CASES for Collaborative Learning

1. Exclusive Breastfeeding Practice in Urban Setting; PIC : Dr. Rina Agustina, PhD
Prevalence of exclusive breastfeeding/EBF practice remains low in City X. Despite the good
knowledge on benefit of the EBF for baby and mother, many urban educated working
mothers did not exclusively breastfeed their baby. Short maternity leave (3 months), work
pressure, and high access to breatmilk substitute products are among factors frequently
found as factors preventing the working mothers to practice EBF. Nevertheless, many other
mothers with similar characteristics manage to practice EBF, indicating that practicing EBF is
not impossible for working mother.

In relation to that, propose a package of intervention aiming at improving proportion of EBF

practice among urban educated working mothers. The setting is a 30-floor building at one
main and busy street in Jakarta where many company/organization have their offices there.

2. Anemia among Adolescent Girls; PIC : Dr. Luh Ade Wiradnyani, MSc
Adolescent nutrition becomes one of main issues as female adolescent is a mother to-be.
Health and nutritional status before and during pregnancy has proven as a very vital factor
for children in their future life. Poor nutrition intake is one of the biggest concern related to
adolescent health and nutritional status. Studies found that the poor intake is not necessarily
due to lack of food access. Habit of skipping breakfast, personal food preferences, intensive
exposure of convinient yet less nutritious foods/drinks through advertisement are believed
as factors associated with the poor intake.

In relation to that, propose a package of intervention to improve the female adolescent

nutrient intake, particularly those related to anemia prevention. To note, government has
newly started implementing iron-folic acid supplementation program through schools. The
setting is junior and senior high schools in City Y (a middle-income city)

3. Non Communicable Diseases among Urban Society; PIC: Purnawati H Rachman, MGizi
Non communicable diseases in urban developing countries have significantly increased
during the past 5 years. Recent studies have shown that these urban societies tend to
consume high energy dense foods compared to nutritious foods. This includes high fat intake
from fried foods and high sugar intake from sugar sweetened beverages. Among the
educated and wealthy adults, in particular, lack of physical activity, low fruit and vegetable
intake and lack of health seeking behavior are still the major determinants of NCD’s. With
high obesity prevalence, many of the people are at risk to NCD’s.

Suggest a food and nutrient intervention that could tackle this problem among an educated
and wealthy community, living in one hamlet in urban area.

4. Lack of fruit and Vegetable Consumption among School Children; PIC: Dr. Ir. Umi Fahmida,
MSc
The increasing prevalence of obesity is not only evident among adults. School children are
growing rapidly as well, leaving a 17.8% of obese prevalence among the children. Lack of
fruit and vegetable consumption is almost apparent among 98% of the school children in the
area. In this case, not only the preference of the children matters, but also the awareness of
the parents to influence their children to eat more nutritious foods. The school also has a big
role in determining the food choices of school children. Currently canteens rarely provide
fruit and vegetables due to low purchase. They mostly sell extruded snacks, sachet drinks
with high sugar content and also candies.

Suggest a food and nutrient intervention that could be conducted in one of the schools to
address the problem of lack of fruit and vegetable consumption among the school children.