From Philanthropy to Action:  Why Maternal Health and Child Nutrition Require Behaviour Change, Local Capacity, and Stronger Systems

Michael Susanto from Tanoto Foundation discusses maternal and child nutrition, systems strengthening, and philanthropy during the AVPN Southeast Asia Health Impact Leadership Forum.

While national figures often paint a picture of steady triumph, a closer look into the landscape of Maternal and Child Health and Nutrition (MCHN) reveals a more complex reality. 

In Indonesia, for instance, stunting prevalence among children under five successfully dropped from 30.8% in 2018 to 19.8% in 2024. Yet beneath this milestone lies a stubborn public health paradox: 1 in 5 children remain stunted, affecting roughly 4.5 million lives. Concurrently, maternal undernutrition persists. 27.7% of mothers suffering from anaemia and 17% experiencing chronic energy deficiencies, serving as a direct precursor to childhood malnutrition. 

To improve both, we must first understand what is happening at home, in the community, and look closely at the factors behind the daily choices families make for their children.

This critical intersection of policy, community reality, and system resilience was the focal point of the recent AVPN Southeast Asia Health Impact Leadership Forum in Jakarta. At the forum, sector leaders emphasised that meeting the World Health Organization’s global nutrition targets – including a 50% reduction in anaemia among women of reproductive age and a 40% reduction in childhood stunting – demands a shared responsibility across the entire development ecosystem.

If philanthropy is to accelerate progress in maternal and child nutrition, funding alone is no longer enough. Drawing on Tanoto Foundation’s experience across Indonesia, three lessons stand out on how philanthropy can move from commitment to lasting, systemic change:

1. Nutrition Problems are Often Behavioural, not Just Supply-Side.

    The challenge commonly found in nutrition programmes is that access alone does not guarantee utilisation. Families make feeding decisions based on a complex combination of knowledge, habits, cultural norms, and perceptions of what is appropriate for their children.

    An interesting discovery was drawn during one of Tanoto Foundation’s study in a fisherman village in Sumba. Here, we found that children were not eating fish – an excellent, locally available protein source – despite living right next to the sea. Although fish was available and accessible, it was not part of the usual household menu due to concerns over bones and smell.

    This finding reinforces the need for behaviour change. While many nutrition programmes provide essential food to communities, its sustainability relies on parents and caregivers having the practical knowledge on what, when, and how to feed their children. Behaviour change must start at home, where the kids are being fed.

    2. Local Capacity Determines Whether Policies Create Impact

      Over the past decade, Indonesia has introduced a range of policies and programmes aimed at accelerating stunting reduction. However, the gap between policy design and implementation remains a common challenge across the development sector. At the village level, data may also be available, but local actors may need extra support to analyse and use it effectively. 

      To ensure that the local teams have the capacity to implement lasting solutions, Tanoto Foundation works with local governments across seven regions, providing technical assistance, facilitating discussions, strengthening monitoring tools, and supporting programme implementation.

      In one partner region, initial data identified a localised spike in stunting. Rather than applying a standard nutrition fix, further analysis of the local environment by trained teams revealed a high incidence of diarrhoea, pointing directly to underlying water, sanitation, and hygiene (WASH) issues. By introducing a targeted WASH intervention alongside nutrition tracking, the overall situation improved.

      The lesson is clear: data does not automatically lead to better outcomes. Local actors need the capacity to interpret evidence, identify root causes, and coordinate responses across sectors. 

      3. Philanthropy Creates Value by Strengthening Existing Systems

      Areas where government funding may not fully cover intervention, innovation, or learning needs are exactly where philanthropy plays a crucial role. Along with development partners, philanthropy can help test approaches, take calculated risks, and generate evidence that can later support broader adoption.

      At Tanoto Foundation, we believe that catalytic financing must be paired with collaboration. Beyond funding, philanthropic organisations can help connect actors, strengthen systems, and support the adoption of programmes by government and communities. 

      These roles are then strengthened through three important principles: alignment, adoption, and policy. 

      Alignment ensures that partners work toward the same goal instead of operating in silos. Adoption is important for sustainability of programmes – co-creation and co-ownership between philanthropy, communities, and governments are what has been found to be the key for a long-lasting programme. Whereas policy helps to set the tone, ensuring that the proper instruments and budgets are in place for effective implementation.

      Beyond Short-Term Interventions: Designing for Scale

      The World Health Organization’s global nutrition target calls for a 50% reduction in anaemia among women of reproductive age and a 40% reduction in the number of stunted children. Meeting these targets in a country as complex as Indonesia requires us to rethink how we measure philanthropic success.

      With global good practices already available with evidence-based interventions, philanthropy can facilitate bringing in global expertise to complement local capacity and address needs in the space by engaging with and building key partnerships to strengthen local systems. 

      Since 2019, Tanoto Foundation’s strategic partnerships with the World Bank and UNICEF have focused on a catalytic approach – one that intentionally funnelled global expertise into policy strengthening and creating scalable, localised implementation models.  

      This work leaves us with a critical truth to ponder: The ultimate measure of high-impact philanthropy is not how much aid we distribute, but how quickly we can transition our innovations into public policy. If a nutrition initiative depends indefinitely on outside funding to survive, it functions as a short-term stopgap rather than a systemic solution. 

      True progress happens when we deliberately plan for sustainability from day one – building the evidence base and local capacity so robustly that public institutions seamlessly absorb, fund, and protect these systems long after individual grants have ended. Food lines eventually end, but sustainable national architecture lasts for generations.