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Project Background

Sumba is a remote island in Indonesia where government services are limited, health statistics are low, and poverty rates high. Here 1 in 3 children is stunted – often a result of limited access to food supply, poor health, hygiene and/or feeding practices, and/or poverty. Stunting has huge costs for the child and for the economy, as it affects children’s immune systems and brain development well into their adult life.

We know that Mother and Child Health is improved when the basic health structures such community health posts (Posyandu) are in place, the staff and community health volunteers (kader) are well-trained, adequately equipped, able and motivated to deliver health services, and parents have basic knowledge about nutrition, including the importance of a balanced diet for their children.

The Posyandu provide invaluable monthly health services relating to children under five, their parents and pregnant women. They are run by kader and village midwives who are the frontline in tackling mother and child health issues. Unfortunately, these workers often lack adequate training, support or even basic equipment to fulfill their important role.

This project contributes to SurfAid’s overarching 6-year project called NusaTani (meaning ‘Farming Islands’ in Bahasa Indonesia) in Sumba, working to tackle poverty, stunting and malnutrition at a household level through nutrition-sensitive agriculture. This includes educating community members, their leaders and health professionals on nutrition, with a special focus on parents.

Key Project Activities

SurfAid trained and coached the kader and village midwives to better promote good feeding and care practices among parents and perform growth monitoring of children under five.

  • 47 basic parenting sessions were delivered reaching 317 parents and caregivers. The last 6 sessions were delivered independently by trained community volunteers. Parenting sessions play a crucial role in addressing and mitigating the challenges of malnutrition. They provide education on essential nutrients, age-appropriate foods, and dietary practices that promote healthy growth and development. The sessions also focus on early childhood development, emphasizing the critical role of nutrition during the early years, and cover hygiene and sanitation practices that are essential for preventing illnesses that can contribute to malnutrition.
  • Dedicated parenting classes for single parents. 
  • Single parents could feel embarrassed attending the regular sessions which are aiming to reach both the father and mother. This separate class showed an increase in single parent participation.
  • 16 cooking classes were delivered aimed at addressing childhood malnutrition. These included information on locally available, affordable, and nutritious food options, including how to cook them, and centered around a local protein source – Bekicot, or snails.  We introduced the concept of utilising Bekicot as a nutritional supplement and source of protein. The simplicity of preparing snails, promoting the idea that snails could be a viable source of protein, especially when conventional sources were limited or expensive, contributed to a high rate of take-up. The cooking process involved boiling, washing with saltwater, and frying snails.
  • Creative educational materials, brochures and games for training sessions were produced, such as a nutrition calendar, flash cards for parenting sessions, growth charts and audio stories

Key Project Outcomes

  • 23 community health posts supported and 114 community health volunteers trained, reaching about 745 families and 1000 children under 5 years.
  • 268 (F = 211 / M= 57) health professionals and kader increased their knowledge on locally sourced diverse diets related to the first 1000 days of life.
  • 21 kader with improved facilitation and data recording practices related to nutrition in the first 1000 days of life.
  • 131 training sessions on health to local leaders, health staff, husbands, fathers and caregivers reaching in total 2,193 people.
  • Regular posyandu check-ups revealed positive outcomes, with children experiencing weight gain and increased appetite after eating the snails.
  • One of the biggest challenges to improving nutritional status in Sumba is adequate daily intake of animal protein for children under 5 years old (U5). With the introduction of alternative and free animal protein, snails, there was a concrete local solution. Consumption of snails has succeeded in increasing the nutritional status of children U5. In some villages a number of children were categorised as malnourished for 3 consecutive months. However, after regularly eating snails, they showed an increase in body weight in line with healthy weight standards. Parents also observed a notable increase in their children's appetite after incorporating snails into their meals.
  • The IEC materials (nutrition calendar, flash cards for parenting sessions, growth charts and audio stories) were adapted to the local context using local language and symbols. We also prioritised graphics rather than words which facilitate the interpretation process for illiterate beneficiaries. .

Community Involvement

SurfAid’s approach includes a focus on securing ongoing village and/or government funding and support. When communities and local governments provide funding or support for activities, it increases their local ownership, which in turn increases security and maintenance of the equipment and crops. The government has been highly enthusiastic and involved in SurfAid’s programs to date. This is a strong positive indictment of SurfAid’s value, results and relevance, and bodes well for its program sustainability.

What's Next?

The snails were abundant during the rainy season but scarce during the dry season, posing a challenge for consistent implementation. The sustainable solutions will be to start snail farming, ensuring a year-round supply and empowering communities to take charge of their nutritional needs.

The overarching program of NusaTani is coming to an end. The program is very successful and has many tangible results.

SurfAid is taking the learning from this successful program to a new program in another remote location in Indonesia, with worse nutritional statistics for children. The program in Rote island was officially opened in August 2023 and is currently in its inception phase. This means that additional information is gathered with the local government and the communities to make sure the best fit-for-purpose interventions are designed and implemented.

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