
Exploring Maternal, Infant, and Young Child Nutrition
& Early Childhood Development Practices in Indonesia
As an integral part of the Government of Indonesia’s efforts to reduce stunting, in 2018-2019 the Ministry of Communication and Informatics developed a National Campaign and Behavior Change Communication Pillar strategy. To support the strategy’s implementation, Empatika conducted an innovative formative assessment on maternal nutrition, complementary feeding period (6-23 months), and early child development (ECD) practices in six diverse communities in six provinces across Indonesia.
Significant research has been conducted in Indonesia about the prenatal period, what and how children are fed after birth. However, the reasons behind these choices are only partially understood. This study aimed to help fill gaps in understanding about the prenatal period, what and how children are fed after birth, and then explore solutions to the challenges for improving key practices.
To do this, Empatika developed our people-driven design (PDD) approach to co-creation, based on the principles of human-centered design. This consisted of two phases, immersion and co-creation with communities:
Immersion phase: researchers lived with families in the study locations for four nights, aiming to understand critical nutrition practices. Findings from the immersion informed the focus for the co-creation phase, which featured tailored workshops in each community site.
PDD co-creation phase: a series of customized workshops were conducted with the same communities from the immersion phase to share the key findings and together identify priority challenges related to maternal, infant, and young child nutrition (MIYCN). Each group then developed a prototype solution related to one of their community’s key MIYCN challenges. Following a six to eight week testing period, researchers returned to communities to reflect on feasibility and the overall process.
Some of the key insights from the formative research included:
Mothers did not consider breastmilk to be a food or a source of nutrients, and any breast milk they continued to give served the function of mainly providing comfort, and secondarily hydration.
Rice was understood to be the main food while other foods were viewed as adding flavor and eaten in small quantities. Availability was not always the reason that animal source foods were not provided. Mothers valued foods that could be prepared easily and considered that adding vegetables and fish to porridge was too time-consuming.
Snacking was a big component of child diets starting from a young age. Crackers, biscuits, cakes, and other ultra-processed foods were offered to babies, often in the first six months.
Mothers commonly felt that there was nothing they could do about the lack of appetite in a baby or young child, and that it would pass. Parents did not minimize distractions while feeding babies and children. Older infants and young children were sometimes put in front of TVs or smartphones and left to eat by themselves.
The PDD co-creation workshops in each community were tailored around the key insights from the formative research, each using a different challenge question to frame the group’s discussion and brainstorming. Below are some of the proposed solutions from groups, which were then prototyped and tested :
Selling and promoting healthy home-made snacks at kiosks such as homemade real fruit popsicles. Having the posyandu only provide fruits to children.
Producing a developmental milestone chart to help mothers track their child’s progress, along with promotional posters providing illustrations of locally-available, recommended foods.
Developing an interactive recipe book for mothers to help them introduce new foods (especially to include fruits, vegetables, and proteins) to babies and record notes of babies’ responses.
Adding a private counseling space to a new posyandu with play spaces for children and an adjacent space for a garden to improve counseling sessions on infant and young child feeding.
Forming a cooking club to help bring back healthy and enjoyable meals inspired by parents’ childhood experiences.
Establishing a community vegetable garden to provide a source of nutritious, fresh produce.
Findings from this study are published as People-driven Design: Innovating for stunting reduction in Indonesia and Exploring Maternal, Infant, and Young Child Nutrition & Early Childhood Development Practices in Indonesia, developed for national and sub-national level stakeholders, and local organizational partners involved in SBC as part of “Strategi Nasional Percepatan Pencegahan Stunting”, a national strategy implemented in Indonesia aimed at reducing stunting among children.
Location
Hulu Sungai Utara, South Kalimantan; Majene, West Sulawesi; Alor, NTT; Seram, Maluku; Pasaman, West Sumatera; Garut, West Java
Methods
Immersion and People-driven design
Participants
Mothers and children, fathers, families, health service providers, TBAs, teachers, village leaders, community members





