NUTRITIONAL BASELINE SURVEY Sumba Timur - Nutrition ...

SEAMEO-Tropmed Community Nutrition Programme gtz 

NUTRITIONAL STATUS AMONG 

PRESCHOOLERS AND THEIR MOTHERS 

FROM SELECTED VILLAGES 

IN EAST SUMBA, 

NUSA TENGGARA TIMUR, 

INDONESIA 

Preliminary report 

Erika Wasito Universitas Indonesia 

Anne-Madeleine Bau P.O.Box 3852 

February 1999 Jakarta 10038 

Indonesia 

Deutsche Gesellschaft für 

Technische Zusammenarbeit (GTZ) GmbH

ACKNOWLEDGEMENTS 

CKNOWLEDGEMENTS 

This survey became only possible by the assistance and support of many people. We would like to 

express our highest gratitude to: 

Enumerators 

Enumerators 

Ibu Irnawati Ibrahim 

Bapak Abukabar M.Said 

Ibu Juliana Lomi 

Rambu Lika Yuliana 

Ibu Nurhayati Chartikasari 

Bapak Boby Siokan 

Rambu Yuliana Pihuwala 

Ibu Oktavina Tanda 

Bapak Yudi Y. Lobo 

Ibu Kathrin Djoe 

Bapak Oemar Ali Fadaq 

Bapak Andreas 

Heads Heads Heads of of the the village 

village 

Kaders 

Kaders 

Midwives Midwives 

Midwives 

NT NT-Project NT Project Sumba and Lombok 

Bapak Pua Muhammad Saleh 

Bapak Kosmas Ngala 

Bapak Dominggus Umbu Zaza 

Ibu Dorothea Timbu 

Ibu Maria Konsolata Mude 

Bapak Hendrik Hepewila 

Mas Nicolaus Hendrik Hepewila 

Bapak K-D Peters, Mataram 

Bapak Ajeng, Mataram 

Bapak Colin Gleichmann, Mataram 

Penbangunan Penbangunan Penbangunan Masyarakat Masyarakat Desa, Desa, PMD 

PMD 

Bapak Frans Ph. Sa. Drs. Head of Office 

Bapak Melkissedek Nabasa 

Ibu Lolang 

Dinas Dinas Kesehatan 

Kesehatan 

Bapak Dr. Stefanus Bria Seran, Head of Office 

Last but not least we would like to express our special thanks to all mothers who came with their 

children to the POSYANDU or house of the head of the village. They had to walk and to wait sometimes 

for a long period to be measured. All of them waited patiently.

Terima kasih banyak! 

Jakarta, February 1999 Erika Wasito Anne-Madeleine Bau

Nutritional Baseline Survey 1998, East Sumba 

Table of contents 

List of tables ............................................................................................................................ II 

List of figures........................................................................................................................... III 

Abbreviations........................................................................................................................... IV 

Summary ................................................................................................................................. V 

1. Introduction................................................................................................................... 1 

2. Background .................................................................................................................. 3 

3. Methodology................................................................................................................. 5 

3.1 Survey area and sample size........................................................................................ 5 

3.2 Structure of data assessment....................................................................................... 6 

3.3 Preparation of the field work......................................................................................... 7 

3.4 Data Analysis................................................................................................................ 8 

4. Results and Discussion ................................................................................................ 9 

4.1 Socio-economic and demographic data........................................................................ 9 

4.2 Hygiene, water sources and seasonal water shortages.............................................. 13 

4.3 Housing conditions ..................................................................................................... 16 

4.4 Agricultural activities................................................................................................... 17 

4.5 Household food consumption and seasonal food shortages....................................... 21 

4.6 Household expenditures ............................................................................................. 25 

4.7 Problems experienced by households ........................................................................ 26 

4.8 Information about IDT-villages activities ..................................................................... 27 

4.9 Health care behaviour of mothers............................................................................... 29 

4.10 Nutritional status of mothers ...................................................................................... 32 

4.11 Nutritional status of children ....................................................................................... 34 

4.12 Infant and Child Nutrition ............................................................................................ 40 

4.13 Child Health................................................................................................................ 45 

5. Determinants of children’s nutritional status for NT-Project village ............................. 50 

6. Discussion and conclusion ......................................................................................... 57 

7. Recommendation for an community nutrition programme in East Sumba .................. 60 

Appendix 

• Map of East Sumba and NT-Project region 

• Questionnaire 

• Tables for further explanation 

I


List of tables 

Table 1: Prevalence of stunting and wasting in several regions of Indonesia 

Table 2: Villages and number of population included in the nutritional survey carried out in 

the NT Project area Sumba Timur in 1998 

Table 3: Selected indicators for nutritional status and health 

Table 4: Selected socio-economic information about the households in project and nonproject 

villages 1998 

Table 5: Frequency distribution (%) of origin and religion of the mother 

Table 6: Frequency distribution (%) of education of head of the household (hh) and the 

mother 

Table 7: Frequency distribution (%) of occupation of head of the household (hh) and the 

mother 

Table 8: Frequency distribution (%) of selected indicators for socio-economic status 

Table 9: Frequency distribution (%) of water sources for drinking, bathing, washing and 

cooking water 

Table 10: Frequency distribution (%) of distance to collect drinking water 

Table 11: Frequency distribution (%) of the place of defecation 

Table 12: Frequency distribution (%) of general characteristics of the house 

Table 13: Frequency distribution (%) of own land or leased land 

Table 14: Frequency distribution (%) of reason for not cultivation all of the land 

Table 15: Frequency distribution (%) of cultivated land type 

Table 16: Frequency distribution (%) of the cultivation and usage of crops by the surveyed 

households 

Table 17: Frequency distribution (%) of possession and usage of livestock 

Table 18: Frequency distribution (%) of consumption of selected foods in surveyed 

households 

Table 19: Frequency distribution (%) of reasons for food shortages 

Table 20: Frequency distribution (%) of coping strategies for food shortages 

Table 21: Frequency distribution (%) of monthly expenditure (Rupiah) by surveyed 

households 

Table 22: Frequency distribution (%) of major problem in agriculture mentioned by 

households 

Table 23: Frequency distribution (%) of major problem in daily life 

Table 24: Frequency distribution (%) of POKMAS participation 

Table 25: Frequency distribution (%) of type and source of training and aids received by 

POKMAS members 

Table 26: Frequency distribution (%) of mothers condition in project and non-project villages 

Table 27: Use of health facilities for antenatal care and family planning during the last 

pregnancy 

Table 28: Frequency distribution (%) of participation of family planning methods 

Table 29: Frequency distribution (%) of difficulties to reach the 

PUSKESMAS/PUSTU/POLINDES 

Table 30: Frequency distribution (%) of nutritional status of the mothers by surveyed area 

Table 31: Mothers haemoglobin value and frequency distribution of anaemia 

Table 32: Sex and age distribution (%) for children under five years 

Table 33: Anthropometric characteristics 

Table 34: Mean values of anthropometrical indicators by age category 

Table 35: Prevalence (%) of malnutrition expressed by stunting, underweight and wasting 

per village. 

Table 36: Frequency distribution (%) of time of breastfeeding duration and pre-lactal feeding 

II


Table 37: Frequency distribution (%) of children who received breast milk and additional food 

past 24 hours according to age categories in project and non-project villages 

Table 38: Frequency distribution (%) exclusively breast fed children under 6 months of age 

by surveyed area 

Table 39: Frequency distribution (%) of time complementary food is given to the child 

Table 40: Frequency distribution (%) of daily meal frequency beside breast milk in project 

villages (n=365) 

Table 41: Frequency distribution (%) of daily meal frequency beside breast milk in nonproject 


Table 42: Food frequency (%) of children older than 12 months (one week prior to the 

survey) in project villages (n=262) 

Table 43: Food frequency (%) of children older than 12 months (one week prior to the 

survey) in non-project villages (n=149) 

Table 44: Prevalence (%) of diseases 

Table 45: Frequency distribution (%) of children vaccination coverage 

Table 46: Frequency distribution (%) of micro-nutrient supplements received by children 

older than 12 months during last year 

Table 47: Children’s micro nutrient status 

Table 48: Child’s mean age of children who suffered and not suffered from anemia 

Table 49: Association between number of children under 5 years of age in project village 

households and nutritional status of children 

Table 50: Association between occupational income status of the mother and nutritional 

status of children 

Table 51: Association between head of the household education level and nutritional status 

of children 

Table 52: Association between housing condition (material used) and nutritional status 

Table 53: Association between fish and cooking oil consumption and nutritional status 

Table 54: Association between possession of KMS and height for age 

Table 55: Association between vaccination coverage and height for age 

Table 56: Percentage of children who suffer from diarrhoea by source of drinking water 

Table 57: Association between ARI and nutritional status of the children 

List of figures 

Figure 1: Percentage of households claiming to have insufficient water according to months 

of the year 

Figure 2: Percentage of households claiming to have food shortages according to months of 

the year 

Figure 3: Prevalence of stunting based on age group in project and non-project villages 

Figure 4: Prevalence of underweight based on age group in project and non-project villages 

Figure 5: Prevalence of wasting based on age group in project and non-project villages 

III


Abbreviations 

ARI Acute Respiratory Infections 

BMI Body Mass Index 

GTZ Gesellschaft für technische Zusammenarbeit und Entwicklung 

IDT Program Impres Desa Tertinggal 

KMS Kartu Menuju Sehat (Growth chart) 

Hh Household 

NCHS National Center for Health Statistics, USA 

NTB Nusa Tenggara Barat (West Nusa Tenggara) 

NTT Nusa Tenggara Timur (East Nusa Tenggara) 

PMD Pembangunan Masyarakat Desa (Village Community Development) 

POKMAS Kelompok Masyarkat (Community group) 

POLINDES Poliklinik Desa (Village clinic) 

POSYANDU Pos Pelayanan Terpadu (Integrated Health Post) 

PUSKESMAS Pusat Kesehatan Masyarakat (Community Health Services) 

PUSTU Puskemas Pembantu 

UNICEF United Nations Children`s Fund 

WHZ Weight to Height 

WHZ


Summary 

The nutritional baseline survey East Sumba, carried out in November/December 1998, 

covered the villages of the NT-Project „Self-help promotion for low income communities in 

the critical areas in NTT and NTB“. The aim of the survey was to obtain data about the 

nutritional situation of preschool children and their mothers, to plan intervention of a 

community nutrition program as well as to have a data base for evaluation of project 

activities in the project region. The survey was carried out in 12 villages and 4 subdistricts, 

namely Haharu, Lewa, Pahangulodu and Pandawai. Eight villages were the project village of 

the NT-Project and in addition one village per sub-district were selected as non-project 

villages. , A total 455 households and 578 children were assessed, consisting of 294 

households and 365 children in eight NT project villages and 161 households and 213 

children in four non-project villages. 

The typical households in the survey area were extended families with an average of 5-6 

household members and 1.4 underfive children. There were no significant differences in 

household size and structure in project and non-project villages. The main religions in 

project and non-project villages were traditional belief (Merapu) and Christian. 80% of the 

heads of the household and mothers attended only elementary school (up to 6 years of 

schooling) in project villages and 70% in non-project villages. Significantly higher (p


The material used for house construction indicated that the non-project villages were 

wealthier than the project villages. Most of the households used relatively expensive 

materials for the floor, wall, and roof like timber and tile. 

The majority of the households (83.3% in project and 82% in non-project villages) owned 

their farmland, mostly dry land. The common land size was 0.51-1.0 ha in project villages 

and 0.01-0.50 ha in non-project villages. Leasing land or share cropping was not common. 

In project and non-project villages, the main problem to cultivate all of the land was lack of 

manpower. The crop pattern in project and non-project villages was the same. The 

households’ mainly cultivated corn, coconuts, beans, cassava and banana which were 

mostly used as own consumption. Chickens and pigs were the main animals raised by the 

households. Households in non-project villages raised significantly more animals than in 

project villages. More households in the project villages joined community group called 

POKMAS (kelompok masyarakat), attended training and got aid to carry out their agricultural 

activities. 

Almost 90% of the households stated that they suffered from food shortages that started in 

July until March because of small harvest, pest and diseases, and lack of rain. The main 

coping strategies for food shortages were selling assets and changing eating pattern. The 

food consumption pattern was also unfavourable. Meals mainly consisted of staple food (rice 

mix with corn) and vegetables. The consumption of protein sources (plant or animal 

protein), fruits and energy food (oil) were very low. 

Regardless the fact of unfavorable food pattern, households’ main expenditure was on food. 

Ninety percent of the household in project and non-project villages had spent their money on 

food. In general, the households in non-project villages spent more money on food, health, 

agriculture and social activities than the project villages. 

Lack of equipment was the main problem in agriculture stated by the households in project 

and non-project villages while the major problem in daily life was food shortages, low income 

and frequently ill. Even though the water problem might become the underlying factors of 

unfavorable situation in the villages, this problem was not mentioned very often. 

VI


8.8% in project and 12.4% in non-project villages of mothers experienced either stillbirth or 

miscarriage. In both surveyed areas, half of the mothers received ante-natal care less than 4 

times during the last pregnancy. In project villages 13.6% did not get service for iron 

supplementation and 16.4% of them mentioned because no service were available. 

Participation in family planning was 20% lower as the national average. 36.4% of the 

mothers in project villages and 9.9% in non-project villages claimed to have difficulties to 

come to the health services, because it is to far. 

Based on the BMI classification, 30% of the mothers in project villages and 34% in nonproject 

villages were chronically energy deficient. Mother’s anemia prevalence was 47.4% in 

project and 33.3% in non-project villages. Visible goiter was found in 3.1% of the mothers in 

project villages and 2.5% in non-project villages. 

The prevalence of stunting of children under 5 years was 44.4% in project villages and 

36.3% in non-project villages. The prevalence of underweight and wasting tended to be 

higher in project villages (41.1% and 11.8%) than in non-project villages (38.2% and 7.4%) 

but the difference was not statistically significant. The prevalence of low nutritional status 

increased with the age of the child. The highest disease prevalence of preschool children in 

project and non-project villages was acute respiratory infection (58.6% in project and 52.6% 

in non-project villages). Anemia prevalence was 64.9% in project villages and 62.5% in nonproject 

villages. Anemia was more prevalent in younger children. 

About 40% of mothers claimed that they gave colostrum to their child in project and 75% in 

non-project villages. The colostrum feeding rate seemed still to be a problem of traditional 

believe in the villages. Almost all of the children were breast fed for one year in both 

surveyed areas. About one fourth in project and two third in non-project villages already 

received additional food besides breastmilk within the first four months of age. The 

percentage of children, who had not got complementary food at the age more than 6 months 

was higher in project villages (19.2%). 

VII


The meal frequency in the age group of 12-18 months was too low in both surveyed areas. 

More than 12% got only twice a day a meal, which is much too few since children need more 

often feeding per day to cover their requirements. Besides the staple food, only vegetables 

and sugar were given in daily basis. The percentage of children who never got animal 

protein was twice as high in non-project villages than in project villages. Only small 

percentage of children (less than 10%) got oil/ fat in daily basis and almost 35% only got it 

once per week or never at all. 

Related to socio-economic condition, the nutritional status of the children was worse when 

more underfive children lived in the household (in terms of WHZ and WAZ), lower education 

level of head of the households (in terms of HAZ and WAZ) and mothers did not earn money 

(in term of WAZ). The fish frequency consumption was associated positively with the height 

for age z-scores. In term of health care, children who owned KMS, or got diphtheria and 

polio immunisation had a better nutritional status. Younger children owned no KMS and had 

incomplete immunisation coverage. Acute respiratory infection decreased the nutritional 

status of preschoolers in terms of HAZ and WAZ value. In overall, the condition in nonproject 

villages was better than in Nusa Tenggara Project villages. 

VIII


1. Introduction 

The Southeast Asian Ministers of Education Organisation (SEAMEO) has established a 

regional center in community nutrition since 1966. Training, research and service are the 

major activities through which the center contributes towards achieving a better regional 

nutritional status. One of the main aspects of the training is the Management of Community 

Nutrition Programs. Applied research, aiming to identify options to improve nutritional status 

of communities, is carried out mainly in Indonesia but also in other countries of the region. 

The German Government, through the Deutsche Gesellschaft für Technische 

Zusammenarbeit (GTZ), has supported the SEAMEO Nutrition Center since 1990. The 

German support will continue until July 1999, and a final support phase is recommended 

from August 1999 – September 2001. 

Assuming that the German support for the SEAMEO Center after July 1999 will continue, it 

would like to gain more experience in community interventions and wants to have the 

opportunity to develop further as national and international consultant. To reach this purpose 

SEAMEO need to have experience in carrying out its own project interventions. 

The Government of Indonesia in co-operation with GTZ want to focus NTT and NTB with a 

comprehensive Program Approach. It is expected that the implementation of three projects 

components in the form of a coherent project package will help to achieve a more significant 

contribution towards improving the welfare of the poorer population. 

SEAMEO wants to gain experience through co-operation with 3 other projects of GTZ. 

NT-Project: Self-help promotion for Low Income Communities in the critical Areas in NTT 

and NTB aiming at strengthening institutions at the village and district level to perform 

support functions for village self-help groups. 

SFMD-Project: Support for Decentralisation Measures, Strengthening Local Governments in 

NTB and NTT aiming at strengthening local government in managing regional development 

Health Project: Improvement of the District Health Care Delivery System in NTT aiming to 

strengthening the overall performance of the major elements of the district health services in 

the context of ongoing efforts towards district autonomy. 

The overlap of project areas of the above mentioned GTZ-projects will be in Alor and 

Sumba. Therefore SEAMEO decided to carry out Nutritional Baseline Surveys in the project 

villages of NT-Project to investigate the health and nutrition situation and to be able to plan 

suitable interventions which can be carried out by SEAMEO. 

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The first survey was carried out in East Sumba, November-December 1998. The results are 

presented in this report. The survey in Alor will be conducted in March by the assistance of 

the master-students of SEAMEO. 

In order to assess the nutrition and health situation the survey consisted of two parts: 

1. Nutritional Baseline Survey to get a data base on nutrition and health situation and 

2. Evaluation of POSYANDU activities, to access the quality of health services in the area. 

This report presents the results of the nutritional baseline survey, which was carried out in 

November and December in villages of East-Sumba district, where the NT-Project is active. 

The results of the evaluation of POSYANDU activities will be reported in a separate report. 

Survey objectives 

The aim of the survey was to 

• obtain representative data about the nutritional situation of children under 5 years and 

their mothers in the project region 

• find determinants of nutritional status by assessing 

- the socio-economic situation in the family, 

- the health status and knowledge 

- the feeding habits of children under 5 years 

• to provide a data base for evaluating project activities of NT-Project and the future 

SEAMEO project 

• to plan interventions to improve the caring capacity on household level. 

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2. Background 

East Nusa Tenggara consists of 12 districts. The province covers a land area of 47.349,90 

km 2 and has a population of 3.402.503 with an average density of 70/km 2 compared to the 

national average of 99/km 2 . The study was carried out in East Sumba. East Sumba district 

consists of nine sub-districts with a total area of about 7.000 km 2 and a population of 

170.747 in 1996 this means a population density of 24 persons/km 2 . 

The percentage of population classified as poor is 21.2% in NTT, compared to 13.7% on the 

national average (1993). East Nusa Tenggara is one of the provinces in the eastern part of 

Indonesia targeted for IDT program. In order to alleviate poverty problem in Indonesia, a 

Presidential Instruction Program for less developed village was issued in 1993. The program 

referred as “Program Impres Desa Tertinggal“ (IDT) is aimed to improve continuos activities 

to alleviate poverty in less developed villages. 

The topography of NTT, apart from the coastal areas, is hilly and mountainous. The climate 

is dry and tropical with average temperature between 24 0 and 34 0 Celsius. 66.3% of the land 

area are classified as critical. The remaining 33.7% of land are suitable for sustained 

farming, consist of 2.6% for wet farming and 31.1% for dry farming. Approximately 80% of 

the working population are engaged in agriculture. The percentage of rural population in 

NTT is 82.1 compared to 64 on national average. 

The school attendance ranks very low in NTT in comparison to other provinces of Indonesia. 

The percentage of population above the age of 10 who never attended or finished primary 

school is the fifth highest in NTT with 54.8% compare to 42.1% on national level. The 

average illiteracy rate for NTT is quoted as 20.5% compared to 13.4% on national average, 

with 24% for females and 16.8% for males. In NTT the predominant religion is Christian. 

Indigenous religions are particularly common in both parts of Sumba. In these two 

Kabupaten traditional influence and barriers are particularly strong. 

The remoteness of many areas has allowed traditions to be maintained strongly in some 

parts of the province. Childbirth is considered as a natural event, which should preferably 

happen at home and in the presence of the family. Inadequate maternal behaviour regarding 

pregnancy and childbirth in NTT is also reflected in poor compliance with the recommended 

schedule for four antenatal visits for each pregnant women. 

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The contraceptive prevalence rate in NTT is with 62.7% lower than the national average of 

69.6%. The median number of months since previous birth was 41.8 months in Indonesia 

and only 33.2% in NTT. 

The overall disease pattern in NTT is governed by three major infectious diseases: Malaria, 

respiratory infection and diarrhoea. Among non-infectious diseases the visible goitre rate is 

significantly higher in NTT with 31.5% compared to 6.8 for all Indonesia. 

Coverage with vaccination against tuberculosis (BCG), diphteria, pertussis and tetanus 

(DPT), polio and measles between preschool children are also considered lower in NTT than 

in overall Indonesia. Nevertheless, the reported incidence rate for measles both in the age 

group under one year and between one and four years is lower than the national average. 

The relatively sparse distribution of population in NTT bears particular difficulties with regard 

to coverage with health services and facilities (Profil Kesehatan Indonesia 1996). 

The nutritional status of children in NTT is significantly worse than in Indonesian average. 

SEAMEO Tropmed carried out several nutrition baseline surveys in Indonesia. According to 

table 1 the highest stunting rate were found in Nusa Tenggara and Kalimantan. 

Table 1: Prevalence of stunting and wasting in several regions of Indonesia 

Province Study area Year 

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n 

Stunting 

(%) 

Wasting 

(%) 

NTB (Flores) PPSTN project area 1989 667 52.0 11.0 

NTB (Lombok) 9 sub-villages 1990 660 57.9 10.1 

NTB (Lombok) PPSTN project area 1992 480 46.6 14.7 

NTB (Sumbawa) Kab. Dompu 1995 234 44.4 14.1 

NTB (Sumbawa) Kap. Sumbawa 1995 235 45.1 7.2 

NTB (Lombok) PPSTN project area 1996 525 48.8 10.8 

NTT (Flores Timur) Sikka, 17 villages 1997 614 51.3 10.1 

West Kalimantan 5 villages 1992 131 47.3 12.3 

West-Kalimantan 5 villages 1993 202 69.3 13.9 

West Kalimantan SFDP project area 1996 178 51.4 16.6 

West Sumatra Pasaman, 40 villages 1992 911 44.2 12.0 

West Sumatra Ophir, 2 villages 1992 719 49.1 14.0 

West Sumatra ProRLK project area 1994 386 40.8 10.1 

South Sulawesi Jeneponto, 25 villages 1992 833 38.9 15.9 

East Java 2 villages 1992 182 34.5 - 

East Java Credit groups 1993 191 33.0 - 

East Java Malang, 11 villages 1994 434 32.5 8.3 

East Java Blitar 1995 451 30.2 - 

East Java PHBK 1993 188 31.9 9.0 

Jakarta East Jakarta 1993 308 22.4 15.9 

Jakarta East Jakarta 1998 660 16.1 17.9


3. Methodology 

3.1 Survey area and sample size 

The survey covered the villages of the NT-Project “Self-help promotion for low income 

communities in the critical areas in NTT and NTB”. The numbers of households were 

randomly selected from the complete lists of families in each village, who had at least one 

child under the age of five. 

The number of the random sample is composed as follows: 

Expected prevalence = p of about 35 % chronically malnutritioned children in villages from 

previous survey (Phan Ju lan, June 1998). 

n= 4x p x (100-p) 

25 

p= expected prevalence 

Number of random sample 

n= 4x 35 x 65 = 364 children 

25 

Total number of random sample: 364 children 

The survey was carried out in 12 villages from 4 sub-districts. Eight villages are the project 

village of the NT-Project and in addition one village per sub-district were selected as nonproject 

villages. The non-project villages are close by and similar in terms of number of 

population to the 8 project villages. It was decided to include non-project villages to get an 

impression of the current situation in project villages in comparison with non-project villages 

and to provide data for a comparison in a follow-up survey at the end of project activities. A 

total of 455 households and 578 children were assessed, which consisted of 294 households 

and 365 children in eight NT project villages and 161 households and 213 children in four 

non-project villages. All children under 5 years in one selected households were assessed. 

The following table presents the village names with village area, population number and 

number of surveyed households per village. 

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Table 2: Villages and number of population included in the nutritional surveys carried out in 

the NT Project area Sumba Timur in 1998 

Subdistrict Village Village area 

km 2 

Total No. of 

population in 

village 

Surveyed 

hh 

Village 

classification 

Haharu Wunga 47.0 1147 33 NTT Sumba 

Napu 142.6 772 39 NTT Sumba 

Mondu 99.4 1037 36 Non-project 

Lewa Praibokul - 1047 38 NTT Sumba 

Kombapari 25.0 1702 36 Non-project 

Pahangulodu Kabaru 58.7 687 29 NTT Sumba 

Lambakara 34.3 1079 45 Non-project 

Pandawai Kotakawau 157.6 1370 43 NTT Sumba 

Pambotanjara 17.9 1241 31 NTT Sumba 

Mbatakapidu 48.2 1549 39 NTT Sumba 

Maubokul 152.1 1572 42 NTT Sumba 

Palakahembi 105.1 4200 44 Non-project 

3.2 Structure of data assessment 

The nutritional status of children under five years of age and their mothers was used as the 

indicator for the nutritional status of the whole population in the surveyed area. The 

questionnaire was designed to provide representative data of socio-economic condition, 

nutritional, health situation and feeding habits of children under five years of age. The survey 

was carried out according to the guidelines described by Gross et.al. (1996). 

Table 3: Selected indicators for nutritional status and health 

Socio-economic condition Demographic data 

Housing condition 

Agricultural activities 

Information about IDT-villages 

Hygiene 

Water shortages 

Household expenditure 

Nutritional status: Household food consumption 

Food shortages 

Anthropometry of mother and child 

Feeding habits (breast-feeding and complementary food) 

Health status Diseases 

Vaccination status 

Usage of health facilities 

Household health behaviour 

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Anthropometric measurement 

Children aged 0-59 months and their mothers were weighed with an electronic digital scale 

(SECA, Germany) by UNICEF with a precision of 0.1 kg. Children under 24 months were 

weighed in the arms of their mother or care taker. This had the advantage that restless 

infants could be weighed easily. The body weight was calculated as the difference between 

the combined weight of mother and child, and the mother’s individual weight. 

Height was measured using a microtoise to the nearest 0.1 cm. The height of children 

younger than 2 years old was measured with a length board (see Gross et al. 1996). 

Hemoglobin concentrations were estimated according to the cyanomethemoglobin method 

using a portable mini-photometer (Compur Minilab, Bayer Diagnostic GmbH, Muenchen, 

Germany). Capillary blood was obtained from the ring finger using an automatic skin 

puncturing device (Autoclix, Boehringer Mannhein, Mannheim, Germany). A blood sample 

was taken after a spontaneous flow of blood occurred. Target sample size was 100 mothers 

and children, 10 randomly selected in each village. 

Presence of iodine in salt was assessed using Iodida test supplied by UNICEF, Jakarta 

(Manufacturer). Grades were given to the observable change of iodine presence in salt. The 

darkest colour (purple) indicated that there is 30 ppm iodine in salt, as instructed on the 

instruction of the test kit. 

3.3 Preparation for field work 

All enumerators had five days of training (12. to 16.11.1998) in the project office of NT- 

Project Sumba Timur by Erika Wasito with the participation and supervision of Anne- 

Madeleine Bau. The training included the introduction to the survey methodology, 

randomisation, interview with the structured questionnaire, interview practise and focus 

group discussion as well as measurement training. The questionnaire, which was prepared 

already in Jakarta got adaptations to local conditions and was pre-tested. 

The data were collected by 3 survey teams, which consist of 3 enumerators per survey team, 

who were under graduate students. Their professional background was not connected with 

nutrition or health. They all spoke Indonesian and one in each team also the local Sumba 

language. 

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The field-work took place from 18.11. to 4.12.1998. The enumerators stayed for 4 days in 

each of the villages. They were dropped by jeep to the villages and then they had to arrange 

by themselves the household list and make all arrangement with the nurse, midwife or 

cadres. Each team had one motorcycle, in order to reach also houses far away, since the 

houses are situated in a very remote area in Sumba. The authors of this report visited and 

supervised them every day, to be sure about the quality of data collected. Questionnaires 

were intensively checked on plausibility after each return of the enumerators. 

Information was collected using combination of a questionnaire, observation and 

anthropometric measurements of mothers and their pre-school children. Usually it was the 

mother who answered both the questions about the child as well as the questions about 

household. Before the interview all mothers were asked to attend the health centre or 

POSYANDU for anthropometric measurement. The enumerators measured the mothers and 

the children under the supervision of the authors. The households were very co-operative. 

Some problems appeared because the families, which were not selected for the interview, 

also wanted to be interviewed. They thought humanitarian help would follow the survey. 

Focus group discussion about seasonal calendar, using of health facilities and water 

situation was conducted by assistance of a translator. 

3.4 Data analysis 

Data analysis was performed with SPSS 7.5. Z-scores of height-for-age, weight-for-age and 

weight-for-height were calculated with EPI-INFO 6.04 using the National Centre for Health 

Statistics data from the United States (1985) as reference. 

Analyses were done using frequency distribution, ANOVA test and chi-square test. 

Associations of children’s nutritional status with selected possible determinants have been 

done by multivariate and simple factorial analysis (ANOVA) and non-projectling the 

confounding factors. Confounding factors were age (HAZ, WHZ, WAZ) and sex (HAZ, 

WAZ). Normality distribution of continuos variable were tested by Kolmogorov Smirnov test. 

Version: 30.04.00 8 

File: intrsumba.doc


4. Results of Nutritional Baseline Survey 

The tables are divided between NT project Sumba and non-project villages in East Sumba. The 

reason for this presentation is to get an impression of the current situation in project villages in 

comparison with non-project villages. All villages are IDT villages. 

4.1 Socio-economic and demographic data 

Most of the household in the surveyed area were extended families where the families lived with 

the grand parents and/or relatives with a mean of 5.4 � 2.1 family members in project and 5.7 � 

2.2 in non-project villages. Almost one third of the surveyed households had more than six 

household members, 25.9 % in project and 31% in non-project villages. Only 3.4 % in project 

and 1.9 % in non-project villages were female headed households. Polygamy was found in the 

villages, however no data was gathered on this. If a man had more than one wife, each wife 

with her children was treated as separate household. 

According to table 4, there were no significant differences in socio-economic condition 

according household size and structure between NT-project and non-project villages. Almost 

half of the mothers in project and non-project villages had the opportunity to earn money, which 

seemed mainly connected with agricultural activities. 

Table 4: Selected socio-economic information about the households in project and non-project 

villages 1998 

Characteristics NT Sumba project Non-project 

Total surveyed households 294 161 

Surveyed children


The main religion in East Sumba is Christian, however Sumba’s isolation has helped preserve 

one of the country’s animist cultures, which is called ‘Merapu’. More than half of the mothers in 

project villages mentioned that they still believed in ‘Merapu’, whereas only 24% in non-project 

villages (p12 years 1.4 0.7 2.5 1.2 

Do not know 0.7 - - - 

Education level of head of the households vs mothers: P


Education level of head of NTproject and non-project villages: P


An indicator often used for wealth ranking is the possession of certain valuable commodities. 

The percentage of possession of selected household commodities in surveyed household is 

presented in the following table. 

Radio and bicycle were the main selected commodities possessed by the households in project 

or non-project villages. Public electricity provided by the government was possessed by 18% of 

households in non-project villages, but this facility was actually available in two out of four nonproject 

villages (Lambakara and Palakahembi) while in Project villages it was only available in 

one out of eight project village (Kabaru village). In general, the households in non-project 

villages owned more selected household possessions than households in project villages did. 

Significance difference was found for bicycle, boat and government electricity. 

Table 8: Frequency distribution (%) of selected indicators for socio-economic status 

Household possession 

NTT project Non-project p-value 

n=294 

n=161 

Radio 13.9 16.8 > 0.05 

Bicycle 5.8 28.6 0.001* 

TV 1.4 2.5 > 0.05 

Motorboat 0.7 1.2 > 0.05 

Boat 3.7 8.7 0.025* 

Motorcycle 4.1 6.2 > 0.05 

Electricity (government) 1.4 18.0 0.001* 

Electricity (generator) 2.7 3.1 > 0.05 

* Project vs non-project village: significant difference (Chi-square test) 

Version: 04/30/00 

File: Result.doc 

12


4.2 Hygiene, water sources and seasonal water shortage 

A household with four members needs in average 5-10 l water per day, which was mentioned 

during discussions in villages. In the surveyed area, women and children were mainly 

responsible for fetching the drinking water. If the distance was too far, the men get the 

responsibility to collect it. Some springs did not have any pressure and people queue from early 

in the morning onward to obtain clean drinking water. People were eager to get clean water 

because they did not like to boil the water since they felt the unboiled water was tastier. 

Table 9 shows the water source for daily activities, like drinking, cooking, bathing and washing. 

The water sources were significantly different (p


As shown in table 10, the distance to the source of drinking water was shorter in non-project 

villages. More than 60% of the non-project households versus 33% in project villages had to 

walk less than 100 meters. In contrast, higher percentage of the households in project villages 

had to walk more than 1 km to get the daily drinking water. 

Table 10: Frequency distribution (%) of distance to collect drinking water 

Distance to drinking water 

NTT project 1998 Non-project 1998 

n=294 

n=161 


Usage of latrine is an indicator of hygiene since use of alternative places might be associated 

with an increased risk for infection. The usage of latrine was more common in non-project 

villages, where half of the households already used the latrine (p


4.3 Housing condition 

Materials used in house construction (roof, wall, floor and windows) are often used as “wealth 

indicators“ to classify families into low, medium and high socio-economic groups. The following 

table shows the differences between the project and non-project villages in terms of these 

indicators. 

Table 12: Frequency distribution (%) of general characteristics of the house 

Housing condition 

Version: 04/30/00 


NTT project 1998 

n=294 

Non-project 1998 

n=161 

Roof material** 

Leave 65.3 52.8 

Tile 34.7 47.2 

Wall material 

Timber 18.7 61.5 

Cemented/Brick 4.8 8.7 

Bamboo 48.6 22.4 

Pasteboard 0.3 1.2 

Leave 27.6 6.2 

Floor material 

Timber 62.9 46.6 

Mud 15.3 23.0 

Cemented/Brick 6.5 11.2 

Bamboo 15.3 19.3 

Number of bedroom* 

0 6.8 - 

1 16.7 18.0 

2 32.3 37.3 

3 24.5 24.2 

4 15.3 14.3 

>4 4.5 6.2 

Window possession 29.3 48.4 

* chi square: difference between non-project and project villages is significant (


The material most frequently used for walls was bamboo in project and timber in non-project 

villages. The usage of bamboo and leaves was a very strong wealth indicator and significantly 

higher (p


>2.0 ha 5.4 0.3 3.1 - 

Do not know 14.3 3.4 16.1 2.5 

Overall, more or less 2.0 % in project and non-project villages had no land at all. The main 

occupation of the head of the households from those who had no land were civil servant or 

teacher. 

Regardless the land ownership 76.7% in project and 75.3% in non-project villages cultivated all 

of their land. Reasons for not cultivating were shown in the following table 14. More than 80% in 

project and more than 60% in non-project villages mentioned that they did not have enough 

manpower to work their land. More than 12% in non-project villages also mentioned a lack of 

money, to be able to buy enough seeds, as the constraint to cultivate their land. As understood 

by observation, they still used very traditional tools to prepare the land, which could be very time 

consuming. 

Table 14: Frequency distribution (%) of reason for not cultivation all of the land 

Reason NTT project 1998 Non-project 1998 

n=67 

n=39 

Lack of money 3.0 12.8 

Lack of tools 6.0 7.7 

Lack of time 1.5 - 

Lack of manpower 80.6 61.5 

Other 7.5 17.9 

Do not know 1.5 - 

In Sumba, agriculture was characterized by dry-land. The majority in project and non-project 

villages had dry-land. Only 2.4% had wet land, which was a very strong wealth indicator. 

Cultivation of crops depends from the quality of land. Therefore only around 30% of the 

households cultivated rice. The main crop in Sumba was corn. 

Table 15: Frequency distribution (%) of cultivated land type 

Kind of land NTT project 1998 Non-project 1998 

n=288 

n=158 

Dry 90.6 93.7 

Wet 2.4 1.9 

Both 6.9 4.4 

Version: 04/30/00 


18


Version: 04/30/00 


19


The crops produced in the non-project villages were not very much different from the production 

in the project villages. As table 16 shows, the main crops were corn, followed by coconut, 

beans, cassava, and banana, which were cultivated at least by 50% of the households in both 

areas. The usage of the crops was mainly for own consumption. Coconut, banana, beans, 

candlenut, cashew and cassava were cultivated to have an opportunity to sell something during 

food shortages to buy corn and rice. 

Table 16: Frequency distribution (%) of the cultivation and usage of crops by the surveyed 

households 

Version: 04/30/00 


Not 

cultivated 


Own 

consump. 

n=294 

Sale Both equal 

important 

Not 

cultivated 


n=161 

Own 

consump. 

Sale Both equal 

important 

Corn 6.1* 92.1 0 0.7 5.0 78.9 0 16.1 

Rice 63.3 35.0 0 1.4 68.9 23.0 0 8.1 

Cassava 33.0 57.1 0 9.5 56.5 39.8 0 3.7 

Tubers 67.3 24.5 0 7.8 85.7 13.0 0 1.2 

Beans 30.6 57.8 0 11.6 32.3 42.2 0 25.5 

Cabbage 82.0 11.6 0 6.1 52.2 25.5 0 22.4 

Spinach 68.7 25.5 0 5.4 54.0 26.1 0 19.9 

Waterspinach 

89.1 8.2 0 2.4 81.4 11.2 0 7.5 

Banana 35.0 46.9 0 17.7 32.9 39.1 0 28.0 

Cashew 57.1 28.6 8.8 4.4 57.1 19.3 12.4 10.6 

Candle 

nut 

71.1 16.3 9.5 2.7 86.3 2.5 9.3 1.9 

Coconut 27.2 51.4 1.4 19.7 29.2 43.5 1.2 26.1 

others 94.2 3.4 0 1.0 88.2 8.1 0 3.7 

* Percentage of answer do not know (3.1) included in not cultivated 

20


Animal possession might indicate socio-oeconomic status of the household. Animals were very 

important during traditional ceremonies to be sacrificed, as more animals are sacrificed as 

higher the socio-economic status. According to table 17, households in project villages kept 

significantly more pigs, sheep, goats, chicken, horses and dogs. The possession of cows was 

higher in non-project villages even though it was not significantly different. The main usage of 

these animals in project as well as in non-project villages were mainly for own consumption or 

for sale (see appendix, frequency distribution of amount of animals) 

Table 17: Frequency distribution (%) of possession and usage of livestock 

Version: 04/30/00 


NT project 1998 

n=294 


n=161 

p-value 

Pigs 

Not raised 15.6 33.5 0.001* 

Own consumption 32.7 26.1 

For sale 8.5 5.0 

Both of equal importance 39.5 35.4 

Other 3.7 - 

Sheeps/goats 

Not raised 59.9 75.7 0.004* 


For sale 10.2 3.7 


Other 0.9 - 

Cows 

Not raised 78.2 70.8 0.142 


For sale 7.5 12.4 


Other 0.3 - 

Chicken 

Not raised 8.2 10.6 0.01* 




Other 0.3 - 

Horses 

Not raised 60.2 76.4 0.001* 


For sale 15.3 8.7 


Other 5.8 4.7 

Dogs 

Not raised 15.0 23.6 0.008* 




Other 47.6 24.8 

* significant difference between project and non-project villages 

21


4.5 Household food consumption and seasonal food shortages 

The main staple food in project villages as well as in non-project villages was rice, which was 

consumed, on daily basis by more than 95% of the household. Other important staple food was 

corn, which was consumed by more than 80% of the households in project and non-project 

villages on daily or weekly basis. The corn was usually consumed mixed with rice, however the 

wealthier families less often mixed their rice with corn. There was a significant difference 

(p=0.006) in corn consumption between the project and non-project villages, where the corn 

was consumed more on weekly basis in non-project villages. This might indicate a better 

condition in non-project villages. 

Consumption of plant protein was uncommon in both project and non-project villages. Legumes 

and ground nut were the most important source of plant protein, which were consumed in 

weekly basis. 

Egg, fresh fish and dry fish, in respective order, were the main sources of animal protein. Egg 

was consumed by more than 50% percent of the household on weekly basis, while fresh fish 

was consumed on weekly basis by almost 40% of the household in project villages and almost 

50% in non-project villages. Consumption of meat was less important since more than 75% 

consumed it in monthly basis or less often. The reason could be because of the unavailability 

and/or the unaffordable price. However the results showed that consumption of meat in weekly 

basis was more in non-project villages compared to in project villages, which might indicate a 

better condition in non-project villages. 

Green leafy vegetables were consumed on daily basis in more than 50% of the household in 

project villages and more than 75% in non-project villages. Consumption of fruits was less 

frequent. The main reason could be that the availability of fruits was low in Sumba Timur, 

except for banana, which was the most frequent consumed fruit. 

Consumption of fats and oils was low. The large majority consumed these foods only several 

times per week or only monthly. However, the consumption of coconut oil or coconut milk in 

daily basis was significantly higher (p


Table 18: Frequency distribution (%) of consumption of selected foods in surveyed households 

Food frequency Sumba Timur 1998 

Never Seldom Monthly Weekly Daily 

NTT Non- NTT Non- NTT Non- NTT Non- NTT Nonprojectprojectprojectprojectproject 

Staple food 

Rice 0.6 0.6 - - 1.3 - 1.7 1.9 96.3 97.6 

Cassava 12.9 23.0 31.6 8.1 11.3 21.8 31.3 39.1 12.9 8.0 

Corn 1.7 2.5 10.2 4.3 5.5 8.7 17.6 28.5 65.3 55.9 

Roots 35.0 62.7 35.7 15.5 12.9 11.8 13.6 9.3 2.7 - 

Noodles 34.0 24.2 23.8 6.2 18.4 28.6 22.8 36.0 1.0 5.0 

Plant protein 

Legumes 13.2 15.5 42.5 19.9 19.0 24.8 20.7 34.8 4.4 5.0 

Tofu 86.7 94.4 10.5 0.6 1.7 3.7 1.4 1.2 0.6 - 

Groundnut 7.8 8.7 51.4 47.2 15.7 18.6 22.1 21.7 3.1 3.8 

Animal protein 

Egg 4.7 11.2 13.3 6.8 26.4 24.2 50.7 56.5 4.7 1.2 

Meat 5.7 9.9 37.8 32.9 43.5 34.8 12.5 21.8 0.3 0.6 

Fish, fresh 19.3 7.5 11.9 11.8 25.2 13.7 37.1 48.4 6.5 18.6 

Fish dried 18.0 14.3 14.3 3.7 25.5 36.6 38.5 41.6 3.7 3.7 

Vegetables 

Green vegetable 3.0 0.6 15.0 0.6 7.1 - 23.8 24.8 51.0 77.6 

Other vegetable 12.9 39.7 17.3 4.3 12.6 3.1 23.8 21.7 32.7 31.1 

Fruits 

Banana 2.3 6.8 36.7 18.0 30.6 19.2 23.4 46.6 6.8 9.4 

Papaya 9.8 14.3 40.1 28.0 28.5 18.7 15.3 35.4 6.1 3.7 

Orange 36.7 39.8 50.0 53.4 7.8 4.4 4.4 2.5 1.0 - 

Jackfruit 24.4 36.6 50.0 44.7 15.7 9.3 5.5 9.3 4.4 - 

Milk 88.1 93.2 8.5 1.9 1.4 1.2 1.0 1.9 1.0 1.8 

Energy food 

Coconut milk 3.7 6.8 12.9 6.8 28.9 16.8 51.4 54.1 3.0 15.6 

Coconut oil 8.5 5.6 10.9 9.3 24.5 6.2 42.8 49.1 13.2 29.8 

Palm oil 77.5 81.4 1.7 - 6.1 7.5 12.9 8.7 1.7 2.5 

Sugar 1.7 1.2 1.4 0.6 5.1 3.1 11.6 3.1 80.3 91.9 

Snacks 35.3 40.4 25.9 8.1 16.3 20.5 14.9 23.0 7.5 8.1 

*Number of households in NTT project=294 and in Non-project =161 

Version: 04/30/00 


23


Seasonal food shortages and coping strategies 

Figure 2 shows that households from non-project villages stated to suffer more from food 

shortages than the project villages. The percentage of households who suffered from food 

shortages in non-project villages were significantly higher than the project villages in March until 

July (p


During food shortages, the households mentioned several coping strategies. The main coping 

strategie in project as well as non-project villages was by selling asset, such as animals or other 

household possession. Changing the eating pattern was another important strategy in project 

villages, which was also mentioned in focus group discussions. Households mentioned that they 

looked for wild roots in the forest as their staple food. In the non-project villages, asking for food 

or money from parents or relatives ranked higher than changing eating pattern. 

Only 2.5% in project and 2.1% in non-project villages mentioned that food aid by world vision 

was a strategy to handle the food shortages. This leads to the question, how important food aid 

to rural population is, or if technical assistance would be the better concept. 

Table 20: Frequency distribution (%) of coping strategies for food shortages 

Coping strategies NTT project 1998 Non-project 1998 

n=279 

n=142 

Sell assets 38.4 55.6 

Change eating pattern 26.5 7.0 

Ask from parents/relatives 11.8 26.1 

Borrow from friend/relative 11.1 4.2 

Aid by World Vision 2.5 2.1 

Other 5.5 4.2 

Do not know 4.3 0.7 

Version: 04/30/00 


25


4.6 Household expenditure 

Asking about the income directly is a problem all over the world. Therefore, the question of 

household’s expenditure rather than income was used in this survey to get an impression of how 

high the average income of households were. The expenditure was classified into five main 

categories and the total expenditure was the total money spent on these categories in each 

household. The assumption was the more the total amount of money being spent, the higher 

the income of the household. 

According to table 21 the majority in project and non-project villages spent money on food 

(90%), but the average amount, which was spent in non-project villages, was double. In nonproject 

villages the frequency of households who spent money on health was 20% higher. The 

households in non-project villages also spent more money on health that was Rp.10.000 in 

comparison to Rp. 5.000 in project villages. The frequency of households, which spent money 

on education, agriculture and social activities (25%), were equally distributed in the project 

villages. In the non-project villages the frequency of households spending money on social 

activities (59%) and agriculture (42%) ranked higher than the frequency of households spending 

money on education (25%). The households spent significantly more money on health, 

agriculture and social activities in non-project villages than in project villages. 

Table 21: Frequency distribution (%) of monthly expenditure (Rupiah) by surveyed households 

Average money 

spent on 

Version: 04/30/00 



% of households 


% of households 

n (median (10 and 90 percentile) n (median (10 and 90 percentile) 

Food (p >0.05) 294 91.5% 161 88.2% 

Average amount 269 55.000 (20.000, 200.000) 142 100.000 (40.000, 200.000) 

Health (p 0.05) 294 25.2% 161 23.0% 

Average amount 74 19.000 (5.000, 100.000) 37 25.000 (4.000, 100.000) 

Agriculture (p


4.7 Problems experienced by households 

The majority of the households in project and non-project villages mentioned lack of equipment 

as the biggest problem in agriculture, which they had experienced. As understood by 

observation, they still used very traditional tools for agricultural activities, which could be very 

time consuming. In order to cultivate all of their land in shorter time, they need more people to 

work their land. This condition might be related to the main reason of not cultivating all of their 

land, which was lack of manpower, as shown in the previous table. Introduction of improved 

and appropriate equipment as well as teaching of skills how to use it, could be a big 

improvement for the farmers. 

Table 22: Frequency distribution (%) of major problem in agriculture mentioned by households 

Major problem in agriculture NT Sumba 1998 


n=294 

n=161 

Lack of equipment 70.4 64.6 

Lack of manpower 3.7 8.7 

Lack of animal food 2.4 4.3 

Lack of money 2.0 6.2 

Pest and diseases 2.0 1.2 

Knowledge in agriculture 1.4 1.2 

Animal stealing 1.0 1.2 

Knowledge in raising animals 0.3 0.6 

Lack of land 0.3 - 

No problems 5.8 3.7 

Others 10.5 8.1 

According to table 23, the biggest three problems in daily life were food shortages, low income 

and frequently ill. Poor or inadequate water supply was seen as a big problem also in the 

project villages, whereas in the non-project villages little land ranked higher than a shortage of 

water. The fact that the water problem was not including in the first three was quite surprising. 

From the observation, the problem of water availability was obvious and might underlay the 

other unfavorable condition in agriculture or daily life, both in project and non-project villages. 

The possible reason was that the population had faced this problem for a long time so that it 

became part of their lives. Since water availability was more related to the nature and 

geographical condition, the people might also think there were no more changes they could 

make to improve the situation. In comparison to the non-project villages, the project villages 

faced more frequent a poor and inadequate water supply. 

Version: 04/30/00 


27


Table 23: Frequency distribution (%) of major problem in daily life 

Major problem in daily life NT Sumba 1998 


n=294 

n=161 

Food shortage 22.8 32.3 

Low income 20.1 31.1 

Frequently ill 18.0 16.1 

Poor or inadequate water supply 15.0 1.9 

No or little land 7.8 13.0 

Small harvest 5.8 0.6 

Health services inadequate 1.0 - 

Inadequate energy supply 0.7 - 

Low yield from the land 0.3 - 

Other 0.7 1.9 


No answer 5.1 2.5 

Frequent illness was reported to be a problem in project villages as well as in non-project 

villages, however only small percentage of households reported the inadequacy of health 

service as a problem. In non-project villages, none of the household mentioned the inadequacy 

of health service as a problem. 

4.8 Information about IDT-villages activities 

The project “Self-help promotion for low income communities in the critical areas in NTT and 

NTB” is aiming at strengthening institutions at the villages and district level to perform support 

functions for villages self-help groups. The NT-Project works since January 1998 in the 

surveyed villages. 

Several POKMAS-“Self-help” groups (Kelompok Masyarakat – Community group) were founded 

in each village. These groups carried out small income generation projects by themselves 

through financial support of IDT money provided by PMD (Government of Indonesia). The main 

POKMAS activities were in agriculture like raising goats or cultivating peanuts. 

Some information was collected about activities, which were carried out by the NT project as 

well as by PMD. These data provide first information about activities. 

Version: 04/30/00 


28


Table 24: Frequency distribution (%) of POKMAS participation 

Version: 04/30/00 



n=294 


n=161 

POKMAS participation 

Yes, situation improved 45.6 21.7 

Yes, not improved 18.7 25.5 

No 35.0 50.3 


According to table 24, 64% of the households belong to one POKMAS in project villages, 

whereas in non-project villages only 47.2%. The situation by joining the POKMAS has improved 

for almost half of the surveyed households while it was only 22% in non-project villages. 

To carry out the activities of the POKMAS, members need to get training and credits. As shown 

in table 25, more than 60% of POKMAS households in project villages got training on agriculture 

or administration. Participation in a community group enabled households to get aid from the 

government or non-government organization. These aids would facilitate their activities in 

agriculture or other potential sectors. The following table shows the type and source of aid 

received by the households who participated in POKMAS. 

Table 25: Frequency distribution (%) of type and source of training and aids received by 

POKMAS members 

Type of aid NTT project 1998 


Type of training 

n=189 

n=76 

No 25.4 46.1 

On agriculture 24.9 26.3 

On administration 24.4 5.2 

Both 13.3 14.5 

Yes, other 7.9 6.6 


Credits 

No 24.9 28.9 

Yes, from the government 51.3 52.6 

Yes, from NGO 22.8 17.1 

Yes, from the bank 0.5 0.0 


Agriculture equipment 

No 31.2 26.1 

Yes, from government 27.5 47.4 

Yes, from NGO 39.7 40.8 


29


4.9 Health care behavior of mothers 

The nutritional status of women has an important influence on child development during 

pregnancy and lactation. Therefore information about pregnancy, birth, health care and 

knowledge was obtained during the survey. 

The percentage of pregnancies was 6.8% in project and 8.9% in non-project villages. Either 

stillbirth or miscarriage were experienced by 8.8% of the mothers in the surveyed villages. 

Mortality rate of children under five (17.3% in project and 22.4% in non-project villages) was not 

as high as the one reported in East Lombok (36%) in 1998. 

Table 26: Frequency distribution (%) of mothers condition in project and non-project villages 

NTT project 1998 Non-project 1998 

n=265 

n= 161 

Age of the mother (mean+sd.) 28.7 ± 7.7 28.7 � 8.4 

Pregnancy 

Yes, < 3 months 0.7 1.9 

Yes, 4-6 months 2.4 3.7 

Yes, 6-9 months 3.7 3.1 

no 92.9 91.3 

No. of children died < 5 years 

0 82.7 77.6 

1 13.9 13.0 

2 2.0 6.8 

>2 1.4 2.4 

Experience of stillbirth 5.4 6.8 

Experience of miscarriage 3.4 5.6 

Version: 04/30/00 


30


Almost 90% of the women in project and non-project villages used health services during 

pregnancy. Most of the women (45.6%) in project and 57.8% in non-project villages went for 

check-up more than four times. In project villages 17.3% of the women went one to two times 

for antenatal care. Women in non-project villages used significantly (p


Family planning methods were used by almost half of the women in both survey areas. The 

coverage rate of using contraceptives was 20% lower than the national average. However only 

one-third of the total received it from the PUSKESMAS, PUSTU or POLINDES. The main 

contraceptive method through this channel was injection. Traditional methods of family planning 

were still common. These methods were used by 13.9% women in project and 11.2% in nonproject 

villages. 

The main reason mentioned by women for not using family planning methods was that the 

family size was still small (see table in appendix). This reason was mentioned by 28.6% of 

women in project and 21.7% in non-project villages. Other reasons were, the husband 

disapproved (5.8% in project, 1.2% in non-project villages) or the woman felt uncomfortable 

(4.8% in project and 9.9% in non-project villages). Service on family planning seemed to be 

available, only 3.4% women in project and 1.9% in non-project villages mentioned that they did 

not know anything about contraceptives. 

Table 28: Frequency distribution (%) of participation of family planning methods 

Version: 04/30/00 


NT project 1998 

n=294 


n= 161 

Family planning participation 

Usage of birth non-project traditionally 13.9 11.2 

Usage of contraceptives 29.2 34.2 

No 44.7 42.1 

Other 6.5 8.7 

Do not know about contraceptives 3.4 1.9 


Most of the women in non-project villages (87%) did not find difficulties at all to reach the health 

center. In comparison 36.4% of the women in project villages said that they found difficulties to 

reach the PUSKESMAS, PUSTU or POLINDES, mainly due to the distance. 

Table 29: Frequency distribution (%) of difficulties to reach the PUSKESMAS/PUSTU/POLINDES 

Reason NTT project 1998 Non-project 1998 

n=294 

n=161 

To far 36.4 9.9 

No money 1.7 3.1 

No vehicle for transportation 0.7 - 

32


No difficulties 59.9 87.0 


4.10 Nutritional status of mothers 

The nutritional status of non-pregnant women was assessed by calculating their body mass 

index (kg/m 2 ). Women’s BMI value below 18.5 kg/m 2 indicates under-nourishment or energy 

deficiency. Most healthy adults have a value between 20-25 kg/m 2 . 

The nutritional status of the mothers shown by BMI tended to be equally distributed between the 

surveyed areas. The mean BMI was still higher than the cut off point of 18.5 kg/m 2 . However 

30% of the mothers in project and 34% in non-project villages were chronically energy deficient. 

The mid upper arm circumference (MUAC) measurement was another measurement to indicate 

under-nourishment. The mean value of the MUAC was higher than the cut off point of 22.0 cm, 

and the percentage of MUAC < 22.0 cm was only less than 20% in project and non-project 

villages. 

The prevalence of visible goiter in mothers was 3.1% in project and 2.5% in non-project villages. 

This was surprising because there was no iodine found in the salt sample. Salt was locally 

produced from seawater and the iodine might be lost during this process. Iodized salt was 

found in households where one household member had already a goiter. In other word, the 

household used iodized salt as treatment for goiter. 

Table 30: Frequency distribution (%) of nutritional status of the mothers by surveyed area 

NTT Sumba 1998 Non-project Sumba 

1998 

n=294 N=161 

BMI (pregnant women excluded) (kg/m 2 ) 

< 18.5 29.6 33.5 

18.5 – 25 68.4 65.2 

> 25 2.0 1.2 

BMI (mean � SD) kg/m 2 19.8 � 2.2 19.5 � 2.1 

Mean height 151.7 � 7.1 152.5 � 5.4 

Mid upper arm circumference 

< 22 cm 19.0 15.5 

Mean � SD, cm 23.6 � 2.0 23.6 � 1.9 

Percentage of goiter in mothers 3.1 2.5 

Version: 04/30/00 


33


Presence of iodine in salt 2.4 1.2 

Cut of points for women nutritional status: BMI < 18.5, MUAC


Mothers’ micronutrient status 

The iron-nutrient status of mothers were measured only by a randomly chosen sub-sample of 

mothers from both areas, by measuring hemoglobin concentration as an indicator. Almost half 

of the mothers in project and 34% of the mothers in non-project villages suffered from anemia. 

Low hemoglobin level in blood of pregnant mothers can cause stillbirths, miscarriage and low 

birth weight of the child. The mean of hemoglobin availability in blood was 12.1 g/dl for nonpregnant 

women. 

Table 31: Mothers hemoglobin value and frequency distribution of anemia 

NTT Project 

1998 

Non-project 1998 Total 

Mothers age (mean � SD, years) 27.3 � 5.8 (76) 27.0 � 7.2 (42) 27.3 � 6.3 (118) 

Hemoglobin level (mean � SD, g/dl) 

Total 12.0 � 1.5 (76) 12.1 � 2.3 (42) 12.0 � 1.8 (118) 

Non-pregnant 12.0 � 1.4 (71) 12.3 �2.3 (38) 12.1 �1.8 (109) 

Pregnant 11.8 � 2.2 (5) 10.2 � 1.3 (4) 11.1 � 1.9 (9) 

Percentage of anemic mothers 47.4 (76) 33.3 (42) 42.4 (118) 

Cut of points for anemia: Pregnant women 11.0g/dl 

Not pregnant women 12.0g/dl 

Version: 04/30/00 


35


4.11 Nutritional status of children under five years 

The total sample size of children was 365 children in project and 213 children in non-project 

villages. The percentage of boys and girls, who were surveyed, was almost equal in project 

villages, but the boys were slightly over-represented in non-project villages. The distribution of 

the different age categories in project and non-project villages was similar. 

Table 32: Sex and age distribution (%) for children under five years 

Version: 04/30/00 


NTT project 

(n= 365) 

Non-project 

(n=213) 

Sex 

Boys 51.0 57.7 

Girls 49.0 42.3 

Agegroup 

< 6 months 11.2 13.1 

6


Table 33: Anthropometric characteristics 

NTT Sumba 1998 Non-project Sumba 1998 

Boys 

Girls 

Total 

Boys 

Girls 

Total 

n= 169 n=162 

n=331 n=118 n=86 

n=204 

Age (months) 26.1 ± 15.7 25.0 ± 16.7 25.5 ± 16.2 26.0 ± 17.7 25.5 ± 16.7 25.8 ± 17.3 

HAZ -1.86 ± 1.32 -1.50 ± 1.42 -1.68 ± 1.38 -1.63 ± 0.99 -1.45 ± 1.22 -1.55 ± 1.09 

WAZ -1.81 ± 1.03 -1.58 ± 1.09 -1.70 ± 1.06 -1.79 ± 0.81 -1.51 ± 0.90 -1.67 ± 0.86 

WHZ -0.91 ± 0.98 -0.82 ± 0.91 -0.87 ± 0.95 -1.02 ± 0.89 -0.76 ± 0.92 -0.91 ± 0.91 

Stunting 47.9 40.7 44.4 39.8 31.4 36.3 

Underweight 42.6 39.5 41.1 41.5 33.7 38.2 

Wasting 13.0 10.5 11.8 9.3 4.7 7.4 

Difference by sex: 

ANOVA, independent t-test: NT Sumba: HAZ p=0.019, WAZ p=0.048, WHZ p=0.385 

Chi-square: NTT Sumba 1998: stunting p=0.224, underweight p= 0.578, wasting p=0.500 

ANOVA, independent t-test: Non-project Sumba 1998: HAZ p=0.268, WAZ p=0.021, WHZ p=0.046 

Chi-square: Non-project Sumba 1998: stunting p=0.240, underweight p= 0.308, wasting p=0.280 

Difference by survey area: 

Chi-square: stunting p=0.071, underweight p= 0.526, wasting p=0.106 

Independent t-test: HAZ p=0.233, WAZ p=0.760, WAZ p=0.587 

Difference by age: non parametric: 2independent-test: by survey area p=0.521, by sex per area p> 0.05 

Range for analysis: Flag=0& HAZ>-5.0&HAZ


Table 34: Mean values of anthropometrical indicators by age category 

Version: 04/30/00 


NTT Sumba 1998 

n=331 


n=204 

< 6 months 

N 35 26 

HAZ -0.34 � 1.08 -0.86 � 0.86 

WAZ -0.36 � 0.80 -0.69 � 0.83 

WHZ 0.18 � 0.73 -0.11 � 0.73 

6 -11.9 months 

N 54 35 

HAZ -0.88 � 1.04 -1.21 � 0.94 

WAZ -1.27 � 0.97 -1.39 � 0.87 

WHZ -0.72 � 1.00 -0.62 � 0.90 

12 -17.9 months 

N 40 21 

HAZ -1.44 � 1.14 -1.87 � 1.00 

WAZ -1.79 � 0.92 -1.87 � 0.67 

WHZ -1.14 � 0.87 -0.90 � 0.93 

18 - 23.9 months 

N 39 24 

HAZ -2.31 � 1.05 -1.85 � 1.06 

WAZ -1.85 � 0.91 -1.76 � 0.73 

WHZ -0.82 � 1.08 -1.04 � 0.86 

24 – 29.9 months 

N 37 15 

HAZ -2.09 � 1.29 -1.32 � 1.06 

WAZ -2.23 � 1.13 -2.06 � 0.52 

WHZ -1.14 � 0.90 -1.40 � 0.69 

30 – 35.9 months 

N 28 21 

HAZ -2.00 � 1.71 -1.85 � 1.12 

WAZ -2.17 � 0.93 -1.85 � 0.68 

WHZ -1.19 � 0.96 -0.90 � 0.79 

36 – 47.9 months 

N 62 31 

HAZ -2.21 � 1.25 -1.76 � 1.10 

WAZ -2.02 � 0.84 -1.95 � 0.68 

WHZ -0.95 � 0.83 -1.18 � 0.86 

> 48 months 

N 36 31 

HAZ -2.21 � 1.22 -1.79 � 1.21 

WAZ -1.91 � 0.87 -2.04 � 0.85 

WHZ -0.83 � 0.88 -1.33 � 0.80 

38


The prevalence of stunting (HAZ, height for age z-score, < -2.00), underweight (WAZ, weight for 

age, < -2.00) and wasting (WHZ, weight for height, < -2.00) based on children age group were 

presented in the following Figure. 

Under the age of 6 months the prevalence of stunting in project villages was still under 10%, but 

increased 70 afterwards steadily to 60% up to the age of 18 months. 

60 

50 70 

The high 

40 

60 prevalence of underweight, which is shown in figure 4 shows that 35.5 

32.5 

children were 

53.3 

54.8 

53.2 

Project 

currently 30 not very well nourished. As older the children become as higher the prevalence (n=331) 

50 

of 

47.6 48.4 44.4 

19.2 

41 

Control 

underweight. 20 

16.7 20 

40 

38.1 

(n=204) 

35 

33.3 

10 5.7 

28.6 

30 

25.9 

0 

20 

=48.0 

The wasting prevalence which indicate acute malnutrition was much higher in project villages, 

25 7.7 

Months 

10 5.7 

but there Figure was 3. Prevalence no significant of stunting difference based found on age between group the in 21.4 project and control non-project villages 

villages in all 

20 

age groups. 20 0 Very high prevalence of stunting (between 20% and 21%) was found in the Project age 

(n=331) 

=48.0 16.1 

Months was conducted in November and December. Control 

15 

During Figure this 4. time Prevalence 75-80% of of underweight the households based suffered 

13.3 

(n=204) 

on age from group food in shortages project and in control project villages villages. 

11.3 

10.3 

In general, the prevalence 9.3 of low 9.1 nutritional status tended to increase when the age increased 

10 

8.3 

8.3 

8.3 

and the prevalence in project villages was higher than in non-project villages. 

5 

0 

Version: 04/30/00 


0 0 

42.9 

64.1 

41.7 

51.4 

62.2 40 

=48.0 

Months 

Figure 5. Prevalence of wasting based on age group in project and control villages 

57.1 

64.3 

52.4 

4.8 

64.5 

48.4 

6.5 

63.9 

Project 

(n=331) 

Control 

(n=204) 

39


Table 35: Prevalence (%) of malnutrition expressed by stunting, underweight and wasting per 

village. 

Subdistrict Village Surveyed stunting under- wasting Village 

children 

weight 


Haharu Wunga 33 30.3 36.4 6.1 NTT Project 

Napu 36 38.9 41.7 19.4 NTT Project 

Mondu 40 25.0 27.5 7.5 Non-project 

Lewa Praibokul 49 36.7 38.8 14.3 NTT Project 

Kombapari 43 51.2 51.2 9.3 Non-project 

Pahangulodu Kabaru 33 21.2 39.4 18.2 NTT Project 

Lambakara 59 35.6 44.1 8.5 Non-project 

Pandawai Kotakawau 55 56.9 49.1 10.9 NTT Project 

Pambotanjara 38 65.8 39.5 10.5 NTT Project 

Mbatakapidu 48 56.3 47.9 12.5 NTT Project 

Maubokul 39 46.2 30.3 2.6 NTT Project 

Palakahembi 62 33.9 30.6 4.8 Non-project 

535 Total 

Table 35 shows the prevalence of stunting, underweight and wasting by villages. The 

prevalence of stunting, underweight and wasting tended to be better in non-project villages than 

in project villages in each sub-district. Higher prevalence of stunting and underweight in nonproject 

villages were only found in non-project villages in Lewa and Pahangulodu sub-district. 

Pandawai seemed to be the worst sub-district according to the stunting prevalence. The villages 

and especially the sub-villages of Pandawai are situated in a very remote area with weak 

infrastructure compared to the villages in the sub-dictricts of Haharu, Lewa and Pahangulodu. 

Version: 04/30/00 


40


4.12 Infant and child nutrition 

It is very important that children are put to the breast as soon as possible after birth. One reason 

for this is to make sure that the children receive colostrum, the specific milk excreted after birth. 

Exclusive breast-feeding is another important practice, as children less than age 4 months 

should not receive food other than breast milk. However, sometimes the mothers give fluids or 

soft foods once or two times to newborns until the breast milk can be excreted. These foods or 

fluids are referred to as prelactal foods. 

Table 36 shows that about 40% of the children in project and non-project villages were put 

immediately after birth to the breast. A high percentage of mothers even waited up to 12 hours 

to put the child to the breast. The situation was similar in the project and non-project villages. 

However, the mothers who claimed that they gave the colostrum were higher than 40% in 

project and non-project villages. In non-project villages, more than 75% of the mothers claimed 

giving the colostrum, while it was only 52% of the mothers in project villages. The high 

percentage (75%) of mothers who gave colostrum to their child seemed to be in contradiction 

with the fact that 30-40% start breast feeding only after 12 hours. Colostrum feeding seemed 

still to be a problem in the rural area of Sumba. During the focus group discussion, the mothers 

revealed the traditional believe why colostrum should be discarded. It was suggested from 

generation to generation that the milk should be white and the yellow milk was dirty and might 

cause a disease to the child. It should be noted that in non-project villages although mothers 

gave the colostrum, 60% of the child received prelactal feeding. Prelactal feeding increased with 

increased time lag to breast feed after delivery (see table appendix). 

Table 36: Frequency distribution (%) of time of breastfeeding duration and pre-lactal feeding 

Breast-feeding practices NTT project 1998 Non-project 1998 

Time child breast-fed after delivery 

(n= 365) 

(n=213) 

Immediately 40.3 41.3 

1-4 hours 18.4 16.0 

5-12 hours 9.0 0.5 

After 12 hours 31.5 42.3 

Do not know 

Colostrum feeding rate 

0.8 - 

all 52.3 77.0 

Infants


It is highly recommended that children under 4 months of age should be given only breast milk, 

but when children reach the age of 6 months complementary food other than breast milk should 

be added to their daily meals, because at that age nutrition requirements cannot be fulfilled only 

by breast milk. At the time of the survey around 40% of the children in project and non-project 

villages were being breast-fed. Table 37 shows that all most all children were breast fed for one 

year in both surveyed areas and nearly the half of mothers in project villages continued up to the 

age of two years. About one fourth in project and two third of the children in non-project villages 

already received additional food besides breast milk. The breast feeding habits and the time of 

giving additional food were in project villages better compared to the non-project villages, where 

the majority of the mother’s breast fed their child only until 18 months and gave much earlier 

additional food to their children. Early feeding of other foods besides breast milk is less 

nutritious and increases the risk of diarrhea. 

Table 37: Frequency distribution (%) of children who received breast milk and additional food 

past 24 hours according to age categories in project and non-project villages 

Age group 

Version: 04/30/00 


n 

Breastfed 

(%) past 24 

hour 

NT project Non-projectvillages 

n 

Received 

additional 

food(%) past 

24 hour 

n 

Breastfed 

(%) past 

24 hour 

n 

Received 

additional 

food(%) 

past 24 

hour 

< 4 months 23 100.0 23 26.1 19 89.5 19 63.2 

4-6 months 18 94.4 18 44.4 9 100.0 9 77.8 

> 6-12 months 58 93.3 62 80.6 28 100.0 36 83.3 

> 12-18 months 43 72.1 43 93.0 19 63.2 22 95.5 

> 18 - 24 months 42 47.6 42 92.9 20 20.0 24 95.8 

> 24 177 2.3 177 100.0 14 7.1 103 98.1 

42


As shown in table 38, 66% of children under 6 months were still exclusively breast fed and 32% 

got already complementary food beside the breast milk in project villages. It should be noted 

that in non-project villages the opposite appeared. 

Table 38: Frequency distribution (%) exclusively breast fed children under 6 months of age by 

surveyed area 

Version: 04/30/00 



n= 41 


n=28 

Children < 6 months 

Exclusively breast fed 65.9 32.1 

Not breast fed anymore 2.4 7.1 

Breast fed and other food/fluids 31.7 60.7 

The following table also shows that a higher percentage of children in non-project villages 

already got complementary food before 4 months in non-project village. In contrast, the 

percentage of children who had not got complementary food at the age more than 6 months 

was higher in project villages. This indicated that giving complementary food too late also 

existed. 

Table 39: Frequency distribution (%) of time complementary food is given to the child 

Complementary feeding practices NTT project 1998 Non-project 1998 

Age of the first introduction of solid foods 

n= 365 

n=213 

< 4 months 14.0 19.2 

4-6 months 56.7 56.3 

> 6 months 19.2 15.5 

Not yet 9.0 8.5 


43


Children under five years are still in a fast growing stage. The nutrient requirements are 

increased as their age increases. To fulfill their nutrient requirement, the children need to be fed 

more or equal to 3 times per day since the children can not eat a lot of food at once. Table 39 

shows that the feeding frequency increased if their age increased, both in project as well as in 

non-project villages. The meal frequency in the age group starting with 12 to 18 months was in 

both surveyed areas to low. More than 12% got only twice a day a meal, which is much to few 

since children need to be more often fed per day to cover their requirements. 

Table 40: Frequency distribution (%) of daily meal frequency beside breast milk in project 


Age group N Once Twice 3 times > 4 times Not yet Do not No 

(months) 

know answer 

< 4 23 - 4.3 4.3 - 91.3 - - 

4-6 18 5.6 11.1 33.3 5.6 44.4 - - 

> 6-12 54 5.6 25.9 42.6 18.5 5.6 - 1.9 

>12-18 31 - 12.9 51.6 32.3 1.6 3.2 - 

>18-24 30 - 13.3 50.0 33.3 3.3 - - 

>24-30 34 - 11.8 52.9 32.4 - 2.9 - 

>30 175 1.1 13.7 52.6 31.4 - 1.1 - 

Table 41:Frequency distribution (%) of daily meal frequency beside breast milk in non-project 


Age group 

(months) 

N Once Twice 3 times > 4 times Not yet 

< 4 19 5.3 10.5 21.1 - 63.2 

4-6 9 - 22.2 33.3 - 44.4 

> 6-12 28 7.1 35.7 46.4 7.1 3.6 

>12-18 19 - 15.8 63.2 21.1 - 

>18-24 20 - 15.0 80.0 5.0 - 

>24-30 14 - - 78.6 21.4 - 

>30 104 - 9.6 77.9 11.5 1.0 

Version: 04/30/00 


44


The following tables show children’s food frequency one week prior to the survey for those who 

were older than 12 months, respectively in project and non-project villages. 

In general, the child’s food pattern was similar in project and non-project villages. Besides the 

staple food, only vegetables and sugar were given on daily basis. Protein sources, both from 

animal or plant, were given in weekly basis. However, the percentage of children who never got 

animal protein was twice as high in non-project villages than in project villages. Children older 

than 12 months need urgently animal protein source not only to cover their protein requirements 

but also to provide iron, zinc and retinal which is easier absorbable than from sources. Micronutrient 

coverage of a child depends also from the intake of fruits. More than one-third of the 

children got fruits only once per week and almost another one-third never got fruits at all in 

project and non-project villages. Only small percentage (less than 10%) of children got oil/fat in 

daily basis and almost 35% only got it once per week or never at all. The percentage of sugar 

consumption was higher in non-project villages. 

Table 42: Food frequency (%) of children older than 12 months (one week prior to the survey) in 

project villages (n=262) 

Food items Once 

a week 

Version: 04/30/00 


Twice a 

week 

3 times 

a week 

Every day never Do not 

know 

No 

answer 

Staple food 0.8 2.7 2.3 92.4 0.4 0.4 1.1 

Plant protein source 32.4 24.4 9.9 4.6 27.1 0.4 1.1 

Animal protein source 23.3 34.4 26.0 6.5 7.3 0.8 1.9 

Vegetable 7.3 12.6 11.5 29.0 37.8 0.8 1.1 

Fruits 37.4 17.6 11.5 5.7 25.6 0.8 1.5 

Formula milk 3.8 0.4 0.4 1.9 91.2 1.1 1.1 

Breast milk - - - 20.6 79.4 - - 

Oil/fat 34.0 29.0 14.9 3.8 16.0 0.4 1.9 

Sugar 2.3 9.5 21.8 57.3 7.3 0.8 1.1 

Snacks/biscuits 37.8 9.9 6.1 4.2 39.7 0.4 1.9 

Other 3.1 - 0.4 - 88.2 5.0 3.4 

45


Table 43: Food frequency (%) of children older than 12 months (one week prior to the survey) in 

non-project villages (n=149) 

Food items Once 

a week 

Version: 04/30/00 


Twice 

A week 

3 times 

a week 

Every day never Do not know 

Staple food - 0.7 4.7 92.6 2.0 - 

Plant protein source 32.2 23.5 8.1 4.7 28.9 2.7 

Animal protein source 20.1 28.9 26.2 12.8 12.1 - 

Vegetable 11.4 14.8 14.8 51.7 7.4 - 

Fruits 36.9 20.1 12.1 8.1 22.1 0.7 

Formula milk 7.4 1.3 - 3.4 87.9 - 

Breast milk - - - 16.8 83.2 - 

Oil/fat 34.2 19.5 19.5 8.1 18.8 - 

Sugar 2.7 4.0 1.3 87.9 4.0 - 

Snacks/biscuits 55.0 8.7 0.7 5.4 30.2 - 

Other 5.4 - - 79.2 14.1 1.3 

4.13 Child health 

The nutritional status of the child is not only a matter of nutrients and food intake; it also 

depends on the overall health condition of the child, especially in infectious diseases. 

The period prevalence diarrhea was similar in both surveyed areas. The prevalence of acute 

respiratory infection tended to be higher in project villages, but the difference was not 

statistically significant. 

Table 44: Prevalence (%) of diseases 

Diseases NTT project 1998 

(n= 365) 

Non-project 

1998 

(n=213) 

p value 

Period diarrhea+ 17.0 18.8 0.331 

Point ARI 58.6 52.6 0.260 

Skin diseases 16.7 19.2 0.239 

* chi-square: significant difference between project and non-project village, 

+Diarrhea in the period one week prior to the survey 

46


Based on government program, a child must get 5 types of immunization (BCG, DPT, polio, 

measles and hepatitis) completed before the age of 12 months. Each immunization is given at 

certain age during the first year of life. Under this condition, the assessment of immunization 

coverage was done for the children who already reached the certain immunization age. The 

BCG coverage was assessed for children age more or equal to 1month; DPT, Polio and 

hepatitis coverage were assessed for children age more or equal to 4 months; measles 

coverage was assessed for children age more or equal to 9 months. 

In the surveyed villages, the immunization for preschooler’s was done in integrated health posts 

(POSYANDU, “Pusat Pelayanan Terpadu”) by the health staff of the health center. The 

immunization received by each child was recorded in the growth chart (KMS, “Kartu Menuju 

Sehat”) or the health center in the village called Pustu, “Puskesmas Pembantu” (Assisted Health 

Center) or Polindes, “Poliklinik Desa” (village clinic). During the survey, mother’s answers on 

immunization confirmed the time schedule of vaccinations by these data. 

The results showed that the immunization coverage was high. More than three-fourth of the 

children in project area received all type of immunization. The percentage in non-project 

villages was even higher as more or less 90% of the children got the immunizations. The 

difference was significant for hepatitis and measles coverage. During the survey, small 

percentage of mothers (less than 5%) did not remember the type of immunization had been 

given to their child, and since no written data were available for their child, the immunization 

status of their children could not be confirmed. 

Table 45: Frequency distribution (%) of children vaccination coverage 

Vaccination 

Coverage 

NTT project (n= 365) Non-project 1998 (n= 213) 

n Never Insufficient** complete n Never Insufficient** complete 

BCG 358 11.5 - 86.0 212 7.1 - 92.9 

DPT 342 7.9 6.1 79.5 194 5.2 5.7 89.2 

POLIO 342 10.8 5.0 79.5 194 5.2 6.2 88.7 

HEPATITIS* 342 13.7 3.2 74.6 194 6.7 2.1 91.2 

MEASLES* 292 13.4 - 82.2 161 6.2 - 93.8 

*p


According to Indonesian health policy children under 5 years of age should get every 6 months 

a Vitamin A capsule. Table 46 presents the findings of micro-nutrient supplements for children. 

Only 53% of the children got twice a Vitamin A capsule last year. More than 10% even never got 

a capsule. Vitamin A supplementation is very important for preschool children since their diet 

does not cover their requirements and deficiency could cause night blindness. 

Iron syrup and iodine tablets are not distributed at all in the surveyed area. The high percentage 

of mothers who did not know whether their child got these tablets was surprising since it seems 

they are not sure about what the health staff is doing with their children. 

Table 46: Frequency distribution (%) of micro-nutrient supplements received by children older 

than 12 months during last year 

Type of supplementation NTT project 1998 

(n= 262) 

Version: 04/30/00 



(n=149) 

Vit.A capsule 

Never 9.5 12.1 

Once 22.1 26.2 

Twice 53.4 58.4 


No answer 3.8 - 

Iron syrup 

No 79.0 97.3 

Daily for 2 months 2.2 1.3 



Iodine tablet 

Never 72.5 89.3 

Once 1.5 7.4 

Twice 0.8 2.7 



48


The prevalence of anemia was high both in project and non-project villages. The prevalence 

among the boys and the girls was not statistically different, except those in non-project villages. 

In non-project villages, the prevalence of anemia was significantly higher among the boys. 

Considering the hemoglobin value, the mean value in project and non-project villages as well in 

total were low, which was shown by haemoglobin value less than 11.0 g/dl. 

Table 47: Children’s micronutrient status 

NTT Sumba Non-project Sumba Total 

n mean � SD n Mean � SD n Mean � SD 

Child age (months) 74 26.2 � 14.8 40 23.0 � 15.7 114 25.1 � 15.2 

Hemoglobin level (g/L) 74 10.2 � 1.8 40 10.6 � 1.2 114 10.3 � 1.6 

Anemia prevalence* n % n % n % 

By sex (%) 

Male 42 66.7 27 74.1 69 69.6 

Female 32 62.5 13 38.5 45 55.6 

p-value** 0.449 0.034*** 0.093 

Total 74 64.9 40 62.5 114 64.0 

*cut of points: Hb < 11g/dl 

** chi-square test 

*** significant difference 

Table 48: Child’s mean age of children who suffered and not suffered from anemia 

Anemia status NTT Sumba Non-project Sumba Total 

n mean � SD N mean � SD n mean � SD 

Anemic (Hb < 11g/dl) 48 25.1 � 15.4 25 15.9 � 11.9 73 22.0 � 14.8 

Normal (Hb > 11g/dl) 26 28.1 �13.9 15 34.7 �14.6 41 30.5 �14.3 

p-value* 0.411


Significance differences between project and non-project village were found: 

Socio-economic indicators: 

Number of HH members earning money 

Mothers religion 

Fathers and mothers education level 

Fathers and mothers additional work 

Possession of bicycle, boat, government electricity 

Housing condition (roof, wall, floor-material, windows) 

Place of defecation 

Water source for drinking, bathing, washing and cooking water 

Distance to collect drinking water 

Possession of own land 

Cultivation of crops 

Possession of livestock 

Pokmas participation 

Expenditure of the household 

Months of food and water shortages 

Mothers nutritional status and health care: 

Number of child spacing less than 2 years 

Frequency of antenatal care 

Iron supplementation 

Difficulties to reach health facilities 

Child nutrition and health care: 

Colostrum feeding rate 

Caretaker for the child 

Point diarrhea 

Vaccination coverage 

Version: 04/30/00 


50


5. Determinants of children’s nutritional status for NT-Project villages 1998 

The association of children’s nutritional status with selected possible determinants was 

calculated only for NT-Project villages, East Sumba. This analysis was carried out to 

investigate whether there were sub-groups in the surveyed villages who lived under more 

difficult circumstances than the rest of the population. Furthermore, specific possible causes 

of malnutrition among children were investigated. 

Socio-economic determinants 

The mean z-scores of all three nutritional indicators decreased with the increase number of 

children per household. Significant association was found for weight for height and weight for 

age. As shown in table 49, in households with more or equal three children the mean of 

WAZ and WHZ decreases sharply. Even though there was no significant difference found for 

stunting the mean showed a trend that the condition in houses with more than one child are 

worse. 

Table 49: Association between number of children under 5 years of age in project village 

households and nutritional status of children 

No. of children 

HAZ 

WHZ 

WAZ 


Table 50 shows the association between income earning of the mother and the nutritional 

status of children. The income earning of the mothers was significantly associated to weight 

to age and weight to height. It was surprising that the means decreased when mothers 

earned money, since it is considered, if mothers earn money it might automatically lead to an 

improved nutritional status of their children. One possibility could be that working mothers 

had more workload and as a consequence they might have less time for their children, which 

risk their nutritional status. Or the other possibility that the money earned by mothers was 

not enough to influence the nutritional status of their children. 

Table 50: Association between occupational income status of the mother and nutritional 

status of children 

Version:30.04.00 

File: DetSumba.doc 

N 

HAZ 

mean � SD 

WHZ 

mean � SD 

WAZ 

mean � SD 

Mother earns money 

Yes 170 -1.79 � 1.34 -0.98 � 0.98 -1.84 � 1.01 

No 161 -1.57 � 1.42 -0.75 � 0.96 -1.55 � 1.09 

p-value 0.257 0.030 0.025 

HAZ: height for age z-score, WHZ: weight for height z-score, WAZ: weight for age z-score 

Multi-factorial test of variance, with age and sex as covariant 

WHZ: Simple factorial test of variance, with age as covariant 

51


It was expected that children of an illiterate head of the household had a lower nutritional 

status, because of not having such a wide range of job opportunities, which might have 

better income. However, children whose head of the household had lower education level did 

not have a lower nutritional status as shown by mean z-scores in table 51. The best children 

nutritional status were found within the highest education level (more than nine years school 

attendance) of the head of the household. The reason might be because the main 

occupation of this group was civil servant or teacher. This group had a better income and 

also a better awareness about the importance of health and nutrition than farmers, which 

was indicated by total money spent by these group. 

Table 51: Association between head of the household education level and nutritional status 

of children 

HAZ 

WHZ 

WAZ 

N mean � SD mean � SD mean � SD 

6-9 years 34 -1.64 � 1.19 -1.10 � 0.94 -1.80 � 1.02 

>9-12 years 31 -1.10 � 1.52 -0.93 � 0.88 -1.41 � 1.25 

p-value 0.017 0.412 0.323 


HAZ, WAZ: Multi-factorial test of variance, with age and sex as covariant 


Material used in construction of the house is maybe a good wealth indicator, but this survey 

showed no significant association to the nutritional status of the child. Cheaper materials 

mean use of leave for roofs, mud or bamboo for floors and bamboo and leave for walls. 

Table 52: Association between housing condition (material used) and nutritional status 

Material used 

HAZ 

WHZ 

WAZ 

N mean � SD Mean � SD mean � SD 

Expensive** 242 -1.71 � 1.36 -0.86 � 0.94 -1.71 � 1.05 

Cheaper* 89 -1.60 � 1.43 -0.88 � 0.96 -1.67 � 1.11 

p-value 0.325 0.989 0.604 




* leave roof, mud or bamboo for floors and bamboo and leave for walls 

** tile roof, timber or cemented brick for floor, timber or cemented brick for wall 



52


Consumption pattern 

The household consumption of fish was not significantly associated with the height for age of 

the children. The height for age of the children improved with more frequent consumption of 

fish, which could be an important protein source for the child and support the growth of the 

child. 

The same but not significant association is seen by consumption of cooking oil. This does 

not necessarily mean that an increased oil consumption will automatically lead to an 

improved growth since households with frequent oil consumption may also better off in other 

terms, which influence child growth. It is however a fact that oil consumption is very low, and 

that oil is a good provider of energy and necessary for the absorption of fatsoluble vitamins 

such as vitamin A. 

Table 53: Association between fish and cooking oil consumption and nutritional status 



N 

HAZ 

mean � SD 

WHZ 

mean � SD 

WAZ 

mean � SD 

Fish 

Daily/weekly 141 -1.63 � 1.41 -0.88 � 0.99 -1.69 � 0.97 

Monthly 82 -1.58 � 1.33 -0.94 � 1.01 -1.67 � 1.14 

Seldom/never 106 -1.86 � 1.36 -0.81 � 0.83 -1.75 � 1.13 

p-value 0.118 0.698 0.647 

Cooking oil 

Weekly 109 -1.30 � 1.42 -0.68 � 0.22 -1.35 � 1.17 

Monthly 50 -1.73 � 1.39 -0.64 � 0.96 -1.66 � 0.99 

Seldom/never 163 -1.93 � 1.31 -1.03 � 0.95 -1.95 � 0.92 

p-value 0.821 0.119 0.240 




The household consumption of all other items were not significantly associated with the 

nutritional status of the children. However, there was a trend that the mean z-score 

increased with the increased frequency of consumption of banana and also meat. 

53


Child health and nutritional care 

Possession of a growth chart, KMS (Kartu Menuju Sehat) can be used as an indicator for 

child’s preventive health care. During monthly POSYANDU meetings children should get 

vaccinations, growth monitoring and Vitamin A supplementation. As shown in table 54 one 

fourth of the children did not possess a card and the mean height for age z-score of these 

children tended to be lower than those who own a card. An important finding was that the 

mean age of these children was significantly lower, because it seems that health service for 

younger children was of lower quality. 

Table 54: Association between possession of KMS and height for age 

KMS 

HAZ 

Age 

N 

mean � SD 

mean � SD 

Yes 265 -1.67 � 1.32 26.76 � 15.61 

No 65 -1.73 � 1.62 20.32 � 17.64 

p-value 

HAZ: height for age z-score 

0.096 0.004 

Simple factorial test of variance, with age and sex as covariant 

ANOVA test for age 

The same association was found between the height for age and vaccination coverage. The 

mean height for age z-scores was lower if the child never received a vaccination. Children 

who never received vaccination as shown in table 55 had also a significantly lower mean 

age. This might indicate that the POSYANDU attendance or even primary health care 

delivery services in villages of East Sumba were insufficient. 

Table 55: Association between vaccination coverage and height for age 



N 

HAZ 

mean � SD 

Age 

mean � SD 

DPT 

Complete 249 -1.80 � 1.28 29.03 � 15.12 

Never 21 -1.97 � 1.68 17.82 � 15.57 

p-value 0.095 0.001 

Polio 

Complete 248 -1.76 � 1.30 29.07 � 15.15 

Never 31 -1.84 � 1.64 18.44 � 16.15 

p-value 0.094 0.001 

HAZ: height for age z-score 

Simple factorial test of variance, with age and sex as covariant 

ANOVA test for age 

54


Prevalence of diarrhoea or infectious diseases is one of the causal factors of malnutrition in 

young children. Sumba is a very dry area and the availability of water in general is limited. 

Some project villages were more or less affected by water shortages. By observation and 

interview it seemed that the water situation would have a strong association to health and 

nutritional status of the children. 

Table 56 indicates that the prevalence of diarrhoea during the last 7 days was the highest 

when the household collected the drinking water from the river. The water situation depends 

strongly on the village location. It could be expected that during the rainy season (December 

to February) the influence from water source on diarrhoea is more significant, because water 

availability and quality is limited. But there was no significant association found between the 

sources of drinking water and nutritional status of those who suffered from diarrhoea. If the 

drinking water was obtained from the river or canal the children had a lower mean z-score. 

Table 56: Percentage of children who suffer from diarrhoea by source of drinking water 

Diarrhoea 

N yes no 

Well 76 19.7% 80.3% 

River, canal 61 24.6% 75.4% 

Spring 210 17.6% 82.4% 

Diarrhoea defined as more than 3 liquid stools per day 

Chi-square: p=0.177 



55


Children suffering from respiratory infection had lower mean z-scores than children who did 

not suffer from respiratory infection. Significant associations were found for height for age 

and weight for age. The results indicate the negative effect of infectious diseases on 

nutritional status of children, or that those with low HAZ or WAZ are more susceptible to 

infections. 

Table 57: Association between ARI and nutritional status of the children 

HAZ 

WHZ 

WAZ 

N mean � SD Mean � SD mean � SD 

Yes 198 -1.84 � 1.36 -0.89 � 0.96 -1.80 � 1.08 

No 133 -1.45 � 1.39 -0.83 � 0.94 -1.55 � 1.02 

p-value 0.007 0.679 0.037 

HAZ: height for age z-score, WAZ: weight for age z-score 



To investigate which factors are important determinants of height for age of children 

multivariate variance analysis was applied with height for age, weight for age and weight for 

height as dependent variable and all variable of the questionnaire as independent factor. 

Age and sex were used as covariant. 

Following variables are significantly associated with low height-for-age in project villages 

• Fathers education level 

• Infectious diseases (ARI) 



56


6. Discussion and conclusion 

The general poverty and nutritional situation in Nusa Tenggara was bad considering the high 

prevalence of 46.3% stunting among preschool children in 8 villages of NT-project East 

Sumba, which is comparable with other parts of Nusa Tenggara Timur (see table 1). 

Significant differences in living conditions were found between project and non-project 

villages. Regardless the fact that the distribution of main occupation was the same in both 

surveyed areas and even the land owned by the household was more in project villages, the 

conditions were worse than in non-project villages. The non-project villages had significantly 

more favourable socio-economic condition, water supply, food consumption pattern as well 

as mother’s and children health and nutrition care behaviour. The biggest influence seemed 

better access to education and health infrastructure as well as better opportunities for 

income generation in non-project villages. Some NT-project villages and especially subvillages 

could not be reached by car because of the difficult terrain and remote areas. 

The data obtained by the survey do therefore support that the project villages of NT-Project 

belong to the poorest of East Sumba. The non-project villages can not really used as nonproject 

villages because the living conditions are already better. However, there was no 

other choice of villages. All villages of Sumba are targeted as IDT-villages. 

Food availability at household level was a problem. This was demonstrated by the frequent 

complaints of households about food shortages as well as the low nutritional status of 

mothers. The main staple food was rice usually mixed with corn. Households which ate more 

often cassava and corn, can be considered as poorer households. Significant association to 

nutritional status of children was found with more frequent consumption of fish in 

households. Consumption of meat was less important which was indicated by a very high 

prevalence of anaemia in mothers and children. The low (once a week) consumption of eggs 

was surprising since mostly all households raised chicken. The percentage of households, 

which had daily vegetable consumption was very high in consideration that November and 

December are already food shortages months. During harvest time, starting in April and 

May, the consumption could be even more favourable. Consumption of fruits was even less 

frequent. Banana was the most frequent consumed fruit. Consumption of fats and oils was 

also to low. Fat is a very important energy source and necessary for absorption of fat soluble 

vitamins such as vitamin A. 


File: conrec.doc 

59


Poor or inadequate water supply was ranked as the fourth biggest problem in daily life, 

seasonal scarcity occurring between July and November. Some households still obtained 

water from the river, which is likely to be polluted and dirty. If the drinking water was obtained 

from the river the prevalence of diarrhoea and the mean z-scores of height for age were 

worse in comparison to other water sources. From observation, the problem of water 

availability was obvious and improvement should become highest priority in the villages. 

According to the Indonesian health policy women should receive antenatal care and iron 

supplementation as long as possible during pregnancy. The access to health services was 

for women in remote areas more difficult. Only 50% of the women went 4 times the health 

service for ante-natal care and got iron supplements on daily basis. These results were also 

supported by the prevalence of anaemia in mothers in project villages. Mostly half of the 

mothers suffered from anaemia, which can lead to stillbirth and miscarriages. Anaemia has a 

big influence on the productivity. 

Breast feeding behaviour of mothers did not seem the basis problem of the nutritional status 

of the children. Breast feeding was common until the child reaches the age of one year. 

However there is still work to do in supporting of immediately breast feeding after birth, 

colostrum feeding and exclusively breast-feeding at least up to the age of 4 months. 

The most vulnerable age group found for all nutrition indicators was between 12 and 18 

months. This age group needs special attention, because the child starts to walk and needs 

therefore more energetic as well as qualitative food for proper growth. 

The main problem of children’s nutrition was the quality of complementary food. After 

children have reached the age of 6 months, food other than breast milk should be added to 

their daily meals, because at this age nutrition requirements cannot be covered only by 

breast milk. This was supported by the results of anaemia in children. In total 64% of the 

children were anaemic. It is important to stress on, that the mean age of anaemic children 

was significantly lower than the mean age of non-anaemic children. Iron deficiency among 

children reduces growth, increases the risk of infections and reduces motor development. 



60


Considering the daily diet, there is a high possibility that many children are not only iron 

deficient but also Vitamin A. More than one-third of the children got fruits only once per week 

and almost another one-third never got fruits at all. The vegetable consumption was even 

worse. Besides supplementation mothers should be encouraged to feed their children green 

leafy vegetable and fruits. The plantation of fruit trees and diversification of crops should be 

promoted. 

The health infrastructure in NT-villages and especially in sub-villages was currently 

insufficient because of a lack of management and motivation within the human resources in 

the health delivery system. This statement was supported by association between KMS 

possession, vaccination coverage rate and nutritional status of children. Results showed that 

children under 5 years had worse height for age z-scores when they did not own a KMS and 

had not received Diphtheria and Polio vaccination. Significant differences were also found in 

lower age of the children who did not receive vaccinations. However in villages where health 

services were available the coverage and usage of health services was also insufficient. The 

main possibility was due to the low accessibility to reach health services. Difficulties to reach 

health facilities were more often mentioned by women from project villages. 

The prevalence of infectious diseases was quite high and there was a strong association 

with low height for age mean z-sores. Low nutritional status makes the children vulnerable 

for infections. 



61


Appendix 

Version: 04/30/00 

File: Appendix.doc

Nutritional Baseline Survey, Sumba Timur Village code/ household number 

Page 1 /____/_____/_____/_____/ 

Version: 04/30/00 

NUTRITIONAL BASELINE SURVEY 

Sumba Timur - East Nusa Tenggara 

Interviewer/ Survey Team: NO. 

1) Irnawati 4) Rambu Yana 7) Rambu Yuli 

2) Juliana 5) Nurhayati 8) Oktavina 

3) Abukabar 6) Boby 9) Yudi 

Date of Interview : ______________ 

Interview Duration : _____ minutes 

Respondent Name : _______________________ 

Household Number : /____/____/____/____/ 

Kecamatan Village Subvillage Code 

Haharu Wunga Wunga Bawah 01 

Wunga Atas 

Napu Napu 02 

Prailangina 

control village Mondu 03 

Lewa Praibokul Kambata Majangga 04 

Mbajiku Padua 

Kambata Kundu rawa 

Kiku Watu Ngodu 

control village Kombapari 05 

Pahangulodu Kabaru Kahanugu Eti 06 

Kabaru 

control village Lambakara 07 

Pandawai Kotakawau Matawai amah 08 

Londalima 

Wangga bewa 

Pambotanjara Lajarik 09 

Wairinding 

Mbatakapidu Kambatawundut 10 

Kambata Laiborak 

Kambata Watuhada 

Maubokul Laitaku 11 

Walatungga 

Tanarara 

Maubokul 

control village Palakahembi 12


Page 2 /____/_____/_____/_____/ 

1. Household Member characteristics / Who cooks together 

No. Name Family 

Status 

1 

2 

3 

4 

5 

6 

7 

8 

9 

10 

11 

12 

13 

14 

15 

Version: 04/30/00 

Sex Age 

(years) 

are you 

able to 

write and 

read 

Family status : 1) Father 4) Grand parents 77) Others 

2) Mother 5) Aunt/uncle 99) No answer 

3) Children 

Gender : 1) Male 2) Female 

Able to write and read: 1) Yes 2) No 

Earning 

money 

Earning money :Does she or he earned money in the last three months 

1) Yes 2) No 88) do not know 99) no answer 

Information from the household sheet to be filled into variables 2-10 

2. Observation: Is the head of the household male or female? 

1) Male 2) Female 

3. Observation: Age of the mother 

4. Observation: How many persons live in the household? 

5. Observation: How many children under 5 years old live in the household? 

6. Observation: How old was the mother at the birth of the oldest child? 

7. Observation: How old was the mother at the birth of the youngest child 

8. Observation: How many cases exist with birth spacing less than 2 yrs? 

9. Observation: How many household members earned money in the 

last 3 months? 

10. Observation: Did the mother earn money in the last 3 months? 

1) do not know 2)no answer


Page 3 /____/_____/_____/_____/ 

11. Question: From which part of the country did you come? 

1) Same village 4) Other Parts of NTB 

2) Other part of this island 77) Other 

3) Other parts of NTT 99) No answer 

12. What is your religion 

1) Protestant 4) Muslim 

2) Catholic 5) Hindu 

3) Local religion (merapu) 6) Buddhism 

77) other 99) no answer 

13. Question: What schooling have you and your husband 

1) < 3 years 

2) finished primary school (3-6 years) Mother 

3) Junior High School (>6-9) 

4) Senior High School (>9-12) Father 

5) University or other higher education (>12) 

14. Question: What occupation has the father and mother been chiefly engaged 

in during the last four weeks? 

01) No occupation 08) Private employee 

02) On daily wages 09) Dealer trader or salesperson 

03) Farmer 10) Civil servant/ teacher 

04) Husbandry 11) Working in household 

05) Fisherman 77) Other 

06) Craftsman 99) No Answer 

07) Handicrafts 

Father 

Mother 

15. Do you own 

Version: 04/30/00 

Main job Additional job 

1) radio 5) Boat 

2) bicycle 6) Motorcycle 

3) TV 7) Electricity (government) 

4) Motorboat 8) Electricity (generator) 

1) yes 2) no 99) no answer


Page 4 /____/_____/_____/_____/ 

Personal Hygiene, environment and sanitation 

16. Observation: What material was used to construct 

. the roof 

. the walls 

. the floor 

1) Timber 4) Bamboo 7) Roof tile 

2) Mud 5) Pasteboard 8) Tin 

3) Cemented/Brick 6) Leave 77) Other 

17. Observation: How many bedrooms are there in the house or residence? 

18. Observation: Does the house has any window? 

1) Yes 2) No 99) no observation made 

19. Question: Where do you usually defecate 

1) field, garden 5) river, stream 

2) beach, sea 6) private latrine 

3) MCK 77) other 

4) WC 99) no answer 

20. Question: From where was the household water obtained yesterday? 

1) Well 5) Spring Drinking 

2) River/canal/ hole near to the river 77) other Bathing 

3) Government water supply or pipe 88) do not know Washing 

4) Lake 99) no answer Cooking 

21. Question: How far is the distance from the house to the drinking water source? 

1)


Page 5 /____/_____/_____/_____/ 

Food Production 

23. Question: How much land do you own for agriculture activity 

1) no 3) 0.51-1.0 ha 5) 1.51-2.0 ha 88) don’t know 

2) 0.01-0.5 ha 4) 1.01-1.5 ha 6) >2.0 ha 99) no answer 

24. Question: How much land do you have available by leasing, share cropping 

or other arrangements? 

1) no 3) 0.51-1.0 ha 5) 1.51-2.0 ha 88) don’t know 

2) 0.01-0.5 ha 4) 1.01-1.5 ha 6) >2.0 ha 99) no answer 

25. Question: Do you cultivate all of your land 

1) yes 3) lack of tools 5) lack of 

Version: 04/30/00 

manpower 

77) other 

2) Lack of money 4) lack of time 6) has no land 88) don’t know 

99) no answer 

26. Question: Which kind of land do you cultivate 

1) dry 3) both 88) do not know 

2) wet 4) has no land 99) no answer 

27. Question: Do you cultivate? How do you use it? 

How much did you harvest the last two harvests? 

Cultivation 

Corn 

Rice 

Cassava 

Tubers 

Beans 

Vegetable: mainly 

cabbage 

spinach 

water spinach 

Cash crop : 

Banana 

Cashew nut 

Kemiri 

Coconut 

Use Average amount 

Year: 

kg 

1) Not cultivated 3) For sale 77) ) others 

2) Own consumption 4) Both approximately 

equal important 

Average amount 

Year: 

kg 

88) do not know 

99) No answer 

28. Observation: Which kind of fruit trees are in the village


Page 6 /____/_____/_____/_____/ 

29. Question: Do you raise? 

How do you use it ? 

Animal Species Amount Use 

Pigs 

Sheep/Goat 

Cow/Buffalo 

Chicken/duck 

Fish 

Horse 

Dog 

Others 

1) Not raised 4) Both of approximately equal important 

2) Own consumption 77) Other 

3) For sale 88) do not know 

99) No answer 

30. Question: Which are major problems in agriculture? 

1) knowledge in farming/ cultivation 6) lack of equipment 

2) knowledge in raising livestock 7) animal stealing 

3) lack of money 8) lack of animal food 

4) lack of land 77) other 

5) lack of manpower 88) don’t know 

6) pest and disease 99) no answer 

31. Question: Which are your major problem in daily life ? 

Problems 

1)No problems 

2)No or little land 

3)Low yield from the land/ low catch fish 

4)Little income 

5)Frequently ill 

6)Little food 

7)Poor or inadequate water supply 

8)Inadequate energy supply (wood, electricity, etc.) 

9)Health services inadequate 

77) other 

88)do not know 

99)no answer 

Version: 04/30/00


Page 7 /____/_____/_____/_____/ 

32. Question: Does one of your family join the community group IDT (POKMAS ). 

If yes, is your situation improved? 

1) Yes, situation improved 

2) Yes, situation has not improved 

3) No 


99) no answer 

33. Question: Which kind of training did any of your family member get last year? 

1) no 7) both, each once 

2) on agriculture, once 77) yes, others 

3) more than once 88) do not know 

4) on administration, once 99) no answer 

5) more than once 

6) both, once (2 and 4) 

34. Question: Do you get any credits (in terms of money), 

if yes from whom? 

Version: 04/30/00 

1) no 

2) yes, money from the bank 

3) yes, money from government institution 

4) yes, money from NGO 


99) no answer 

35. Question: Do you get any agriculture equipment or others assistance….? 

1) no 

2) yes, agriculture equipment from government institution 

3) yes, agriculture equipment from NGO 

4) other types from NGO 

5) other types from government 


99) no answer


Page 8 /____/_____/_____/_____/ 

Food situation 

36. Question: What was the frequency of consumption of the following foods for 

the household during the last three months? 

Frequency of 

consumption 

I. STAPLE FOOD 

1. Rice 

2. Cassava 

3. Corn 

Version: 04/30/00 

4. Roots/tubers 

5. Noodles 

II. PROTEIN SOURCE 

A. PLANT PROTEIN SOURCE 

1. Legumes 

2. Tofu/Tempe 

3. Ground Nut 

B. ANIMAL PROTEIN SOURCE 

1. Egg 

2. Meat 

3. Fresh Fish 

4. Dried Fish 

III. VEGETABLES 

1. Green leafy vegetables 

2. Other fresh vegetables 

IV. FRUITS 

1. Banana 

2. Papaya 

3. Orange 

4. Jack Fruit 

V. MILK 

VI. OIL/FAT 

1. Coconut Milk 

2. Coconut oil 

3. Red palm oil 

VII. OTHERS 

1.Sugar 

2. Snacks 

1) never 4) weekly, more than once 7) daily, once 

2) strongly dependent on the 

season, therefore seldom 

5) weekly, once 8) daily, more than once 

3) monthly, once 6) weekly, more than once


Page 9 /____/_____/_____/_____/ 

37. Question: Mark the month with food shortages during the past 12 months? 

(1)YES 2)NO) 

Month Answer Month Answer 

January July 

February August 

March September 

April October 

May November 

June December 

38. Question: Do you suffer food shortage because of....? 

1) Pest/diseases 

2) Rain too late 

3) Irregular rain 

4) Harvest not enough for one year 

5) Cris mon/ not enough money to buy seeds 

1) yes 2) no 3) no food shortages 

77) other 88) do not know no answer 99) no answer 

39. Question: If there is food shortage, how do you cope with? 

1) Borrow from relatives/friends 

2) Ask from parents/relatives 

3) Borrow from “money-lender” 

4) Change eating pattern 

5) Sell Assets 

6) Get incentives (FFW) from 

61) NT Project 

62) World Vision 

63) Other 

7) no food shortages 

77) Other 


99) No answer 

40. Question: How much money did you spend in average during the last month 

on… 

average amount in Rp 

Food 

Health 

Education 

Agriculture 

Social activities (funeral, wedding..) 

Version: 04/30/00


Page 10 /____/_____/_____/_____/ 

Questionnaire for Mother 

Pregnancy and Breastfeeding 

1. Question: Are you (the mother) pregnant? 

1) yes, < 3months 4) no 

2) yes, > 3-6 months 88) don’t know 

3) yes, > 6-9 months 99) no answer 

2. Question: Have you ever experienced…? (99) if no answer 

How many times 

1)Child born alive, died before 

reaching the age of 5 years 

2)Still birth 

3)Miscarriage 

3. Question: Did you attend POSYANDU for antenatal care during the last 

pregnancy? 

1) Yes, once-twice 

2) Yes, 3x-4x 

3) >4 

4) Never 


99) No answer 

4. Question: Is it difficult for you to reach the PUSKESMAS/ PUSTU? 

1) Yes, it is too far 4) No 77) Others 

2) Yes, no money 88) do not know 99) No answer 

3) vehicle for transportation 

5. Question: Did you take Iron supplementation during your last or current 

pregnancy? 

1) Yes, once per week 5) did not get/no service 

2) Yes, twice per week 77) other 

3) Yes, every day 88) No, don‘t know 

4) No, don’t like 99) No answer 

Version: 04/30/00


Page 11 /____/_____/_____/_____/ 

6. Question: Are you joining family planning? If the answer is no, what is the 

reason, if yes from where? 

1) Yes, traditional 

2) Yes, contraceptive (injection, IUD, Pill, Implants, etc.) from PUSKESMAS/ 

PUSTU, POLINDES 

3) Yes, contraceptive from POSYANDU 

4) Yes, contraceptive from Agriculture Department 

5) Yes, contraceptive from Transmigration Department 

6) No, no service available 

7) No, husband disapprove 

8) No, afraid 

9) No, feel uncomfortable 

10) No, pregnant 

11) No, family size still small 

12) No, other: 

88) Don’t know about contraceptive 

99) No answer 

7. Question: Have you ever been given health and nutrition extension via official 

channels? If yes, from whom? 

1) No 3) Yes, Health center 77) other: specify 

2) Yes, POSYANDU 4) Yes, TBA 88) don’t know 

5) Yes, midwife 99) no answer 

8. Question: From whom would you like to get information about nutrition 

1) Yes, POSYANDU 5) do not like to get information 

2) Yes, Health center 77) yes other: specify 

3) Yes, TBA 88) don’t know 

4) Yes, midwife 99) no answer 

9. Question: If your child has fever, who decides what to do ? 

1) father 3) grandmother 5) brother/sister 77) others 

2) mother 4) grand father 6) neighbor 88) do not know 

7) various people 99) no answer 

10. Question: Which person did you consult when your child had fever last time 

1) grandmother/grandfather 6) PUSKESMAS 

2) Private health services 7) neighbor 

3) Traditional healer/ Dukun 77) Other, specify 

4) Self-treatment 88) don’t know 

5) POSYANDU 99) no answer 

Version: 04/30/00


Page 12 /____/_____/_____/_____/ 

11. Question: Do you know what POSYANDU is? 

1) YES 2) No 99) no answer 

12. Question: What activities is POSYANDU doing? (Do not read the answers) 

POSact1 POSact2 POSact3 POSact4 POSact5 

1) MCC 

2) Immunization 

3) weighing children 

4) Oralit and Diarrhea treatment 

5) Food supplementation 

6) Family planning 

7) Nutrition education 

8) Interpretation of KMS 

9) Iron, Vit A distribution 

77) others 

88) don’t know 

99) no answer 

13. Question: How often did you go to POSYANDU last 3 months ? 

1) every months 3) twice 88) don’t know 

2) once 4) never 99) no answer 

14. Measurement: presence of iodine in tested sample 

1) No color change 88) Don’t know, not sure 

2) Blue color change 

occurs 

99) No observation made 

Version: 04/30/00


Page 13 /____/_____/_____/_____/ 

Questionnaire for CHILD 

1. Question: Name of child: ................................................................. 

1) Youngest U-5 

2) Older U-5 

3) Oldest U-5 

2. Question: Is the child a boy or a girl? 

1) Boy 2) Girl 

3. Question: Does the child possess a weighing chart? 

1) Yes 2) No 

4. Question: When was the child born ? 

(day, month, year) check by KMS or POSYANDU dd/ mm/ yr 

5. Observation: How often has the child been weighed during first year of life? 

1) never 3) 5 to 8 88) do not know 

2) 1 to 4 4) >8 99) no answer 

Food and Breastfeeding 

6. Question: How many hours after birth did you start with breast-feeding? 

1) Immediately


Page 14 /____/_____/_____/_____/ 

10. Question: If your child is not currently breast-fed how long did you 

breast-feed your child (month) ? 

1) still breastfed 3) > 4-6 mo 5) >12- 24 mo 88) do not know 

2) < 4 mo 4) >6-12 mo 6) >24 mo 99) no answer 

11. Question: Has your child drunk anything besides mother’s milk during 

the last 24 hours? 

1) yes 88) Don’t know 

2) no 99) No answer 

3) no longer breastfed 

12. Question: At what age did you begin feeding the child solid food ? 

months 

1) < 4 months 3) > 6 months 88) don’t know 

2) >4-6 months 4) not yet 99) no answer 

13. Question: Regardless of whether your child is breast-fed or not, 

besides breast milk, how often was your child given something 

to eat yesterday ? 

1) once 4) More than 4 times or equal to 

2) twice 5) not yet 

3) three time 88) Don’t know 

99) No answer 

14. Question: What did you give the child last week? 

Staple food (corn, rice, cassava, sweet potatoes) 1) once 

Plant protein sources (soy-beans, mungbeans,..) 2) twice 

Animal protein sources (chicken, eggs, fish,...) 3) three times 

Vegetables (cabbage,... 4) every day 

Fruits (banana, papaya,... 5) never 

Milk formula in can 88) do not know 

Breast milk 99) no answer 

Oil/fat (coconut milk, ... 

Sugar 

Snack/biscuits 

Others 

15. Question: Who was mainly responsible for bringing up the children, yesterday ? 

1) Mother 5) Grandmother/grandfather 

2) Father 6) Other relative 

3) Both, mother and father 7) Other non-relative 

4) Sister /brother 8) none 

88) do not know 99) No answer 

Version: 04/30/00


Page 15 /____/_____/_____/_____/ 

Health 

16. Question: Does the child currently have more than 3 loose bowel 

movements a day? 



17. Question: Has the child suffered from a diarrhea disease during the last 7 

days? 



18. Question: The kind of immunization the child has received : 

Version: 04/30/00 

immunization yes/no 

BCG (1 month) 

DPT 1 (4 months) 



POLIO 1 (4 months) 



HEPATITIS 1 (4 months) 

HEPATITIS 2 (6 months) 

MEASLES (9 months) 

other injection 

(if mother does not know 

the injection) 

1) yes Completeness: 

2) No 1) complete 

88) do not know 2) Incomplete 

99) No answer 

completeness 

(to be filled later) 

19. Question: Did your child receive a Vit.A capsule during the last 6 months ? 

1) never 2) once 3) twice 88) don’t know 99) no answer 

20. Question: How often did your child receive iron syrup last year? 

1) No 2) daily 

(for 2 months) 

88) don’t 

know 

99) no answer 

21. Question: How often did your child receive iodine tablets last year? 

1) never 2) once 3) twice 88) don’t know 99) no answer


Page 16 /____/_____/_____/_____/ 

Anthropometric Data of the mother 

1. Question: Name of the Mother____________________________ 

2. Measurement: Weight of the mother (00.1kg) kg 

3. Measurement: Height of the mother (cm) cm 

4. Measurement: mid-upper-arm-circumference (cm) cm 

5. Measurement: Hemoglobin g/dl 

6. Observation: Does the mother have an enlarged thyroid gland ? 

1) Yes, Visibly 88) Don’t know, not sure 

2) No 99) No observation made 

Antropometric data of the child 

1. Question: Name of child: ................................................................. 

1) Youngest U-5 

2) Older U-5 

3) Oldest U-5 

2. Measurement: Weight of the child (00.1 kg) kg 

3. Measurement: Height of the child (cm) cm 

4. Measurement: Hemoglobin g/dl 

5. Observation: At a glance, does the child suffer an infection in the 

upper or lower respiratory system 

(cough, runny nose, sore throat or ear ache ?) 

1) yes 88) don’t know 

2) no 99) no answer 

6. Observation: Does the child has Skin disease? 

1) Yes 2) No 3) no observation 

Version: 04/30/00


Frequency distribution (%) of drinking water source by surveyed village 

Subdistrict Village Well River/canal/ 

hole near 

Version: 04/30/00 

File: Appendix.doc 

the river 

Pipe/PDAM Spring Village 


Haharu Wunga 60.6 39.4 0 0 NTT Sumba 

Napu 5.1 0 0 94.9 NTT Sumba 

Mondu 25.0 11.1 61.1 2.8 Non-project 

Lewa Praibokul 18.4 10.5 0 71.1 NTT Sumba 

Kombapari 16.7 5.6 8.3 69.4 Non-project 

Pahangulodu Kabaru 44.8 0 0 55.2 NTT Sumba 

Lambakara 86.7 0 11.1 2.2 Non-project 

Pandawai Kotakawau 0 14.0 4.7 81.4 NTT Sumba 

Pambotanjara 29.0 35.5 0 35.5 NTT Sumba 

Mbatakapidu 28.2 5.1 0 66.7 NTT Sumba 

Maubokul 0 23.8 40.5 35.7 NTT Sumba 

Palakahembi 86.2 0 13.6 0 Non-project


Frequency distribution (%) of amount of animal 

Version: 04/30/00 




Pigs n=248 n=107 

1 31.9 32.7 

2 28.2 34.6 

3 16.5 14.0 

>= 4 23.4 17.8 

Sheeps/goats n=116 n=39 

1 8.2 5 

2-3 11.3 10.5 

4-5 9.8 8.6 

6-10 5.1 - 

11-40 4.5 - 

Cows n=64 n=47 

1 7.5 10.6 

2-3 4.8 14.9 

4-10 6.8 3.6 

11-42 2.2 - 

Chicken n=262 n=127 

= 11 19.5 20.5 

Horses n=117 n=38 

1 16.0 11.8 

2-3 12.3 6.9 

4-10 10.1 4.9 

11-40 1.2 

Dogs n=250 n=123 

1 28.0 41.5 

2 39.2 33.3 

>=3 32.8 25.2 

Frequency distribution (%) of care taker of the child 


(n= 365) 


(n=213) 

Mother 55.1 57.7 

Father 6.6 8.0 

Both 9.6 1.9 

Sister/brother 6.0 7.0 

Grandmother/grandfather 17.0 19.7 

Other relatives 4.7 4.7 

Other non-relatives 1.1 0.9


Frequency distribution (%) of who was responsible for child yesterday 

Version: 04/30/00 


< 1 year 

n=103 

NT Sumba 1998 Non-project 1998 

>1 year 

n=262 

< 1 year 

n=64 

> 1 year 

n=149 

Mother 71.8 48.5 71.9 51.7 

Father 1.9 8.4 9.4 7.4 

Both 7.8 10.3 1.6 2.0 

Sister 4.9 6.5 4.7 8.1 

Grandmother/grandfather 9.7 19.8 9.4 24.2 

Other relatives 2.9 5.3 3.1 5.4 

Other non-relatives 1.0 1.1 0 1.3 

Frequency distribution (%) of joining family planning activities by surveyed area 


N=294 n=161 

Traditional 13.9 11.2 

Contraceptives from 

PUSKESMAS/PUSTU/POLINDES 

22.4 26.7 

Contraceptives from POSYANDU 6.8 7.5 

No service available 0.7 - 

No, husband disapprove 5.8 1.2 

No, afraid 2.4 3.7 

Feel uncomfortable 4.8 9.9 

Pregnant 2.4 5.6 

Family size still small 28.6 21.7 

Other 6.5 8.7 

Do not know about contraceptives 3.4 1.9 

No answer 2.4 1.9


Frequency distribution (%) of number of children, who get prelactal feeding 


Time lag BF Yes No DNK No 

answer 

Yes No DNK 

Immediately 23 117 7 0 28 60 0 

1-4 h 24 28 15 0 12 22 0 

5-12 h 12 15 6 0 0 1 0 

> 12 h 94 19 0 2 86 3 0 

DNK 2 0 1 0 0 0 1 

Total 155 179 29 2 126 86 1 

Frequency distribution (%) of meal frequency and the mean age of the children 

Meal frequency (without 

breastfeeding) 

Version: 04/30/00 



n= 365 

Age 

mean ± SD 

Non-project 

1998 

n=213 

Age 

mean ± SD 

Once 1.6 9.3 ± 3.1 1.4 8.3 ± 4.2 

Twice 14.5 20.1 ± 13.6 14.1 18.6 ± 16.2 

3 times 46.8 28.9 ± 15.9 65.7 29.8 ± 15.9 

≥4 times 26.6 30.0 ± 14.6 10.3 29.6 ± 16.7 

Not yet 9.0 3.0 ± 4.0 8.5 3.3 ± 1.7 

Do not know 1.4 -

NUTRITIONAL BASELINE SURVEY Sumba Timur - Nutrition ...

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