A Snapshot of Health and Child Development in
Indonesia: Baseline FindingsAmelia Maika, Elan Satriawan, Amanda Beatty, Sally Brinkman, Menno Pradhan
The 3rd Conference of The International Society for Child Indicators, University of York, York, United Kingdom, 27-29 July 2011.
over 27 million people living below the poverty line, up to half the population is estimated vulnerable to poverty (UNICEF, 2010; World Bank, 2010)
Inequality and regional disparities are a fundamental feature of poverty in the country
The large disparity in socio-economics is also reflected in the wide variation in educational outcomes. Children from the poorer villages start school later, complete fewer years of schooling and have higher drop out and repetition rates (World Bank, 2006)
INDONESIA: from a lower to middle income country, however
0
20
40
60
80
100
120
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160
Bangladesh
Brunei Darussalam
Cambodia
CongoEthiopia
India
Indonesia
Lao
Malaysia
Mozambique
Phillipines
ThailandVietnam
East Asia & Pacific
Least developed countries
Least developed countries
World
Bangladesh
7
Cambodia
Congo
Ethiopia
Developing countries
Indonesia
Lao
Mozambique
PhillipniesEast Asia & Pacific
India
Least Developed Countries
World
Under-five and Infant Mortality Rate
Under-five mortality rate Infant mortality rate
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100
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300
400
500
600
700
800
Bangladesh
Cambodia
Congo
Ethiopia
IndiaIndonesia
Lao
Malaysia
Mozambique
Phillipines
Thailand
VietnamEast Asia & Pacific
World
Maternal Mortality Rate
These numbers are decreasing in the last decade – still high in East Asia
Impact evaluation study ECED program in Indonesia
Examining ranges of child development outcomes (health, school readiness, cognitive, behavior)
Examining household characteristics, parental practices and ECED utilization
Provide policy recommendation
Objectives
randomized control trial approach
Subject: 6370 children age 1 and 4, primary caregiver
Methodology
310 Villages in 9 Districts
Project Duration
Baseline Midterm Final round
Batch 1 villages
Batch 3 villages
Villages outside ECED project
0 months 18 months 36 months
TREATMENT
Comparison 1
Comparison 2
Early Development Instrument (EDI) Strengths and Difficulties Questionnaire
(SDQ) Dimensional Change Card Sort (DCCS)
Measures
9% of caregivers cannot read at all3% cannot read well/only read partially
never not finish primary
primary junior senior more0102030405060708090
100Parental Education
Father Mother
% children exclusively
breastfed to 6 months old
% children breastfed with complementary food 6-9 months old
% children still breastfed
20-23 months old
Indonesia (ECED survey)
31 75 63
Indonesia (DHS, MICS, UNICEF)
40 75 59
East Asia and Pacific 43 45 27Least developed countries
35 64 63
World 38 56 39
Breastfeeding Practices
Stunting (%) Wasting (%)Indonesia (ECED sample)
34.1 19.3
Indonesia (2007) 40.1 14.8India (2005) 47.9 20.0Kenya (2003) 35.8 6.2Madagascar (2003) 52.8 15.2Philippines (2003) 33.8 6.0Vietnam (2006) 35.8 8.4Brazil (2006) 7.1 1.6
Indication of malnutrition
EDI: International Comparison%
vul
nera
ble
child
ren
Canad
a (17
6,000
)
Austral
ia (26
0,000
)
Mexico
(174,0
00)
Chile (2
,500)
Jorda
n (1,0
00)
Mozambiq
ue (1
,000)
Philip
pines
(1,00
0)
Indon
esia (
3,250
)0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
PhysSocEmotLang_CogCom Gen
Never 1-2 days a week
3-5 days a week
6-7 days a week
0102030405060708090
100
Reading book/magazine
age 1age 4
52% of household do not have book
frequency readings to children correlates sig with cognitive and development score, the amount of book and parental education
Caregiver practices
Never 1-2 days a week
3-5 days a week
6-7 days a week
0102030405060708090
100
Story telling
Never 1-2 days a week
3-5 days a week
6-7 days a week
0102030405060708090
100
Playing music, singing and dancing
More common practices in playing music, singing and dancing
SDQ: International Comparison USA UK
Indonesia Jordan Philippines
Emotional symptoms 1.5 (1.7) 1.9 (2.0) 3.7 (2.0) 2.2 (2.3) 2.4 (2.0)
Conduct problems 1.4 (1.6) 1.6 (1.7) 3.5 (1.9) 3.4 (2.3) 2.9 (2.0) Hyperactivity-inattention 3.2 (2.5) 3.6 (2.7) 5.0 (1.3) 4.2 (2.2) 5.0 (2.2)
Peer problems 1.3 (1.5) 1.4 (1.7) 2.6 (1.5) 2.5 (1.8) 3.5 (1.6)
Prosocial behavior 8.4 (1.9) 8.6 (1.6) 6.4 (2.0) 7.7 (2.1) 6.3 (2.1)
DCCS: International Comparison
Indonesi
a (%)Philippines
(%)Jordan
(%)Fail color and shape 34 60 33Pass color and shape only
49 35 41
Pass color, shape and border
17 5 26
A child’s drawing ability is related to fine motor and cognitive skills
Range of cognitive development shown
by drawing ability
2001 2002 2003 2004 2004 2006 2007 2008 20090102030405060708090
100
Figure 1. Preschool Partici-pation (current)
Age 3-4 th Age 5-6 th Age 3-6 th
2001 2002 2003 2004 2004 2006 2007 2008 20090102030405060708090
100
Figure 2. Preschool Participation (current+ever)
Age 3-4 th Age 5-6 th Age 3-6 th
Preschool Participation across the country is very low (Statistic Indonesia 2010)
Participation among the sample is even lower
ECED center could encourage more reading habit at home, providing access to books, give opportunity for parent to borrow book from the center, as well as work together with local library to support this access.
increase parent‘s involvement in ECED program, teaching caregiver practices that could support attachment and early stimulation at home such as storytelling.
In order to increase parent’s literacy level the center should consider linking with adult education program in the community, such as Kejar Paket A program.
Policy recommendations
This research is funded by AUSAID through Telethon Institute of Child Health Research (TICHR) Australia. ECED survey is a project collaboration between Directorate of Early Childhood Education and Development MoNE Indonesia and the World Bank. Access to ECED data is provided by the World Bank.
Researchers: Amelia Maika and Elan Satriawan (Gadjah Mada University Indonesia), Amanda Beatty (the World Bank), Sally Brinkman (TICHR, Australia), Menno Pradhan (Free University Amsterdam, The Netherlands).
Acknowledgement
Terima Kasih
