Materi Dr. (H.C.) Dr. Hasto Wardoyo, SP - OG, Subsp. FER - Plenary Lecture 3

PROGRAM PENURUNAN STUNTING
Penanganan Stunting
(STUNTING & IntervensiPROGRAMS)
REDUCTION Kesehatan Mental dalam
mewujudkan generasi EMAS 2045
18thOctober 2023 By:

Disampaikan : Kepala BKKBN Jakarta,
Hasto 17 Juni 2023
Wardoyo
Chairman of National Population & Family
Planning Board
Disampaikan pada diskusi model pemenuhan nutrisi dan kesehatan mental

dalam 1000 Hari Pertama Kehiduan berbasis Posyandu &
Pendamping Keluarga
“ Quo Vadis ? “
• Globalisation, disruption
• Advances in Technologies (nano,bio, robotic and
IT), Industrialisasi 4.0--5-0
• People always on (public expectations)
• DEMOGRAPHIC POPULATION
• Individualisme and Pluralisme, Hedonisme
Obstacles ,challenges and opportunities for the government

2
Outline
1 Bonus Demografi
Prevalensi dan Penuruan
2 Stunting
3 Kebijakan dan program

4 Tantangan dan Rekomendasi
Kebijakan
Demografi (Demographic Population)
c
Indonesia Population % elderly population,
1971-2020
Population & PGR,

Population 1961-2020 Population Growth Rate/PGR The distribution of the elderly
(million people) (percent)
population is uneven, 70% are in
Java, 18% in Sumatera, and the rest
are spread across the Bali-Nusra
region, Kalimantan, Sulawesi,
Maluku & Papua.
Population composition by age,

1971-2020
Indonesia's Population Growth Rate/PGR continues to decline during 1961-2020.

The percentage of the population of productive age (15-64 years) has continued
to increase since 1971. The percentage of the productive population which is
greater than the population of non-productive age shows that Indonesia is still
in the demographic bonus era, in addition Indonesia has entered an aging
population, marked by the percentage of the population aged 60 years and
above reaches > 10 percent.
Indonesia Population
TFR 2.14 MASIH TERJADI
DISPARITAS DI TINGKAT
KABUPATEN 00%
TFR > 2,4

Jawa (7,1%), Papua (64,3%), NTT-NTB- Bali (68,3%), 00%
Kalimantan (44,6%), Sulawesi (65,4%), Sumatera (66,2%) dan
Maluku (85,7%)
TFR >2,3 – 2,4

Jawa (13,3%), Papua (2,4%), NTT-NTB- Bali (4,9%), Kalimantan (17,9%),
Sulawesi (7,4%), Sumatera (15,6%) dan Maluku (0,0%) 00%
00%
TFR 2,1 - 2,3
Jawa ( 28,3%), Papua (2,4% ), NTT-NTB- Bali (12,2%), Kalimantan
(26,8%), Sulawesi (19,8%), Sumatera (12,3%) dan Maluku (9,5%)
TFR<2,1
Jawa ( 51,3% ), Papua ( 31,0% ), NTT-NTB- Bali (14,6%), Kalimantan ( 10,7%),
Sulawesi (7,4%), Sumatera (5,8%) dan Maluku (4,8%)
@sudibyo_alimoeso28032023
DISPARITAS TFR
KABUPATEN/ KOTA
MASIH TINGGI
32%
TFR dibawah 2,24 (Nasional)
00%
6 Provinsi yaitu DI
Yogyakarta, Jatim, Bali,
Jateng, Jabar dan Jambi:
Sebagian besar Kab/
Kotanya di bawah rata-
rata nasional. 68 %
TFR di atas 2,24 (Nasional)
▪ Sebagian besar Propinsi TFR di atas rata-rata nasional. Beberapa provinsi bahkan kabupaten/
kotanya sama sekali belum mencapai angka 2,24 yaitu Sulawesi Barat, Sulawesi Tenggara,
Sulawesi Tengah, Kalimantan Utara, Lampung, Riau dan Aceh
@sudibyo_alimoeso28032023
▪ Terdapat perbedaan kondisi demografi di berbagai wilayah di Indonesia. Hal ini
mengindikasikan bahwa diperlukan kebijakan kependudukan yang berbeda sesuai dengan
kondisi di masing-masing wilayah.
KITA PUNYA BONUS DEMOGRAFI
Saat ini Indonesia menikmati Bonus Demografi karena penurunan fertilitas.
Bisa berlanjut bahkan setelah DR naik, namun harus bersumber dari kelompok
lansia yang sehat, berpendidikan dan produktif.
Kita telah, sedang, dan masih akan menikmati Bonus 1 ->>| Bonus 2 ->>>
82,5 Angka Ketergantungan

80,2 80,8
78,3 Banyaknya penduduk usia non-produktif
Yang ditanggung oleh 100 orang penduduk usia produktif
72,4
66,1 Bonus Demografi

60,5 Window of
55,5 Opportunity 54,7
52,0 52,1
50,5 49,3
48,6 47,7
47,2 46,9 47,3
Tahun
1965 1975 1985 1995 2005 2015 2025 2035 2045

9
10
PATHWAY TO DEMOGRAPHIC DIVIDEND
Sejahtera
Stunting
Sengsara
Stunting ; Prevalensi dan penurunan
c
1.1. Sasaran dan dukungan Daerah Dalam Percepatan
Pencegahan dan Penurunan Stunting
• 514 Kab/Kota
berkomitmen
2018 2022- melaksanakan PPS
2020 +100 Kab/Kota 2024 • 12 Provinsi Prioritas
Sampai 2021, 358 kab/kota TPPS dibentuk:
menandatangani komitmen
+60 kab/kota melaksanakan PPS • 34 TPPS Provinsi
• 514 TPPS Kab/Kota
• 7.256 TPPS Kecamatan
• 82.773 TPPS Desa/Kel.
100 kab/kota +100 kab/kota PERPRES

72/2021
RAN PASTI
2019 2021 2021-2024
514 kab/kota
1.2. Tren Penurunan Stunting dan Target
Target RPJMN
2020-2024
40
36,8 35,6 37,2 34 Angka Riil
35
30,8
30 27,7
24,4
25 21,6
Dari tahun 2013-2019 (6 tahun) rata-rata 1.3%/tahun.
20
21.1 14
Tahun 2019 – 2021, 1.6%/tahun 18.4
15
Tahun 2021-2022 sebesar 2.8%/tahun. 17,8
10
Untuk menuju 14% dibutuhkan penurunan 3.8%/tahun.

?
5
2007 2010 2013 2016 2018 2019 2021 2022 2023 2024
RISKESDAS SSGBI SSGI SKI TARGET
PERCEPATAN PERBAIKAN GIZI PERCEPATAN PENURUNAN STUNTING
PERPRES 42 TAHUN 2013. Gerakan Nasional PERPRES 72 TAHUN 2021.
Percepatan Perbaikan Gizi RAN PASTI 2021-2014 4
Prevalensi baduta & balita stunting
Tren prevalensi balita stunting 2007-2022 &
target penurunan stunting 2021-2024, Indonesia Prevalensi baduta stunting di dunia, 2019-2024
Indonesia: 4,7 juta (21,6%) Indonesia: 161 ribu (17,9%)
Penurunan 10%/3,3% per tahun

Sumber: Pusat data dan informasi Kemenkes, Riskedas 2018, SSGBI 2019 & SSGI 2021
Target prevalensi stunting 2020-2024: Perpres 18/2020 ttg RPJMN 2020-2024
1. Target % penurunan baduta stunting 2020-2024 bersumber dari Renstra BKKBN

1. Terdapat 2,8% penurunan stunting dari tahun 2022-2021.
2020-2024.
2. Masih terdapat gap antara target dan pencapaian penurunan prevalensi stunting
2. Dilakukan penyesuaian indikasi target dalam perjanjian kinerja 2022-2024:
tahun 2022 (21,6% vs 18%).
2022=21%; 2023: 17% & 2024: 14%
3. Laju penurunan prevalensi stunting 2015-2019: 0.8% per tahun
3. Terjadi penurunan baduta stunting sebesar 10% selama 2020-2022. Persentase
4. Laju penurunan prevalensi stunting tahun 2023 2 kali lipat: 5,6%
penurunan baduta stunting 3,36% per tahun.
STUNTING PREVALENCE BY PROVINCE 2021-2022
6 Province increase prevalence rate : West Sulawesi, Papua, West Nusa Tenggara, West Papua, West Sumatera, dan East Kalimantan
3 Province decrease prevalence rate: South Sumatera, South Kalimantan, dan North Kalimantan
Indonesia reduce the

prevalence rate 2.8%
during 2021 to 2022
Source: Ministry of Health (Indonesian nutritional status survey/SSGI)

2022
16
0
5
10
15
20
25
30
35
40
3.
2.
1.
SSGI
24,8
16 - SUMATERA SELATAN
-6,2
18,6
30
63 - KALIMANTAN SELATAN
-5,4
24,6
27,5
65 - KALIMANTAN UTARA
-5,4
22,1
22,3
14 - RIAU
-5,3
17
29
75 - GORONTALO
-5,2
23,8
25,8
SSGI 2021
12 - SUMATERA UTARA
-4,7
21,1
Kalimantan Utara: 5,4%

24,5
Sumatera Selatan : 6,2%

36 - BANTEN
-4,5
20
Kalimantan Selatan : 5,4%

22,4
15 - JAMBI -4,4 18
: Survei Status Gizi Indonesia

24,5
32 - JAWA BARAT
-4,3
20,2
SSGI 2022
23,5
35 - JAWA TIMUR
-4,3
19,2
18,5
18 - LAMPUNG
-3,3
15,2
10,9
51 - BALI
-2,9
(Delta SSGI 2022 – SSGI 2021)

Penurunan Prevalensi Tertinggi
24,4
DELTA
00 - INDONESIA
-2,8
21,6
28,7
81 - MALUKU
-2,6
26,1
37,8
53 - NUSA TENGGARA TIMUR
-2,5
35,3
Sumber Data : Prevalensi stunting SSGI tahun 2021 - SSGI tahun 2022
30,2
74 - SULAWESI TENGGARA
-2,5
27,7
22,1
17 - BENGKULU
-2,3
19,8
17,6
21 - KEPULAUAN RIAU
-2,2
15,4
33,2
-2
11 - ACEH
3.
2.
1.
31,2
16,8
-2
31 - DKI JAKARTA
14,8
29,8
-2
61 - KALIMANTAN BARAT
27,8
29,7
72 - SULAWESI TENGAH
28,2
27,5
82 - MALUKU UTARA
26
DELTA SSGI 2021-SSGI 2022 (%)
21,6
71 - SULAWESI UTARA
-1,5 -1,3999 -1,1
20,5
17,3
34 - DI YOGYAKARTA
Sulawesi Barat : 1,2%
-0,9
16,4
Kalimantan Timur : 1,1%
27,4
62 - KALIMANTAN TENGAH
-0,5
PREVALENSI STUNTING TAHUN 2021-2022 DAN
26,9
Nusa Tenggara Barat : 1,3%
27,4
73 - SULAWESI SELATAN
-0,2
27,2
19 - KEPULAUAN BANGKA 18,6
-0,1
BELITUNG 18,5
6.
5.
4.
20,9
33 - JAWA TENGAH
-0,1
20,8
22,8
64 - KALIMANTAN TIMUR
1,1
23,9
Peningkatan Prevalensi
33,8
76 - SULAWESI BARAT
1,2
(Delta SSGI 2022 – SSGI 2021)
35
31,4
52 - NUSA TENGGARA BARAT
1,3
32,7
Papua : 5,1%
23,3
13 - SUMATERA BARAT
1,9
25,2
26,2
Papua Barat : 3,8%
91 - PAPUA BARAT
3,8
30
Sumatera Barat : 1,9%
29,5
94 - PAPUA
5,1
34,6
17
0
2
4
6
-8
-6
-4
-2
NTT 2,79
Kalteng 63,13
Papua
2,76
Papua 59,00
Papua Barat
2,66
Jambi 50,47
Sulbar
2,58
NTB 46,91
Sultra
2,57
Gorontalo 46,27
Maluku
2,52
Kalsel 45,10
Sumut
2,48
Sulbar 43,54
Malut
2,47
Sulut 42,77
Sumbar
2,46
Kalbar 42,71
NTB
2,43
Malut 42,40
Aceh
2,42
Sulteng 38,77
Kaltara
2,35
Bengkulu 38,17
Kalbar
2,33
Papua Barat 37,50

Sulteng
2,32
Babel 36,99
Kalteng
2,31
Sumsel 36,50
Kalsel
2,31
Sultra 34,51
Bengkulu
2,30
Lampung 34,50
Gorontalo
2,30
Kaltara 33,86
Riau
2,28
Jatim 31,34
Jambi
2,28
Sulsel 29,50
Lampung
2,28
NTT 27,93
Babel
2,24
INDONESIA 26,64
Sumsel
2,23
Riau 25,51
Sumber: Diolah dari data Long Form SP2020, BPS
Sulsel
2,22
Angka Kelahiran Total (TFR) Per Provinsi
Maluku 25,01
Kepri
2,21
Jabar 24,46
Kaltim
2,18
Jateng 23,09
INDONESIA
2,18
Kaltim 22,28
Jabar
Angka Tingkat Kelahiran Remaja (ASFR 15-19 Tahun) Per Provinsi
2,11
Sumut 21,32
2,1
Sulut
Bali 19,76
Jateng
2,09
Banten 18,20
Bali
2,04
Aceh 16,40
Banten
2,01
Sumbar 14,17
Jatim
1,98
Kepri 12,99
DIY
1,89
DIY 11,54
DKI Jakarta
1,75
DKI Jakarta 7,90

DKI Jakarta 10,38
DKI Jakarta
48
D.I. Yogyakarta 10,9
D.I. Yogyakarta
58
Jawa Tengah 12,77
Bali
85
Bali 13,26
Banten
Kep. Riau 13,31
Kep. Riau
127 142
Jawa Timur 13,49

Riau
Jawa Barat 13,56 Sumatera
Selatan
Target 2030: 12 per 1000 kelahiran Hidup

Target 2024: 16 per 1000 Kelahiran Hidup
Banten 13,83
Jambi
Target 2024: 183 per 100.000 Kelahiran Hidup
Kalimantan Timur 15,51

Kalimantan Timur
Riau 15,69
Sumatera Barat
Target 2030: Kurang dari 70 per 100.000 Kelahiran Hidup
Lampung 15,69
Bengkulu
Sumatera Barat 16,35 Jawa Tengah
Kalimantan Utara 16,65 Jawa Timur

158 175 177 177 178 179 183 184
Kep. Babel 16,75 Jawa Barat
Sumatera Selatan 16,78 Indonesia
Indonesia 16,85 Lampung
Jambi 16,99 Sulawesi Selatan
Kalimantan Selatan 17,22 Kalimantan Utara
Sulawesi Utara 17,23 Sumatera Utara
Kalimantar Barat 17,47 Kep. Babel
Kalimantan Tengah 17,95 Kalimantan

Tengah
Sulawesi Selatan 18,20 Aceh
187 189 192 192 194 195 198 200 201
Sumatera Utara 18,28 Kalimantan

224
Sumber: Diolah dari data Long Form SP2020, BPS
Selatan
Sulawesi
Angka Kematian Ibu tahun 2022
Aceh 19,41
Angka Kematian Bayi tahun 2022
226
Tenggara
Bengkulu 19,73 Sulawesi Utara
Sulawesi Tenggara 23,29 Kalimantar Barat
NTB 24,64 Maluku Utara
NTT 25,67 NTB

230 246 255 257
Sulawesi Tengah 27,72 Maluku
Maluku Utara 28,61 Sulawesi Tengah
Sulawesi Barat 29,21 Gorontalo
Gorontalo 29,47 Sulawesi Barat

261 264 266 274
Maluku 29,82 NTT
Papua Barat 37,06 Papua Barat

316 343
Papua 38,17 Papua

565
Prevalensi Stunting per Kelompok Umur, 2019-2022
Tahun 2019 Tahun 2021 Tahun 2022
40,0
34,7
35,0 33,0 35 30
29,1 29,6 26,2
30,0 27,7 27,4 30
26,8 25 22,5
24,5 24,2 24,4 22,4 21,6
25,0 25 20,4
20
20,0 20
15,0 15 13,7
11,8 15
11,7 13,5 11,7
10,0 8,4
10 10
5,0 5 5
-
0
0-5 bln 6-11 bln 12-23 24-35 36-47 48-60 Total 0-5 bln 6-11 bln 12-23 bln 24-35 bln 36-47 bln 48-60 bln Total
0
bln bln bln bln 0-5 bln 6-11 bln 12-23 bln 24-35 bln 36-47 bln 48-60 bln Total
ASI Ekslusif Sumber: SSGBI 2019 ,SSGI 2021, SSGI

2022, Kemenkes
MP-ASI
1. Terjadi peningkatan prevalensi stunting usia 0-5 bulan antara 2019-2021 & 2022, diperlukan sosialisasi ASI eksklusif
2. Mulai terjadi peningkatan prevalensi stunting pasca periode ASI eksklusif; diperlukan edukasi MPASI yang tepat
sesuai usia
20
Stunting ; Kebijakan dan Program
c
PENDEK vs. STUNTING
pendek stunting
Apa saja dampak Stunting ?
Stunting memiliki dampak pada
menurunnya kualitas sumber daya manusia,
produktifitas dan daya saing. Bagaimana
DAMPAK JANGKA PENDEK DAMPAK JANGKA PANJANG
pemetaan dampaknya?
Terganggunya perkembangan Menurunnya kemampuan kognitif
otak dan prestasti belajar
Kecerdasan berkurang
Menurunnya kekebalan tubuh
sehingga mudah terpapar
Gangguan pertumbuhan fisik penyakit
Gangguan metabolisme dalam Meningkatnya risiko memiliki

tubuh penyakit diabetes, obesitas,
penyakit jantung, pembuluh
daerah, kanker,, stroke dan
disabilitas pada usia tua
20
Indeks Modal Manusia Indonesia
Per ingkat 6 di ASEAN
Indeks Modal Manusia Negar a-Negar a ASEAN (20 18)
Sumber : World Bank, 2018
Singapura
Vietnam
Malaysia
0 Viral Video Warga Satu Desa di Tuban Borong Ibu

Thailand SHARES Seratusan Lebih Mobil Baru Mir
Filipina ! 2 years ago Suara Kaltim ! 1
Indonesia
Kamboja
Mengapa Human Capital Index (HDI) rendah
Apa yang menyebabkan skor HCI Indonesia “tida
Myanmar
• Literasi rendah
pengukurannya, HCI menggunakan empat variab
Laos
• Kualitas pendidikan dan pelatihan (skilled)
deployment, development dan know-how. Soal capa
Timor Leste • Skilled (high-skilled, medium skilled)…rangking kita
skor tingkat literasi dan segala urusan dengan pen
0,4 0,5 0,6 0,7 rendah
0,8 0,9
Indeks
Deployment berkaitan dengan partisipasi tenaga k
5
genderRumah
gap dan
Walilainnya. Sudahmelihat beb
Development
Katum Atapnya
Wali Katum atau Gusti Muhammad Ramli, Bolong-bolong, Tapi Saat Hujan Lebat,
berada di bawah Myanmar dan Vietnam.
Dua Malaikat di Pagi Hari Perintah Mengangkat Pejabat yang Baik

! 2 years ago Suara Kaltim ! 2 years ago Suara Kaltim
Pembangunan Keluarga adalah
pondasi utama tercapainya kemajuan
bangsa
Tahun 2025 – 2035 merupakan fase puncak periode
bonus demografi yang harus terus dikapitalisasi.
Keluarga sehat, produktif, dan berkualitas adalah

Tujuan Program Bangga Kencana Menuju Indonesia
Emas 2045 (100 Tahun Indonesia Merdeka)
Generasi Milenial dan Post-Milenial adalah sasaran

utama Program Bangga Kencana, pola komunikasi
harus berubah
Program Bangga Kencana bukan semata-mata KB,

namun membangun keluarga secara utuh dalam
berbagai dimensinya
Persoalan Stunting masih menjadi problem bagi

keluarga Indonesia, BKKBN bertanggungjawab untuk
menyelesaikannya.
27
PENGARAH WAKIL PRESIDEN Anggota :
1. Menteri Kesehatan;
KETUA 2) Menteri Keuangan;
3) Menteri Sosial;
4) Menteri Desa, Pembangunan Daerah
Tertinggal, dan Transmigrasi;
PTM PTM PTM 5) Menteri Agama;
6) Menteri Pekerjaan Umum dan Perumahan
Wakil Ketua Bidang Wakil Ketua Bidang Wakil Ketua Bidang
Rakyat;
Perencanaan, Pelaksanaan Koordinasi Pembinaan Dan
7) Menteri Sekretariat Negara; dan
pemantauan dan Pengawasan Penyelenggaraan
8) Kepala Staf Kepresidenan
evaluasi Pemerintah Daerah
PELAKSANA Mekanisme tata kerja dan sekretariat

KETUA Sekretariat Pelaksana Pelaksana diatur dengan Peraturan Badan
PTM PTM PTM PTM PTM
Wakil Ketua Wakil Ketua Bidang Wakil Ketua Bidang Wakil Ketua Bidang Koordinasi Wakil Ketua Bidang
Bidang Koordinasi, Sinkronisasi, Koordinasi Pembinaan Dan Pengawasan Advokasi Dan
Perencanaan Pengendalian Dan Intervensi Spesifik Penyelenggaraan Pemerintah Komitmen
Pengawalan Pelaksanaan Daerah Kepemimpinan
PRESIDENTIAL REGULATION NUMBER 72/2021 CONCERNING on ACCELERATION OF STUNTING REDUCTION:
NATIONAL STRATEGY TO ACCELERATE STUNTING REDUCTION
Pillars: Targets of sustainable National Action Plan:

Purposes
development goals by 2030 the at-risk family approach
1. Increasing the commitment and vision of Provision of data on families at risk of

1. Reducing the prevalence of leadership in ministries/agencies, provincial stunting and data on stunting cases
stunting Regional Governments, district/city Regional
Governments, and Village Governments; Assistance to families at risk of
2. Improving the quality of stunting
2. Improvement of behavior change
preparation for family life communication and community Accompaniment of all prospective
empowerment; brides/prospective couples of childbearing
age;
3. Ensuring the fulfillment of
nutritional intake 3. Increasing the convergence of Specific Surveillance of families at risk of stunting
Interventions and Sensitive Interventions in
4. Improving parenting patterns ministries/agencies, provincial Regional
Governments, district/city Regional Stunting case audit
Governments, and Village Governments;
5. Improving access to and quality of
health services
4. Increasing food and nutrition security at the
individual, family, and community levels; Determined by the Chief Executive of
6. Increase access to drinking water the Team for the Acceleration of
and sanitation Stunting Reduction
5. Strengthening and developing systems, data,
information, research, and innovation
Komitmen (Pilar 1) : Pengukuhan Duta Bapak Asuh Anak Stunting
Bapak KASAD dikukuhkan menjadi Bapak Asuh Anak Stunting

Giat BKKBN bersama Pusdokkes Polri
Raker Dokkes Polri di RS Polri Sukanto, 27 Februari 2023
Pilar 2 : edukasi secara masif
( contoh :Arti Pentingnya 1000 HPK)
and general state of health. The word “fontanel” is derived from the Latin fonticulus and the Old French
Makna 1000 HPK
fontaine, meaning a little fountain or spring.1–3 The normal fontanel varies widely in shape and time of
closure. The incidence of abnormal fontanel differs, depending on the abnormality and cause.
View/ Print Figure
FIGURE 1.
(Left) Lateral view of the newborn skull. (Right) Superior view of the newborn skull.
Redrawn with permission after Netter FH. Atlas of human anatomy. Summit, N.J.: Ciba-Geigy, 1994.
If the anterior fontanel is open, ultrasonography is useful to evaluate ventricular dilatation.13 A Examination of a newborn's fontanels offers the physician a window
Ubun-ubun Depan dan Belakang
computed tomographic (CT) scan can detect a fused suture, dilated ventricles, enlarged subarachnoid
space, brain size, or an intracranial or extracranial mass.14 Magnetic resonance imaging (MRI) can
and general state of health. The word “fontanel” is derived from the L
fontaine, meaning a little fountain or spring.1–3 The normal fontanel
Menutup sebelum usia 1000 HPK
detect cortical and white-matter abnormalities, such as degenerative diseases, and document the
extent of calvarial masses. Disadvantages of CT scans and MRI include cost, the need for sedation,
closure. The incidence of abnormal fontanel differs, depending on th
AAFP AAFP
and, in the| case of CT,Foundation
irradiation.13,15 | AFP Journal | FPM Journal | FMX
Normal Fontanel
POSTERIOR FONTANEL Issues AFP By Topic Collections CME Quiz
At birth, the average size of the posterior fontanel is 0.5 cm in white infants and 0.7 cm in black
infants.16 The fontanel usually is completely closed by two months of age.10
<< Previous article Jun 15, 2003 Issue Next article >>
ANTERIOR FONTANEL
The Abnormal Fontanel

The key feature of a normal anterior fontanel is variation. On the first day of an infant's life, the normal
fontanel ranges from 0.6 cm to 3.6 cm, with a mean of 2.1 cm.17 Black infants have larger fontanels
4.7 cm).16
(1.4 cm toPDF " The fontanels #
PRINT of full-term
COMMENTSand preterm infants are similar in size once preterm
infants reach term. The fontanel can enlarge in the first few months of life,18 and the median age of Ubun-ubun Belakang
FIGURE 1.
closure is 13.8 months. By three months of age, the anterior fontanel is closed in 1 percent of infants; (Left) Lateral(Fontanela
JOSEPH
by 12 months, itKIESLER,
is closed in 38M.D.,
percent;and RICK
and by RICER,
24 months, M.D.,
it is closed in 96University offontanels
percent. Anterior
posterior)
view of the newborn
Cincinnati College of Medicine, Cincinnati,
skull. (Right) Superior view of the n
Redrawn with permission after Netter FH. Atlas of human anatomy. Sum
tend
Ohioto close earlier in boys than in girls; the initial size of the fontanel is not a predictor of when it will
close.19
Am Fam Anterior
Abnormal Physician. 2003 Jun 15;67(12):2547-2552.
Fontanel
LARGE FONTANEL AND DELAYED FONTANEL CLOSURE
The diagnosis of an abnormal fontanel requires an understanding of the wide variation of normal. At
Usia Menutupnya Ubun-ubun Depan
A list of the medical conditions associated with a large fontanel or delayed fontanel closure can be
birth, an infant has six fontanels. The anterior fontanel is the largest and most important for clinical
found in Table 1.20,21 Achondroplasia, congenital hypothyroidism, Down syndrome, rickets, and
evaluation.
Usia (Bulan)
increased The
intracranial average
pressure size of the anterior
Ubun –ubun Menutup (%)
are among the most common fontanel
conditions. is 2.1 cm, and the median time of closure is
13.8 months. The most common causes of a large anterior fontanel or delayed fontanel closure are
Achondroplasia is an autosomal-dominant disorder of the epiphyseal plate cartilage that results in
dwarfism.
3
achondroplasia, hypothyroidism,
22 At birth, the infant has an enlarged head, low
1
Down syndrome,
nasal bridge, increased
prominent forehead, and intracranial pressure, and rickets. A
FIGURE 2.
bulging
shortened anterior
extremities, fontanel
in addition can
to a large fontanel.9
be a result of increased intracranial pressure or intracranial and
12 38 Ubun-ubun Measurement of the anterior fontanel.
depan
extracranial
An tumors,
elevated thyroid-stimulating and a
hormone sunken
level fontanel
on a newborn screening usually is congenital
usually detects a sign of dehydration. A physical examination
24
helps the physician
hypothyroidism, determine
but an abnormally which 96
large anterior fontanel imagingwith
in conjunction modality, such
an open posterior as plain films, (Fontanela
of the Anterior)
ultrasonography,
Anatomy Fontanels
fontanel can be an early sign of the disorder. Myxedema and growth deficiency are later signs.
computed tomographic scan, or magnetic resonance imaging, to use for diagnosis. Fontanels are the fibrous, membrane-covered gaps cre
Anatomy of the Fontanels
juxtaposed, as opposed to sutures, which are narrow s
Fontanels are the fibrous, membrane-covered gaps created when m
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Semua Kemampuan Dasar Manusia
dibentuk saat 1000 HPK
Organogenesis
✓ Penglihatan
✓ Pendengaran 6 Bulan
✓ Bicara-Bahasa
Dalam
✓ Emosi Kandungan Pertama
• Organogenesis • ASI eklusif 6-24 Bulan
• 280 hari
✓ Logika
✓ Kemandirian-interaksi
✓ Motorik
2021-2024 RAN PASTI (Acceleration Stunting
Reduction National Action Plans) Policy
Stunting UPSTREAM INTERVENTION
SPECIFIC AND SENSITIVE Risk a. Emphasis on intervention efforts to PROMOTE &
INTERVENTIONS PREVENT the birth of stunted babies by preparing
Family for the pregnancy of the bride/prospective mother
Focus on the INCUBATION Approach through family life planning.
program that pays attention to b. HANDLING of stunting toddlers through curative
health and nutritional adequacy: interventions
3 months PROSPECTIVE
BRIDGE+FOR PREGNANT
WOMEN IN INTERVAL/PUBLIC RAN PENTAHELIX Approach
PERIOD + CHILDREN UNDER
TWO YEARS/CHILDREN UNDER Integrated PASTI Multisectoral
Providing a collaboration platform between
the government and stakeholders (business
FIVE YEARS supported by the Nutrition and world, universities, community and media)
provision of health services, access to Intervention Multistakehol
clean water and social assistance Approach der Approach
Precision data clusters Operational Cluster Managerial cluster
PACKAGE CONVERGENCE
FAMILY LEVEL SERVICE
❑ Regulatory and budgeting support;
❑ Mechanisms and work procedures that are synergistic from the center to the family companion
team
TIM PENDAMPING KELUARGA
KALIMANTAN BARAT
SAMBAS 539 1.617

200.000 TIM TUGAS :
BENGKAYANG 240 720 Meningkatkan akses informasi dan
Unsur dalam Tim: pelayanan melalui:
LANDAK 316 948
• Bidan atau nakes lainya a. penyuluhan;
MEMPAWAH 276 828 • Kader TP PKK b. fasilitasi pelayanan rujukan,
c. fasilitasi penerimaan program bantuan
SANGGAU 408 1.224 • Kader KB/Kader sosial
KETAPANG 305 915 Pembangunan lainnya Mendeteksi dini faktor resiko Stunting
TOTAL SINTANG 372 1.116 TOTAL (spesifik & sensitif);
TPK : SDM
KAPUAS HULU 235 705 12.609
4.203 Sasaran Pendampingan Keluarga
SEKADAU 163 489
MELAWI 178 534
KAYONG UTARA 101 303
KUBU RAYA 420 1.260
KOTA PONTIANAK 416 1.248

KOTA
234 702
SINGKAWANG
PEMBAGIAN PERAN SUAMI –ISTRI DALAM MEMPERTAHANKAN KEHARMONISAN
KELUARGA PADA MASA PANDEMI COVID-19
5,8 2,2 1,5 1,1

11,1 7,2 5,2 Istri Saja
15,9 12,4
21,7 Istri Dominan
22,8
Suami dan istri seimbang
34,3
Suami Dominan
Suami Saja
86,0 87,9
82,5
53,8
71,5
49,1
8,3
4,0 4,9 5,3
,5,2 ,9 ,1 2,7,2 ,4 ,4
Melakukan Mengasuh anak Membeli Mengingatkan Mengingatkan Mengingatkan
pekerjaan kebutuhan hidup sehat beribadah dan berfikir dan
rumah rumah berdoa berprilaku
positif
D.I. YOGYAKARTA 128,6%
JAWA TENGAH 113,4%
JAWA TIMUR 107,8%
BENGKULU 99,6%
LAMPUNG 95,7%
ACEH 95,5%
Sumber: Pemutakhiran PK 2022

SULAWESI SELATAN 85,8%
SULAWESI BARAT 85,8%
JAWA BARAT 81,9%
GORONTALO 81,2%
NUSA TENGGARA BARAT 79,1%
BANTEN 74,3%
NUSA TENGGARA TIMUR 73,2%
SUMATERA UTARA 69,8%
SULAWESI TENGGARA 66,4%
SULAWESI TENGAH 62,0%
SULAWESI UTARA 60,1%
SUMATERA BARAT 58,8%
Keluarga Berisiko Stunting (KRS)
Mendapat Pendampingan*
MALUKU 56,9%
KALIMANTAN SELATAN 54,3%
JAMBI 53,9%
BALI 53,0%
SUMATERA SELATAN 52,9%
KEP. BANGKA BELITUNG 49,1%
PAPUA BARAT 47,0%
RIAU 42,0%
KALIMANTAN TIMUR 41,3%
MALUKU UTARA 39,9%
KALIMANTAN UTARA 38,9%
PAPUA 38,5%
KEP. RIAU 38,0%
KALIMANTAN BARAT 32,8%
KALIMANTAN TENGAH 30,8%
DKI JAKARTA 0,2%
PAPUA BARAT DAYA 0,0%
*) Pendampingan KRS juga dilakukan melalui BAAS
PAPUA PEGUNUNGAN 0,0%

PAPUA SELATAN 0,0%
PAPUA TENGAH 0,0%
Pendekatan Intervensi Gizi Terpadu Dalam RAN PASTI
22
9 specific nutrition interventions, Semester 1 2023
Additional nutritional intake of
chronic energy deficiency of pregnant
mother
90 iron tablets
Girl consumes iron tablets
Exclusive breastfeeding
Children 6-23 mo with

complementary feeding
Intervention to children under 5
With undernutrition
Measurement of growth &
development of children under 5
Wasting with complementary
feeding
Complete immunization TARGET
ACHIEVEMENT
Source: Ministry of Health
11 sensitive nutrition interventions, semester 1 2023
PostpartumFP
FP* *
Postpartum
Recipient of contribution assistance (PBI)
*
Unwanted Target: 96,8 million
pregnancy * Achievement: 96.749.173 (99,95%)(99.95%)
Brides’ Medical Conditional cash transfer

check up Target: 10 million families
* Achievement: 9.878.641 (98%) (98.78%)
Access to clean
water* Recipients of social food assistance
Access to Hygiene Target: 18 million families
Achievement: 18.533.065 (103%)(103.0%)
Family at risk of * TARGET
stunting covered
ACHIEVEMENT
Good knowledge of *
stunting* *Achievement year 2022
Village ODF Source: Bappenas, BKKBN, Kemenkes, Kemensos,

PUPR
1 PREVALENSI PEMAKAIAN KONTRASEPSI MODERN (mCPR)
TARGET DAN CAPAIAN mCPR
2016-2023
Keterangan:
1. Perhitungan mCPR 2016-2019 bersumber dari Survei Kinerja dan Akuntabilitas
(SKAP) BKKBN, dan 2020 bersumber dari estimasi trend mCPR SKAP 2016-
2019 yang dikontrol dengan statistik rutin tahun 2020.
2. Perhitungan mCPR 2021-2023 bersumber dari Pendataan Keluarga dan
Pemutakhirannya 2021-2023 (tidak termasuk Prov DKI Jakarta).
3. CI estimasi mCPR 2023 = [60,1;60,7].
4. Kesalahan sampling diukur dengan Relative Standard Error atau RSE (%),
dimana RSE mCPR 2023 sebesar 0,250, dengan CI = [0,249;0,251].
5. mCPR 2023 (dengan Data Pemutakhiran PK-23 Prov DKI Jakarta) sebesar
▪ mCPR 2023 (dengan Data Pemutakhiran PK-23 59,6.
Prov DKI Jakarta) sebesar 59,6. 6. mCPR 2023 (dengan Data Statistik Rutin 2023 Prov DKI Jakarta) sebesar
▪ mCPR 2023 (dengan Data Statistik Rutin 2023 Prov 60,4.
DKI Jakarta) sebesar 60,4.
Sumber:population.un.org
Lanjutan… PREVALENSI PEMAKAIAN KONTRASEPSI MODERN (mCPR)
TREND CAPAIAN MCPR PER MIX KONTRASEPSI

2022-2023
PEMAKAIAN MCPR MENURUT KELOMPOK UMUR
21,5 21,9
19,3
15,7
14,8
6,2
0,5
15-19 20-24 25-29 30-34 35-39 40-44 45-49

TARGET DAN CAPAIAN mCPR 2023: PROVINSI
Lanjutan… PREVALENSI PEMAKAIAN KONTRASEPSI
MODERN (mCPR)
Confidence Interval
Estimasi mCPR Relative
mCPR mCPR Standard
No Provinsi
▪ PERBANDINGAN 2022 2023
Lower Upper
Error
(RSE) (%)
CAPAIAN mCPR
2022 DAN 2023 1 ACEH 49,9 50,7 49,1 52,3 1,631
2 BALI 54,6 59,7 57,6 61,7 1,736
3 BANTEN 57,4 59,6 58,2 61,0 1,223
▪ CONFIDENCE 4 BENGKULU 66,4 66,0 64,0 68,0 1,548
INTERVAL 5 DAERAH ISTIMEWA YOGYAKARTA 57,1 58,2 56,9 59,6 1,208
ESTIMASI mCPR 6 GORONTALO 58,8 61,2 59,1 63,2 1,684
7 JAMBI 64,9 65,4 63,7 67,0 1,294
8 JAWA BARAT 63,0 63,2 62,4 63,9 0,625
▪ SAMPLING 9 JAWA TENGAH 65,0 65,0 64,3 65,6 0,511
10 JAWA TIMUR 65,6 67,5 66,8 68,2 0,532
11 KALIMANTAN BARAT 58,3 59,2 57,0 61,2 1,807
12 KALIMANTAN SELATAN 70,7 71,2 70,1 72,2 0,757
13 KALIMANTAN TENGAH 64,2 65,5 62,9 68,0 1,993
14 KALIMANTAN TIMUR 51,5 54,6 53,0 56,3 1,544
15 KALIMANTAN UTARA 47,4 51,0 48,0 54,1 3,023
16 KEPULAUAN BANGKA BELITUNG 66,8 67,5 65,3 69,5 1,609
17 KEPULAUAN RIAU 37,2 44,0 41,9 46,1 2,418
18 LAMPUNG 64,5 65,3 64,0 66,6 1,017
19 MALUKU 33,9 39,2 36,4 42,1 3,719
20 MALUKU UTARA 47,7 49,2 44,8 53,6 4,558
21 NUSA TENGGARA BARAT 58,0 60,2 59,0 61,4 1,008
22 NUSA TENGGARA TIMUR 42,2 41,5 40,0 43,1 1,885
23 PAPUA 10,6 10,5 8,9 12,2 7,908
24 PAPUA BARAT 28,1 31,0 27,9 34,3 5,268
25 RIAU 55,9 55,8 53,4 58,2 2,181
26 SULAWESI BARAT 49,9 51,1 49,1 53,2 2,024
27 SULAWESI SELATAN 55,8 59,0 57,8 60,1 0,987
28 SULAWESI TENGAH 52,4 55,8 54,1 57,4 1,537
29 SULAWESI TENGGARA 49,2 51,2 49,0 53,4 2,213
30 SULAWESI UTARA 57,4 59,8 58,0 61,6 1,539
31 SUMATERA BARAT 54,8 56,2 54,6 57,8 1,468
32 SUMATERA SELATAN 62,6 62,8 61,4 64,2 1,167
33 SUMATERA UTARA 47,2 50,1 48,1 52,0 1,989
NASIONAL 59,4 60,4 60,1 60,7 0,250
2 PERSENTASE KB AKTIF (PA) METODE KONTRASEPSI JANGKA PANJANG (MKJP)
TARGET DAN CAPAIAN PA MKJP 2016-2023 PA MKJP MENURUT KELOMPOK UMUR PUS
25,6
22,7
19,0
17,4
11,1
▪ PA MKJP 2023 (dengan Data Pemutakhiran PK-23
Prov DKI Jakarta) sebesar 23,2.
▪ PA MKJP 2023 (dengan Data Statistik Rutin 2023 3,9
Prov DKI Jakarta) sebesar 23,7.
0,3
15-19 20-24 25-29 30-34 35-39 40-44 45-49
Keterangan:
1. Perhitungan PA MKJP 2016-2019 bersumber dari Survei Kinerja dan Akuntabilitas (SKAP) BKKBN, dan 2020 bersumber dari estimasi trend PA MKJP SKAP 2016-2019 yang dikontrol dengan
statistik rutin tahun 2020.
2. Perhitungan PA MKJP 2021-2023 bersumber dari bersumber dari Pendataan Keluarga dan Pemutakhirannya 2021-2023 (tidak termasuk Prov DKI Jakarta).
3. CI estimasi PA MKJP 2023 = [22,7;23,2].
4. Kesalahan sampling diukur dengan Relative Standard Error atau RSE (%), dimana RSE PA MKJP 2023 sebesar 0,581, dengan CI = [0,575;0,588].
5. PA MKJP 2023 (dengan Data Pemutakhiran PK-23 Prov DKI Jakarta) sebesar 23,2.
6. PA MKJP 2023 (dengan Data Statistik Rutin 2023 Prov DKI Jakarta) sebesar 23,7.
Implementation National Plan Of Action
in Accelerate Stunting Reduction 2021-2024
Implementation in 2022
9 Specific
Intervention 11 Sensitive
intervention
27.7 Target; Families at-risk of stunting, Prospective bride and groom, prospective
24.4 eligible couple, pregnant women, woman in post partum periode/interval, Children 21.6
0-5 years age) (SSGI) Target of Intervention in 17.8
2023
14
5 Pillar of National Strategy in accelerate stunting reduction and national action plan
in accelerate stunting reduction (RAN PASTI)
2019 2021 2022 2023 2024
INDONESIAN STUNTING PREVALENCE
21,9 Million Families at-risk of stunting*

13,5 Million Families at-
Reduction number of Families at-risk of stunting risk of stunting**
*Family Registry (PK) 2021 | ** Updating Family Registry Pemutakhiran PK 2022
Note: Further studies are needed to see the impact of the implementation of the National Strategy in Accelerate stunting reduction and RAN PASTI on reducing the number of families at risk of stunting 6
STUNTING CASE AUDIT Achievements of 4 Stunting Case Audit indicators 2022:
(AUDIT KASUS STUNTING/AKS)
PRESIDENTIAL REGULATION OF THE REPUBLIC OF INDONESIA NUMBER 72 OF 2021
CONCERNING THE ACCELERATION OF STUNTING REDUCTION
districts/cities have formed audit teams for
Article 8
(1) In implementing the National Strategy for Accelerating Stunting Reduction as referred to in Article stunting cases
7, a national action plan has been prepared through an approach to families at risk of Stunting.
(3) The national action plan as intended in paragraph (2) consists of priority activities which include at
97%
least:
a. providing data on families at risk of stunting; districts/cities have carried out audits of
b. assistance to families at risk of stunting;
c. accompanying all prospective brides/prospective couples of childbearing age; stunting cases and family assistance
d. surveillance of families at risk of stunting; and management twice a year.
e. Stunting case audit.
Article 9
86%
The audit of stunting cases as intended in Article 8 paragraph (3) letter e aims to find the causes of
stunting cases as an effort to prevent similar cases from occurring.
districts/cities have disseminated the results of
THE NATIONAL POPULATION AND FAMILY PLANNING BOARD (BKKBN) REGULATION
NUMBER 12 OF 2021 CONCERNING THE NATIONAL ACTION PLAN TO ACCELERATE THE audits of stunting cases and family assistance
REDUCTION OF INDONESIAN STUNTING RATES IN 2021-2024 management twice a year.
85%
4 INDICATOR 1. Formation of teams in districts/cities
Stunting Case Audit: 2. Implementation of Stunting Case Audits
& family assistance management twice districts/cities have followed up on the results
a year. of audits of stunting cases and family assistance
3. Dissemination of audit results & family management twice a year
assistance management twice a year.
4. Follow up audit results & family
81%
assistance management twice a year. Source: SIPASTI 2022 (information system
Target for the task force to accelerate stunting
100% at district/city level 2022-2024 reduction thematic stunting)
Risk of stunting in 4 target groups, 2022
02
30.580 Brides 121.724 pregnant mothers 100.407 Post partum
mothers 275.078 children under
2 or 5 month at risk/stunting
a. Too old (>35 years old) & a. Too old (>35 years old) & too
too young <21 years old) young <21 years old) a. Too young
b. Underweight b. Not exclusive breastfeeding a. Poor nutritional status (stunted,
b. Chronic energy deficiency
c. Anemia c. Chronic energy deficiency underweight, wasting)
c. Underweight
b. Not exclusive breastfeeding
d. Chronic energy deficiency d. Anemia d. Underweight
c. Incomplete immunization
e. Unbalanced nutrition e. Thalassemia e. Prematurity d. Unbalanced nutrition of
intake f. Passive smokers f. Divorced complementary food
f. Inadequate access to g. Inadequate access to g. Passive smokers e. Comorbid: (upper respiratory
sanitation sanitation h. Not using PP FP tract infection, diarrhea,
g. Passive smokers h. Not consume iron tablet tuberculosis, heart failure,
i. Infrequent ANC visit congenital defects)
f. Prematurity & LBW
g. Poor maternal education
h. Poor wealth status
i. Poor sanitation (open
Total: 527.789 auditee in Stunting Case Audit 2022 defecation) and scarcity of clean
water
j. Passive smokers
Source: Data collected from 14 provinces (1. Riau; 2. Maluku; 3. Central Sulawesi; 4. West Java; 5. Aceh; 6. Yogyakarta; 7. North
Maluku; 8. South Sumatera; 9.Banten; 10. East Java; 11. North Sulawesi; 12.Central Java; 13. Bali; 14. South Sumatera ). BKKBN
Risks of stunting in 4 Target Groups
1. Exposure to cigarette smoke

2. Unbalanced nutrition of
1. Too young (<20 years old) complementary food
1. Chronic energy deficiency 1. Exposure to cigarette smoke
2. Exposed to cigarette smoke 3. Inadequate access to sanitation
2. Exposure to cigarette smoke 2. Unbalanced nutrition intake 4. History of maternal illness (chronic
3. Chronic energy deficiency 3. Anemia 3. Anemia energy deficiency, hepatitis, pre-
4. Anemia 4. Unbalanced nutrition intake 4. Chronic energy deficiency
eclampsia)
5. Unbalanced nutrition intake 5. Too young <21 years old and too 5. Not using birth control
5. Not exclusive breastfeeding
old >35 years old 6. Too young <21 years old and too
6. Abnormal BMI 6. Abnormal BMI (underweight, old >35 years old 6. Inappropriate home conditions
(underweight, overweight, 7. Poor family 7. Low birth weight and low birth
overweight, obesity)
obesity) 8. Inadequate sanitation access length
7. Inadequate access to sanitation
9. Abnormal BMI is not normal 8. Inadequate access to clean water
7. Inadequate access to 8. Comorbidities (Thalassemia, pre
(Underweight, overweight, obesity) 9. Incomplete immunization
sanitation eclampsia, hypertension,
10. Inadequate access to clean water 10. Child's disease history (upper
8. Inadequate access to clean Diabetes) 11. Comorbidities (Thalassemia, pre respiratory tract infection, diarrhea,
9. Inadequate access to clean eclampsia, hypertension, Diabetes)
water water
tuberculosis, heart failure, congenital
9. Comorbid Diseases defects)
11. Anemia
12. Premature
20.153 Bride and groom** 7.967 Pregnant Woman** 2.076 Postpasrtum Mother ** 11.690 baby and toddler**
Sumber: *Survey AKS Semester I Tahun 2023, Bidang Program dan Kegiatan Sekretariat Pelaksana PPS Pusat Bulan Juni 2023; ** Tools Monitoring Satgas Bulan Juni 2023
Stunting Case Audit
from Kendal (1)
Male child (A.R); age 19 months, history of low birth
weight (weight 2300 grams, body length 48 cm), high risk
mother age (38 years) with intellectual disability / mental
retardation, growth and development disorders, did not
have health insurance, mother is not protected with
contraception and not consuming balanced
complementary foods.
Measurement of Stimulation, early
detection, & early intervention of
growth and child development at
primary health care
Referral of growth and Number of Yes answers= 3
development therapy to Possibility of development disorder Children Development Card
hospital
Development milestones under normal
status
Before - After Intervention
Before Month 1 Month 2 Month 3
(May ) July August September
Name Age Start of PMT Intervention Last Nutritional Status Conclusion
Height Weight Weight Height
Weight (kg) Height (cm) Weight (kg) (cm) (kg) Height (cm) (kg) (cm)
Height/Age: Normal
Complete Supplementary Food for 90 days since
Weight/Age: normal
A.R 19 month 16 June 2023 sourced from Foster Parents of 7.4 72.1 8.6 75 9 77 9 78,3 Normal
weight/Height: Good
Stunting Children DP2KBP2PA Kendal, Head of
Nutrition
KSPK DP2KBP2PA Kendal
Stunting Case Audit
from Cimahi (2) Medical History: scabies, frequent skin problems, chronic diarrhea starting at 3 -4
months of age, chronic cough >2 weeks. Early complementary feeding at 3 months,
Name : EL (inisial) only instant porridge without animal protein. Incomplete immunization, irregular
Gender: Perempuan weighing to Posyandu, Inadequate latrines due to public toilets, 2 toilets for 6
Birthday: 19-11-2021 (20 Month) families (rented rooms)Toxic family environment: Parents (mother and father) smoke
Comorbid: TBC The mother does not use contraceptives
Maret April Mei Juni Juli

Weight/Height 6,1/70 6,5/71 7,1/72,3 7,1/73 7,3/75
Intervention/ a. Refer to a Pediatrician, a. Referred to a a. TB treatment a. TB treatment a. TB treatment
result b. TB Test, confirmed + dermatologist b. Complete Basic Immunization b. Provision of b. Provision of supplementary food
c. HIV test with non- b. Family planning education a. Child growth & development supplementary food from ‘foster father for stunting
reactive result c. Parents smoke less Monitoring from ‘foster father for children’
d. Complete Immunization cigarettes or smoke b. Feeding & hygiene education stunting children’ c. Landlord has built a septic tank
e. Education on the outside the house c. Provision of food source of c. Skin treatment d. Nutrition Status Monitoring
dangers of smoking to d. Supplementary feeding animal protein d. Parents regularly Healthy latrine and septic tank
mothers and fathers for special needs (PKMK) d. Drying bedding/pillows bring their child to education for rent owners
f. Supplementary feeding from Puskesmas contaminated with mites posyandu e. Mother's screening result was
(PKMK) from Puskesmas e. Mother starts preparing e. Nutrition Status positive for TB
complementary food Monitoring TB
accompanied/monitored by screening for auditee Improved weight and height for age
family attendant parents
Source: PETIK AKSI 3 BKKBN (Cimahi City, West Java, 2023)

Clin Pediatr Endocrinol 2016; 25(2), 71–76
Copyright© 2016 by The Japanese Society for Pediatric Endocrinology
Short Communication
Growth standard charts for Japanese children with

mean and standard deviation (SD) values based on the
year 2000 national survey
Tsuyoshi Isojima1, 2, Noriko Kato3, Yoshiya Ito1, 4, Susumu Kanzaki1, 5, and Mitsunori Murata1, 6
1The Japanese Society for Pediatric Endocrinology, Kyoto, Japan
2Department of Pediatrics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
3Department of Early Childhood and Elementary Education, Jumonji University, Niiza, Japan
4Faculty of Nursing, Japanese Red Cross Hokkaido College of Nursing, Kitami, Japan
5Division of Pediatrics and Perinatology, Tottori University Faculty of Medicine, Yonago, Japan
6Health Center, Wayo Women’s University, Chiba, Japan
Key words: growth charts, Japanese children, LMS method, standard deviation score
Introduction suitable for monitoring children with extreme

54
growth retardation. Considering this, we
55
International National Madarina
National Growth Julia
Chart
(B) (B)
International GrowthGrowth
Chart (A) Chart (A)
Growth Chart
Departemen Ilmu Kesehatan A
Fakultas Kedokteran, Kesehatan Masyaraka
2.5%Universitas Gadjah Mada
Yogyakarta
too
2.5% too 2.5%
short
short too
short
2.5% too
short
- 2 SD Median A - 2 SD Median B
14
- 2 SD Median B
- 2 SD Median A 56
Mengenal Kurva Pertumbuhan
Area of possible m isinterpretation
“the False Positives ”
dan Aplikasinya
2.5% too short
(Chart A - int)
2.5% too short

(Chart B - nas)
Madarina Julia
- 2 SD - 2 SD Departemen Ilmu Kesehatan Anak
chart B Fakultas
chartKedokteran,
A Kesehatan Masyarakat dan Keperawatan
Universitas Gadjah Mada
Yogyakarta
Discrepancy between prevalence of “under -2 SDs” made by
Chart A and Chart B, e.g. 30%-2.5% 16
57
Madarina Yulia
c
Tantangan & rekomemendasi
kebijakan
59
USIA CATIN WANITA INDEKS MASSA TUBUH
Data Catin Elsimil 20-34 <20 ≥35 kurang normal berlebih
Nasional 29.607 orang

(13.3%)
42.235 orang 30.907 orang
(18.9%)
Sumber Data: Aplikasi Elsimil BKKBN Per 17 (13.9%)
Oktober 2023
12.791 orang
(5.7%)
180.512 orang 149.769 orang

(81.0%) (67.2%)
LINGKAR LENGAN ATAS STATUS ANEMIA
normal KEK 38.884 orang

47.174 orang
751 orang (17.4 %)
(21.2%)
CATIN YANG MENGISI (0.3%) normal
APLIKASI ELSIMIL: anemia ringan
11.048 orang
222.910 (5%) anemia sedang
anemia berat
29.341 orang
142.886 orang tidak memeriksakan
(13.2%)
(64.1%) Hb
175.736 orang
(78.8%)
JUMLAH USIA WANITA
NO NAMA PROVINSI % <20
CATIN <20 20-34 >=35
1 DKI JAKARTA 0 0 0 0 0,0%
2 DAERAH ISTIMEWA YOGYAKARTA 2433 139 2142 152
5,7%
3 NUSA TENGGARA TIMUR 6036 354 5257 425 5,9%
4 SUMATERA BARAT 6474 435 5661 378 6,7% Data Catin Wanita Usia <20 tahun
5
6
BALI
ACEH
1314
8372
101
722
1187
7179
26
471
7,7%
8,6%
berdasarkan Elsimil per 17 Oktober 2023
7 SUMATERA UTARA 10744 933 9256 555 8,7%
8 JAWA TENGAH 30252 2870 25230 2152 9,5%
9 KEPULAUAN RIAU 839 80 692 67 9,5%
10 MALUKU 973 93 820 60 9,6%
11 RIAU 6277 656 5318 303 10,5%
12 MALUKU UTARA 394 42 333 19 10,7%
13 PAPUA BARAT 218 24 175 19 11,0%
14 LAMPUNG 10541 1261 8735 545 12,0%
15 BANTEN 6254 762 5251 241 12,2%
16 KALIMANTAN TIMUR 2199 292 1761 146 13,3%
17 JAWA TIMUR 40546 5570 32217 2759 13,7%
18 KALIMANTAN UTARA 396 55 307 34 13,9%
19 KEPULAUAN BANGKA BELITUNG 702 99 578 25 14,1%
20 PAPUA 705 106 536 63 15,0%
21 JAWA BARAT 38346 5881 30688 1777 15,3%
22 KALIMANTAN BARAT 2960 457 2323 180 15,4%
23 SULAWESI TENGGARA 2526 428 1975 123 16,9%
24 JAMBI 4873 829 3863 181 17,0%
25 KALIMANTAN SELATAN 4904 854 3738 312 17,4%
26 BENGKULU 3152 562 2478 112 17,8%
27 GORONTALO 1625 300 1227 98 18,5%
28 SUMATERA SELATAN 7676 1419 5989 268 18,5%
29 SULAWESI SELATAN 9520 1768 7139 613 18,6%
30 SULAWESI BARAT 1111 234 815 62 21,1%
31 SULAWESI UTARA 954 204 705 45 21,4%
32 NUSA TENGGARA BARAT 6113 1312 4368 433 21,5%
33 SULAWESI TENGAH 2142 467 1584 91 21,8%
34 KALIMANTAN TENGAH 1339 298 985 56 22,3%
NASIONAL 222910 29607 180512 12791 13,3%
JUMLAH USIA WANITA
NO NAMA PROVINSI % >=35
CATIN <20 20-34 >=35
1 DKI JAKARTA 0 0 0 0 0,0%
2 BALI 1314 101 1187 26 2,0%
4 BENGKULU 3152 562 2478 112 3,6% Data Catin Wanita Usia ≥35 tahun
6 JAMBI 4873 829 3863 181 3,7% berdasarkan Elsimil per 17 Oktober 2023
7 BANTEN 6254 762 5251 241 3,9%
9 SULAWESI TENGAH 2142 467 1584 91 4,2%
10 JAWA BARAT 38346 5881 30688 1777 4,6%
11 SULAWESI UTARA 954 204 705 45 4,7%
12 MALUKU UTARA 394 42 333 19 4,8%
13 RIAU 6277 656 5318 303 4,8%
15 SUMATERA UTARA 10744 933 9256 555 5,2%
16 LAMPUNG 10541 1261 8735 545 5,2%
17 SULAWESI BARAT 1111 234 815 62 5,6%
18 ACEH 8372 722 7179 471 5,6%
19 SUMATERA BARAT 6474 435 5661 378 5,8%
20 GORONTALO 1625 300 1227 98 6,0%
22 MALUKU 973 93 820 60 6,2%
23 DAERAH ISTIMEWA YOGYAKARTA 2433 139 2142 152
6,2%
27 JAWA TIMUR 40546 5570 32217 2759 6,8%
30 JAWA TENGAH 30252 2870 25230 2152 7,1%
31 KEPULAUAN RIAU 839 80 692 67 8,0%
33 PAPUA BARAT 218 24 175 19 8,7%
34 PAPUA 705 106 536 63 8,9%
NASIONAL 222910 29607 180512 12791 5,7%
JUMLAH INDEKS MASA TUBUH
NO NAMA PROVINSI % KURUS
CATIN KURUS NORMAL BERLEBIH
1 SUMATERA UTARA 10744 766 7929 2049 7,1%
2 BALI 1314 108 904 302 8,2%
4 MALUKU UTARA 394 37 252 105 9,4%
5 1625 154 941 530
6
GORONTALO
ACEH 8372 833 5956 1583
9,5%
9,9%
Data Catin Wanita IMT Kurang
7
8
PAPUA 705
973
71
100
467
715
167
158
10,1% berdasarkan Elsimil per 17 Oktober 2023
MALUKU 10,3%
10 PAPUA BARAT 218 25 133 60 11,5%
11 RIAU 6277 725 4234 1318 11,6%
13 BANTEN 6254 730 4570 954 11,7%
14 SUMATERA BARAT 6474 766 4374 1334 11,8%
15 SULAWESI TENGAH 2142 259 1453 430 12,1%
17 SULAWESI UTARA 954 120 620 214 12,6%
21 SULAWESI BARAT 1111 149 747 215 13,4%
23 BENGKULU 3152 436 2193 523 13,8%
25 JAWA BARAT 38346 5432 26210 6704 14,2%
26 KEPULAUAN RIAU 839 120 498 221 14,3%
27 JAWA TIMUR 40546 5903 25058 9585 14,6%
28 JAMBI 4873 738 3234 901 15,1%
30 LAMPUNG 10541 1678 7274 1589 15,9%
32 DAERAH ISTIMEWA YOGYAKARTA 2433 418 1476 539 17,2%
33 JAWA TENGAH 30252 5240 19541 5471 17,3%
34 DKI JAKARTA 0 0 0 0 #DIV/0!
NASIONAL 222910 30906 149769 42235 13,9%
JUMLAH INDEKS MASA TUBUH %
NO NAMA PROVINSI
CATIN KURUS NORMAL BERLEBIH BERLEBIH
4 LAMPUNG 10541 1678 7274 1589 15,1%
5 BANTEN
6 MALUKU
6254
973
730
100
4570
715
954
158
15,3%
Data Catin Wanita IMT Berlebih
16,2%
7 BENGKULU 3152 436 2193 523 16,6% berdasarkan Elsimil per 17 Oktober 2023
9 JAWA BARAT 38346 5432 26210 6704 17,5%
11 JAWA TENGAH 30252 5240 19541 5471 18,1%
12 JAMBI 4873 738 3234 901 18,5%
14 ACEH 8372 833 5956 1583 18,9%
15 SUMATERA UTARA 10744 766 7929 2049 19,1%
16 SULAWESI BARAT 1111 149 747 215 19,4%
18 SULAWESI TENGAH 2142 259 1453 430 20,1%
20 SUMATERA BARAT 6474 766 4374 1334 20,6%
21 RIAU 6277 725 4234 1318 21,0%
22 702 92 455 155
KEPULAUAN BANGKA BELITUNG 22,1%
23 2433 418 1476 539
DAERAH ISTIMEWA YOGYAKARTA 22,2%
24 SULAWESI UTARA 954 120 620 214 22,4%
25 BALI 1314 108 904 302 23,0%
26 JAWA TIMUR 40546 5903 25058 9585 23,6%
27 PAPUA 705 71 467 167 23,7%
29 KEPULAUAN RIAU 839 120 498 221 26,3%
30 MALUKU UTARA 394 37 252 105 26,6%
31 PAPUA BARAT 218 25 133 60 27,5%
33 GORONTALO 1625 154 941 530 32,6%
34 DKI JAKARTA 0 0 0 0 0
NASIONAL 222910 30906 149769 42235 18,9%
JUMLAH LILA
NO NAMA PROVINSI
CATIN KEK NORMAL % KEK
1 MALUKU UTARA 394 59 335 15,0%
2 PAPUA BARAT 218 35 183 16,1%
3 BALI 1314 212 1102 16,1%
4 10744 1761 8983
5
SUMATERA UTARA
RIAU 6277 1092 5185
16,4%
17,4%
Data Catin Wanita KEK
6 ACEH 8372 1469 6903 17,5% berdasarkan Elsimil per 17 Oktober 2023
7 GORONTALO 1625 297 1328 18,3%
8 SUMATERA BARAT 6474 1184 5290 18,3%
9 KALIMANTAN TENGAH 1339 245 1094 18,3%
10 KALIMANTAN BARAT 2960 572 2388 19,3%
11 KALIMANTAN UTARA 396 78 318 19,7%
12 SUMATERA SELATAN 7676 1514 6162 19,7%
13 KEPULAUAN RIAU 839 168 671 20,0%
14 MALUKU 973 196 777 20,1%
15 JAMBI 4873 995 3878 20,4%
16 JAWA BARAT 38346 7885 30461 20,6%
17 BENGKULU 3152 651 2501 20,7%
18 LAMPUNG 10541 2224 8317 21,1%
19 JAWA TIMUR 40546 8591 31955 21,2%
20 SULAWESI SELATAN 9520 2020 7500 21,2%
21 SULAWESI BARAT 1111 239 872 21,5%
22 KEPULAUAN BANGKA BELITUNG 702 155 547 22,1%
23 BANTEN 6254 1420 4834 22,7%
24 SULAWESI TENGGARA 2526 584 1942 23,1%
25 SULAWESI UTARA 954 222 732 23,3%
26 KALIMANTAN SELATAN 4904 1143 3761 23,3%
27 KALIMANTAN TIMUR 2199 515 1684 23,4%
28 SULAWESI TENGAH 2142 510 1632 23,8%
29 JAWA TENGAH 30252 7279 22973 24,1%
30 NUSA TENGGARA TIMUR 6036 1473 4563 24,4%
31 NUSA TENGGARA BARAT 6113 1523 4590 24,9%
32 PAPUA 705 178 527 25,2%
33 DAERAH ISTIMEWA YOGYAKARTA 2433 685 1748 28,2%
34 DKI JAKARTA 0 0 0 #DIV/0!
NASIONAL 222910 47174 175736 21,2%
HB
NO NAMA PROVINSI JUMLAH CATIN % ANEMIA
NORMAL ANEMIA TIDAK ADA HB
1 KEPULAUAN RIAU 839 577 110 152 13,1%
2 RIAU 6277 4209 847 1221 13,5%
3 SULAWESI UTARA 954 478 130 346 13,6%
4 SUMATERA UTARA 10744 7292 1496 1956 13,9%
5 BENGKULU 3152 1958 455 739 14,4%
Data Catin Wanita Anemia
7
8
SULAWESI TENGGARA 2526
6254
1807
3671
380
961
339
1622
15,0% berdasarkan Elsimil per 17 Oktober 2023
BANTEN 15,4%
9 JAWA BARAT 38346 24120 6087 8139 15,9%
10 LAMPUNG 10541 7411 1682 1448 16,0%
11 ACEH 8372 5529 1371 1472 16,4%
12 MALUKU 973 616 160 197 16,4%
14 BALI 1314 663 228 423 17,4%
15 JAWA TIMUR 40546 27484 7254 5808 17,9%
18 702 470 137 95
KEPULAUAN BANGKA BELITUNG 19,5%
19 SULAWESI BARAT 1111 713 218 180 19,6%
21 JAWA TENGAH 30252 19821 6122 4309 20,2%
22 SUMATERA BARAT 6474 4151 1326 997 20,5%
23 MALUKU UTARA 394 259 82 53 20,8%
DAERAH ISTIMEWA
24 2433 1707 517 209
YOGYAKARTA 21,2%
25 PAPUA BARAT 218 142 49 27 22,5%
28 JAMBI 4873 3069 1169 635 24,0%
29 SULAWESI TENGAH 2142 1242 527 373 24,6%
30 GORONTALO 1625 949 413 263 25,4%
33 PAPUA 705 344 254 107 36,0%
34 DKI JAKARTA 0 0 0 0 #DIV/0!
NASIONAL 222910 142886 41140 38884 18,5%
Tantangan Bagi Kualitas Anak /Generasi Emas 2045
Defabel/Autusme
Napza
4.1 % 5.1 %
Mental disorder
Kualitas SDM 9.8 % 41.5 %
Stunting
21.6 %
ODGJ
7/1000
5,1% remaja pernah mengkonsumsi NAPZA (SKAP, 2019)

Toxic : Racun….
68
ODGJ
Indonesia Darurat
Perceraian
Rekomendasi Kebijakan
❖Penanganan stunting dari hulu ke hilir
❖Program bersifat holistik terintegrasi dengan pembangunan kualitas
SDM secara umum
❖Membangun visi Bersama dan komitmen para provider di seluruh
rantai pelayanan dari hulu ke hilir
❖Penting mengedepankan edukasi, sosialisasi dan massif informasi,
untuk merubah perilaku dalam hal pola makan, sanitasi dan
Kesehatan reproduksi

Materi Dr. (H.C.) Dr. Hasto Wardoyo, SP - OG, Subsp. FER - Plenary Lecture 3

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Materi Dr. (H.C.) Dr. Hasto Wardoyo, SP - OG, Subsp. FER - Plenary Lecture 3

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PROGRAM PENURUNAN STUNTING

18thOctober 2023 By:

Disampaikan pada diskusi model pemenuhan nutrisi dan kesehatan mental

Obstacles ,challenges and opportunities for the government

3 Kebijakan dan program

Population & PGR,

Population composition by age,

Indonesia's Population Growth Rate/PGR continues to decline during 1961-2020.

TFR > 2,4

TFR >2,3 – 2,4

82,5 Angka Ketergantungan

66,1 Bonus Demografi

1965 1975 1985 1995 2005 2015 2025 2035 2045

100 kab/kota +100 kab/kota PERPRES

Untuk menuju 14% dibutuhkan penurunan 3.8%/tahun.

Indonesia: 4,7 juta (21,6%) Indonesia: 161 ribu (17,9%)

Penurunan 10%/3,3% per tahun

1. Target % penurunan baduta stunting 2020-2024 bersumber dari Renstra BKKBN

Indonesia reduce the

Source: Ministry of Health (Indonesian nutritional status survey/SSGI)

Kalimantan Utara: 5,4%

Sumatera Selatan : 6,2%

Kalimantan Selatan : 5,4%

: Survei Status Gizi Indonesia

(Delta SSGI 2022 – SSGI 2021)

(Delta SSGI 2022 – SSGI 2021)

Papua Barat 37,50

DKI Jakarta 7,90

Jawa Timur 13,49

Target 2030: 12 per 1000 kelahiran Hidup

Kalimantan Timur 15,51

Sumatera Barat 16,35 Jawa Tengah

Kalimantan Utara 16,65 Jawa Timur

Kep. Babel 16,75 Jawa Barat

Sumatera Selatan 16,78 Indonesia

Indonesia 16,85 Lampung

Jambi 16,99 Sulawesi Selatan

Kalimantan Selatan 17,22 Kalimantan Utara

Sulawesi Utara 17,23 Sumatera Utara

Kalimantar Barat 17,47 Kep. Babel

Kalimantan Tengah 17,95 Kalimantan

Sumatera Utara 18,28 Kalimantan

Sumber: Diolah dari data Long Form SP2020, BPS

Sulawesi Tenggara 23,29 Kalimantar Barat

NTB 24,64 Maluku Utara

NTT 25,67 NTB

Sulawesi Tengah 27,72 Maluku

Maluku Utara 28,61 Sulawesi Tengah

Sulawesi Barat 29,21 Gorontalo

Gorontalo 29,47 Sulawesi Barat

Maluku 29,82 NTT

Papua Barat 37,06 Papua Barat

Papua 38,17 Papua

ASI Ekslusif Sumber: SSGBI 2019 ,SSGI 2021, SSGI

Gangguan metabolisme dalam Meningkatnya risiko memiliki

0 Viral Video Warga Satu Desa di Tuban Borong Ibu

Dua Malaikat di Pagi Hari Perintah Mengangkat Pejabat yang Baik

Keluarga sehat, produktif, dan berkualitas adalah

Generasi Milenial dan Post-Milenial adalah sasaran

Program Bangga Kencana bukan semata-mata KB,

Persoalan Stunting masih menjadi problem bagi

PELAKSANA Mekanisme tata kerja dan sekretariat