Implementation of the “CESS-GAMMARA” Program to Prevent Stunting and Wasting in Children: A Case Study from Jeneponto, Indonesia

Abstract

Background: Stunting and wasting are two major nutritional problems that hinder children's growth and development, especially in eastern Indonesia. Jeneponto Regency, South Sulawesi, is one of the areas with the highest prevalence of stunting nationally, which is exacerbated by low nutritional literacy and inappropriate feeding practices. Objective: Implement the CESS-GAMMARA Program as a community-based nutrition education intervention to prevent stunting and wasting by increasing mothers' knowledge and skills in providing breast milk and complementary feeding. Methods: This study is a quasi-experimental study that has been implemented since 2023 at the Nutrition Clinic of Lanto Dg Pasewang Hospital with 126 toddlers as participants. Activities include individual nutrition education, anthropometric measurements, 24-hour food recalls, and the preparation of meal plans based on the 3U3S approach (3 main meals, 3 snacks), accompanied by the provision of eggs, formula, and regular assistance. Results: A total of 14 children were declared cured, 62 children improved, 3 did not improve, and 47 were lost to control. Statistical tests showed a significant relationship between nutrition education, increased intake, and child growth status. The 3U3S approach was considered easy to understand and apply. Conclusion: CESS-GAMMARA is effective in improving the nutritional status of toddlers and can be a community nutrition education model that can be widely replicated.