Iron deficiency anemia (IDA) has a long-term impact on each life stage and remains worldwide a major public health problem. Eleven experts were invited to participate in a virtual meeting to discuss the present situation and the available intervention to prevent iron deficiency anemia in Indonesia. The experts consisted of obstetric gynecologists, pediatricians, nutritionists, midwives, a clinical psychologist, and an education expert. Existing interventions focus attention on preconception and early childhood stages. Considering the inter-generational effects of IDA, we call attention to expanding strategies to all life stages through integrating political, educational, and nutritional interventions. The experts agreed that health education and nutritional intervention should be started since adolescence. Further research to explore the effectiveness of these interventions would be important for many regions in the world. The outcome of this Indonesian consensus is applicable worldwide.

Many studies have examined the relationship between nutrition and dental caries. However further studies are needed regarding nutritional factors that can have a strong impact on the incidence of early childhood caries (ECC). Nutrition is one factor that determines caries occurrence. Exposure to carbohydrates in the oral cavity causes carbohydrate fermentation, which produces acids. This acidic substance erodes the enamel surface of teeth, leading to ECC. This systematic review and meta-analysis of cohort studies assessed the aspects of nutrition and diet that contribute to the incidence of ECC in children. We conducted a systematic review by extracting data according to Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. A search was conducted of published articles in Scopus, MEDLINE via PubMed, and Science Direct using the keywords “nutrition,” “sugar,” “carbohydrate,” “dietary habit,” “dental caries,” and “oral health.” The protocol was registered at PROSPERO 2023 (Registration ID: CRD42023394583). The article screening yielded 6 articles that met the inclusion criteria. From the total of 443 studies found. Those that could not determine a correlation between the ECC variables and nutrition and with data analyses that only used a bivariate analysis were excluded. The results of the meta-analysis showed that nutritional factors had the strongest impact on caries including feeding practice (OR 3.64; 95% CI 2.03, 6.55), sugar intake (OR 3.24; 95% CI 2.59, 4.03), and low fruit and vegetable intake (OR 2.71; 95% CI 1.47, 5.01). Two nutritional factors had the strongest relationship with the risk of ECC: feeding practice and sugar intake. The lowest risk factor for causing ECC was low fruit and vegetable intake.

Background: Anemia poses a significant challenge to the health and productivity of adolescent girls. This has prompted the Indonesian government to initiate a program to distribute iron and folic acid (IFA) supplements. Therefore, it is necessary to address the level of acceptance of or compliance with IFA supplementation among adolescent girls. Objectives: This study aims to assess the acceptance level of the program among adolescent girls in Indonesia. Methods: A PRISMA-guided literature search was conducted in the NCBI, PubMed, Scopus, ScienceDirect, and Garuda databases for experimental or observational research published in Scopus-indexed journals from Q1 to Q4 or in Sinta 1 to Sinta 3 from 2013 to 2023. Discussion: Eight studies conducted in five provinces in Indonesia showed that the coverage of IFA supplement distribution programs was less than 50%, with acceptance levels between 0% and 25.2% according to the Indonesian standard. The majority of IFA supplement distribution programs were not implemented in accordance with the standard. In addition, the supplements were not consistently provided every week, nor were they taken immediately at school. Factors that influence the consumption of IFA supplements among adolescent girls included knowledge, motivation, self-efficacy, attitude, parental influence, peer pressure, school policies and commitments, and the IFA supplements provided. Positive factors encouraged consumption, while negative factors discouraged consumption. Conclusions: The acceptance level of the IFA supplement distribution program remains low. To improve this, it is essential to increase the knowledge of adolescent girls and their parents about anemia, including its definition, causes, side effects, and symptoms, as well as the benefits and risks of not taking IFA supplements. Other necessary measures include improving the distribution system and providing supporting facilities.

Although low birth weight (LBW) is still a major health problem in Indonesia, studies about determinants of LBW with large sample sizes are still limited. This study aimed to examine the association between LBW and maternal characteristics, as well as socio-economic backgrounds in Indonesia. A secondary analysis of 2017 Indonesian Demographic and Health Survey (IDHS) was conducted, specifically using the questionnaires for women of childbearing age. A bivariate chi-square analysis and a multivariate logistic regression analysis were performed. As many as 6.7% of infants were born with LBW. In terms of maternal characteristics, women who gave birth to twins were 20.30 times more likely to have infants with LBW (p < 0.001). Women with birth intervals of <24 and ≥24 months were likely to have LBW infants (p < 0.05). Complications during pregnancy were also associated with LBW (1.99 times higher than women with no complications) (p < 0.001). In terms of socio-economic factors, women with higher education and higher wealth index were less likely to give birth to infants with LBW. Additionally, marital status and type of residence were also significantly associated with a higher risk of LBW. In conclusion, LBW was associated with maternal characteristics and socio-economic backgrounds among women of childbearing age in Indonesia, including twin births, birth interval, and pregnancy complications as well as educational attainment, wealth index, marital status, and type of residence.

Background: Antenatal care (ANC) is low in developing countries, with an estimated 20% of Indonesian women not initiating ANC during the first trimester. The present study sought to determine the impact of a mentoring program on the timing of the first ANC visit. Methods: This cluster randomized controlled trial was conducted in 3 subdistricts of the Bantul District, divided into 61 clusters per treatment arm, with a final sample size of 205 confirmed pregnant women. The mentoring program consisted of (1) health education, (2) monitoring, and (3) text-message reminders. The primary outcome was the timing of first ANC visit. A multilevel mixed-effect logistic regression model was used to measure the effect of the program on the likelihood of having an earlier first ANC visit, with statistical significance at α=0.05. Results: At the individual-level, the intervention group had a mean time of first ANC visit±2 days earlier than the control group (P<0.05). After adjusted for cluster and other covariates, the odds of starting the first ANC visit early (<39 days of gestation) was higher in the intervention group (adjusted odds ratio [AOR] 3.00; 95% confidence interval [CI] 1.17-7.72). Conclusion: Maternal mentoring can improve the timing of the first ANC visit. This program has the potential to be adopted by health care systems in settings where there is little education on the importance of ANC. Future research could extend the length of mentorship until delivery in order to better understand the relationship between mentorship and early ANC on pregnancy outcomes.

Stunting is one of the public health problems that has yet to be solved in Indonesia. This study developed synbiotic fermented milk with iron and zinc fortification that was then tested in a clinical setting. The product was made from skimmed milk and fructooligosaccharides (FOS) and fermented with Lactobacillus plantarum. A sample of 94 stunted children under five years old were randomly assigned to intervention or control groups. The intervention group received double-fortified synbiotic milk, while the control group drank non-fortified milk. After three months, the number of normal children in both groups, according to weight- or height-for-age z-score category, was found to be increasing. However, the difference between the two groups was not significant (p > 0.05). The study suggests that fermented milk may have a good effect on child growth. Further research is needed to deepen the potency of synbiotic fermented milk for stunted children.