“We can’t afford to buy nutritious food for everyday life, let alone paying for our child’s school tuition. My husband is even more concerned buying more cigarettes with our money… ”, said one Mrs. X in a research interview conducted in Malang City and Kediri Regency, East Java.
In 2030, Indonesia is predicted to experience a demographic bonus phenomenon where the dominating population in this era is the young generation. Of course, this will encourage the development of our nation, both in terms of economy, agriculture and industry. Thus, this generation is strongly encouraged to excel, have a good quality of education, and are capable of various things.
Definitely, this good news brings new hope for Indonesia, but do you know that there is a global health problem with a total of 155 million cases of sufferers in the world marked by chronic malnutrition in toddlers, especially in the first 1000 days of their life?
Yes, it is stunting. Those who are stunted will have very low stature growth along with impaired cognitive development, the ability to study academically, and non-academically. With these bad effects, of course, it will be a challenge to take advantage of the golden opportunity in the existing demographic bonus.
This problem is not merely only related to lack of nutrition, sanitation, education, health services, and social protection but also related to tobacco consumption or smoking behavior. Tobacco consumption has a significant impact on stunting in children.
In their study, Astuti et al stated that exposure to cigarette smoke for 3 hours a day can increase the incidence of stunting by 10 times, and exposure in the first 1000 days of a child's life will increase the risk of stunting by up to 2 times. Inhalation exposure during pregnancy can increase the risk of fetal growth problems in the womb, premature birth, and low birth weight. In addition, the nicotine that is inhaled by children can interfere with the absorption of essential nutrients for their growth.
A father who is a smoker tends to put aside a certain amount of money to buy cigarettes. Worse, this amount can be proportional to the price of necessities needed to meet the nutritional needs of his family. This is certainly causing concern. We all know that children with stunting usually come from disadvantaged socioeconomic groups of families. This will look like an intertwined chain, where the low economy will imply constraints in the fulfillment of quality nutrition and education. The child's growth and cognitive problems will be impaired so that their performance in studying will also have an impact. This will certainly affect their future as well and allow this cycle to repeat itself.
Various efforts have been made by the government in minimizing the stunting rate in Indonesia, but it should be remembered that stunting cases are complex and multidimensional. Many aspects contribute to the increasing numbers in Indonesia. Of course, this requires collaboration between various parties. Programs that are community-based and cover wider coverage can be successful if there is a strong political commitment, a multisectoral collaboration between the government, non-governmental organizations, national and international organizations, even the community, yes you and me, all of us.
Intervention to change behavior in the community is needed. Efforts to carry out advocacy, interpersonal communication, community mobilization, and strategies for using mass and social media can achieve this.
Research data in Indonesia states that knowledge and awareness regarding stunting are still low. Only 2.1% of parents heard, read, and knew about stunting. Thus, we need to increase their knowledge and raise their awareness so that they can form behavior that aware of it.
As young people, what can we do to contribute to stunting prevention? There are some simple steps we can start early on as agents of change.
1. Enriching self-knowledge and understanding related to this issue
Yes, before we equip others, we need to first equip ourselves with a deep understanding of these two things, tobacco and stunting. The hope is, by having the correct understanding, we can have awareness and concern to contribute actively in overcoming these problems. We will be motivated to carry out useful research and innovation in controlling this problem.
2. Becoming a peer educator and being involved in education and outreach activities
Today, many activities are aimed at increasing public understanding and awareness of stunting. We as young people are known for our new and unique ideas and innovations. We can become peer educators who do not only discuss stunting but also promote and disseminate the relationship between smoking behavior and which is quite high in Indonesian families with a high stunting rate.
3. Conducting campaigns through social media
Nowadays, the use of social media as a tool to disseminate information related to a health problem is increasingly prevalent. A study conducted by Khatimah and Laksmi confirms that the use of social media, such as Instagram, provides a great opportunity for individuals to be able to have an active role, both as creators and spreaders, in the role of educating and raising awareness of the general public. With our creativity and fresh ideas, we can package a campaign that is attractive and right on target, comprehensive yet easy to understand, and reaches the wider community.
Thus, we all know by now that stunting is not a single factor issue. Stunting is a multidimensional issue in which the use of tobacco has a role in contributing to the high incidence of this in Indonesia. More effort is needed in long-term thinking and collaboration between various stakeholders and sectors to deal with this issue. We, as the youth, can do so much more to combat this issue together! Yuk, #cegahstunting
Gosh, Social Assistance Recipient Poor Families Spend Money To Buy Cigarettes | Kabar24 - Bisnis.com (2020). Available at: https://kabar24.bisnis.com/read/20200728/15/1272032/astaga-keluarga-miskin-penerima-bansos-huangan-uang-untuk-beli-rokok (Accessed: 21 May 2021).
Astuti, DD, Handayani, TW, Astuti, DP, 2020. Cigarette smoke exposure and increased risks of stunting among under-five children. Clin. Epidemiol. Glob. Heal. 8, 943â€“948. https://doi.org/10.1016/j.cegh.2020.02.029
Hossain, M., Choudhury, N., Abdullah, KAB, Mondal, P., Jackson, AA, Walson, J., Ahmed, T., 2017. Evidence-based approaches to childhood stunting in low and middle income countries: A systematic review. Arch. Dis. Child. 102, 903â€“909. https://doi.org/10.1136/archdischild-2016-311050
Khatimah, K., Laksmi, L., 2019. Prevent Stunting Campaign: Dissemination of Health Information through Instagram. Rec. Libr. J. 5, 80. https://doi.org/10.20473/rlj.v5-i1.2019.80-89
Post, T. (2021) Stunting prevention in Indonesia: Strategy, will and collective effort, The Jakarta Post. Available at: https://www.thejakartapost.com/academia/2020/07/22/stunting-prevention-in-indonesia-strategy-will-and-collective-effort.html (Accessed: 21 May 2021).
Rosemary, R. and Ciptaningtyas, R. (2020) Up in smoke? Tobacco and Indonesia's efforts to reduce stunting - Indonesia at Melbourne, Indonesia at Melbourne. Available at: https://indonesiaatmelbourne.unimelb.edu.au/up-in-smoke-tobacco-and-indonesias-efforts-to-reduce-stunting/ (Accessed: 20 May 2021).
Study Links Smoking to Child Stunting in Poor Families (2019). Available at: https://jakartaglobe.id/movement/study-links-smoking-to-child-stunting-in-poor-families/ (Accessed: 20 May 2021).
Vilcins, D., Sly, PD, Jagals, P., 2018. What it is and what it means | Concern Worldwide US 84, 551â€“562.
WHO, 2018. Reducing Stunting In Children, Equity considerations for achieving the Global Nutrition Targets 2025.
Saraswati Retno Gumilang - PHL CIMSA FK UNAIR
DR. dr. Brian Sri Prahastuti, MPH - Tenaga Ahli Utama Kantor Staf Presiden
Rekianarsyi Arrasyidipa Narayaprawira Wiranto Putra