The high number of malnourished children under the age of five (under-5) is found in Sangihe Talaud District due to the limited knowledge and skills of community health workers, Posyandu volunteers (health cadres) in dealing with the underweight children and assisting the mothers/ caregivers. People need to acquire foods from outside Sangihe Islands, mainly from Manado (Sulawesi mainland).
The high prices of non-local foods and low in the availability of healthy food sources contribute to the low nutritional status of Sangihe under-5 children. Through trainings, comparative study, and applying the innovative method of Positive Deviance Inquiry (PDI), ADRA Indonesia revitalized the Integrated Services Post/ISP or Posyandu, under the community health center program of sub-district level, to equip the ISP volunteers in the villages in order to enable them to deal with and assist the mothers/ caregivers to learn, from the existing positive deviances in their own residences, how to sustain a child’s nutritional status by utilizing the available highly nutritious local food sources.
Now, they are also able to identify and treat the severely and moderately underweight children by providing tailored and appropriate extra support. Nutrition Post in each Posyandu has improved, changing its function not only to rehabilitate the malnourished under-5 children but also to train mothers and caregivers in child health care practices, such as good feeding, caring and health-seeking practices, an out-patient system for severely underweight children.
Home visits are regularly—often so frequent—done to monitor the growth and progress of the nutritional status of these children. Each village meeting for development planning which is done monthly includes the report of the current nutritional status of the under-five children within the community. By doing this, they are aware and alert for any underweight case that threatens their community children and knows the procedure for treatment and referral to the higher medical institution, either community health center or hospital.