Amelia Maika, Elan Satriawan, Amanda Beatty, Sally Brinkman, Menno Pradhan The 3 rd Conference of The International Society for Child Indicators, University.

A Snapshot of Health and Child Development in

Indonesia: Baseline Findings

Amelia 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

140

160

Bangladesh

Brunei Darussalam

Cambodia

Congo

Ethiopia

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

Phillipnies

East Asia & Pacific

India

Least Developed Countries

World

Under-five and Infant Mortality Rate

Under-five mortality rate Infant mortality rate

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300

400

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700

800

Bangladesh

Cambodia

Congo

Ethiopia

IndiaIndonesia

Lao

Malaysia

Mozambique

Phillipines

Thailand

Vietnam

East 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 more0

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100

Parental 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 27

Least developed countries

35 64 63

World 38 56 39

Breastfeeding Practices

Stunting (%) Wasting (%)

Indonesia (ECED sample)

34.1 19.3

Indonesia (2007) 40.1 14.8

India (2005) 47.9 20.0

Kenya (2003) 35.8 6.2

Madagascar (2003) 52.8 15.2

Philippines (2003) 33.8 6.0

Vietnam (2006) 35.8 8.4

Brazil (2006) 7.1 1.6

Indication of malnutrition

EDI: International Comparison%

vu

lnera

ble

ch

ild

ren

Canad

a (1

76,0

00)

Austra

lia (2

60,0

00)

Mex

ico (1

74,0

00)

Chile (2

,500

)

Jord

an (1

,000

)

Moz

ambiqu

e (1

,000

)

Philip

pine

s (1,

000)

Indo

nesia

(3,2

50)

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Phys

Soc

Emot

Lang_Cog

Com Gen

Never 1-2 days a week

3-5 days a week

6-7 days a week

0

10

20

30

40

50

60

70

80

90

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

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30

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100

Story telling

Never 1-2 days a week

3-5 days a week

6-7 days a week

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10

20

30

40

50

60

70

80

90

100

Playing music, singing and dancing

More common practices in playing music, singing and dancing

SDQ: International Comparison

  USA UK Indonesi

a 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 33

Pass 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 20090

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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 20090

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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

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