Understanding the Contextual Idiosyncrasies of Stunting Prevention Program at District and Village Levels in Indonesia Using the Ecological Approach


Mutiara Tirta Prabandari Lintang Kusuma

 

Department of Health Nutrition, Faculty of Medicine, Nursing,

and Public Health, Universitas Gadjah Mada, Indonesia

 

ABSTRACT

Background: Despite rapid economic growth, stunting affects one third of the child­ren under five population in Indonesia. The Government of Indonesia (GoI) realizing the problem, established the National Strategy to Accelerate Stunting Prevention as a national priority program for 2017 to 2021. The GoI plans to maximize the use of resources, policies, and programs that encompasses nutrition-specific and sensitive interventions directed to the first 100 days of life. This study aimed to explore the extent of program planning, budgeting, and implementation related to stunting prevention at district and village level as well as to understand the challenges presented to converge intervention.

Subjects and Method: A case study with ecological approach was conducted in 10 villages from five districts in Indonesia. The study method included focus group discussions with 70 district officials and 100 village representatives, interviews with 12 key informants from district planning agency, document analysis, and reflective journaling. The data were reported descriptively.

Results: Most head districts, officials from relevant departments and village leaders committed to stunting prevention following the vice president decree of stunting as a national priority. As a result, programs and budget were in place and local initiatives to prevent stunting were on the rise. Despite the commitment, many expressed ambivalences and disregarded the issue as a mere short stature (genetic variation). Thus, problems related to efficiency, coverage, and sustainability persists as maintaining motivation among staffs were difficult. In some settings, the situation was exacerbated by factors such as high financial dependency, misconception, and poor gender relation.

Conclusion: The policy and programs to control stunting among children in Indonesia are in place. However, challenges occur due to the complexity in governance system as well as lack of political will. Better communication and cooperation are essential for well implemented policies.

Keywords: stunting, ecological approach, case study, nutrition intervention, nutrition policy

Correspondence: Mutiara Tirta Prabandari Lintang Kusuma. Department of Health Nutrition, Faculty of Medicine, Nursing, and Public Health, Universitas Gadjah Mada, Indonesia. Jl. Farmako, Sekip Utara Yogyakarta 55281. Email: mutiara.tirta@gmail.com. Mobile: +62­8­139880­320

DOI: https://doi.org/10.26911/the7thicph.04.34

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