5W 1H Stunting

Andri Kurnia Wahyudhi

What is stunting?
• Anak balita dengan nilai z-scorenya kurang dari
2SD/standar deviasi (stunted) dan kurang dari 3SD
(severely stunted ) Kemenkes, 2018

• Stunting is measured by a height-for-age z-score of

more than 2 standard deviations below the World
Health Organization (WHO) Child Growth Standards
median, showing a restriction of a child’s potential
growth (WHO 2018)
WHO, 2018
What is stunting?

Nilai normal

Batas stunted/wasted

Shrimpton, 2001
What is stunting?
Nilai normal

Batas stunted/wasted

Victoria, 2010
Who is stunting?

Underweight

Severely
Underweight
Who is stunting?

Stunted

Severely Stunted
Who is stunting?

Wasted

Severely wasted
Who is stunting?
STUNTING = NUTRITIONAL STUNTED

Nutritional stunted is caused

- insufficient maternal nutrition
- intrauterine undernutrition
- lack of breastfeeding until 6 months of age
- later introduction of complementary feeding
- Inadequate (quantity and quality) complementary feeding
- Impaired absorption of nutrients owing to infectious diseases
Who is stunting?
When is stunting happened?
“Stunting begins in utero and continues for at least
the first 2years of postnatal life; the period from
conception to a child’s second birthday (the first
thousand days) has therefore been identified as the
most critical window of opportunity for
interventions”
Where is stunting?

Victoria, 2010
Where is stunting?
Why and How stunting is being a problem?
Why and How stunting is being a problem?

Pendergast and
Humprey, 2014
How to overcome stunting ?
Antenatal
- 20% stunting terjadi intrauterin
- Perbaikan status gizi ibu hamil dan menyusui (500
hari pertama)
- Suplementasi besi ibu hamil (mengurangi 20%
BBLR)
- Suplementasi kalsium dan mikronutrien ibu hamil
How to overcome stunting ?
0-6 bulan
- 20% stunting terjadi pada 6 bulan pertama
- 6 bulan pertama pertumbuhan paling cepat dan
berhubungan dengan perkembangan otak
- ASI eksklusif mencegah morbiditas dan mortalitas
serta memperbaiki fungsi kognitif
How to overcome stunting ?
6-24 bulan
- Growth faltering mulai terjadi usia 3 bulan menurun
cepat hingga 12 bulan dan menurun lambat sampai
18 hingga 19 bulan dan catch up setelahnya
- Pemberian makanan pendamping ASI yang baik,
memperbaiki 1/3 defisit panjang badan
- Pencegahan diare dan pneumonia
- Pencegahan environmental enteric dysfunction
- Pencegahan infeksi parasit (cacing dan malaria)
How to overcome stunting ?
• In Brazil, for example, stunting declined from 37%
in 1974–5 to 7% in 2006–7 following economic
growth and reduced disparity, increased
urbanisation, improved female education,
decreased fertility rates, improved WASH and
health service reform
TERIMA KASIH
How succesfull stunting was
overcomed?
Diatas 24 bulan
- Kegagalan pertumbuhan linear terjadi mulai
antenatal hingga 24 bulan dan sedikit kemungkinan
pulih setelahnya