The first 1000 days are days counted between a woman’s pregnancy (± 270 days) and her child’s 2nd birthday (± 730 days) that offer a unique window of opportunity to get healthier and more prosperous futures. The right nutrition during this 1000 days window can have a profound impact on a child’s ability to grow, learn, and rise out of poverty. It can also shape a society’s long-term health, stability and prosperity.
Nowadays, malnutrition is still a leading cause of death of young children throughout the world. The consequences of malnutrition are particularly severe, often irreversible, and reach far into the future for infants and children under the age of two.
- During pregnancy, malnutrition can have a devastating impact on the healthy growth and development of a child. Babies who are malnourished in the womb have a higher risk of dying in infancy and are more likely to face lifelong cognitive and physical deficits and chronic health problems.
- For children under the age of two, malnutrition can be life-threatening. It can weaken a child’s immune system and make him or her more susceptible to dying from common illnesses such as pneumonia, diarrhea and malaria.
The purpose of focusing on improving nutrition for mothers and children in the 1000 days window is to ensure a healthy and productive life of a child and also break the cycle of poverty. Leading scientists, economists and health experts agree that improving nutrition during the critical 1000 days window is one of the best investments to achieve lasting progress in global health and development. Evidence shows that the right nutrition during the 1000 days window can:
- save more than one million lives each year;
- significantly reduce the human and economic burden of diseases such as tuberculosis, malaria and HIV/AIDS;
- reduce the risk for developing various non-communicable diseases such as diabetes, and other chronic conditions later in life;
- improve an individual’s educational achievement and earning potential; and,
- increase a country’s GDP by at least 2-3 percent annually.
The solutions to improve nutrition in the 1,000 day window are readily available, affordable and cost-effective, including:
- Ensuring that mothers and young children get the necessary vitamins and minerals they need;
- Promoting good nutritional practices, including breastfeeding and appropriate, healthy foods for infants; and
- Treating malnourished children with special, therapeutic foods.
The intervention types of this program is as follows:
– Increase Intake of Vitamins and Minerals
- Vitamin A supplements
- Zinc supplements
- Micronutrient powders
- De-worming drugs
- Iron/folic acid supplements for pregnant women
- Iodized oil capsules
- Salt iodization
- Iron fortification
- Fortification of staple foods/biofortification
– Promote Good Nutritional Practices
- Breastfeeding
- Complementary feeding
- Improved hygiene practices
- Diet diversification
– Prevent and Treat Moderate and Severe Malnutrition
- Treatment of severe undernutrition with RUTF (Ready to use therapeutic food)
- Prevention/treatment of moderate undernutrition
SUN Movement
SUN (Scaling Up Nutrition), is a unique Movement founded on the principle that all people have a right to food and good nutrition. It unites people—from governments, civil society, the United Nations, donors, businesses and researchers—in a collective effort to improve nutrition. Successful, sustainable efforts to improve nutrition must be anchored at the national level, with national-level officials owning and leading tailored efforts to address malnutrition.
Therefore, SUN is not a new institution, initiative or financial mechanism. Instead, SUN is a country-led movement that brings organizations together across sectors to support national plans to scale up nutrition by helping to ensure that financial and technical resources are accessible, coordinated, predictable and ready to go to scale. The SUN movement focuses on promoting the implementation of evidenced-based nutrition interventions, as well as integrating nutrition goals into broader efforts in critical sectors such as, health, social protection, development and agriculture.
At the center of the movement is national level leadership that coordinates both national and international efforts, with the SUN movement committed to aligning financial and technical support with these country plans. Leadership at the national level ensures that priorities and programs are designed and implemented in a way that meets the needs of various regions and populations within the country and enables the scale up of sustainable efforts.
The 1000 Days partnership supports the SUN movement by:
- focusing attention on the 1000 days window of opportunity for impact;
- engaging government, civil society, and the private sector in efforts to improve early nutrition; and
- promoting partnerships across these sectors to achieve a scale change in improving early nutrition.
The causes of malnutrition include both factors that most people would generally associate with nutrition, as well as factors that affect the broader context of life and health. Recognizing this, the SUN Movement looks to implement both specific nutrition interventions and nutrition-sensitive approaches.
Specific Nutrition Interventions:
- Support for exclusive breastfeeding up to 6 months of age and continued breastfeeding, together with appropriate and nutritious food, up to 2 years of age;
- Fortification of foods;
- Micronutrient supplementation; and
- Treatment of severe malnutrition.
Nutrition-Sensitive Approaches:
- Agriculture: Making nutritious food more accessible to everyone, and supporting small farms as a source of income for women and families;
- Clean Water and Sanitation: Improving access to reduce infection and disease;
- Education and Employment: Making sure children have the energy that they need to learn and earn sufficient income as adults;
- Health Care: Improving access to services to ensure that women and children stay healthy;
- Support for Resilience: Establishing a stronger, healthier population and sustained prosperity to better endure emergencies and conflicts; and
- Women’s Empowerment: At the core of all efforts, women are empowered to be leaders in their families and communities, leading the way to a healthier and stronger world.
1000 Days Movement in Indonesia
For many development countries including Indonesia, this movement is one part of MDGs (Millennium Development Goals). There are 8 goals of MDGs that have to be achieved by 2015 which are:
- Eradication of extreme poverty & starvation
- Achieving universal primary education
- Promotion of gender equality & empowerment of women
- Reducing child mortality
- Improvement of maternal health
- Combating HIV/Aids, Malaria & other infectious diseases
- Ensuring sustainable environment
- Developing a global partnership for development
Indonesia has joined SUN Movement since December 2011 & become one of 50 countries that has joined this program so far. In 2012, the Government of Republic Indonesia has also established The Guidelines for First 1000 Days of Life National Movement (Pedoman Perencanaan Program Gerakan Nasional Sadar Gizi Dalam Rangka 1000 Hari Pertama Kehidupan).
There are 2 types of activities in 1000 days movement: specific & sensitive intervention. The details of specific interventions in Indonesia are as follows:
– For Pregnant mother:
- Iron supplementation
- Additional food for chronic energy deficiency
- Deworming for pregnant mothers
- Insecticides mosquito net for positive malaria pregnant mother
– For 0-6 months:
1. Breastfeeding promotion (individual & group counseling)
– For 7-23 months:
1. Breastfeeding promotion
2. Communication, Information & education for improving MPASI
3. Zinc Supplementation
4. Zinc for diarrhea management
5. Deworming
6. Iron fortification
7. Insecticides mosquito net for malaria
While sensitive interventions in Indonesia are as follows:
1. Provide clean water & sanitation
2. Food & nutrition security
3. Family planning (KB)
4. Public health insurance
5. Basic delivery insurance
6. Food fortification
7. Community nutrition education
8. Intervention for teenage girls
9. Poverty eradication
In Indonesia, the indicator for successfulness of this program by the end of 2025 will be as follows:
- Reducing 40% proportion of stunting children under 5 years old
- Reducing proportion of wasting children under 5 years old until less than 5%
- Reducing 30% proportion of low birth weight infant
- No increase in overweight children
- Reducing 50% proportion of IDA (Iron Deficiency Anemia) in productive mother
- Increasing minimum 50% percentage of mother that give 6 months exclusive breastmilk
REFERENCES:
http://scalingupnutrition.org/
http://www.antaranews.com/en/news/88036/indonesia-racing-against-time-to-achieve-mdgs
Republik Indonesia. 2012. Pedoman Perencanaan Program Gerakan Nasional Sadar Gizi Dalam Rangka 1000 Hari Pertama Kehidupan.