Dual Burden of Malnutrition in Indonesia

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This assignment delves into the complex issue of the dual burden of malnutrition in Indonesia. It analyzes research papers that highlight the coexistence of undernutrition and overnutrition within households and communities. The focus is on understanding the socioeconomic, dietary, and cultural factors contributing to this phenomenon, as well as its implications for health outcomes and inequalities.

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Running head: DUAL BURDEN OF MALNUTRITION IN INDONESIA
Dual burden of malnutrition in Indonesia
Name of the Student:
Name of the university:
Author Note:

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1DUAL BURDEN OF MALNUTRITION IN INDONESIA
Table of Contents
Introduction: 2
Etiology and epidemiology: 3
Determinants for the dual burden of malnutrition: 4
Food production statistics for Indonesia: 6
National dietary pattern: 8
Strategies: 8
Conclusion: 11
References: 12
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2DUAL BURDEN OF MALNUTRITION IN INDONESIA
Introduction:
Nutrition is considered to be one of the basic requirements of human life, without proper
nourishment the human life will perish in not time. However, the question remains whether all
the sectors of the society are able to avail this basic human right, regardless of the socio-
economic status, cultural- racial identity or demographical attributes. The human civilization is at
the peak of innovation, with the technological advancements through the roof, everything is just
at the fingertips for the human society. However, in the face of such astounding progress, there
are still nations where the humans are denied the most basic need of all times, nutrition
(Roemling & Qaim, 2012).
Malnutrition has been one of the very consistent public health and welfare issues, that
continues to persist even now; dual burden of nutrition, however, is a completely new concept.
Dual burden of Nutrition can be defined as the characteristics phenomenon for a nation where
there is a conspicuous coexistence of malnutrition along with the issues of overweight and
obesity adult diet related non- communicable diseases not just in the personal level with and
different individuals but also on a large scale basis among households, and across population for
entire nations. The conundrum of contradiction between overweight and underwear has emerged
as a learning Public Health issues in the last decade, and according to alphabetical analysis
conducted by the World Health Organization in the year of 2014, 2 million adults were
discovered to be overweight, 600 million to be obese while 460 million people were found to be
underweight. Unfortunately, poor nutrition has been considered as the leading causes of
mortality and the children under the age of 5, especially in the low and middle-income countries,
that are facing the dual pattern of malnutrition issue 30% faster than the first world developed
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3DUAL BURDEN OF MALNUTRITION IN INDONESIA
countries. Therefore, the issue of dual burden of malnutrition requires a sound strategic plan that
can help the developing nations to provide a proper quality of life to all its citizens. This
assignment will focus on the dual pattern of malnutrition issue escalating in Indonesia an attempt
to provide a strategic recommendation for the nation to follow in order to overcome the situation
(Jehn & Brewis, 2009).
Etiology and epidemiology:
Asia is one of the largest continents that are facing consequences of unequal distribution of
wealth and malnutrition from a long period of time, Indonesia is one of the south east countries
that is facing the greatest challenge with the double burden of malnutrition. According to a recent
report by the World Health Organisation, 1.2 million individuals of Indonesia are at this point
malnutrition which contributes to the total percentage of malnutrition in Asia by a large chunk.
Although the simultaneous existence of under and over- nutrition within the population of the
developing countries that are going through a rapid economic transition and been widely
documented a clear statistical idea of Indonesia and the double burden of nutrition that it is
facing has not been researched extensively. The policy makers and politicians have effectively
attempted for the economic group of the nation as well as human resource development,
although the country has not yet overcome the challenges of poverty, socio economic differences
and non-communicable diseases successfully (Jaacks, Slining & Popkin, 2015).
According to the recent reports despite the economic growth that Indonesia has achieved, the
country remains available to food insecurity with 87 million people. The recent report by World
Bank group has explored dare to be 8.4 million Indonesian children to be stunted and are living
with extreme or chronic malnutrition. The data contributes 37.2 % of malnutritioned children

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4DUAL BURDEN OF MALNUTRITION IN INDONESIA
under the age of 5 suffering with chronic malnutrition, despite the milestones the nation has
achieved in its developmental trajectory (Corsi, Finlay & Subramanian, 2011). In this context
has to be mentioned that stunting on malnutrition increases the risk for non-communicable
diseases such as diabetes and coronary heart diseases multiple folds, regardless of age the public
awareness of the malnutrition is extremely low. Nationwide statistical data suggest that in the
last 5 years incident of stunting in the population has increased from 35.6% to 37.2%, and the
figures continue to escalate.
On the other hand, the overall prevalence of overweight and obesity in the Asian countries
provides an astounding contradiction to the rising malnutrition that these me friends are facing.
The percentage of the overall balance of overweight and obesity in Indonesia is rising obstinately
where is a childhood stunting in the same nation continue to escalate as well (Corsi, Finlay &
Subramanian, 2011).
Determinants for the dual burden of malnutrition:
There has been a large number of statistical research studies conducted to determine the
contributing factors to the growing rate of child malnutrition in Indonesia, the mortality rates for
the children under the age of 5 have been increasing rapidly in Indonesia, and the underlying
reason for it had been the unwarranted rate increase in overall population. The total population of
Indonesia presently remains at 264,004,580, the population density for which can be calculated
as 142 per square km (Abdullah, 2015). The population count for the country tops the population
chart for the world, and there had not been any effective strategic plans to overcome the rapid
increase. The unprecedented rate at which the population is increasing and the lack of effective
management and educational strategies to generate awareness and the Mars have emerged as one
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5DUAL BURDEN OF MALNUTRITION IN INDONESIA
of the main contributing factors to the dual burden of malnutrition in Indonesia. The
compromised health for the underweight pregnant women in Indonesia is the key factor leading
to low weight babies being born in Indonesia and the distracted growth pattern been continued
for years to come. Along with that it also needs to be mentioned that the malnutritioned mothers
are known to have difficulty with successful lactation which results in the children obtaining
breast milk low in essential micronutrients escalating the likelihood of the infants being
underweight drastically (Barnett, 2011).
Another significant contribution factor can be considered the low socioeconomic status
majority of Indonesian population is suffering from malnutrition problem. These people cannot
afford healthy nutritious food in quantities that can serve as facilitators of normal growth and
development; hence the infants suffer along with their parents with the unhygienic low standard
of lifestyle. Another important fact that needs to mention within this context that in Indonesia
Mein nutrition is not the only rising issue that needs attention, the double burden situation also
points at the overweight individuals suffering from obesity, diabetes, and cardiac heart diseases.
According to many research studies, it has been discovered that the group with low
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6DUAL BURDEN OF MALNUTRITION IN INDONESIA
socioeconomic status are more likely to suffer from obesity than those that belong to the higher
socio economic status in Indonesia (Barnett, 2011). The extensive lack of basic health education
and awareness about standard dietary plans are the main reasons behind this contradictory health
issue escalating in Indonesia. Whereas the children are suffering from malnutrition and are
becoming stunted contributing to the increasing mortality rate for the children and infants in
Indonesia, the adults and gaining obesity, paving the way for more complicated diseases. Hence
the lack of awareness, low financial background and lack of national level maternal and child
nutrition strategy can be considered as the major contributors to this conundrum that Indonesia is
facing.
Food production statistics for Indonesia:
The total population of Indonesia is 261.1 million, which such a drastically high
population. This country has faced food production and demand ratio issues for a long time. The
last decade has seen a decline of 4.5% in the gross domestic production where the consumption
per capita has increased considerably. The past decade has seen 4% increase in total
consumption statistics while the food production has not increased as much to meet the demands,
which has inevitably led to the women and children being endangered for not gaining proper
nutrition and hygiene (Ihab et al., 2013).

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7DUAL BURDEN OF MALNUTRITION IN INDONESIA
Considering the agricultural statistics of Indonesia, rice and corn is the most staple food
item for Indonesian citizens. Despite agriculture contributing to 14% of the total GDP of the
nation, the food production still lags behind the demand. One contributing factor to this can be
the highly politicized rice policy in Indonesia, which has made the rice pricing almost 10%
higher than the global standard rate. Undoubtedly it imparts a substantial detrimental effect on
the lower class citizen of Indonesia in being able to afford the most basic food item, the
malnutrition, therefore, is inevitable. Aside from rice, other crops like sugar, soya bean, and corn
are so common food items in Indonesian cuisine, although with the lack of proper trade
protection and self-sufficiency, it is impossible to produce these crops to satisfy the demands
after heavy exportations. The highly politicized trade statistics of agricultural items in Indonesia
is one of the greatest contributing factors in the nation having the lowest calorie intake per
citizen, and the gradual loss of agricultural productivity of the nation contributes more to this
rising issue (Khor, 2008).
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8DUAL BURDEN OF MALNUTRITION IN INDONESIA
National dietary pattern:
Food and culture are intimately linked with one another, and the impact of cultural
beliefs and traditions on the cuisine is a conspicuous matter. Indonesia takes pride in its exotic
cuisine bearing extreme influence to its traditional recipes. The Indonesian dietary pattern is rich
in spices and is completely dependent on carbohydrates. With rice and corn being the most
fundamental food crops in their cuisine, and coupled with table sugar, pulses, leafy vegetables
and soy contributes to a very heavy carb dietary platter for the residents. With their diet being
completely dominated by cereals or oilseeds, their diet lacks protein and mineral to a large extent
and lead to vitamin A or B complex deficiency, iron deficiency and essential minerals and long
chain fatty acids. With their diet being completely focused around the heavy carbohydrates l, the
chances of obesity increase where lack of protein rich diet deteriorates the health of the children
and infants (Kimani-Murage et al., 2015).
Strategies:
In the context of the health and welfare of the citizens, the political sector has the most
influential impact. Ice information is facing in the issue of tool button of malnutrition web for
child and Infant population of the country is suffering from malnutrition the adults of the social,
economic class are suffering from obesity and the port of diseases it comes coupled with. The
first strategy in order to overcome the 12 or 10 of magnetization in Indonesia should focus on
strengthening the entrance of the government in policy making and food production demand and
supply sector along with the maternal and Child Health and nutrition protocols (Oddo et al.,
2012). Strengthening and facilitating attention from the government towards making policies that
a certain equal distribution of food and health nutritional resources towards on the classes of the
society will be a highly beneficial strategy in overcoming the problem of malnutrition and
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9DUAL BURDEN OF MALNUTRITION IN INDONESIA
obesity in the lower economics classes. It has to be understood that nutrition has been prioritized
as the why are the most important basic needs within the health and wellbeing, Hans if
politicized adequately, the impact of better and refined policies can bring for drastic change in
the availability of food and other resources for the victim sector and will decrease the child
mortality rates significantly (Rachmi et al., 2016).
Along with government policies, guidelines and legislative protocol frameworks also an
important made it comes to overcoming the dual pattern of magnetism in a developing country. It
has to be understood that the protocols and guidelines are mostly design in a globalised format;
hence, adhering to these protocols will benefit Indonesia in designing strategic actions that will
cater to the specific needs based on the determinants of dual burden of malnutrition. It must not
skip noticed that the globalised guidelines for improving the health and well-being of the citizens
are more inclined towards low Carbohydrate and high protein dietary patterns. Who aligning the
local or National guidelines with the Global frameworks will help the Indonesian authorities to
bring the escalating issue of overweight contradicting them and nutrition in check with a dietary
plan that is balanced and optimal (Saibul et al., 2009).
Strategic Alliance is the greatest option for co-aligning local guidelines and Framework
with the globalised patterns. There are various strategic focus groups and action group that
promote a healthy diet in the impressionable citizens. The privatized or civil society
organizations funding the action groups focus only on promoting healthy diet and nutrition in
plants along with healthy exercise activities and counselling to help the victims of a challenge
and revert to standard lifestyle as soon as possible. Establishing a strategic Alliance bases with
these highly professional groups can ensure in better management maintenance and preventive
campaigning in order to reduce the malnutrition in children and mothers and obesity in adults

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10DUAL BURDEN OF MALNUTRITION IN INDONESIA
belonging to lower and to the middle social, economic status of Australia. (Sekiyama et al.,
2015)
Furthermore, it also means to mention that community input as a profound influence on
improvement of Public Health issues like the one under consideration for this case scenario. The
lack of proper health education and awareness in the general mass of Indonesia has been already
discovered as one of the most contributing factors leading to do a bottle of malnutrition in that
country, targeting the individuals for campaigning and educating the mass of the nutritional
needs of young to be mothers and young mothers, to ensure proper weight and nourishment for
the mother and will contribute to improving the statistics for stunting in case of infants
(Vaezghasemi et al., 2014).
Mention about having sound maternal nutrition and health strategies on the national level
can be extremely beneficial for developing countries and their citizens to overcome challenges
that come with malnutrition and obesity. The Healthcare system for the function needs to
undergo a complete response to include nutritional Strategies for your mothers and intense along
with having community wide monitoring services and educational and awareness about the
preventative mechanisms for malnutrition or obesity. This white community services well and
short those proper nutrition resources I will be available to the lower economics classes and
oversee the dietary pattern father mother and their infants. Lastly, it needs to be mentioned that
along the supply and availability issue, the effort and capability are also one of the importance of
determinants in case of compromise health and nutrition for the Indonesian society. There is a
need for intervention from the national or international level authorities to reduce the cost of
basic resources, and help the citizens are well the fundamental necessities in order to maintain a
standard lifestyle and overcome the issue of dual burden of malnutrition (Wibowo et al., 2015).
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11DUAL BURDEN OF MALNUTRITION IN INDONESIA
Conclusion:
On a concluding note, it can be said that malnutrition and obesity, are the contradictory
evils that are eating away at the growth and development of the still developing countries. And
without proper attention from the government and other regulatory authorities, the alarming issue
against escalating which in turn is increasing the child mortality rate in Indonesia drastically.
Also taking a few strategic actions can change the face of the situation and help is it is a standard
quality of life style completed all the basic needs of human life, along with diminishing the dual
burden of nutrition.
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12DUAL BURDEN OF MALNUTRITION IN INDONESIA
References:
Abdullah, A. (2015). The double burden of undernutrition and overnutrition in developing
countries: an update. Current obesity reports, 4(3), 337-349.
Barnett, I. (2011). Is the dual burden of over-and under-nutrition a concern for poor households
in Ethiopia, India, Peru and Vietnam?. Young Lives.
Corsi, D. J., Finlay, J. E., & Subramanian, S. V. (2011). Global burden of double malnutrition:
has anyone seen it?. PLoS One, 6(9), e25120.
Ihab, A. N., Rohana, A. J., Manan, W. W., Suriati, W. W., Zalilah, M. S., & Rusli, A. M. (2013).
The coexistence of dual form of malnutrition in a sample of rural Malaysia. International
journal of preventive medicine, 4(6), 690.
Jaacks, L. M., Slining, M. M., & Popkin, B. M. (2015). Recent trends in the prevalence of under
and overweight among adolescent girls in lowand middleincome countries. Pediatric
obesity, 10(6), 428-435.
Jehn, M., & Brewis, A. (2009). Paradoxical malnutrition in mother–child pairs: untangling the
phenomenon of over-and under-nutrition in underdeveloped economies. Economics &
Human Biology, 7(1), 28-35.
Khor, G. L. (2003). Update on the prevalence of malnutrition among children in Asia. Nepal
Med Coll J, 5(2), 113-22.
Khor, G. L. (2008). Food-based approaches to combat the double burden among the poor:
challenges in the Asian context. Asia Pacific journal of clinical nutrition, 17(S1), 111-115.

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13DUAL BURDEN OF MALNUTRITION IN INDONESIA
Kimani-Murage, E. W., Muthuri, S. K., Oti, S. O., Mutua, M. K., van de Vijver, S., &
Kyobutungi, C. (2015). Evidence of a double burden of malnutrition in urban poor settings in
Nairobi, Kenya. PloS one, 10(6), e0129943.
Oddo, V. M., Rah, J. H., Semba, R. D., Sun, K., Akhter, N., Sari, M., ... & Kraemer, K. (2012).
Predictors of maternal and child double burden of malnutrition in rural Indonesia and
Bangladesh. The American journal of clinical nutrition, 95(4), 951-958.
Rachmi, C. N., Agho, K. E., Li, M., & Baur, L. A. (2016). Stunting, underweight and overweight
in children aged 2.0–4.9 years in Indonesia: prevalence trends and associated risk
factors. PloS one, 11(5), e0154756.
Roemling, C., & Qaim, M. (2012). Obesity trends and determinants in Indonesia. Appetite, 58(3),
1005-1013.
Roemling, C., & Qaim, M. (2013). Dual burden households and intra-household nutritional
inequality in Indonesia. Economics & Human Biology, 11(4), 563-573.
Römling, C., & Qaim, M. (2011). Direct and indirect determinants of obesity: the case of
Indonesia.
Saibul, N., Shariff, Z. M., Lin, K. G., Kandiah, M., Ghani, N. A., & Rahman, H. A. (2009). Food
variety score is associated with dual burden of malnutrition in Orang Asli (Malaysian
indigenous peoples) households: implications for health promotion. Asia Pacific journal of
clinical nutrition, 18(3), 412-422.
Sekiyama, M., Jiang, H. W., Gunawan, B., Dewanti, L., Honda, R., Shimizu-Furusawa, H., ... &
Watanabe, C. (2015). Double burden of malnutrition in rural West Java: household-level
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analysis for father-child and mother-child pairs and the association with dietary
intake. Nutrients, 7(10), 8376-8391.
Tzioumis, E., & Adair, L. S. (2014). Childhood dual burden of under-and overnutrition in low-
and middle-income countries: a critical review. Food and nutrition bulletin, 35(2), 230-243.
Vaezghasemi, M., Öhman, A., Eriksson, M., Hakimi, M., Weinehall, L., Kusnanto, H., & Ng, N.
(2014). The effect of gender and social capital on the dual burden of malnutrition: a
multilevel study in Indonesia. PloS one, 9(8), e103849.
Wibowo, Y., Sutrisna, B., Hardinsyah, H., Djuwita, R., Korib, M., Syafiq, A., ... & Najib, M.
(2015). Relationship between intra-household food distribution and coexistence of dual
forms of malnutrition. Nutrition research and practice, 9(2), 174-179.
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