“Warung Anak Sehat” project

The “Warung Anak Sehat” project is a project, which is set up to fight against malnutrition in children. The project creates a network of female entrepreneurs who will manage healthy food kiosks inside schools. The women will do this by serving a pre-planned menu of nutritious street food. How? The provision of micro-credits will support the women in doing this great job of running these kiosks. Furthermore, they will also benefit from training programs in nutrition. This will create a synergistic environment for their operations!

The goal of the project is to contributes to reducing child malnutrition with the facilitation of access to affordable healthy food. Thus, thereby improving quality of life of children trough improving their health and nutrition status. But moreover, it will also provide even more benefits: the project creates job and empowers women. Furthermore, through the training programs the  nutrition knowledge of the mothers will grow. Want to know more about this great initiative? Please watch the video below!

Written by Jessica


Ecosysteme.danone.com [internet]. Warung Anak Sehat (Phase 3). Indonesia. Retrieved 12 December. Retrieved from: http://ecosysteme.danone.com/project/warung-anak-sehat-healthy-children-kiosk/

Reaching Rural Areas


The double burden of malnutrition is a big problem in urban areas of Indonesia. As discussed in a previous post “Intervention Innovations in Indonesia” many cases occur in middle-income families in urban areas. Researchers recognize that easy access to food with a low-nutrient and high calorie content is widely available in these cities. However, it turns out that this is not just an issue in urban areas.

A study of rural Bangladesh and Indonesia yielded some interesting insights into the spread of double burden of malnutrition outside of urban centers.

According to the study, coexistence of overweight women and stunted children in a household (how they define double burden of malnutrition in this study) is persistent in rural areas of Indonesia1. This is a significant proportion of the country’s population, about 46%, and should not be ignored3.

Here are some of the risk factors associated with double burden of malnutrition in Indonesia1:

  • Maternal short stature
  • Low levels of maternal education
  • Older age of the child
  • Not breast-feeding the child
  • Belonging to a wealthier quintile
  • The child being female (families will often expend more effort to care for and feed male children)

These risk factors are very similar to risk factors in urban areas. Researchers feel this issue may be spreading to rural areas as well due to increased access to energy dense foods, as well as mechanization of agricultural practices leading to a more sedentary lifestyle for rural farmers1.

Unfortunately, double burden efforts have done little to focus on the issue in rural areas, what can be done?

Looking at research for malnutrition interventions in other areas may yield the desired results. A study of intervention methods in rural Iran showed some promising results.

In their study, they had a multi-faceted approach and addressed a wide range of issues. The following examples of actions taken in this study may be applicable to rural Indonesian populations2:

  • educating mothers about: breastfeeding, complementary feeding, child feeding in diarrhea and other diseases, balancing and diversifying diet and food groups, preparing safe drinking water, creating a healthy home environment and family planning
  • reinforcing the growth monitoring programme and sensitizing mothers to children’s growth cards
  • strengthening literacy programmes for women
  • increasing access to foods through establishment of rural cooperative stores
  • promoting home gardening

While Indonesia has made strides in decreasing malnutrition in their cities, they cannot leave out their large rural population. The emphasis on maternal education remains the same as the study mentioned in “Intervention Innovations in Indonesia”, though the emphasis on gardening and cooperatives may be particularly impactful in rural areas. Additionally, an emphasis on proper sanitation measures, such as preparing clean water and appropriate waste disposal would be useful in both urban and rural settings.

The following video shows an intervention in a neighboring country facing similar issues, it focuses on the promotion of home gardening and children’s education as a means of helping to eradicate malnutrition.

Addressing Malnutrition through School Intervention

Written by: Devon Boullion


1Oddo, V. M., Rah, J. H., Setnba, R. D., Kai, S., Akhter, N., Sari, M., & … Kraemer, K. (2012). Predictors of maternal and child double burden of malnutrition in rural Indonesia and Bangladesh. American Journal Of Clinical Nutrition, 95(4), 951-958. doi:10.3945/ajcn.111.026070

2Sheikholeslam, R., Kimiagar, M., Siasi, F., Abdollahi, Z., Jazayeri, A., Keyghobadi, K., & … Hormozdyari, H. (2004). Multidisciplinary intervention for reducing malnutrition among children in the Islamic Republic of Iran. Eastern Mediterranean Health Journal, 10(6), 844-852.


Malnourishment: Is It Only Affecting Indonesia?

obese%20womanMalnutrition can affect all areas of health and be detrimental to daily activities. The insidious nature of malnourishment is that eating either too much or too little causes this issue. How can you make sure you’re eating properly?
Though undernourishment predominantly occurs in low and middle-income countries (LMIC), this pervasive health issue burdens high-income countries as well. Overnutrition in the United States affects about 55% of the population and 85% of Americans lack essential vitamins; this is not just an issue in Indonesia1, 2.

Interventions for malnutrition-related issues in Indonesia involve financial support for affected families as well as nutritional education. While you may not have severe financial constraints affecting your nutrition, making healthy choices is difficult when you are surrounded by delicious, cheap food that lacks nutritional value.

So, what are some good ways to prevent malnutrition3?

  1. When making dietary choices, focus on the variety, nutritional value and amount of food chosen.
  2. Make sure to fill your plate with vegetables, fruits, grains and proteins. Additionally, while oils are not technically a food group, health oils should be consumed in moderation.
  3. Choose options lower in saturated fat, sodium and added sugars.
  4. Make sure to read nutrition labels on all prepackaged products. Often times, making recipes from scratch is the easiest way to eat healthy!

You can check out the United States public health initiative, Choose My Plate, in order to build your own nutritious meal plan and learn more about healthy lifestyle choices; there is even a section about eating healthy on a budget! Make an eating plan that is both healthy and nutritious at:


The only potential issue with the website is the recommendation of dairy as a necessity, you can have a healthy lifestyle without the consumption of dairy products, just make sure to get your calcium, vitamin D and potassium elsewhere.

Empower yourself to make the eating choices that are best for your body!


Written by: Devon Boullion


1Chopra, M., Galbraith, S., & Darnton-Hill, I. (2002). A global response to a global problem: the epidemic of overnutrition. Bulletin Of The World Health Organization, 80(12), 952-958.

2Guardian New and Media Limited, (2015). Hidden hunger: America’s growing malnutrition epidemic. The Guardian. Retrieved from https://www.theguardian.com/lifeandstyle/2015/feb/10/nutrition-hunger-food-children-vitamins-us

3U.S. Department of Agriculture. ChooseMyPlate.gov Website. Washington, DC. Build a Healthy Eating Style. Retrieved from https://www.choosemyplate.gov/MyPlate

Intervention Innovation in Indonesia

Traditionally, interventions surrounding malnutrition have implemented an educational program and given participants a grocery stipend. This appears to be a good approach until you really look into the portion of the population most affected by the double burden of malnutrition in Indonesia.

Can you guess which socioeconomic group is most at risk?

  1. lowest
  2. middle
  3. highest


Did you make your guess?

If you guessed b.middle, you are correct!

This seems counter-intuitive, wouldn’t those who earned the least be most likely to suffer from malnutrition?

This answer lies in how the double burden of disease is defined. In this case, the double burden of malnutrition is defined as the association between the continued issues of malnutrition and simultaneous increase in obesity rates due to high availability of foods high in Calories and low in micronutrients. While those with moderate income have better food security than low-income groups, they may not have a good nutritional education. Those with moderate income can afford food but may not have the knowledge to make an educated nutritional choice for themselves and their children.

In order to increase efficacy of intervention programs, researchers wanted to implement social cognitive therapy (SCT) in Surabaya City, Indonesia. Essentially, they sought to use the reciprocal determinism along with the interaction between person, environment and behavior in order to help heighten self-efficacy in the mothers.

The new intervention strategy, NEO-MOM added motivational interviews from home visitors as well as hands on nutritional education sessions and role-play experiences from nutrition experts. The comparison group did not receive the interviews or nutrition education. The target behavior was to increase consumption of fruits and vegetables, as well as animal protein (to a lesser degree). Researchers primarily wanted to observe an increase in height of the children but also aimed to achieve a decrease in stunting for children and a decrease in obesity in the mothers.The research suggests that increasing self-efficacy via verbal motivation and bi-weekly goal setting is an effective addition to traditional intervention methods. Success (:!

Due to their high population density and particularly high prevalence of the double burden of malnutrition, urban areas like Surabaya City are ideal location for implementing a more costly program like NEO-MOM.

This motivational, educational method is more than just an intervention, it’s an innovation. They’re doing more than just providing information on how to eat right, they’re performing a service which is needed desperately around the globe… Empowering women to make the right choices for themselves and their children.


Written by: Devon Boullion


Mahmudiono, T., Nindya, T. S., Andrias, D. R., Megatsari, H., & Rosenkranz, R. R. (2016). The effectiveness of nutrition education for overweight/obese mothers with stunted children (NEO-MOM) in reducing the double burden of malnutrition in Indonesia: study protocol for a randomized controlled trial. BMC Public Health, 16486. doi:10.1186/s12889-016-3155-1