Strategic Review of Food Security and Nutrition in Indonesia 2019-2020 Update

Sirojuddin Arif, Widjajanti Isdijoso, Akhmad Ramadhan Fatah, Ana Rosidha Tamyis
Food & Nutrition, Gender, Governance & Decentralization, Health, Poverty & Inequality, Social Protection
Indonesia, Nusa Tenggara Timur, Jawa Timur
Research Report, August, 2020, Final

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EXECUTIVE SUMMARY

As Indonesia has been experiencing impressive economic advancement and emerging as an upper-middle income country, it has also recorded important progress in enhancing food security and nutrition. Access to food increased and undernutrition continued to decrease over the last few years. However, the nutritional status of Indonesians is still low by international standards, and the variation across regions remains huge. While struggling to address long-standing food security and nutrition challenges, Indonesia is currently facing an unprecedented crisis triggered by the COVID-19 pandemic. Thus, new and enhanced strategies are needed for the country to achieve the 2030 Agenda, especially Sustainable Development Goal 2 (SDG 2), which states that by 2030 the country will end hunger, achieve food security and improved nutrition and promote sustainable agriculture.

This report is an update of the 2014–2015 Strategic Review. It was initiated in August 2019 and was extended until July 2020 to cover the initial impact of the COVID-19 pandemic on food security and nutrition. It is based on the latest secondary data available, updates on relevant policies and programmes related to food security and nutrition, the latest discourses, and emerging issues, including the impact of the COVID-19 pandemic. This report presents: (1) an update on the food security and nutrition situation since the 2014–2015 Strategic Review, mostly referring to data from 2013 to the most recent available and covering the three dimensions of food security (availability, access and utilization), the trend in nutritional status, the effects of disasters and climate change on food security and nutrition, and new challenges in nutrition; (2) an analysis of the latest development in policies and programmes that are aiming at improving the food security and nutritional status, both at national and sub-national levels; (3) the potential impact of the COVID-19 pandemic on food security and nutrition (through July 2020); and (4) conclusions and recommendations on measures to improve food security and nutrition in the country.

The situation analysis shows that Indonesia has made important progress in further improving food security and nutrition. Nevertheless, some challenges remain. First, the increases in the production of most food commodities, especially rice, have not caught up with the increase in consumption. The persistent dependency on rice imports could threaten food security during the COVID-19-induced crisis. Second, although insufficient food consumption is declining, in 2018, around 21 million people in Indonesia still had calorie intake below the minimum dietary requirement. Poverty and high food prices in relation to income remain major challenges in the effort to increase access to food. Third, the food consumption pattern of most Indonesians is still less than ideal, with carbohydrates continuing to dominate the food intake; insufficient consumption of sources of protein, fruits and vegetables; and the increasing trend in processed food consumption in both urban and rural areas. Fourth, even though the prevalence of stunting (low height for age), underweight and wasting (low weight for height) among children under 5 declined since 2013, the level of undernutrition is still high by international standards. In addition, the prevalence of overweight and obesity has steadily increased among children 6 to 12 years old, adolescents and adults. Evidence also suggests that micronutrient deficiencies prevail although representative data has not been collected for years. Indonesia is thus facing a triple burden of malnutrition in which undernutrition co-exists with overnutrition and micronutrient deficiencies. The current crisis caused by the COVID-19 pandemic and social distancing measures could erode the progress that has been achieved.

The policy analysis highlights significant progress as well as some policy gaps. Indonesia is still facing big challenges in increasing and diversifying food production that can support nutritional improvement toward more balanced diets. The focus on increasing rice production has not been able to meet the government ambition to significantly reduce import dependency, and it comes at the expense of less than sufficient effort to increase the production of fruit and vegetables, as well as sources of plant and animal protein, with the exception of fish. Thus, the Indonesian Government need not only increase productivity of food commodities, but also give more support to the production of a more diversified range of food commodities. In addition, there is also a need to further acknowledge women’s role in agriculture, and to provide support to women farmers to have full access to opportunities in this sector.

Regarding access to food, there has been significant progress in the development of social protection schemes as a vehicle to ensuring sufficient access to food for poor and vulnerable people. This is important as the price of various food commodities, particularly rice, in Indonesia is still relatively high. Furthermore, there have been commendable initiatives undertaken by the Government to make social protection schemes—particularly SEMBAKO and Program Keluarga Harapan (PKH)—more nutrition-sensitive. There are some implementation constraints that still need attention, particularly in improving the quality of the social welfare beneficiary database for better targeting, and further enhancement of the nutritional sensitivity of both regular social protection and social assistance provided during disaster or crises situations.

Indonesia is still facing challenges in various aspects of food utilization. Regarding food safety, there is a need to update the existing regulations, increase the capacity of the oversight organization and better educate the public. For the promotion of a balanced diet, the formulation of desirable dietary scores needs to be adjusted in order to target a lower proportion of carbohydrate intake, and higher proportion of fruit and vegetables in line with the latest Ministry of Health guidance on a balanced diet. With regard to further nutritional improvements, despite significant efforts to improve both nutrition-sensitive and nutrition-specific interventions, the effectiveness of these efforts needs to be enhanced by increasing awareness and knowledge of all stakeholders at all levels of the Government, and making the effort more holistic and integrated. In addition, it is also important to increase more attention to data availability on micronutrient deficiencies to have a basis for tackling all aspects of the triple burden of malnutrition, for example through food fortification.

Regarding institutional arrangements, the latest approach of assigning the leadership on improving nutrition under the Vice President is intended to strengthen coordination efforts, particularly related to stunting. However, the effort to link the production, access and utilization sides of food security with nutrition improvement efforts requires further attention. The fact that various related authorities in food security and nutrition-sensitive services are in the hands of district governments requires concerted efforts to translate central-level policies into effective local-level action. In this regard, the latest government approach to implement regional targeting and focus on an integrated approach to targeted districts and villages could potentially produce more effective results.

In 2020, the challenge of addressing food insecurity and malnutrition further increased due to the outbreak of COVID-19. The Central Bureau of Statistics revealed that as the Indonesian economy contracted by 2.4 percent (q-to-q) in the first quarter of 2020, around 1.6 million more people have fallen into poverty between September 2019 and March 2020 (BPS, 2020d, 2020e). The Government has responded swiftly with a scaling up of social protection programmes, but challenges with the social protection database remain, including the risk of missing many of the most vulnerable, including women-headed households and people with disabilities. As COVID-19 has also affected the implementation of government policies and programmes on health and nutrition, urgent measures are needed to ensure that these services continue.

Based on this analysis, some recommendations are made to decision-makers to deal with the impacts of COVID-19 on food security and nutrition. Addressing the effects of COVID-19 requires the Government to take a rather short-term perspective to prevent the pandemic from eliminating the progress made so far and ensuring that the country can continue its path to achieving SDG 2 by 2030. The recommendations are as follows.

  1. Food availability: The Government needs to closely monitor the rice stocks and pursue a flexible trade policy making timely import adjustments when necessary. They also should maintain farmers’ incentives to uphold food production by ensuring input supplies, concessions for loan repayment and links to the market. Improvements in the transportation and overall supply chain system are also required to ensure that food commodities remain available and prices do not rise.
  2. Food access: The Government needs to continue to ensure that all poor and vulnerable households receive social protection to cushion the impacts of COVID-19. Efforts to expand social assistance may need to involve sub-national governments and non-profit or community-based organizations.
  3. Food utilization: The Government needs to ensure that children and pregnant and lactating mothers can have access to basic health services again, especially in those village health posts (Posyandus) and community health centres (Puskesmas) that were closed in the last few months due to COVID-19—without compromising the safety of health workers or patients.
  4. Nutrition: To prevent an increase in wasting and stunting during the COVID-19 crisis, the Government needs to expand the provision of supplementary foods (e.g. fortified biscuits) to help children and pregnant and lactating mothers from vulnerable groups to meet their nutrition requirements.

Actions are required on many dimensions of food security and nutrition to address long-standing shortcomings in these policy domains as well as new challenges, especially the rise of the triple burden of malnutrition. It is very important for the Government to stay on track and ensure that SDG 2 can be achieved by 2030 with no one being left behind. Therefore, this review makes the following recommendations:

  1. Broaden the policy focus beyond stunting to address the triple burden of malnutrition. The Government should broaden its policy focus not only on stunting but also on other dimensions of malnutrition, especially wasting, obesity, overweight and micronutrient deficiencies. With regard to micronutrient deficiencies, a representative survey is required on the results of which respective supplementation and fortification plans can be based.
  2. Promote a balanced diet through social and behavioural change communication with the population. To promote a balanced diet, not only does the Government need to improve its mass communication strategies but they also need to further support the population to put the messages of such a campaign into practice. For example, a diversified diet needs to be affordable by all sectors of society, either directly or through social protection measures.
  3. Improve access to diversified food through the development of diversified, resilient and nutrition-sensitive food systems. It is also important for the Government to ensure the availability and accessibility of diversified food by developing a diversified agricultural system that is nutrition-sensitive and resilient to climatic shocks. Access to diversified food can also be improved by enhancing food affordability.
  4. Ensure social protection programmes are targeting those most in need, so that no one is left behind. Overall funding for social protection programmes is limited, so the Government needs to ensure that inclusion and exclusion errors are prevented as much as possible; they also need to be made more gender- and disability-responsive, nutrition-sensitive and adaptive to shocks.
  5. Ensure proper utilization of food. Only healthy bodies can appropriately utilize a diversified diet, so it remains fundamental that access to clean water and decent sanitation (including toilet facilities) be expanded, especially for poor and vulnerable groups. The coverage of health services, especially for children and pregnant and lactating mothers, is also to be ensured.
  6. Address gender inequality to improve food security and nutrition. The Government needs to address the various problems that contribute to maintaining or exacerbating gender inequality and support women’s access to information on nutrition and diversified diets, means of agricultural production and marketing, health services, social protection and access to education and economic opportunities in general.
  7. Strengthen the monitoring and evaluation system to enhance policies and programmes on food security and nutrition. Rigorous government monitoring and evaluation should be conducted, and a proper mechanism be put in place to ensure that the results of the monitoring and evaluation will loop back to policy or programme enhancement.
  8. Strengthen the governance of food security and nutrition or rather food systems as a whole through the development of an effective coordinating agency. The governance of food systems could be enhanced by strengthening policy coordination under the Vice President’s Office as an expansion of the efforts to accelerate the reduction of stunting (Stranas Stunting). Indeed, it remains highly relevant that the Government develop an effective institution to govern and coordinate the work of different stakeholders in the areas of food security and nutrition as parts of one food system.

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