihadapkan pada sejumlah persoalan seperti rendahnya ketahanan pangan keluarga, belum optimalnya pemanfaatan lahan kering dan lahan tidur, rendahnya pengetahuan keluarga tentang pola gizi berimbang dan masih banyaknya balita yang mengalami gizi kurang dan gizi buruk.

Program WFP Indonesia tahun 2012 – 2015 merefleksikan transformasi Indonesia yang dinamis dari status negara berpenghasilan rendah ke berpenghasilan menengah dengan memastikan kelompok masyarakat rentan dapat melepaskan diri dari lingkaran kelaparan dan kekurangan gizi seiring kemajuan ekonomi bangsa. Program WFP Indonesia juga merefleksikan bergesernya peran WFP dari hubungan langsung operasional ke arah pengembangan kapasitas pemerintah dan masyarakat dalam menghadapi tantangan – tantangan ketahanan pangan dan gizi. WFP mendukung pemerintah dalam meningkatkan kapasitasnya menangani daearh rentan pangan dan gizi serta dalam kesiapsiagaan bencana melalui bantuan teknis, proyek – proyek percontohan serta dukungan kebijakan.

The new WFP’s Country Programme 2012-2015 reflects Indonesia’s dynamic transfor-mation from low income to middle income status and challenges of ensuring that the poorest and most vulnerable people escape the cycle of hunger and under-nutrition as the country progresses economically.

 A sensory acceptability study was conducted in Timor Tengah Selatan (TTS) District, East Nusa Tenggara (NTT) before WFP Indonesia launched its intervention programme to combat malnutrition using a Lipid Nutrient Supplement (LNS) product. The general objective of this study was to examine the consumption of LNS by infants and children aged 6-24 months. 

The United Nations World Food Programme (WFP) Indonesia, in collaboration with the Ministry of Health of Government of Indonesia had been supporting the Government’s existing Maternal and Child Nutrition programme (MCN) in poor and food insecure areas with high malnutrition rates under the Protracted Relief and Recovery Operation in the period 2005 2011. This documentation is intended to provide an overview of the MCN programme implementation for future capacity development and policy advocacy based on West Nusatenggara context. Data collection was carried out on October – November 2011 through desk review and field visit and the report was based on information from 2007/2008 – June 2011.

Food and nutrition assessments, combined with expenditure surveys, provide information about what people eat, how much money they spend on it, and their nutritional status. Additionally, individuals’ nutrient needs are known, and households are advised on how to ensure consumption of a healthy and nutritious diet. However, in contexts where food availability does not appear to be a problem, it remains unknown how much of the nutrient gap is due to economic constraints to a nutritious diet (unaffordability), a lack of knowledge on healthy eating, and food and nutrition practices. Moreover, current methodologies to assess food and nutrition security are not able to analyse households' constraints in accessing their nutrient requirements, especially for their most vulnerable members, such as children under two years. 

Poor nutrition in the first 1,000 days of life – from the womb to two years of age – can lead to irreversible damage to children’s minds and bodies. The World Food Programme in Asia is targeting its food assistance to make sure that children and adults get the right food, at the right time, in the right place.

In Indonesia, a low-income food-deficit country, more than 100 million people live near or below the poverty line. There are numerous slums; many rural areas lack basic infrastructure; high levels of chronic malnutrition persist. WFP’s realistic appraisal of where its impact will be greatest led to an increasing focus on nutritional interventions, especially for mothers and children, combined with innovative approaches to influencing Government policy through sophisticated and robust food security and nutrition mapping. WFP also plays a central role in anticipating and responding to natural disasters.