Publication: Improving the Quality of Frontline Nutrition Services in Indonesia's Health Sector
Date
2021-12-31
ISSN
Published
2021-12-31
Author(s)
Holschneider, Silvia
Subandoro, Ali Winoto
Karjadi, Elvina
Provo, Anne Marie
Herkutanto, Ria
Ayuningtyas, Pratiwi
Dharmawan, Akim
Sudarjo, Minarto Noto
Abstract
In the past two decades, Indonesia
significantly improved its economic growth, poverty, and
maternal and child health outcomes. Despite these notable
achievements, the country's rates of stunting and
malnutrition are among the highest in the world and threaten
early childhood development as the stepping-stone of human
capital formation. Though government guidelines, standards,
and training have helped improve nutrition services in the
health sector, there continues to be considerable variation
in service quality across districts, between urban and rural
areas, and among public and private facilities, with many
mothers and children being provided suboptimal services.
Malnutrition is a multisectoral issue that is not the
“problem” of the health sector alone. However, many of the
high-impact health interventions known to improve nutrition
outcomes for children are not being implemented in
Indonesia, calling for a higher-quality health system to
produce better nutrition outcomes. This report analyzes the
opportunities to improve the quality of frontline nutrition
interventions in Indonesia’s health sector as an element of
achieving the National Strategy to Accelerate Stunting
Prevention (2018–2021) (StraNas Stunting) goals. It uses a
framework adapted from the Lancet Global Health Commission’s
report on High-Quality Health Systems in the Sustainable
Development Goals Era, which explains that improving the
quality of nutrition health care requires system-wide
action. In specific, high-quality nutrition services
necessitate both process and foundational reforms at the
macro, meso, and micro levels. The paper outlines the
challenges and proposes recommendations to improve quality
nutrition care and services in the country. These are
related to strong leadership, harmonized guidelines and
targets, and robust regulatory and quality improvement
mechanisms; improved monitoring and evaluation and data use;
predictable, adequate, and timely financing; platforms for
care; competent health workers and a sound supportive
supervision system; adequate supplies and functional
equipment; and systems that respond to clients’ health needs
and expectations.
Citation
“Holschneider, Silvia; Subandoro, Ali Winoto; Karjadi, Elvina; Provo, Anne Marie; Herkutanto, Ria; Ayuningtyas, Pratiwi; Dharmawan, Akim; Sudarjo, Minarto Noto. 2021. Improving the Quality of Frontline Nutrition Services in Indonesia's Health Sector. Health, Nutrition and Population Discussion Paper;. © World Bank, Washington, DC. http://openknowledge.worldbank.org/handle/10986/36941 License: CC BY 3.0 IGO.”