Volume VIII/No.14/November 2009

RCCN

News

SEAMEO - TROPMED Regional Center for Community Nutrition - UI Inside this issue: RCCN’s Commitment on Nutrition 1 Capacity Building in the Eastern Part of Indonesia Regional Course on Nutritional 2 Assessment Celebrating the World 3 Breastfeeding Week in August 2009: Building in the Eastern Part DIKTI Awards FKGK Updates NATIONAL BATIK DAY Family Gathering of SEAMEO TROPMED RCCN UI 2009 Master Program and Doctorate Progress Profile Endang Laksminingsih Achadi , MD, MPH, Dr.PH Alumni’s CORNER Accomplished and ongoing research Our Research Update Food-based approach using tempe for optimizing iron status of pregnant women Research Dissemination Publications Snap Shots Scientific-duty Tours SEAMEO Centre Director Meeting and Governing Board Meeting On Mission

3 4 4 4 5 6

6 7 8

9 10 11 13 14 15

Advisor Siti Muslimatun Editors Judhiastuty Februhartanty Gustina Lay Out Achmad T. Djayanto

RCCN’s Commitment on Nutrition Capacity Building in the Eastern Part of Indonesia

A

series of seminar on nutrition and food safety were being conducted in five different provinces around Indonesia this year. Various themes were highlighted during the seminars. The first seminar was conducted on August 3-4, 2009 in Ende, East Nusa Tenggara, in collaboration with the Ende Health District Office. It was officially opened by the vice chief of Ende District. The seminar was attended by 50 participants, from District Health Office, District Agriculture Office, District Planning Office, and from 5 puskesmas where the field study of our Master students was conducted in 2008. RCCN, represented by Drupadi H.S Dillon, PhD, presented topic on nutrition problem in Indonesia. The results of the field study of our Master students in 2008 were exposed and discussed in the following day workshop to discuss feasible alternatives to solve nutrition problem in Ende. Optimalization of local potency for improving mother and child nutrition was the theme of the second seminar. It was conducted in September 29-30, 2009 in Lombok West Nusa Tenggara, in collaboration with Mataram Health Polytechnic and Persagi. The seminar was attended by 120 participants. The representative from Persagi opened the session and presented the result of Basic Health Research 2007, and followed by Khaerul Anwar, SKM from Health Office in Lombok Utara district who discussed the Food and Nutrition Action Plan 2009-2013 of West Nusa Tenggara Province. Two RCCN staffs (DR. Umi Fahmida and Otte Santika, MSc) updated participants on dietary assessment topic by delivering lecture and coaching dietary intake data analysis using Nutrisuvey for Windows program.

SEAMEO-TROPMED RCCN-UI PO Box 3852 Jakarta 10038 INDONESIA Phone: +62-21-31930205; 3914017 Fax: +62-21-3913933 E-mail: [email protected] Website : http://www.seameo-rccn.org

The third seminar picked a theme on probiotics for promoting health and held in Makassar in collaboration with Hasanuddin University on October 7-8, 2009. In the morning session, 3 probiotic experts shared their knowledge to 125 participants who attended the seminar. Ingrid S. Surono, PhD, one of the probiotic experts from our Center, delivered lecture on ‗Probiotic for Healthy Gut Function‘. The Dean of Agriculture Faculty of Riau University, Prof. DR. Usman Pato brought up his research result on the potency of probiotic in lowering blood cholesterol and followed by DR.dr. Anang Endaryanto from Airlangga University who shared ‗The Role of Probiotic on Allergy Management‘.

Visiting Address SEAMEO-RCCN Building Jl. Salemba Raya No 6 Jakarta 10430

This November, other seminars are to be conducted in North Sulawesi and Gorontalo, in collaboration with the local health polytechnic and health office.

Contact Address

EXCELLENCE IN NUTRITION FOR QUALITY HUMAN RESOURCES

Regional Course on Nutritional Assessment

T

his year, aside from being attended by master and doctorate participants, course of ―Nutritional Assessment‖ was designed in the form of Regional Course that may involve nutritionists and health professionals from the South East Asian region. The course becomes the third regional course conducted by the Center in 2009. It was conducted for 2 weeks, and was officially opened on August 31 by Endang L. Achadi, MD, MPH, Dr.PH as the Center‘s Chief Operating Officer. Nutritional Assessment – defined as the interpretation from dietary, laboratory, anthropometric and clinical studies — is very important to identify public health nutrition problems (the risk of both nutrient deficits and excesses) and to monitor and evaluate the effects of nutrition interventions. Nutritional assessment is also an essential component of the nutritional care of the hospitalized patients. This regional course of Nutritional Assessment is designed to give nutritionist and health professionals an understanding of, and skills in, the use of nutritional assessment in community as well as in individuals. The course covers basic principles in nutritional assessment, dietary assessment, biochemical and clinical assessment and anthropometric

Page 2

assessment. In each components participants will gain skill in collecting the data with appropriate quality control measure; analyzing the data using most recommended standards and softwares) and making interpretation of the data at individual and community levels. The course (2 weeks 2 credit points) has been an active medium for sharing and learning experiences among nutritionists and health professionals from different countries with different background (public health, clinical/community nutritionists, program implementer and policy maker). The course was facilitated by prominent resource person from Department of Human Nutrition, Otago University, Dunedin, New Zealand: Prof. Rosalind S. Gibson, and by RCCN‘s staff DR. Umi Fahmida, MSc and Drupadi Dillon, MD, PhD. There were 28 active participants attended the Regional Course which came from some cities in Indonesia, Myanmar, Vietnam, Lao, Malaysia, and Srilanka. Additionally, there were 15 participants consist of 1 (one) Thai, 1 (one) Myanmerese, and 13 (thirteen) Indonesians, joint in the ―2-day seminar‖ as a part of the course.

Celebrating the World Breastfeeding Week in August 2009: Breastfeeding - A Vital Emergency Response

S

EAMEO-TROPMED RCCN UI, Indonesian Breastfeeding Center/ SELASI, Indonesian Breastfeeding Mothers Association/AIMI, and IBCLC Indonesia as institutions with highest concern on breastfeeding promotion in Indonesia collaborated to take part in the celebration of 2009 World Breastfeeding Week by welcoming one of the international breastfeeding experts, Jack Newman MD, FRCPC. The Canadian expert shared his experience in dealing with breastfeeding in developed and developing countries. His presence were most valued in helping local ‖lactivists‖ (lactation activist) and health workers to collaborate in joint plan of actions for breastfeeding promotion.

I

n order to support and increase the spirit of the young Indonesian researcher which has productively made an invention through their research, the Directorate of Higher Education Ministry of National Education provides some funding incentives to the researchers who have successfully disseminated their research in the

Aside from Jack Newman, MD, FRCPC, the Breastfeeding Expert Seminar and Workshop conducted on 7 August 2009 at Hotel Bumikarsa, Bidakara, Jakarta also presented Dr. Utami Roesli, SpA, IBCLC, FABM (Indonesian Breastfeeding Center) and Dr. Ir. Judhiastuty Februhartanty, MSc (SEAMEO-TROPMED RCCN UI) to talk about issues on breastfeeding practices during emergencies and research on breastfeeding in Indonesia respectively. As many as 75 people participated representing governmental agencies, international NGOs, local breastfeeding NGOs, health professional associations, academics, and hospital representatives. The seminar achieved accreditations from the

Indonesian Doctors Association with different credit value for participants, speakers, moderators and organizing committee as well as from IBLCE Australia, Asia Pacific and Africa . A small workshop following the seminar discussed two topics i.e. challenges encountered by working breastfeeding mothers and lack of breastfeeding support from health workers and health facilities. The workshop concludes on confirming the need to establish joint efforts with various stakeholders in obtaining necessary supports for breastfeeding mothers from the working place and health providers.

DIKTI Awards scientific international journal during the last three years. Three RCCN staffs received the incentive through their scientific publication: Ingrid Surono, PhD (Effect of glucose and incubation temperature on metabolically active Lactobacillus plantarum from dadih in removing microcystin-LR); DR. Umi Fahmida (Zinc-iron, but not zinc alone Page 3

supplementation, increased linear growth of stunted infants with low hemoglobin) and Otte Santika, MSc (Development of food-based complementary feeding recommendations for 9- to 11-monthold peri-urban Indonesian infants using linear programming)

FKGK Updates

O

n 31 July 2009, the FKGKers met, shared and discussed about Posyandu (Pos Pelayanan Terpadu or integrated health post in English) which has long been acting as the frontliner in most of nutrition and health activities at the village level in Indonesia. Understanding the vital roles of Posyandu and its continuous challenges as a community-based stand, FKGKers have come to realize the urgent need for spelling out the revitalization of the Posyandu as mandated by the Ministry of Internal Affairs in year 2001. Annas Buanasita (Akademi Gizi, Surabaya) shared some lessons learned

regarding Posyandu cadres‘ capacity building in the urban of Surabaya, whilst M. Taufan (Plan International Indonesia, Aceh) addressed the experience of advocating 2 local laws (Peraturan Daerah) regarding Posyandu revitalization in some parts of Nanggroe Aceh Darussalam. As the follow up of the presentation, the meeting participants have decided to discuss further on issues related to cadre‘s capacity building, the sustainability of the Posyandu, and the role of public community to the success of Posyandu

FKGK (Forum Komunikasi Gizi dan Kesehatan or nutrition and health communication forum in English) is a forum among Indonesian professionals to share and discuss about nutrition and health for the Indonesian people. The forum was informally established in 2004 following a workshop on ―practical communication in nutrition and health field‖ in 2002. Currently the forum is coordinated under Consultancy and Community Service unit of SEAMEO - TROPMED RCCN UI and has its own mailing list at [email protected] since January 2008. We invite anybody interested in the nutrition/health issues to join us and let‘s make a difference.

NATIONAL BATIK DAY

U

NESCO‘s list describes Indonesian Batik as: The techniques, symbolism and culture surrounding hand-dyed cotton and silk garments known as Indonesian Batik permeate the lives of Indonesians from beginning to end: infants are carried in batik slings decorated with symbols designed to bring the child luck, and the dead are shrouded in funerary batik.

SEAMEO TROPMED RCCN are on batik on October 2, 2009 to celebrate UNESCO‘s decision to include batik in the list of "Intangible Cultural Heritage of Humanity" items.

Family Gathering of SEAMEO TROPMED RCCN UI 2009

A

ll crew of SEAMEO TROPMED RCCN spent their time in the Taman Safari Indonesia Hotel Bogor on 24-25 October 2009 for the third Family Gathering of SEAMEO TROPMED RCCN. Games, door prize and trip to Taman Safari Indonesia were among the wonderful moment shared between staffs and their families.

Page 4

Master Program Progress

Graduation and Welcoming Ceremony of Paricipants of Master in Community Nutrition and Doctorate in Nutrition Program on August 7, 2009

Short Course BIOSTATISTIC 1

Short Course Agenda (November 2009 – March 2010) Public Health and Community Nutrition System Analysis HNPPM 1: Project/ Program Planning HNPPM 2: Management Issues for Health/Nutrition Projects and Program Introduction to Nutritional Anthropology Food Economics and Food Security Food Safety Health Promotion in Nutrition Programs Food and Micronutrient Interventions Nutrition in Food Industry

09–23 November 2009 23–30 November 2009 30 November–14 December 2009 04–18 January 2010 18 January – 01 February 2010 01–15 February 2010 15 February – 01 March 2010 01–15 March 2010 15–22 March2010

Doctorate Progress

O

ur doctorate participants - Dra. Risatianti Kolopaking, Psi, MSi, Dwi Nastiti Iswarawanti, SP, MSc, and Min Kyaw Htet, MD, MSc, also Airin Roshita, STP, MSc (who is taking her doctorate training at Queensland University, Australia) – were glad and excited to be able to take part in the 19th ICN in Bangkok. Aside from gaining credits for being presenters (as part of their study assignments), they absorbed new insights and inspiration for their own research work as well as expanded their networks. The following are their posters presented during the event:

Contributing Authors

Title

Poster Section

DN Iswarawanti, Letiza Sampetoding, et al.

Health workers‘ knowledge and perception on supports and barriers towards food safety implementation

Food Safety/Food Borne Diseases

Risatianti Kolopaking, Umi Fahmida, et al.

A content analysis of dietary and physical activity guidelines for elementary school children: A study in an urban area of Jakarta

School Nutrition

Airin Roshita, Megan Jennaway, et al.

Working mothers and child food intake: The importance of maternal engagement in determining the quality and availability of child food intake among urban Indonesian household

Infant and Young Child and Nutrition

Page 5

Profile

Endang Laksminingsih Achadi , MD, MPH, Dr.PH

Health, Reproductive Health, Maternal and Child Health Program, Indonesia Health System and Policy. She hold some strategic functions and positions, such as the Country Technical Partner Leader for Immpact /Ipact (Initiative for Maternal Mortality Program Assessment)/(Initiative for Program Assessment and Capacity Training); Coordinator for Positive Deviance Resource Center (PDRC), Faculty of Public Health, University of Indonesia ; Country Director for Mother Care/Indonesia Project and as a Vice Chairman, Danone Nutrition Institute Indonesia (DII).

E

ndang Laksminingsih Achadi, the Chief Operating Officer of SEAMEO TROPMED RCCN UI, was born in Sumenep on November 17, 1951. In addition to her activities in the Center, she also actively dedicates her day as a lecturer in Public Health Nutrition Department, Faculty of Public Health, University of Indonesia. She has specialization fields in Maternal and Child Nutrition, Maternal & Neonatal

Alumni’s CORNER

Her study for Master and Doctorate degree at the Johns Hopkins University, School of Hygiene and Public Health, Baltimore, USA has given a lot of influences on her expertise. During her study at the Johns Hopkins School, she also took the Graduate Courses in Nutrition at the Cornell University, Ithaca, New York, USA, as a student exchange program between The Johns Hopkins University and Cornell University.

Dina R. Pangestuti

Contributing Authors

Paulus Daniel S.

She is also a part of a technical team member to develop RPJMN (Rencana Pembangunan Jangka Menengah Nasional – National Mid-term Development Plan) 2010-2014 on Health and Nutrition, led by BAPPENAS (State Ministry/National Planning and Development Board) and Ministry of Health.

Alumni of Master Program batch 2006/2008 attended the 19th ICN in Bangkok

D

Widya Rahmawati

She got Satyalencana Karya Satya XX, an award from the President of Indonesia in 2007 for her long dedication to the nutrition field. When she was appointed as the Chairman of Nutrition Department, Faculty of Public Health, University of Indonesia for two periods, the Department has launched Undergraduate Degree in Nutrition in addition to Undergraduate Degree in Public Health; established Public Health Field Laboratory (the first and the only one within the Faculty of Public Health) in Depok; Center of Public Health Nutrition/PKGK (for Research, Technical Assistances and Training), and Positive Deviance Resource Center/ PDRC in collaboration with SAVE the Children.

ina Rahayuning Pangestuti (currently affiliated with Faculty of Public Health, Diponegoro University, Central Java), Paulus Daniel Sahanggamu (self-employed base in Jakarta), and Widya Rahmawati (currently affiliated with Faculty of Medicine, Brawijaya University, East Java) who are the alumni of our Master Program batch 2006Title

2008 actively involved as poster presenters at the 19th ICN in Bangkok. Daniel and Widya presented studies related to the topics of their master thesis, whilst Dina - as a second author - presented a study she did with her colleagues at her current affiliation. The following are their posters presented during the event:

Poster Section

Paulus Daniel Sahanggamu, Drupadi Dillon, et al

Associations amongst nutritional status, salivary immunoglobulin A response to streptococcus mutans and primary dentition caries among Indonesian preschoolers

Human Microbiome and its Relevance to Human Health

Widya Rahmawati, Siti Muslimatun, et al

Iron status of pregnant women in two geo-climatic areas in Indonesia

Micronutrient Deficiencies and their Prevention II

Laksmi Widajanti, Dina Rahayuning Pangestuti, et al

Hazard analysis and critical control points of jenang kudus (Indonesian traditional food)

Food Safety/Food Borne Diseases I

Page 6

Accomplished and ongoing research Programmatic Research

Educational Research Ongoing (Master Program)

Accomplished 1. Effect of tempe and vitamin C rich fruit supplementation during pregnancy on iron status and pregnancy outcomes (Siti Muslimatun, PhD, Maria WijayaErhardt, MSc, Nestle Foundation). November 2007 – July 2008 2. Food poverty and food insecurity in Sumba Island, East Nusa Tenggara Province (Rosnani V. Pangaribuan, Dr.rer.nat, Tina Rosalina, MSc, Neys-van Hoogstraten Foundation). March – November 2008 3. Livelihood-based food security and nutrition assessment in East Nusa Tenggara Province (Siti Muslimatun, PhD, Luh Ade Ari Wiradnyani, MSc, UNICEF, FAO, WFP). November 2008 – May 2009 4. Baseline survey for community alert and capacity for health (coach) project in Nanggroe Aceh Darussalam province (Otte Santika, MSc, Lindawati Wibowo, MSc, World Vision Indonesia). 2 March – 30 June 2009

1.

2.

3.

4.

5.

6.

Ongoing 1. Health and nutrition baseline survey in Sikka district, East Nusa Tenggara Province (Otte Santika, MSc, Lindawati Wibowo, MSc, World Vision Indonesia). 20 May – 30 September 2009 2. Health and nutrition baseline survey in Merauke district, Papua Province (Otte Santika, MSc, Lindawati Wibowo, MSc, World Vision Indonesia). September – December 2009

Exploring acceptability, feasibility, affordability, sustainability and safety (AFASS) criteria in infant feeding of HIV positive mothers in Bandung, West Java (Dian Nurcahyati Basuki, SEAMEO-TROPMED RCCN UI, and SELASI). November 2009June 2010. Review on communication intervention of multiple micronutrient powder program in Central Lombok District, West Nusa Tenggara Province (Andi Erwin, SEAMEOTROPMED RCCN UI, and UNICEF). November 2009-June 2010. Household food security among male and female migrant workers in East Java (Dini Andrias, SEAMEO-TROPMED RCCN UI). November 2009-June 2010. Association of the IgG Endocab and anthropometric indices among of healthy children aged 1-6 years living in low socio-economic urban areas of East Jakarta (Tonny Sundjaya, SEAMEO-TROPMED RCCN UI, Department of Pediatric Intensive Care Unit, RSCM/FKUI). November 2009-June 2010. Evaluation on micronutrient sprinkles to reduce iron deficiency anemia among under five children in Central Lombok District, West Nusa Tenggara Province (Muharni, SEAMEO-TROPMED RCCN UI, and UNICEF). November 2009-June 2010. Complementary feeding recommendation (CFR) of 9-23 months old children using linear programming in East Lombok District, West Nusa Tenggara Province: Formulation of local nutrient dense complementary food recipe (Nur Handayani, SEAMEOTROPMED RCCN UI). November 2009June 2010.

Ongoing (Doctorate Program) 1.

2.

3.

Page 7

Calcium, probiotics, and acute diarrheal disease among Indonesian children aged 1-6 years in East Jakarta (Dr. Rina Agustina, MSc, SEAMEO-TROPMED RCCN UI, Wageningen University, TIFN). August 2004 – until now The effectiveness of school-based nutrition education on dietary intake: study among primary school children in low-to moderateincome urban area of Jakarta (Dra. Risatianti Kolopaking, Psi, MSi, SEAMEO-TROPMED RCCN UI, Danone Institute Indonesia). December 2008 - December 2009 Maternal employment and child‘s growth and development in changing socio-economic environment & culture (Airin Roshita, STP, MSc, SEAMEO-TROPMED RCCN UI, University of Queensland, Neys-van Hoogstraten Foundation). August 2008 – August 2011

Our Research Update Food-based approach using tempe for optimizing iron status of pregnant women (Siti Muslimatun, Maria Wijaya-Erhardt, Juergen Erhardt)

I

The study was conducted in two different geo-climatic areas to assess the characteristics of worm infection. About 30% of pregnant women suffered from helminthiasis at light intensity, where 19% of them were infected by 1 species and 11% were infected by 2 or 3 species of worm. Prevalence of hookworm infection was high (23.5%); which was significantly higher in wet-highland than that in wet-lowland areas (30% and 17.8%, respectively). Prevalence of T. trichiuria infection was significantly

mentary food and control groups. None of the differences shown in pregnancy outcomes is significant.

During the intervention, there 100 100 was no signifi100 intervention control intervention 80 cant difference in intervention control control 80 80 change of hemo60 60 60 globin concentra40 40 tion between the 40 20 groups (n inter20 20 vention group = 00 0 127; n control group = 125). The proportion of anemia depleted iron iron tissue iron iron anemia depleted iron iron tissue iron iron anemia depleted iron deficiency iron tissue iron deficiency iron pregnant women stores deficit stores deficiency deficit deficiency stores deficiency deficit deficiency with anemia and anemia anemia anemia low iron stores was not different Figure 1. Proportion of women with anemia and low iron stores between intervention and control groups both at baseline We conclude that increasing iron and and near term (Figure 1.). At near term, ascorbic acid from tempeh and vitamin plasma ferritin concentration and body C rich fruits did not improve the iron iron was significantly lower (suggests status of pregnant women in rural decreased iron stores) and plasma transIndonesia. It is possible; however, that ferring receptor concentration signifiour supplementary food could produce a cantly higher (reflects increased iron detectable increase in iron stores, requirements at tissue level) in both particularly among pregnant women groups. When data were analyzed sepawith iron deficiency. Geo-climatic areas rately for women with iron deficient and reflect differences in the helminthiasis replete, a significant smaller decrease profile, but not the iron status. plasma ferritin concentrations [1·85 The study was funded by µg/L (1∙55-2·2) vs. 1∙42 (1·16-1∙75), the Nestle Foundation. p=0·046] was noted in iron deficient women. By contrast, in iron replete women no differences in changes of iron status were seen between supplePage 8

near near near term term term

baseline baseline baseline

near near near term term term

baseline baseline baseline

near near near term term term

baseline baseline baseline

near near near term term term

baseline baseline baseline

near near near term term term

baseline baseline baseline

Pregnant women (n=252) at 12-20 weeks of gestation were recruited to receive 6 days/week supplementary foods until delivery. The women were instructed to consume daily on average 50 g tempeh, 15 g dried anchovy/red meat/chicken liver, 50 g guava/100 g papaya together with their lunch meal, 50 g tempeh for snack in the evening, and 50 g guava/orange with dinner meal; and tea or coffee was not drunk 2 hours within meal times to maximize iron absorption. The nutrient composition in the food per day was: iron 3·97 mg, vitamin C 173 mg, and protein 23 g. Six local recipes of tempe cooked with different seasoning ingredients were presented in repeating sequence.

higher in wet-lowland area (11.9% and 0.8%, respectively). Worm infection influenced iron status, albeit weak.

(%) proportion(%) proportion (%) proportion

ncreasing consumption of iron-rich foods and improving bioavailability without increasing significantly the diet cost is long term sustainable intervention. For alleviating iron deficiency using food-based approach, the following factors are considered to be the most important:  increasing the iron intake especially of haem iron  increasing the intake of absorption enhancers for non haem iron such as vitamin C and meat proteins  decreasing the intake of inhibitors like phytic acid (e.g. in beans) or tannins (e.g. in tea)  reducing iron losses by intestinal parasites A study was conducted in wet lowland and wet highland areas to assess the effect of fermented soybean (tempe) and vitamin C rich fruit during pregnancy on maternal iron deficiency and pregnancy outcomes.

Research Dissemination Research topics presented by RCCN‘s staff during the 19th ICN in Bangkok No

Title

Authors

Section

Umi Fahmida, Otte Santika, et al.

Mathematical Modeling and Linear Programming

Umi Fahmida, Avita Usfar, et al.

Right to Adequate Food and Nutrition

ORAL PRESENTATION 1

The cost-to-nutritional benefits of alternative intervention strategies to improve the nutrient intakes of Indonesian children DISTINGUISHED POSTER

2

Household hunger measured by US-FSSM is inline with socioeconomic and health/nutritional situations in predominantly food insecure Indonesian community POSTER PRESENTATION

3

Strategic roles of fathers in optimizing breastfeeding practices: A study in an urban setting of Jakarta

Judhiastuty Februhartanty, Siti Muslimatun, et al.

Infant and Young Child Nutrition

4

Maternal supplementation with fermented soybean (tempe) and vitamin C rich fruit and inflammation status and weight gain in Indonesia

Maria Wijaya-Erhardt, Siti Muslimatun, et al.

Food-based Strategies/ Interventions for Optimal Nutrition

5

The influence of menarche on the iron status of Indonesian adolescent girls

Drupadi Dillon

Micronutrient Deficiencies and their Prevention

6

A new software developed for emergency nutrition assessment

Juergen Erhardt

Nutrition Monitoring and uation

7

South East Asian Nutrition Leadership Program (SEANLP): Building leadership in nutrition in South East Asia

Siti Muslimatun

Capacity Building in Food and Nutrition Revisited (Institution, Program, Policy)

8

A system review on growth monitoring program in Narmada, West Lombok district, Indonesia

Markus Puthut Harmiko, Rosnani Pangaribuan, et al

Nutrition Education/ Communication and Behavioral Changes

9

Food poverty and food insecurity in Sumba island, East Nusa Tenggara Province, Indonesia

Rosnani Pangaribuan, Tina Rosalina

Right to Food and Adequate Nutrition

10

Community-based education intervention for promoting breastfeeding and anemia prevention in Indonesian pregnant women

Maria Wijaya-Erhardt, Siti Muslimatun, et al.

Nutrition Education/ Communication and Behavioral Changes

11

The effect of multiple micronutrient on pregnancy weight gain in Lombok

Helwiyah Umniyati, Siti Muslimatun, et al.

Nutrient Supplementation (single, multiple combinations)

12

Comparison of physical activity between normal and underweight adult male workers based on the WHO BMI cut-off points

Lupi Purnomosari, Johanna Rumawas, et al.

Nutritional Assessment

13

Food-based complementary feeding recommendation (CFR) for 9-11 months old peri urban Indonesian infants developed using linear programming to optimize child feeding: Comparison of rapid assessment procedures and survey result

Otte Santika, Umi Fahmida, et al.

Infant and Young Child Nutrition

14

Is vitamin A-fortified cooking oil effective? A case in Makassar City, Indonesia

Endang Achadi, Arifah Pujonarti, et al.

Food Fortification for Optimal Nutrition

15

Effects of a local-based food supplementation program integrated with posyandu tumbuh kembang anak on nutritional status of underweight children in West Java, Indonesia

Umi Fahmida, Mintarsih, et al.

Dietary Diversitification/ Modification

Page 9

Eval-

Publications 1. IS Surono, U Pato, Koesnandar, A Hosono. In vivo antimutagenicity of dadih probiotic bacteria towards Trp-P1. Asian-Aust J Anim Sci 2009; 22 (1): 119-123. 2. Santika O, Fahmida U, Ferguson E.L. Development of food-based complementary feeding recommendations for 9- to 11-month-old peri-urban Indonesian infants using linear programming. J Nutr 2009; 139: 135-141 3. Scherbaun V, Shapiro O, Purwestri RC, Inayati D.A, Novianty D, Stϋtz, Yusran Y, Mϋller T, Wirawan NN, Suryantan J, Bloem M. A, Koeniger M, Pangaribuan RV, Qaim M, Grune , Hoffman V, Bellows A. C, Biesalski H. K. Locally produced ready-to-use food (RUF). Sight and Life Magazine 2009; 1: 29-37.

Thematic Research Synopsis This year, RCCN compiled all types of programmatic and educational research which were completed within the year of 2005-2008 into a booklet titled ―Thematic Research Synopsis: A journey between 20052008‖. The booklet contains the abstract of the studies, including the involved researchers, collaborators/funding agencies, and year of completion. Some of the listed studies are published articles in some prominent national and international journals. The compilation of the studies was clustered based on the following themes: 1. Micronutrient 2. Food safety 3. Infant feeding practices 4. Nutrition and diseases 5. Probiotic and prebiotic 6. Nutrition and poverty

7. Psychosocial factors of nutrition and health 8. Nutrition and health system analysis 9. Dietary assessment methodologies 10. Nutrition and health education

11. Food-based intervention 12. Nutrition situation in challenging areas 13. Nutrition in emergencies

Handbook on Introduction to Nutritional Anthropology This handbook is developed based upon the existing curriculum used in the course of Introduction to Nutritional Anthropology with some expansion in some of the chapters based on the teaching and learning experiences in the class. Presented in three sections with 12 chapters, the handbook is completed with a case study and learning activities within each chapter for enhancing clarity and stimulating further thinking/discussion. ISBN 978-979-98157-8-1; xi, 213 pages, 27.9 cm

CONTENTS: FOUNDATION OF NUTRITIONAL ANTHROPOLOGY: Introduction to Nutritional Anthropology; Food and Culture; Nutritional Adaptation; Seasonal Constraints on the Food Supply; Households, Gender and Food Distribution SOCIO-CULTURAL ASPECTS OF NUTRITION: Nutrition during Pregnancy and Lactation; Breastfeeding and Infant Feeding; Complementary Feeding; Nutrition in Transition; Socio-cultural Aspects of Dietary Assessments METHODS IN THE FIELD OF NUTRITIONAL ANTHROPOLOGICAL STUDIES: Qualitative Research: Methods in Nutritional Anthropology; Data Analysis and Presentation in Nutritional Anthropology Page 10

Snap Shots UNESCO Information and Knowledge Management (IKM) Attachment Program for SEAMEO Staff (by Achmad T. Djayanto, Judhiastuty Februhartanty) involved in public information services, exhibition, database and publication. Resource persons demonstrated the use of some software, workflow system and actual operations of the IKM Unit.

A

total of 22 officers from the SEAMEO Units who are primarily in charge of information, publication and marketing participated in an Attachment Programme jointly organized by the SEAMEO Secretariat and the UNESCO Asia and Pacific Regional Bureau for Education in Bangkok from 13 to 16 July 2009 at the

SEAMEO Secretariate in Bangkok, Thailand. The Attachment Programme provided opportunity for the officers from the SEAMEO Units to learn about the systems and innovations of the Information and Knowledge Management (IKM) Unit of UNESCO. The four-day programme included sharing of the UNESCO‘s processes

The activity did not only foster stronger collaboration among the participants from both UNESCO and SEAMEO; but it also paved the way for the officers of the SEAMEO Units to reflect on ways to further improve SEAMEO programme implementation through an improved and more efficient systems related to information, publication and marketing of the Organization. Source: http://www.seameo.org/ index.php?option=com_content&task =view&id=408&Itemid=1

Regional Workshop on Health Advocacy and Policy Related to Non-Communicable Diseases , 12-14 August 2009 (by Lupi Purnomosari and Andi Mariyasari Septiari)

L

upi Purnomosari, MSc and Andi Mariyasari, MSc actively participated in the Regional Workshop on Health Advocacy and Policy Related to Non-Communicable Diseases, held in SEAMEO TROPMED Network Philippines, UP Manila on 12-14 August 2009. The workshop was conducted by Asia Pacific Academic Consortium of Public Health Career Network‘s (APACPH & ECN) and College of Public Health University of the Philippines Manila, and funded by SEAMEO TROPMED Network, Foggarty Grant USA, and WHO/ WPRO. This workshop aims to familiarize

participants with the strategies of public health advocacy and policy in the field of non-communicable diseases prevention, promotion and control in translating public health research evidence into public health advocacy & practice. The course was attended by 16 participants from Southeast Asian countries and one from Taiwan. Most of the lecturers were from various institutions in the Philippines, including lecturers from College of Public Health UP Manila and WHO/WPRO. The course contents included topic of Prevention and Control of NCDs: Power of Policy, Policy Framework and Processes, Policy Making, Advocacy for Tobacco Control in the Western Pacific Region, Integrated NCD Prevention and Control Program: the country experience, Case-study in NCD Advocacy and Health Promotion for Rural and Remote Communities – profiling the Australian Chronic Disease Initiative (RCDI), Healthy Cities. From the course, they found a possibility to have a collaboration between SEAMEO TROPMED RCCN Page 11

UI and APACPH-ECN. APACPH is an international non-profit organisation comprising many of the largest and most influensial schools of Public Health in the Asia-Pacific region. Meanwhile, ECN of APACH is network of students and early career professionals in public health throughout the Asia-Pacific region. Since SEAMEO TROPMED RCCN UI have SEANLP program that also aiming to build leadership and give room for early career nutrition professionals to conduct collaboration through research and other scientific activities with their peers in the regions. Beside, we can look for alternative for submitting our paper to its journal or inviting their expert to review our papers. ECN wish to have a branch in Indonesia to maintain the network, therefore with our capacity as a regional center we can use this opportunity to be their branch in Indonesia. For further initiative, we expect to have collaboration activities, such as Asia-Pacific nutrition workshop.

Snap Shots Security Management Course, Jakarta, 14-15 October 2009 (by Nurul Fazar & Solihin)

N

urul Fazar and Solihin, two of the RCCN‘s security officers, attended the Security Management Course on 14 -15 October 2009. This

course was organized by WM Global Consulting in Jakarta with the facilitator Mr. Sih Hartono SE, a navy emeritus lieutenant colonel. In this course, the

participants were exposed with aspects of security management and security intelligence.

Workshop on Scaling Up the Use of Multiple Micronutrient Powders (MNP) to Improve the Quality of Complementary Foods for Young Children, Bangkok, 28 April – 1 May 2009 (by Rosnani V. Pangaribuan)

T

he workshop, conducted to call to action in implementing the MNP fortification in the region, was attended by country representatives from 14 countries. Participants from Indonesia were representative from Ministry of Health, National Planning Agency, Nutrition & Food Research Center and SEAMEO-TROPMED RCCN UI. It was shown during the workshop that all 14 countries demonstrated the enthusiasm to better implement the MNP program. The call to provide

program guideline was raised during the workshop especially the issue regarding the content and quality of MNP and distribution strategy to the community. Home Fortification Technical Advisory Group (HFTAG), a group formed to support the technical issue of MNP program, with its members from public and private sectors, will make available MNP program guidance in 6-12 months. As MNP program in Indonesia will be piloted in 6 provinces (North Sumatra, South Sumatra, West Kalimantan, South

Sulawesi, NTT and NTB) through NICE ADB project, it is suggested to have national workshop to come up with well planned program that can be integrated with the existing health/ nutrition program. Lessons learned from the previous studies and programs in Indonesia on MNP, including the recent UNICEF CHANSYS project in NTT and NTB provinces, will certainly help in the better implementation of national MNP program

International Training on Health Monitoring and Surveillance in Complex Humanitarian Emergencies, Bogor, 6-10 July 2009 (by Lupi Purnomosari)

T

he purpose of the training, held on 6-10 July 2009 at the Hotel Santika Bogor, is to provide the public health professionals with the necessary public health tools to monitor and conduct health surveillance to make the appropriate decisions when assisting victims in emergency situations. The course was conducted and hosted by Department of Biostatistics and Population Studies Faculty of Public Health, University of Indonesia (PH Faculty-UI).

The course was attended by 23 participants from varies institution/ NGOs/universities. The lecturers were from CDC Atlanta, UNICEF Indonesia and Department of Biostatistics and Population Studies PH Faculty-UI. Various topics were discussed during the 5-day training. Among others were refugee and displaced populations, food, nutrition, and reproductive health in complex emergency, surveillance in emergency situation, principles of health monitoring and evaluation,

psychological and social issues in complex emergencies. In afternoon session of each day, participants had to practice using Epi Info and ENA software.

Digital Library Investigation Seminar, Bogor, 28-29 July 2009 (by Rindrawati)

T

he seminar, held on 28-29 July 2009 at SEAMEO BIOTROP Bogor, was targeted for librarian, researcher or other general users who want to expand their skill related with internet, search engine, and digital

library exploration. In total, 25 participants from different institutions, such as Bogor Institute of Agriculture; University of Jambi; Andalas University and others, attended the seminar. The seminar has opened the network for Page 12

librarians to improve their services as source of information.

Scientific-duty Tours Regional Workshop on the SMART Methodology, 9 - 19 October 2009, Bangladesh. Rosnani V.Pangaribuan attended the workshop as one of the Speaker . HR Capacity Building Meeting in Nutrition Program and Drug Management, 21 - 23 October 2009, Bandung. Otte Santika attended the meeting as participant Three Day Collaborating Meeting on Climate Change ToT Manual, 26 - 28 October 2009, Penang, Malaysia. Lina Rospita attended the meeting as participant Symposium on Intestinal Flora : "Intestinal Microbiota and Metabolite Syndrome‖. 26 October - 5 November 2009, Tokyo. Ingrid S Surono attended the symposium as the participant Seminar & Workshop : Current Issues of Micronutrient, 4 September 2009, East Java. Siti Muslimatun, Rosnani V. Pangaribuan & Umi Fahmida attended the seminar as the Speaker. Drupadi Dillon and attended the seminar as participants Guidelines for the Management of Vitamin A Supplementation Program, 10 - 12 September 2009, Depok. Rosnani V.Pangaribuan attended the meeting as the Speaker WHO Antro 2005 Training, 6 -7 August 2009, Bengkulu. Umi Fahmida attended the training as the facilitator Training on Strengthening Health and Nutrition Service System, 12 - 20 August 2009, NTT and NTB. Rosnani V.Pangaribuan attended the training as the Speaker Coordination & Reconciliation of the Ministry of National Education‘s Budget I Semester 2009, 14 - 16 August 2009, Bogor. Monica Erryana, Junita Dara GN attended the meeting as participant PhD Research on Calcium, Probiotics and Diarrhea Meeting, 1 - 30 July 2009, Wageningen the Netherlands. Rina Agustina and Umi Fahmida attended the meeting The First Asian Probiotics Convention, 3 - 5 July 2009, Shanghai China. Rina Agustina attended the conference as the participant Training & Socialization of Vitamin A Supplementation Micro Planning, 14 - 15 July 2009, Tuban, East Java; 2229 July 2009 Bondowoso and Sampang East Java. Rosnani V.Pangaribuan attended the training as the speaker Training for Education Personnel: Nutrition Science Implementation based on Gorontalo Traditional Food, 20 - 22 July 2009, Bone Gorontalo. Siti Muslimatun attended the seminar as the speaker Open Source Software Socialization, 4 May 2009, Ministry of Communication and Information RI, Jakarta. Siti Muslimatun and Endang L Achadi attended the seminar The 5th Asian Conference on Lactic Acid Bacteria, 1-3 July 2009, Singapore. Ingrid Surono attended the conference as the Speaker

Page 13

SEAMEO Centre Director Meeting and Governing Board Meeting SEAMEO TROPMED Network Collaboration and follow up actions taken by the SEAMEO Secretariat and approved further collaboration among SEAMEO Units for the implementation of three key strategies : Information Sharing, Joint Corporate Marketing of Programmes and Services and Joint Human Resource Development. The 2009 SEAMEO CDM agreed on the need to review the Strategic Plan of SEAMEO, work together to materialized the ideas and plans for long term collaboration Centers.

A

s many as 46 participants from mostly all SEAMEO Centre/Network Directors and representative from SEAMEO Affiliate Member / Associate Members attended Seminar on the Direction of the Evaluation of SEAMEO Units followed by the SEAMEO Centre Director Meeting held in Arnoma Hotel Thailand at 3-5 July 2009. DR.Ratna Sitompul, MD, SpM(K), Dr. Endang L Achadi MPH, Dr.PH and Gustina, MSi represented SEAMEO TROPMED RCCN UI attended the meeting. The Meeting welcomed and expressed congratulation on the appointments of New Centers Directors / Official including Dr. Ratna Sitompul as Director and Dr. Endang L Achadi, DrPH as the Chief Operational Officer of SEAMEO TROPMED RCCN / Indonesia. The Meeting took note the results of the 3rd SEAMEO Capacity Building Workshop 2009 on Inter-centre

Meanwhile Dr. Ratna Sitompul, Dr.Endang L Achadi, Siti Muslimatun PhD, and Prof. Gumilar Rusliwa Sumantri, was attending the 48th GBM meeting of the SEAMEO TROPMED Network hosted by the Ministry of Health and Institute of Medical Research, Malaysia at Hotel Istana Kuala Lumpur on 13-14 August 2009. The RCCN progress report included the new vision and mission was presented during the meeting. The 48th GBM held a thematic symposium on H1N1. In order to response better on the possibility of the new wave of H1N1, the group discussions came up with conclusions on: (1) the needs of MOH include: case management, risk management, sharing of best practices, and logistic; (2) recommendations to strengthen the two ministries network (MOH and MOE): improve coordination, communication and advocacies among ministries; and (3) roles of SEAMEO TROPMED Network: facilitate discussion, advocacies, sharing and documentation of best practices, knowledge management, and inter-Center researches.

Obituary: We would like to express our sincere condolences on the passing of Mrs. Siti Subadillah (aged 77) – the beloved wife of the late Prof. A. Djaeni Sedia Oetama (the preceding Director of SEAMEO-TROPMED RCCN UI 1970-1994) at 10.00 AM on 2 November 2009 in Jakarta. May Allah SWT rest her in peace.

Page 14

On Mission The 19th International Congress of Nutrition securing the need for safe and adequate food supply, delivery of basic nutrition and health services, thereby improving the quality of life of peoples and communities around the world.

O

rganized quadrennially under the auspices of IUNS, the International Union of Nutritional Sciences, the International Congress of Nutrition was held for the 19th time from 4-9 October, 2009 in Thailand‘s thriving capital, Bangkok – bringing ICN back to the Asian continent for the first time in 20 years. The main theme of ICN 2009 is “Nutrition Security for All” which is directed to provide innovative solutions to the present and future challenges of

The congress has attracted a total of 4000 people among whom were 3000 presenters from about 106 countries throughout the globe. A total of 300 internationally renowned speakers shared their experiences and discuss future challenges that stem from basic research to policy and program applications. Around 200 oral presentations (free communications) featured the latest findings in nutrition science and related disciplines. Approximately 400 posters were exhibited per day in addition to 200 distinguished poster presentations. A number of organizations pledged financial support to reward young

investigators from developing countries to present their research as oral presentations or distinguished posters. The meeting has become an arena for a reunion among RCCN‘s staff, alumni, and our networks that mostly took part as oral and/or poster presenters, also as co-chairs and moderators. During the meeting, RCCN‘s staff involved in 19 poster presentations, 1 oral presentation, and co-chairing of 2 sessions of free communication, also in the abstract selection as one of the reviewers. Overall, the meeting was impressive and fruitful. All participants witnessed the active involvement of Her Royal Highness Princess Maha Chakri Siridhorn in the whole program and learned that with such leadership Thailand has been successfully reducing its nutritional problems.

The 1st International Symposium on Nutrition and the 6th Asia Pacific Clinical Nutrition Society Conference, Makassar 10 – 13 October 2009

H

asanuddin University in collaboration with the Ministry of National Education, Indonesia Clinical Nutrition Society and Danone Institute Indonesia (DII), has held an International Symposium on Nutrition, followed by the 6th Asia Pacific Clinical Nutrition Society Conference. The theme of the symposium was ―The Development of Nutrition Science for Accelerating Healthy, Educability and Productivity of People‖, and sub-theme ―Repositioning Nutrition in the National and Regional Development‖. The symposium was stimulated by the fact

that despite of all efforts done by the government, malnutrition problems remains high. Six SEAMEO TROPMED RCCN UI staff have participated actively in the Symposium and Conference. They were also among presenter or moderator, Prof. Dr. Darwin Karyadi (former Director of SEAMEO), Dr. Widjaja Lukito, PhD (former Director of SEAMEO and immediate past President of Indonesian Clinical Nutrition Society, Dr. Drupadi Dillon, DR. Ingrid Surono, Andi Mariyasari,

MSc, Dwi Nastiti Iswarawanti, MSc and Dr. Endang Achadi, Dr.PH. Dwi Nastiti Iswarawanti MSc has won the publication grant from DII. The symposium has been successful in bringing international as well as national speakers, attracting over 600 participants, and presenting various topics in verbal and poster sessions. We left the symposium with a mixed feeling of encouragement and deep concern. There are still many to be done, and moreover there are neglected areas that need dedication of many stakeholders.

Research topics presented by RCCN‘s staff during the ISN in Makassar: No

Title

Authors

ORAL PRESENTATION 1 2 3

4 5 6

Early initiation of breastfeeding: Knowlegde and perception among urban Jakarta couples Probiotic, a promising functional food in improving nutritional status of young children Malnutrition and infectious diseases: Do we need another long journey for long-term solutions? POSTER PRESENTATION Sixteen week of iron supplementation given to Indonesian adolescent girls is insufficient to reach optimal iron stores Factors hindering and facilitating exclusive breastfeeding practice among working and non working mothers in Depok Maternal and Children Health and Nutrition situation after emergency period in Four Districts, Aceh Province, Indonesia Page 15

Andi Mariyasari Septiari, Judhiastuty Februhartanty et al. Ingrid Surono, Fredrik Rieuwpassa, et al Widjaja Lukito

Drupadi Dillon, Hans Verhoef, et al Judhiastuty Februhartanty, Yulianti Wibowo, et al Otte Santika, Lindawati Wibowo, et al.

On Mission Roll out of Food Safety Training on Food Safety and Handling for Hotels and Restaurants in Makassar, South Sulawesi home and small-scale food industries, and master students.

S

outh Sulawesi is one of favorite tourism areas. Home and small scale industries on local foods are largely available here. For the purpose of raising awareness on food safety management, ICD/SEAMEO Cooperative Program, SEAMEO TROPMED RCCN UI in collaboration with Food Technology Department, Faculty of Agriculture, Hasanuddin University conducted Food Safety Seminar and Training for public, hotels and restaurants, home and small scale industries. The one-day seminar was conducted on 4 August 2009 at Hasanuddin University.. The training program was

held on 5 and 7 August 2009 at Clarion Hotel Makassar, including a field trip on 6 August 2009 to PT Nuansa Cipta Magello (industrial estate for canned sea foods), kitchen of Clarion Hotel and Convention Center Makassar, dan Hypermart Makassar. The seminar was attended by 77 participants, consisted of lecturers, undergraduate and postgraduate students of food and nutrition field, community nutrition and medical students, housewives, as well as hotel, restaurant and catering managers. The training was attended by 19 participants, representing hotel and restaurant staff,

The seminar and training provided participants with topics on good hygiene and handling practice of food, good manufacturing practice of food, role of food technology in food safety, food additive, HACCP, and food borne diseases with some case studies. SEAMEO TROPMED RCCN UI, represented by Ingrid S Surono, PhD, presented ―Food safety in food technology and community nutrition practical knowledge on food safety for food quality assurance of food‖ at the seminar and ―System and management of food safety‖ during the training.

Development of booklet on “Guidelines for the Management of Vitamin A Supplementation guidelines for the management of vitamin A supplementation (VAS) program.

S

EAMEO-TROPMED RCCN UI in collaboration with the Ministry of Health Indonesia, UNICEF Jakarta and Micronutrient Initiative Indonesia took part in the development of a booklet on

The idea of developing the VAS management guidelines was derived from the survey which was done in 3 provinces (Southeast Sulawesi, West Kalimantan and Lampung) in 2007. The survey results show unsatisfactory coverage of the supplementation program as below 90% (a minimum health service standard set by MOH RI). Using health system analysis, the survey also found some constraints in some of the subcomponent of the VAS program such as socialization activities, target

Page 16

calculation, logistics including distribution of capsules, capacity of the staff and community health worker at Posyandu (integrated health post at the village level), recording and reporting of the activities. All these indicate that there is an urgent need in providing the relevant staff/implementation officers with refreshment training on VAS program management. In order to support the training, the guidelines were developed. By using the guidelines as a reference tool, identification of current situation and challenges were first mapped out by the staff, followed by the possible solution to tackle the problems.