Etiology and epidemiology

Nutrition is considered to be one of the basic requirements of human life, without proper nourishment the human life will perish in not time. However, the question remains whether all the sectors of the society are able to avail this basic human right, regardless of the socio-economic status, cultural- racial identity or demographical attributes. The human civilization is at the peak of innovation, with the technological advancements through the roof, everything is just at the fingertips for the human society. However, in the face of such astounding progress, there are still nations where the humans are denied the most basic need of all times, nutrition (Roemling & Qaim, 2012).

Malnutrition has been one of the very consistent public health and welfare issues, that continues to persist even now; dual burden of nutrition, however, is a completely new concept.  Dual burden of Nutrition can be defined as the characteristics phenomenon for a nation where there is a conspicuous coexistence of malnutrition along with the issues of overweight and obesity adult diet related non- communicable diseases not just in the personal level with and different individuals but also on a large scale basis among households, and across population for entire nations. The conundrum of contradiction between overweight and underwear has emerged as a learning Public Health issues in the last decade, and according to alphabetical analysis conducted by the World Health Organization in the year of 2014, 2 million adults were discovered to be overweight, 600 million to be obese while 460 million people were found to be underweight. Unfortunately, poor nutrition has been considered as the leading causes of mortality and the children under the age of 5, especially in the low and middle-income countries,  that are facing the dual pattern of malnutrition issue 30% faster than the first world developed countries. Therefore, the issue of dual burden of malnutrition requires a sound strategic plan that can help the developing nations to provide a proper quality of life to all its citizens. This assignment will focus on the dual pattern of malnutrition issue escalating in Indonesia an attempt to provide a strategic recommendation for the nation to follow in order to overcome the situation (Jehn & Brewis, 2009).

Asia is one of the largest continents that are facing consequences of unequal distribution of wealth and malnutrition from a long period of time, Indonesia is one of the south east countries that is facing the greatest challenge with the double burden of malnutrition. According to a recent report by the World Health Organisation, 1.2 million individuals of Indonesia are at this point malnutrition which contributes to the total percentage of malnutrition in Asia by a large chunk. Although the simultaneous existence of under and over- nutrition within the population of the developing countries that are going through a rapid economic transition and been widely documented a clear statistical idea of Indonesia and the double burden of nutrition that it is facing has not been researched extensively. The policy makers and politicians have effectively attempted for the economic group of the nation as well as human resource development, although the country has not yet overcome the challenges of poverty, socio economic differences and non-communicable diseases successfully (Jaacks, Slining & Popkin, 2015).

Determinants for the dual burden of malnutrition

According to the recent reports despite the economic growth that Indonesia has achieved, the country remains available to food insecurity with 87 million people. The recent report by World Bank group has explored dare to be 8.4 million Indonesian children to be stunted and are living with extreme or chronic malnutrition. The data contributes 37.2 % of malnutritioned children under the age of 5 suffering with chronic malnutrition, despite the milestones the nation has achieved in its developmental trajectory (Corsi, Finlay & Subramanian,  2011). In this context has to be mentioned that stunting on malnutrition increases the risk for non-communicable diseases such as diabetes and coronary heart diseases multiple folds, regardless of age the public awareness of the malnutrition is extremely low. Nationwide statistical data suggest that in the last 5 years incident of stunting in the population has increased from 35.6% to 37.2%, and the figures continue to escalate.  

On the other hand, the overall prevalence of overweight and obesity in the Asian countries provides an astounding contradiction to the rising malnutrition that these me friends are facing. The percentage of the overall balance of overweight and obesity in Indonesia is rising obstinately where is a childhood stunting in the same nation continue to escalate as well (Corsi, Finlay & Subramanian,  2011).

There has been a large number of statistical research studies conducted to determine the contributing factors to the growing rate of child malnutrition in Indonesia, the mortality rates for the children under the age of 5 have been increasing rapidly in Indonesia, and the underlying reason for it had been the unwarranted rate increase in overall population. The total population of Indonesia presently remains at 264,004,580, the population density for which can be calculated as 142 per square km (Abdullah, 2015). The population count for the country tops the population chart for the world, and there had not been any effective strategic plans to overcome the rapid increase. The unprecedented rate at which the population is increasing and the lack of effective management and educational strategies to generate awareness and the Mars have emerged as one of the main contributing factors to the dual burden of malnutrition in Indonesia. The compromised health for the underweight pregnant women in Indonesia is the key factor leading to low weight babies being born in Indonesia and the distracted growth pattern been continued for years to come. Along with that it also needs to be mentioned that the malnutritioned mothers are known to have difficulty with successful lactation which results in the children obtaining breast milk low in essential micronutrients escalating the likelihood of the infants being underweight drastically (Barnett, 2011).

Another significant contribution factor can be considered the low socioeconomic status majority of Indonesian population is suffering from malnutrition problem. These people cannot afford healthy nutritious food in quantities that can serve as facilitators of normal growth and development; hence the infants suffer along with their parents with the unhygienic low standard of lifestyle. Another important fact that needs to mention within this context that in Indonesia Mein nutrition is not the only rising issue that needs attention, the double burden situation also points at the overweight individuals suffering from obesity, diabetes, and cardiac heart diseases. According to many research studies, it has been discovered that the group with low socioeconomic status are more likely to suffer from obesity than those that belong to the higher socio economic status in Indonesia (Barnett, 2011). The extensive lack of basic health education and awareness about standard dietary plans are the main reasons behind this contradictory health issue escalating in Indonesia. Whereas the children are suffering from malnutrition and are becoming stunted contributing to the increasing mortality rate for the children and infants in Indonesia, the adults and gaining obesity, paving the way for more complicated diseases.  Hence the lack of awareness, low financial background and lack of national level maternal and child nutrition strategy can be considered as the major contributors to this conundrum that Indonesia is facing.

The total population of Indonesia is 261.1 million, which such a drastically high population. This country has faced food production and demand ratio issues for a long time.  The last decade has seen a decline of 4.5% in the gross domestic production where the consumption per capita has increased considerably. The past decade has seen 4% increase in total consumption statistics while the food production has not increased as much to meet the demands, which has inevitably led to the women and children being endangered for not gaining proper nutrition and hygiene (Ihab et al., 2013). 

Considering the agricultural statistics of Indonesia, rice and corn is the most staple food item for Indonesian citizens. Despite agriculture contributing to 14% of the total GDP of the nation, the food production still lags behind the demand. One contributing factor to this can be the highly politicized rice policy in Indonesia, which has made the rice pricing almost 10% higher than the global standard rate. Undoubtedly it imparts a substantial detrimental effect on the lower class citizen of Indonesia in being able to afford the most basic food item, the malnutrition, therefore, is inevitable. Aside from rice, other crops like sugar, soya bean, and corn are so common food items in Indonesian cuisine, although with the lack of proper trade protection and self-sufficiency, it is impossible to produce these crops to satisfy the demands after heavy exportations. The highly politicized trade statistics of agricultural items in Indonesia is one of the greatest contributing factors in the nation having the lowest calorie intake per citizen, and the gradual loss of agricultural productivity of the nation contributes more to this rising issue (Khor, 2008).

 Food and culture are intimately linked with one another, and the impact of cultural beliefs and traditions on the cuisine is a conspicuous matter. Indonesia takes pride in its exotic cuisine bearing extreme influence to its traditional recipes. The Indonesian dietary pattern is rich in spices and is completely dependent on carbohydrates. With rice and corn being the most fundamental food crops in their cuisine, and coupled with table sugar, pulses, leafy vegetables and soy contributes to a very heavy carb dietary platter for the residents. With their diet being completely dominated by cereals or oilseeds, their diet lacks protein and mineral to a large extent and lead to vitamin A or B complex deficiency, iron deficiency and essential minerals and long chain fatty acids. With their diet being completely focused around the heavy carbohydrates l, the chances of obesity increase where lack of protein rich diet deteriorates the health of the children and infants (Kimani-Murage et al., 2015).

In the context of the health and welfare of the citizens, the political sector has the most influential impact. Ice information is facing in the issue of tool button of malnutrition web for child and Infant population of the country is suffering from malnutrition the adults of the social, economic class are suffering from obesity and the port of diseases it comes coupled with. The first strategy in order to overcome the 12 or 10 of magnetization in Indonesia should focus on strengthening the entrance of the government in policy making and food production demand and supply sector along with the maternal and Child Health and nutrition protocols (Oddo et al., 2012). Strengthening and facilitating attention from the government towards making policies that a certain equal distribution of food and health nutritional resources towards on the classes of the society will be a highly beneficial strategy in overcoming the problem of malnutrition and obesity in the lower economics classes. It has to be understood that nutrition has been prioritized as the why are the most important basic needs within the health and wellbeing, Hans if politicized adequately, the impact of better and refined policies can bring for drastic change in the availability of food and other resources for the victim sector and will decrease the child mortality rates significantly (Rachmi et al., 2016).

Along with government policies, guidelines and legislative protocol frameworks also an important made it comes to overcoming the dual pattern of magnetism in a developing country. It has to be understood that the protocols and guidelines are mostly design in a globalised format; hence, adhering to these protocols will benefit Indonesia in designing strategic actions that will cater to the specific needs based on the determinants of dual burden of malnutrition. It must not skip noticed that the globalised guidelines for improving the health and well-being of the citizens are more inclined towards low Carbohydrate and high protein dietary patterns. Who aligning the local or National guidelines with the Global frameworks will help the Indonesian authorities to bring the escalating issue of overweight contradicting them and nutrition in check with a dietary plan that is balanced and optimal (Saibul et al., 2009).

Strategic Alliance is the greatest option for co-aligning local guidelines and Framework with the globalised patterns. There are various strategic focus groups and action group that promote a healthy diet in the impressionable citizens. The privatized or civil society organizations funding the action groups focus only on promoting healthy diet and nutrition in plants along with healthy exercise activities and counselling to help the victims of a challenge and revert to standard lifestyle as soon as possible. Establishing a strategic Alliance bases with these highly professional groups can ensure in better management maintenance and preventive campaigning in order to reduce the malnutrition in children and mothers and obesity in adults belonging to lower and to the middle social, economic status of Australia. (Sekiyama et al., 2015)

Furthermore, it also means to mention that community input as a profound influence on improvement of Public Health issues like the one under consideration for this case scenario. The lack of proper health education and awareness in the general mass of Indonesia has been already discovered as one of the most contributing factors leading to do a bottle of malnutrition in that country,  targeting the individuals for campaigning and educating the mass of the nutritional needs of young to be mothers and young mothers,  to ensure proper weight and nourishment for the mother and will contribute to improving the statistics for stunting in case of infants (Vaezghasemi et al., 2014).

Mention about having sound maternal nutrition and health strategies on the national level can be extremely beneficial for developing countries and their citizens to overcome challenges that come with malnutrition and obesity.  The Healthcare system for the function needs to undergo a complete response to include nutritional Strategies for your mothers and intense along with having community wide monitoring services and educational and awareness about the preventative mechanisms for malnutrition or obesity.  This white community services well and short those proper nutrition resources I will be available to the lower economics classes and oversee the dietary pattern father mother and their infants. Lastly, it needs to be mentioned that along the supply and availability issue, the effort and capability are also one of the importance of determinants in case of compromise health and nutrition for the Indonesian society. There is a need for intervention from the national or international level authorities to reduce the cost of basic resources, and help the citizens are well the fundamental necessities in order to maintain a standard lifestyle and overcome the issue of dual burden of malnutrition (Wibowo et al., 2015).

Conclusion: 

On a concluding note, it can be said that malnutrition and obesity, are the contradictory evils that are eating away at the growth and development of the still developing countries. And without proper attention from the government and other regulatory authorities, the alarming issue against escalating which in turn is increasing the child mortality rate in Indonesia drastically. Also taking a few strategic actions can change the face of the situation and help is it is a standard quality of life style completed all the basic needs of human life, along with diminishing the dual burden of nutrition.

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