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Abstract

Vitamin A deficiency (VAD) remains a persistent public health challenge in Indonesia, particularly among children under five and breastfeeding mothers. This study aimed to analyze the distribution of vitamin A interventions and assess the potential of biscuit fortification as a complementary strategy. This study employs a literature review using the Health Policy Triangle (HPT) framework, examining policy context, content, key actors, and implementation processes related to vitamin A interventions. The analysis was conducted using secondary data from government reports, international agencies, and peer-reviewed literature published between 2018 and 2025, with comparative evidence from Vietnam, Bangladesh, and Ghana. The findings show that while national vitamin A supplementation coverage reached 92% in 2023, substantial inter-provincial inequalities persist, with provinces in eastern Indonesia recording the lowest coverage. Cooking oil fortification is consumed by only 56% of households, as low-income groups rely on unfortified bulk oil. Biscuit fortification under the Supplementary Feeding Program has benefited malnourished children and at-risk pregnant women but remains limited in scope and raises concerns regarding ultra-processed food consumption. Evidence from other countries highlights that combined interventions—supplementation, oil fortification, and fortified biscuits—are more effective than single approaches. This study concludes that an integrated, context-specific strategy supported by cross-sector collaboration and quality assurance offers the most sustainable pathway to reduce VAD and strengthen Indonesia’s nutrition system. Biscuit fortification can serve as a complementary and potentially sustainable strategy within future nutrition policies.

References

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Bahasa Abstract

Defisiensi vitamin A masih menjadi tantangan kesehatan masyarakat yang persisten di Indonesia, khususnya pada balita dan ibu menyusui. Penelitian ini bertujuan untuk menganalisis distribusi intervensi vitamin A serta menilai potensi fortifikasi biskuit sebagai strategi komplementer. Penelitian ini menggunakan tinjauan literatur dengan kerangka Health Policy Triangle (HPT), yang mengkaji konteks kebijakan, isi kebijakan, aktor kunci, serta proses implementasi intervensi vitamin A. Analisis dilakukan menggunakan data sekunder yang bersumber dari laporan pemerintah, lembaga internasional, serta literatur ilmiah terindeks yang dipublikasikan antara tahun 2018 hingga 2025, dengan bukti komparatif dari Vietnam, Bangladesh, dan Ghana. Hasil penelitian menunjukkan bahwa meskipun cakupan suplementasi vitamin A nasional mencapai 92% pada tahun 2023, ketimpangan antarprovinsi masih signifikan, dengan provinsi di Indonesia bagian timur mencatat cakupan terendah. Fortifikasi minyak goreng baru dikonsumsi oleh 56% rumah tangga, karena kelompok berpendapatan rendah masih bergantung pada minyak curah yang tidak difortifikasi. Fortifikasi biskuit dalam Program Pemberian Makanan Tambahan telah memberikan manfaat bagi anak dengan malnutrisi dan ibu hamil berisiko, namun cakupannya masih terbatas serta menimbulkan kekhawatiran terkait konsumsi pangan ultra-proses. Bukti dari negara lain menunjukkan bahwa intervensi kombinasi—suplementasi, fortifikasi minyak, dan fortifikasi biskuit—lebih efektif dibandingkan pendekatan tunggal. Penelitian ini menyimpulkan bahwa strategi terintegrasi yang kontekstual, didukung oleh kolaborasi lintas sektor dan jaminan mutu, merupakan jalur paling berkelanjutan untuk menurunkan angka defisiensi vitamin A serta memperkuat sistem gizi di Indonesia. Fortifikasi biskuit dapat berperan sebagai strategi komplementer yang potensial dan berkelanjutan dalam kebijakan gizi di masa mendatang.

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