Standard 4.1 Prevention and reduction of stunting.

CHAPTER IV NATIONAL PRIORITY PROGRAM (VAT)

The National Priority Program is implemented through the integration of UKM and UKP services in accordance with the five-level prevention principle.

1. Standard 4.1 Prevention and reduction of stunting.

Puskesmas carries out prevention and reduction of stunting along with monitoring and evaluation in accordance with statutory provisions.

a. Criterion 4.1.1

Prevention and reduction of stunting is planned, implemented, monitored and evaluated by involving cross-programs, cross-sectors and community empowerment.

1) Main Thoughts:

a) Prevention and reduction of stunting is planned, implemented, monitored and evaluated by involving cross-programs, cross-sectors and community empowerment.

b) Efforts to prevent and reduce stunting cannot be carried out by the health sector alone, but need to be empowered across sectors and communities through improving diet, parenting patterns and sanitation as well as access to clean water.

c) Efforts to prevent and reduce stunting are integrated across programs, including pregnancy check-up services, immunizations, promotional activities and counseling (breastfeeding and nutrition), providing supplements and other intervention activities.

d) Cross-sector integration in efforts to prevent and reduce stunting, among other things, is carried out through advocacy and outreach to community leaders, families, the community, as well as program targets and other interventions.

e) In preventing and reducing stunting, promotive and preventive efforts are carried out to increase services and coverage of sensitive nutrition interventions (cross sectors) and specific nutrition interventions (cross programs) in accordance with applicable guidelines.

f) Sensitive nutrition interventions include, among others

(1) social protection;

(2) strengthening agriculture;

(3) improving water and environmental sanitation;

(4) family planning;

(5) early childhood development;

(6) maternal mental health;

(7) child protection; And

(8) education in the classroom.

g) Specific nutritional interventions include

(1) giving blood supplement tablets (TTD) to adolescent girls;

(2) giving blood supplement tablets (TTD) to pregnant women;

(3) providing additional food to pregnant women with chronic energy deficiency (CED);

(4) promotion/counseling on infant and child feeding (IMD, exclusive breastfeeding, and food

appropriate breastfeeding companion);

(5) monitoring the growth and development of toddlers;

(6) management of malnourished toddlers;

(7) giving vitamin A to babies and toddlers;

(8) providing additional nutritional intake for malnourished toddlers;

(9) food diversity;

(10) micronutrient supplementation/fortification;

(11) disease management and prevention;

(12) nutritional interventions in emergencies; And

(13) animal protein intake campaign for pregnant women, exclusive breastfeeding; and MPASI for babies and toddlers.

h) Sensitive and specific forms of intervention along the way will follow developments in accordance with the provisions of applicable laws and regulations.

i) Determination of stunting performance indicators is integrated with determination of Puskesmas performance indicators.

j) Prevention and reduction of stunting must be able to ensure accurate and procedural recording and reporting, especially measuring length or height according to age (PB/U - TB/U) and the development of children under five.

k) Recording and reporting of stunting prevention and reduction services, both manually and electronically, is carried out completely, accurately, on time and in accordance with procedures. Reporting to the head of the community health center and district/city regional health service and/or other parties refers to the provisions of statutory regulations. Reporting to the head of the community health center can be done in writing or delivered directly through meetings such as monthly mini workshops, management review meetings, and other forums.

l) The Community Health Center measures the performance indicators that have been determined and is accompanied by an analysis of achievements. Analysis of indicator achievements is carried out using analytical methods in accordance with applicable guidelines and guidance, for example by referring to the situation analysis method contained in the Community Health Center Management Guidebook.

m) The stunting prevention and reduction program plan is prepared by prioritizing promotive and preventive efforts based on the results of analysis of nutritional problems in the Puskesmas work area with cross-program involvement that is integrated with the RUK and RPK for UKM services as well as UKP, laboratory and pharmacy.

2) Assessment Elements:

a) Stunting performance indicators and targets are determined to support prevention and reduction programs, accompanied by achievements and analysis (R,D,W).

b) Establish a stunting prevention and reduction program (R,W).

c) Coordinate and implement stunting prevention and reduction activities in the form of specific and sensitive nutritional interventions in accordance with plans prepared jointly across programs and across sectors in accordance with established policies, procedures and terms of reference (R,D,W).

d) Monitoring, evaluation and follow-up are carried out on the implementation of stunting prevention and reduction programs (D,W).

e) Recording is carried out and reporting is carried out to the head of the community health center and the district/city regional health service in accordance with established procedures (R, D, W).