Development of health and nutrition-oriented human development (sustainable development for mankind) is based on the realization about the importance of health investment for the progress of a nation. Without health, there will be no human resources (HR) is an intellectual and productive which is a prerequisite to the success of a nation. Health is without major capital development, capital-capital other will not work optimum (Grossman, 1972). Health also is a human right that should be met before other human rights can be met.
Health role in preparing high-quality raw materials and human resources maintain and enhance the quality of human resources. Health investment should start from the beginning, even as a mother preparing to become pregnant because of the nutritional status of the mother during pregnancy will affect the health of the fetus. Thus the approach to nutrition and health throughout the life cycle is the right approach and the improvement of nutrition and health should be conducted simultaneously in all stages of life, especially in the early stages of life include pregnant mothers, pregnant women, fetuses, newborns (neonatal), perinatal period weaning, under one year, under two years, under three years old, and pre-school (under five-six years). Early health investment is the beginning of long-term capital-oriented development and improving the quality of human resources should be implemented.
Indonesia Health Sciences Consortium (KIKI) suggested the need for a redefinition the medical term. As we all know WHO defines health as: "The state of perfect physical, ment al, and social and not just freedom from disease and disability, as well as economically and socially productive." While the Act Health No. 23/1992, the General Provisions Article 1 paragraph (1) mentions the meaning health as "a state of well being of body, soul, and socially to enable more people to live productive both socially and economically." The definitions are more appropriate for adult humans age, but have emphasized the importance of early childhood health. The proposed definition of health by KIKI is: "Health is a basic and natural elements of the potential of each individual which is indispensable in early life and growth, and if it does not exist or can not be fulfilled me nghambat physical and mental development someone. "(Consortium of Medical Sciences of Indonesia, 2003)
Brain Development
Brain growth starting from the age of two weeks and the fetus in terms of growth, brain tissue classified into static so it is not possible accretion of cells (hyperplasia) when the differentiation of the cells germinatif (boggin, 1999). Another implication of the growth of the network is no possibility of renewal static (renewal) and if any damage is irreversible (irreversible).
At birth, the growth of the spinal cord and brain stem almost completed while cerebellum is still growing until the first year of life. Neurons (nerve cells receive and send information) began to take shape at the age of 2 months and the fetus number of neurons increased rapidly at 25 weeks gestation until months after birth. By the time the baby is born, almost all adult brain neurons have been formed though not fully developed.
Furthermore, neurons migrate and form axons and dendrites that function send signals (axon) and receiving signals (dendrites) of neurons through synapses (the communication of the nervous system) with the help of neurotransmitters. Reproduction of dendrites and synaptic connections occurs primarily in third trimester pregnancy until the baby is 2 years of age when the number of synapses reaches its peak (Papalia, Olds, and Feldman, 2001). Besides neurons, the brain is also made up of glial cells that protect the network of neurons with myelin (a type of fat). This process, called myelinasi allow communication between neurons more efficiently by increasing the speed of signal transfer and thus can achieve functional maturity of the brain. Myelinasi begins in mid-gestation in some parts of the brain and continues into adulthood in some other parts of the brain. Myelinasi on the brain pathways related to touch (the developed initial sensor body) for example, is complete at birth while myelinasi the visual pathway continues through the first 5 months of life. While myelinasi in the cortex of the brain that control aspects of attention and memory continues until young adulthood (Papalia, Olds, and Feldman, 2001).
Nutritional factors are essential factors for growth and brain development. Malnourished pregnant women and infants affect infant brain development, the study notes that lbw to 5 points lower IQ, stunted 5-10 points lower IQ and lower IQ Gaki up 10-15 points (Grantham-McGregor, Fernald, and Sethuraman, 1999), and anemia lowers IQ to 8 points (Horton and Ross, 2003).
Exclusive breastfeeding is known to have a variety of nutritional and health benefits including the development of the immune system, supply of energy, protein and other nutrients in a balanced composition, and gain emotional psycho form of closeness (attachment) baby with her mother. In terms of intellect and cognitive, breastfed babies have higher IQ 3.2 points compared with infants who received formula milk (Anderson, 1999). Breastfeeding known to be associated with exclusive breastfeeding immediately (immediate breastfeeding) positively (Fikawati and Shafiq, 2003). The prevalence of exclusive breastfeeding up to 6 months in various regions in Indonesia is still low at below 10%
(Syafiq and Fikawati, 2007).
Strategic Health Improvement and Nutrition in Early Childhood
Proposals can be submitted for strategies to improve the health and nutrition of children aged Early was the first, it should be emphasized to all parties of the importance of Early health investment as a prerequisite for the development of national human resources quality. Without the awareness and knowledge of health investment early then the bargaining position of health and nutrition will always be weaker than the other sectors, such as education. Though investment in education will not be optimal even useless without health investment early.
Second, the escort by the Central Government. As already mentioned section earlier, to ensure the sustainability of the program evenly Central Government should oversee both managerial and financial capacity building program health and nutrition of young children. Submit funding the government will put the program in a situation of uncertainty and is certainly not accomplished optimally.
Third, community-based approach. People need to share in and be involved programs to improve health and nutrition of young children. It is very important that a desire to improve yourself. Communities should also be invited to participate and understand their problems involved in the planning of the program, including monitoring and evaluation. This approach also provides a guarantee of sustainability (sustainability) of the program.
Partnerships need to be made with all parties, government institutions, the private sector, and NGOs. It should be noted that the partnership intertwined maintained particularly in relation to sustainability (sustainability). Often occurs from the program because the program stopped funding partners (donor agency) has been terminated with no follow-up and handover by institutions government.
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