Background

PRISMA acknowledges nutrition as an important investment to human capital and economic development. However, stunting – a growth faltering condition resulting from persisting undernutrition and recurrent infections especially in the first 1000 days of life – remains a significant problem in Indonesia. Stunting has long term health and economic effects on individuals and societies as it hinders cognitive and physical development, reduces productive capacity, and increases the risk of diseases.

In the six provinces where PRISMA works, stunting prevalence is more than 30% (especially in East Nusa Tenggara). As PRISMA aims to reduce poverty through increasing income of smallholder farmers, investment in nutrition is an inseparable topic for which the program expects to contribute to reduction of its prevalence.

Addressing nutrition in PRISMA

Stunting is caused by multiple factors: household food insecurity, inadequate care and feeding practices, unhealthy household environment and inadequate access to health services are some of the underlying causes. For small farm households, several cause factors of stunting may co-exist as follows:

• Low productivity of highly nutritious food which causes insufficient production for year-round household consumption. Lack of access to irrigation services, low quality input, and low application of Good Agricultural Practices are among the common factors of low productivity.
• Low application of Good Agricultural Practices often also contributes to contamination of household environment from improper agrochemical usage, unmanaged livestock manure, etc. Low livestock hygiene increases the possibility of infection.
• For cash crops, low productivity results in low income which lowers household ability to afford nutritious foods which they do not produce themselves, clean fuel source, sanitation items, and/or health services.
• Limited household resources hinder households from hiring labor for agricultural and/or domestic work. Women often must endure overburden of workload which results in inadequate care for children and/or herself
• Low access to health services also hinders household’s access to nutrition and health information. Amidst local food taboos and misleading food promotion, low nutrition literacy leads households to consume food with low diversity and nutrition density.

The multifactorial nature of the causes of stunting requires multiple efforts across different sectors. Agriculture has potential to positively impact nutrition through supporting food security. Implementation of Good Agricultural Practices can also reduce contamination in household environment. Recognizing the important link between agriculture and nutrition, PRISMA will optimize opportunities to strengthen the program’s impact on nutrition.

PRISMA’s Nutrition Approach and Strategy

PRISMA focuses on increasing on farm food availability and diversity and improving food environment in the market to ensure year-round access to food. Commercial feasibility and business incentives of market actors will be ensured in the intervention ideas which will be piloted. When business case is feasible, nutrition messaging may be added as social marketing campaign to consume nutritious foods. Moreover, PRISMA will continue to monitor the adoption of Good Agricultural Practices and aspects of women empowerment dimensions on manageable agricultural workload and increased decision making on household resources.