Integrating immunisation, sanitation and nutrition to improve children’s health in Indonesia: a holistic programme with Gavi, Unilever and GroupM

Introduction

Indonesia has made huge strides in its journey to becoming a middle-income economy. Malnutrition, however, remains a heavy burden, with eight million children suffering from stunting. On top of that, a staggering 25% of child deaths under one are caused by pneumonia and diarrhoea. This is compounded by the fact that 1.7 million children in Indonesia were under-vaccinated between 2019 and 2021 due to rising mistrust in vaccinations as a result of the Covid-19 pandemic.

The Government of Indonesia has identified West Java and South Kalimantan provinces as having highest burden of stunting, diarrhoea and pneumonia, as well as suboptimal vaccine coverage. Research found that parents do not consider immunisation and handwashing with soap to be a key aspect of children’s early childhood development. Only 27% of parents of children under the age of two report having their child fully immunised, and knowledge about the importance of handwashing with soap at critical occasions can be as low as 17%.

Programme overview

This unique programme brings together a range of partners, each specialists in different sectors to create a truly holistic approach. Gavi, the Vaccine Alliance, leads on the immunisation component, Unilever brings experience on sanitation and hygiene, The Power of Nutrition brings its technical expertise on nutrition and finally, GroupM as an implementing partner, uses its experience in marketing to ensure the behavioural change elements create lasting impact.

The overall aim of the programme is to reach over one million ‘zero-dose’ children under five, vulnerable to malnutrition, in multiple provinces, including West Java and South Kalimantan. This is being achieved through a variety of different and complementary interventions, such as raising parents’ awareness of the importance of immunisation, health, nutrition and handwashing, alongside strengthening the health system to identify, treat and support families with a malnourished child.

The programme is helping to support mothers and fathers to introduce vital health, handwashing with soap and nutrition behaviours into everyday routines. We are doing this through community engagement and supporting improved communication between mothers and fathers, especially embracing the father’s role. Face-to-face community engagement has also been complemented with the roll-out of digital and print communications materials that address barriers in accessing health and nutrition services. These materials also promote the importance of handwashing with soap.

As well as communications and community engagement activities, we have been working with health workers to help them promote best health, nutrition and hygiene practices to pregnant women and parents with young children.

Next steps

Together with partners, we’re scaling up the programme to reach more subdistricts with community and family engagement activities. The scale-up effort also includes vaccinations for children.

Read about our other programme in Indonesia here.