Deviana W. Dewi
Political Economy of Child Malnutrition: A Mixed Method Study of Indonesia's Stunting Reduction Policy and Progress
Why does child malnutrition, particularly stunting, matter in international development?
Children are defined as stunted if their height-for-age z-score is more than two standard deviations below the 2006 WHO child growth standard median. Compared to monetary poverty comparison across countries, stunting serves as an accurate marker for poverty and underdevelopment for two reasons. First, it is challenging to establish a poverty line that is consistent across countries. The use of Purchasing Power Parity (PPP) rates to compare poverty is problematic because the consumption choices of the poor is not necessarily captured by the basket of goods used to establish PPP measures. Second, children's anthropometric shortfall can reflect the inability to meet basic needs. Height can help identify the chronically deprived, with much evidence on schooling, learning, and wages indicated via height. For instance, children who were not stunted at 36 months old are 33% less likely to live in poverty as an adult. Complementing the monetary indicators, measures of stunting therefore provide meaningful insight to development between countries.
Through my PhD three-paper dissertation research with a mixed-method approach, I aim to answer the following research questions.
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How and why did stunting become a political priority in Indonesia as demonstrated by the adoption of the National Strategy to Accelerate Stunting Prevention in 2018?
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How did Indonesia’s bureaucracy implement the multi-sectoral stunting reduction policy in a decentralized context?
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Did Indonesia’s anti-stunting policy affect district-level stunting rates where it was implemented?
The dissertation uses a mixed-method approach. It qualitatively unpacks the policy processes, and quantitatively examines the policy impact using a difference-in-differences analysis as the policy was implemented in a staggered manner. It bridges political science and public health. Much health policy research pays little attention to the policy-making process. For the governance audience, it sheds light on how neglected issues (stunting) gain political attention and resources, and how to translate a commitment into concrete actions. For the global health audience, I attempt to offer political economy strategies to address stunting.
PhD Dissertation Committee
Advisor: Jeremy Shiffman, Ph.D.
Bloomberg Distinguished Professor
of Global Health Policy
Johns Hopkins School of Advanced International Studies
Thomas Pepinsky, Ph.D.
Walter F. LaFeber Professor of Government and Public Policy
Director, Southeast Asia Program
Cornell University
Ritam Chaurey, Ph.D.
Assistant Professor, International Economics Program
Johns Hopkins School of Advanced International Studies
Jessica Fanzo, Ph.D.
Professor of Climate
Director, Food for Humanity Initiative
Columbia University, The Columbia Climate School
Matthew Kocher, Ph.D.
Senior Lecturer
Director, Doctor of International Affairs
Johns Hopkins School of Advanced International Studies
Food Systems Countdown Initiative
Food systems are a foundation of human and planetary well-being but they also unfortunately contribute to ill health, inequity, environmental degradation, and GHG emissions. How to solve this paradox? We demand urgent food systems transformation. We don't have forever ⏳.
I work part-time as a Research Assistant for The Food Systems Countdown Initiative (FSCI) under the guidance of Kate Schneider. FSCI is an interdisciplinary, multi-institution scientific partnership to monitor global food systems in service of meeting the SDGs and other global goals, and to provide and analyze relevant food systems data across countries.
After a two-year process of research, analysis, and consultation, we recently published on Nature Food the world’s first attempt to monitor changes in our global food systems "The state of food systems worldwide in the countdown to 2030." This analysis suggests 50 indicators of food systems across five themes: (1) diets, nutrition and health; (2) environment, natural resources and production; (3) livelihoods, poverty and equity; (4) governance; and (5) resilience. We are currently exploring how to navigate transformative choices in food systems considering multiple dimensions and interactions between these diverse themes.
Nutrition as a basic need: A new method for utility-consistent and nutritionally adequate food poverty lines
Nutrition is a basic need, so is a healthy diet. The current poverty estimates measured from poverty lines that use energy-based food baskets do not reflect this need. We need a reset of the utility level defining the poverty threshold. With this reset, many more people in the world are mired in poverty-- energy poor versus nutritionally poor. In this ongoing research, I join Kristi Mahrt (International Food Policy Research Institute -- IFPRI), Anna W. Herforth (Food Prices for Nutrition project), Channing Arndt (IFPRI), and Derek Headey (IFPRI) to redefine a nutrition-sensitive poverty line that follows cost of basic needs principals, or "healthy diet poverty line" in Indonesia. We use the 2019 National Socio-Economics Survey (SUSENAS) and the Guidelines for Balanced Nutrition, Regulation of the Minister of Health of the Republic of Indonesia, No. 41, 2014. This work incorporates healthy diet guidelines into the standard cost of basic needs methodology widely used to estimate poverty in LMICs. The cost of basic needs approach aligns the food poverty line with a calorie target. Our approach aligns the food poverty line with both a calorie target and healthy diet guidelines such as those found in food-based dietary guidelines. The methodology has been applied to a Myanmar study.