Efforts in Indonesia to save a volunteer-led community health initiative are working, but more is needed to increase the reach of the program, which is shown to improve child and maternal health, say health officials.

The country's integrated health services posts, known as Posyandu, are monthly clinics for children and pregnant women, providing vaccinations and nutritional supplements.

There are more than 260,000 Posyandu posts nationwide, but a lack of funding, political support and volunteers has rendered half of them inactive, said the head of the Demographic Institute at the University of Indonesia, Sonny Harmadi.

"Times have changed. People no longer take pride in being Posyandu volunteers," he said. "People also prefer to go to clinics [more] than Posyandu."

Volunteers trained by local health departments have typically organized the monthly check-ups.

And even though more health clinics serve rural patients now than when Posyandu posts were launched in the 1980s, there is still a need for the community gatherings, said Sugiri Syarief, head of the government's Agency for Population and Family Planning.

"We cannot afford to let them die because we will lose an important vehicle for early detection of malnutrition," he said.

According to the Health Ministry's 2010 Basic Health Survey, 17.9 percent of children under 5 are underweight nationwide (weight-to-age ratio), a decrease from 31 percent in 1989.

Posyandu monthly check-ups are partly responsible for the drop, said Minarto, the Health Ministry's director for nutrition promotion. "Recent data show that about 70 percent of mothers visit a Posyandu at least once every six months," Minarto said.

Chronic malnutrition, as measured by stunting, or height-to-age ratio, among children under 5 years old stood at 35.7 percent, while acute malnutrition, weight-to-height ratio, also known as acute malnutrition, was 13.3 percent. Fifteen percent is the widely recognized indication of a nutrition emergency.

In addition, in 2007, the maternal mortality rate was 228 deaths per 100,000 live births, far short of the UN Millennium Development Goal target of 102 per 100,000 live births for 2015.

To boost attendance, officials and NGOs are expanding Posyandu services to include early childhood education and elderly care, Minarto said.

Since 2009, the international NGO Save the Children, with Kraft Foods, has worked with Posyandu posts in 54 villages in West Java through its Future Resilience and Stronger Households program.

"West Java is a food basket... but why does malnutrition still exist?" said Evi Yulianti, who is a program manager at Save the Children. "Our observation shows that the biggest problems are parents' lack of knowledge about nutrition and hygiene," she said.

Nutrient-deficient diets coupled with water-borne diseases from unsafe drinking water have led to persistently high levels of malnutrition even during bountiful harvests.