By Natalie Kennedy
On 12 June 2019, APC returned to Kuala Lumpur to revisit the topic of urban poverty and malnutrition. Hosted by APC member Datin Kathleen Chew at the Majestic Hotel, APC convened this meeting to consider the question:
“What is the ideal approach to piloting a holistic intervention to eliminate malnutrition among children living in PPR flats (low-cost, high-rise public housing in Kuala Lumpur)?”
According to UNICEF, and as discussed at our last round table meeting in January, poverty is especially pervasive in PPR estates, at a rate of 85% compared to the Kuala Lumpur poverty rate of 5%. Living in such urban poverty, children in the PPR flats face the double burden of malnutrition – they are twice as likely to face stunting and wasting, and six times as likely to be clinically obese when compared to the average in KL.
The problem isn’t likely to go away. With 80,000 families on the waitlist for PPR flats and the government’s announced intention to develop 600,000 more flats in the near-term, this low-cost housing option is in demand and here to stay. However, as discussed during January’s round table, there are many government programmes aimed at addressing the issue of malnutrition, but they have challenges reaching or being taken up by the target population in urban settings.
With everyone in agreement that this problem requires a cohesive, collaborative effort, APC convened a broad set of stakeholders across multiple sectors – change agents from NGOs already working on the ground in PPR areas, representatives from pilot programmes coordinated by University of Malaya, representatives from the Ministry of Health, and prospective funders.
Participants heard directly from project leaders for two pilot programmes initiated by MP Maria Chin in collaboration with the School of Medicine, U of Malaya. Upon her election in 2018, MP Chin aimed to address directly the dramatic findings of the UNICEF report on urban poverty in PPR flats.
She engaged her volunteers to work with teams from U of Malaya on two pilots. The first is “50 Healthy Families” aimed at improving health literacy and promoting active lifestyles for families in PPR flats; the pilot completed in June after working with a first cohort of 50 families with some early success, and 16 families will continue on as peer leaders for the next cohort. The second pilot is Child of Urban Poverty Iron Project (CUPIP) which is a randomized control trial measuring the impact of daily vitamin and mineral supplementation; due to launch in July 2019, the project will empower local women as cohort directors and engage private sector companies for provision of supplements and medical diagnostics.
With the problem being seen as multi-dimensional, APC presented two potential models for a concerted approach. A potential “bottoms-up” approach is the Gerakan Kepedulian Indonesia (GKI) model for community development in the rusunawa (which are similar to PPR flats). GKI, which is supported by APC member Arif Rachmat, embeds full-time workers within the rusunawa to support an integrated community development model across five pillars: education, health, productivity, infrastructure, and community organizing. The second, more “top-down” approach could be something similar to Malaysia Collective Impact Initiative (MCII), supported by APC member Datin Kathleen Chew, which aims to improve education outcomes for students in national schools by mapping school needs to MCII member programmes, including training for school leadership via Global School Leaders Malaysia (an APC project), among other programmes.
Inspired by the U of M projects and the challenge from APC to discuss a potential holistic, integrated approach given the unique challenges of communities in the PPR estates, the group discussion was underway. At the core was a question which kept popping up: would it be better to attempt a focused intervention with wide reach for all the PPR flats, or rather, build a holistic approach for one PPR estate which could then be iterated and scaled?
With the dialogue shifting from divergent ideation to collecting and distilling the group’s thoughts around this core question, the consensus became clear – a coordinated approach should be prototyped for one PPR community. Of course, the question then became: Who is best placed to lead this coordinated approach?
The on-the-ground NGOs such as Food Aid Foundation (which launched the National Food Bank in Malaysia) emphasized the need to focus on one government ministry as a lead, although eventually many ministries may need to be involved.
Datin Kathleen Chew suggested the formation of a preliminary committee to more fully scope a potential approach, find public sector champions, determine which PPR flats would be the initial focus, and source funding partners.
Laurence Lien called for volunteers for such a committee, and several hands were raised, across multiple sectors. APC is currently formalizing the committee and working directly with the Ministry of Health Nutrition Division to understand programmes currently available or in the pipeline.
As the committee takes shape, we are a step closer to the lofty goal set at the beginning of the meeting: to eliminate malnutrition among children living in PPR flats by 2030.
Members who are interested in this project may contact APC to coordinate further follow up: email@example.com