Aksi Bergizi: Adolescent nutrition pilot program to address the triple burden of malnutrition among adolescent girls and boys in Indonesia
UNICEF Indonesia
(
United Nations / Multilateral body
)
#SDGAction46695
Description
UNICEF, in partnership with the Government of Indonesia, initiated an integrated gender-responsive adolescent nutrition program – Aksi Bergizi – in response to the nutritional gap identified in the country’s adolescent population. Aksi Bergizi was designed to address the triple burden of malnutrition among adolescents in Indonesia by reducing anemia prevalence while promoting healthy eating and physical activity behaviors. Aksi Bergizi was first piloted in two selected districts, namely Klaten (Central Java province) and Lombok Barat (Nusa Tenggara Barat province). The Aksi Bergizi intervention package consists of three components: 1) Strengthening weekly iron-folic acid supplementation (WIFS) for girls. This is administered alongside a home-brought breakfast (where feasible) to facilitate tablet absorption and reduce the side effects of the iron and folic acid tablet. This also helps establish the habit of eating breakfast, which many adolescents are otherwise found to not do on a regular basis. 2) Multi-sectoral nutrition education. This is a weekly interactive and fun nutrition and health awareness session usually conducted immediately following the WIFS session. The content focuses on nutrition and other health issues including reproductive health, HIV/AIDS, water sanitation and hygiene, mental health, addictive substances, violence and injuries, and non-communicable disease while mainstreaming gender across all issues. The session is designed to stimulate adolescent girls and boys to practice essential soft skills in daily life while improving their knowledge on health and nutrition issues. 3) A comprehensive SBCC intervention to improve healthy eating and physical activity. This includes: a. district and provincial level advocacy to build awareness, commitment, and coordination b. capacity strengthening for district officials, health workers, and teachers to conduct, monitor and evaluate the program and student peer support training c. the messaging of a set of targeted actions focused on: i. controlling and preventing anemia through iron or iron and folic acid (IFA) supplements, eating iron-rich and fortified foods, as well as green leafy vegetables ii. healthy eating through increased vegetable, fruit, and water consumption, and reduced sugar, salt, and fat intake iii. increasing physical activity through getting 60 minutes of any enjoyable sport (e.g. walking, jogging, biking, dancing, aerobics, etc.) each day iv. addressing gender norms that affect dietary intake and physical activity of adolescents d. school mobilization activities designed and participated by adolescents themselves such as school competitions, cooking demonstrations, school gardens, posters on healthy food choices displayed in the school canteen, and other student engagement activities, e. social media, writing, and short video production training for adolescents to share their learning from the program with peers and family After one year of pilot implementation, the Aksi Bergizi programme showed positive changes in adolescents’ knowledge and behaviours. In 2020, the government agreed to scale up the intervention package of Aksi Bergizi through all schools nationwide using the Sekolah Sehat (healthy school) program as the platform. Accordingly, continued efforts by UNICEF and the multi-sectoral ministries have been made to support the national scale-up of Aksi Bergizi intervention package with coverage and quality.
The Aksi Bergizi programme has successfully changed adolescents’ knowledge and behaviours in nutrition which in turn will lead to improvement in their nutritional status. An impact evaluation indicated a significant increase in the proportion of adolescent girls who consumed Weekly Iron Folic Acid Supplementation, as well as adolescents who consumed vitamin A-rich fruits and vegetables, did physical activity for 60 minutes every day, and had good knowledge of nutrition. The programme applies a strong gender lens to address gender inequality in nutrition by supporting adolescent girls vulnerable to iron deficiency anemia, preventing the triple burden of nutrition for both adolescent girls and boys, and mitigating gender norms that affect the dietary intake and physical activity of adolescents. Aksi Bergizi addresses a need identified in the adolescent population using a multi-pronged approach with innovation at its core. It engages with multiple stakeholders across health, education, and religious affairs, whereas traditional programs tend to engage a single provincial/district government vertical. The cascade training, in which knowledge flows from the district facilitator to teachers and then on to students, embeds the program with local leadership, increasing the ongoing sustainability of the program. Aksi Bergizi trainers are encouraged to facilitate rather than instruct students, adopting a spirit of fun and diverging from the traditional pedogeological style. This is designed to encourage learning, sharing, and open discussion among the students as they are guided to connect topics to their daily life. Adolescents are closely involved in all critical steps of the program design, implementation and monitoring, strengthening students’ engagement. Peer support further encourages student participation while building cross-student learning, individual leadership, gender sensitivity, communication skills, and confidence. Through educating girls and boys on nutrition and health, they develop a deeper understanding of gender issues such as pregnancy, menstruation, and different nutritional needs. School mobilization activities also encourage participation from girls and boys, dispelling cultural norms of cooking being only for girls and sports for boys.
Ministry of Health, Ministry of Planning, Ministry of Education Culture Research and Technology, Ministry of Religious Affairs, Ministry of Home Affairs
https://drive.google.com/drive/u/0/folders/19aDim1e11IIYVha1fLrzuZ4NKA_e6TW6
SDGS & Targets
Goal 2
End hunger, achieve food security and improved nutrition and promote sustainable agriculture
2.1
By 2030, end hunger and ensure access by all people, in particular the poor and people in vulnerable situations, including infants, to safe, nutritious and sufficient food all year round
2.1.1
Prevalence of undernourishment
2.1.2
Prevalence of moderate or severe food insecurity in the population, based on the Food Insecurity Experience Scale (FIES)
2.2
By 2030, end all forms of malnutrition, including achieving, by 2025, the internationally agreed targets on stunting and wasting in children under 5 years of age, and address the nutritional needs of adolescent girls, pregnant and lactating women and older persons
2.2.1
Prevalence of stunting (height for age <-2 standard deviation from the median of the World Health Organization (WHO) Child Growth Standards) among children under 5 years of age
2.2.2
Prevalence of malnutrition (weight for height >+2 or <-2 standard deviation from the median of the WHO Child Growth Standards) among children under 5 years of age, by type (wasting and overweight)
2.2.3
Prevalence of anaemia in women aged 15 to 49 years, by pregnancy status (percentage)
2.3
2.3.1
Volume of production per labour unit by classes of farming/pastoral/forestry enterprise size
2.3.2
Average income of small-scale food producers, by sex and indigenous status
2.4
By 2030, ensure sustainable food production systems and implement resilient agricultural practices that increase productivity and production, that help maintain ecosystems, that strengthen capacity for adaptation to climate change, extreme weather, drought, flooding and other disasters and that progressively improve land and soil quality
2.4.1
Proportion of agricultural area under productive and sustainable agriculture
2.5
By 2020, maintain the genetic diversity of seeds, cultivated plants and farmed and domesticated animals and their related wild species, including through soundly managed and diversified seed and plant banks at the national, regional and international levels, and promote access to and fair and equitable sharing of benefits arising from the utilization of genetic resources and associated traditional knowledge, as internationally agreed
2.5.1
Number of (a) plant and (b) animal genetic resources for food and agriculture secured in either medium- or long-term conservation facilities
2.5.2
Proportion of local breeds classified as being at risk of extinction
2.a
2.a.1
The agriculture orientation index for government expenditures
2.a.2
Total official flows (official development assistance plus other official flows) to the agriculture sector
2.b
Correct and prevent trade restrictions and distortions in world agricultural markets, including through the parallel elimination of all forms of agricultural export subsidies and all export measures with equivalent effect, in accordance with the mandate of the Doha Development Round
2.b.1
Agricultural export subsidies
2.c
Adopt measures to ensure the proper functioning of food commodity markets and their derivatives and facilitate timely access to market information, including on food reserves, in order to help limit extreme food price volatility
2.c.1
Indicator of food price anomalies
Goal 5
Achieve gender equality and empower all women and girls
5.1
End all forms of discrimination against all women and girls everywhere
5.1.1
Whether or not legal frameworks are in place to promote, enforce and monitor equality and non‑discrimination on the basis of sex
5.2
5.2.1
Proportion of ever-partnered women and girls aged 15 years and older subjected to physical, sexual or psychological violence by a current or former intimate partner in the previous 12 months, by form of violence and by age
5.2.2
Proportion of women and girls aged 15 years and older subjected to sexual violence by persons other than an intimate partner in the previous 12 months, by age and place of occurrence
5.3
5.3.1
Proportion of women aged 20-24 years who were married or in a union before age 15 and before age 18
5.3.2
Proportion of girls and women aged 15-49 years who have undergone female genital mutilation/cutting, by age
5.4
Recognize and value unpaid care and domestic work through the provision of public services, infrastructure and social protection policies and the promotion of shared responsibility within the household and the family as nationally appropriate
5.4.1
Proportion of time spent on unpaid domestic and care work, by sex, age and location
5.5
Ensure women’s full and effective participation and equal opportunities for leadership at all levels of decision-making in political, economic and public life
5.5.1
Proportion of seats held by women in (a) national parliaments and (b) local governments
5.5.2
Proportion of women in managerial positions
5.6
Ensure universal access to sexual and reproductive health and reproductive rights as agreed in accordance with the Programme of Action of the International Conference on Population and Development and the Beijing Platform for Action and the outcome documents of their review conferences
5.6.1
Proportion of women aged 15-49 years who make their own informed decisions regarding sexual relations, contraceptive use and reproductive health care
5.6.2
Number of countries with laws and regulations that guarantee full and equal access to women and men aged 15 years and older to sexual and reproductive health care, information and education
5.a
Undertake reforms to give women equal rights to economic resources, as well as access to ownership and control over land and other forms of property, financial services, inheritance and natural resources, in accordance with national laws
5.a.1
(a) Proportion of total agricultural population with ownership or secure rights over agricultural land, by sex; and (b) share of women among owners or rights-bearers of agricultural land, by type of tenure
5.a.2
Proportion of countries where the legal framework (including customary law) guarantees women’s equal rights to land ownership and/or control
5.b
5.b.1
Proportion of individuals who own a mobile telephone, by sex
5.c
Adopt and strengthen sound policies and enforceable legislation for the promotion of gender equality and the empowerment of all women and girls at all levels
5.c.1
Proportion of countries with systems to track and make public allocations for gender equality and women’s empowerment
SDG 14 targets covered
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Deliverables & Timeline
More than 58% adolescent girls in Indonesia receive Weekly Iron Folic Acid Supplementation
All provinces implement the adolescent nutrition program Aksi Bergizi, with special efforts made for the 12 prioritized stunting provinces
Resources mobilized
Partnership Progress
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Entity
Region
- Asia and Pacific
Other beneficiaries
Adolescent boys and girls in Indonesia, teachers, health workers, government program managers and officers
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Contact Information
Airin, Dr