ARTIKEL

Stunting and Child Marriage
Wed, Oct 17th 2018, 15:04












Yeyen Yenuarizki and Rizky Loviana Roza
Jakarta

Last April, netizens were shocked by the news of teenagers in Bantaeng, South Sulawesi, who said they wished to wed. The parents allowed the bride, 14-year-old Fitrah, and groom Syamsuddin, 16, to rush the wedding with the blessing of the local religious affairs office, citing it was the best measure to prevent premarital sex between the sweethearts.  

Outside cities like Jakarta, child marriage is still common practice. Some village communities prefer to marry their children soon, believing child marriage is a way out of poverty. Others believe child marriage is the most effective solution to minimize extramarital sex which many consider sinful.  

The Convention on the Right of Child defines a child as a human being aged below 18 years old, thus a marriage involving someone under 18 is internationally categorized as child marriage, although Indonesian law permits marriages for girls even under 16 with parental consent. According to Amnesty International, child marriage impacts 41,000 girls in lower-income countries every year. The National Social and Economic Survey 2015 also reported that one out of five girls aged 20-24 years old in Indonesia were married for the first time before they turned 18. 

A study from Harvard Medical School that analyzes data from sub-Saharan Africa countries indicated intergenerational consequences between girls’ marriage and their development including health condition. In Indonesia, a comparison of provincial-level data on child marriage and stunting published by Statistics Indonesia (BPS) in 2015 showcases that provinces with high percentage on child marriage simultaneously records high stunting prevalence. 

The report which based on the 2012 National Socioeconomic Survey, revealed that West Sulawesi has the highest prevalence of child marriage at 37.3 percent, followed by Central Kalimantan at 36.7 percent and Central Sulawesi at 34.4 percent. This somewhat aligned with data that showed these provinces ranked among the top 10 provinces for stunting prevalence with 39.7 percent in West Sulawesi, 34.1 percent in Central Kalimantan and 32 percent in Central Sulawesi.

As for Central Kalimantan, the figures confirmed findings of the youth-led primary healthcare intervention, Pencerah Nusantara, which discovered that the median age of pregnant mothers at the Primary Healthcare Center (puskesmas) of Tumbang Miri, Gunung Mas regency was below 18 years old. Little have people realized that child marriage does not only induce lower economic income and low education rate. It also accounts for the alarming rate of stunting in Indonesia, where two out of five children under five experience impaired growth from poor nutrition, repeated infection, and inadequate psychosocial stimulation, according to the World Health Organization. 

Puskesmas Tumbang Miri detected that a huge 44 percent children under five in Kahut municipality were stunted.  Stunted children tend to experience bigger difficulties in studying compared to those with sufficient nutrition intake. They are also likely to experience slow physical and mental development, reduced productive capacity and poor health, as well as higher risk to earlier development of non-communicable diseases including cardiovascular diseases, diabetes and cancer during adulthood. On national matter, if stunting goes on, World Bank predicted that it will lead to national GDP lost as much as 2-3 percent.

Established to improve public nutrition status, Pencerah Nusantara has developed a longitudinal study in Gunung Mas regency for almost three years. They concluded that cutting off stunting can be started by minimizing child marriage as it triggers teenage pregnancy that exposes both mother and child to higher risk of maternal and child death. Together with Puskesmas Tumbang Miri as the local primary healthcare service, they initiated the Young Borneo program to push forward the participation of young health cadres in instilling the understanding of reproductive health to their peers at schools.  

In other low resource setting regional, local governments’ regulations are implemented to better ensure the sustainable implementation and monitoring of child marriage cases. This action mirrors what the Mayor of Gunungkidul, Badingah, chose to do, by prioritizing children’s education rather than getting married early through a 2015 bylaw number 36 on child marriage. This policy has been enforced in several villages and Desa Mertelu earned credit in suppressing child marriage. Five years since implementing the bylaw, Mertelu saw no child marriage. This achievement is a real deal as Gunungkidul holds the highest child marriage rate in Yogyakarta.

All relevant stakeholders including religious leaders, village governments, education institutions, NGOs and even local businesses should work together in eliminating child marriage that has led to high rates of stunting. There should be no more Fitriah or Syamsuddin as they deserve better quality of life through better education, healthcare access and working opportunities. Furthermore, we all have the responsibility to make sure that stunting ends here and now. It can be started by eliminating child marriage.
 
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Yeyen Yenuarizki is a communication for development specialist at the Center for Indonesia’s Strategic Development Initiatives (CISDI). Rizky Loviana Roza is a physician deployed in Gunung Mas regency, Central Kalimantan province, under the Pencerah Nusantara program. Pencerah Nusantara is a youth-led social movement aims to improve primary healthcare services managed by CISDI.

This article has been published in The Jakarta Post, October 2nd 2018.

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