Barrier from the Side of Stunting Management Policy in Rural Areas of Indonesia: A Qualitative Study

Authors

  • Petrus Kanisius Siga Tage Department of Nursing, Health Sciences Faculty, Universitas Citra Bangsa, Kupang, East Nusa Tenggara, Indonesia
  • Erna Febriyanti Department of Nursing, Health Sciences Faculty, Universitas Citra Bangsa, Kupang, East Nusa Tenggara, Indonesia

DOI:

https://doi.org/10.31965/infokes.Vol22.Iss4.1522

Keywords:

Policy, Qualitative Research, Rural, Stunting

Abstract

This study examines the factors hindering effective stunting management in rural Indonesia, with a particular focus on government policy. Despite ongoing efforts, inadequate attention has been given to key policy-related challenges, including cross-sectoral coordination, merit-based recruitment, budget allocation, and community-based education. This study aims to identify policy barriers that hinder the implementation of stunting mitigation efforts in rural Indonesia. The method used A qualitative approach with a phenomenological design was employed. Data were collected through semi-structured interviews with 32 purposively selected participants, including regional and sub-district heads, village chiefs, health department leaders, and community health center directors, from January to August 2023. The results show that the analysis identified five primary barriers to stunting management: (1) Regulatory inconsistencies, including overlapping inter-agency guidelines that create ambiguity in implementation; (2) Human resource limitations, characterized by a shortage of skilled personnel and nepotistic recruitment practices; (3) Structural and institutional barriers, such as bureaucratic inefficiencies and inter-agency conflicts of interest; (4) Misallocated funding, driven by corruption and weak oversight, leading to ineffective budget distribution; and (5) Community-related factors, including poverty, low nutritional awareness, and unsupportive cultural practices. The conclusion is The conclusion is to addressing these barriers is essential for improving stunting management in rural Indonesia. Enhancing policy consistency, strengthening institutional frameworks, and improving resource allocation are key to overcoming existing challenges. The study recommends periodic regulatory evaluations, enhanced cross-sectoral coordination, and alignment of national policies with local needs. Establishing community-based recruitment and training systems through strategic partnerships could mitigate human resource constraints. Strengthening anti-corruption measures through independent oversight and digital reporting systems. Finally, fostering sustained community education through sociocultural approaches and local leader involvement is critical to increasing awareness and participation in stunting prevention efforts.

Downloads

Download data is not yet available.

References

Afandi, M., Anomsari, E., Novira, A., & Sudartini, S. (2022). A Penta-Helix Approach to Collaborative Governance of Stunting Intervention in West Java Indonesia. Proceedings of the Third International Conference Administration Science, ICAS 2021. https://doi.org/10.4108/EAI.15-9-2021.2315238

Al Jawaldeh, A., Doggui, R., Borghi, E., Aguenaou, H., Ammari, L. E., Abul-Fadl, A., & McColl, K. (2020). Tackling childhood stunting in the Eastern Mediterranean Region in the context of COVID-19. Children, 7(11), 239. https://doi.org/10.3390/children7110239

Beal, T., Tumilowicz, A., Sutrisna, A., Izwardy, D., & Neufeld, L. M. (2018). A review of child stunting determinants in Indonesia. Maternal & child nutrition, 14(4), e12617. https://doi.org/10.1111/mcn.12617

Beatty, A., Borkum, E., Leith, W., Null, C., & Suriastini, W. (2024). A Cluster Randomized Controlled Trial of A Community-Based Initiative to Reduce Stunting in Rural Indonesia. Maternal & Child Nutrition, 20(1), e13593. https://doi.org/10.1111/mcn.13593

Belew, A. K., Worku, N., Gelaye, K. A., Gonete, K. A., Hunegnaw, M. T., Muhammad, E. A., Astael, T., Mitike, G., Lakew, A. M., & Abebe, Z. (2023). Functionality of Nutrition Steering and Technical Committees and Quality of Child Growth Monitoring Program in Northwest Ethiopia. Discover Food, 3(1), 1–10. https://doi.org/10.1007/s44187-023-00049-5

Bhattacharya, R., & Ravi, J. K. (2023). A Qualitative Evaluation of the Micro-level Barriers to Better Delivery and Utilisation of Nutrition Services in Rural India. Asia-Pacific Journal of Rural Development, 33(1), 7-32. https://doi.org/10.1177/10185291241235446

Bogin, B. (2022). Fear, Violence, Inequality, and Stunting in Guatemala. American Journal of Human Biology, 34(2), e23627. https://doi.org/10.1002/ajhb.23627

Braun, V., & Clarke, V. (2006). Using Thematic Analysis in Psychology. Qualitative Research in Psychology, 3(2), 77–101. https://doi.org/10.1191/1478088706qp063oa

Campos, P. A., & Reich, M. R. (2019). Political analysis for health policy implementation. Health Systems & Reform, 5(3), 224-235. https://doi.org/10.1080/23288604.2019.1625251

De Onis, M., Blössner, M., & Borghi, E. (2012). Prevalence and Trends of Stunting Among Pre-school Children, 1990–2020. Public Health Nutrition, 15(1), 142–148. https://doi.org/10.1017/S1368980011001315

Global Nutrition Report. (2020). Country Nutrition Profiles . Global Nutrition Report. Retrieved from: https://globalnutritionreport.org/resources/nutrition-profiles/asia/south-eastern-asia/

Grey, K., Gonzales, G. B., Abera, M., Lelijveld, N., Thompson, D., Berhane, M., Abdissa, A., Girma, T., & Kerac, M. (2021). Severe Malnutrition or Famine Exposure in Childhood and Cardiometabolic Non Communicable Disease Later in Life: A Systematic Review. BMJ Global Health, 6(3), 3161. https://doi.org/10.1136/BMJGH-2020-003161

Guillermo, M. S., & Guillermo, M. S. (2023). Perceptions on the Implementation of the Philippine Development Plan in Ensuring Efficient Governance. Open Journal of Leadership, 12(4), 375–399. https://doi.org/10.4236/OJL.2023.124018

Handryastuti, S., Pusponegoro, H. D., Nurdadi, S., Chandra, A., Pramita, F. A., Soebadi, A., Widjaja, I. R., & Rafli, A. (2022). Comparison of Cognitive Function in Children with Stunting and Children with Undernutrition with Normal Stature. Journal of Nutrition and Metabolism, 2022, 9775727. https://doi.org/10.1155/2022/9775727

Herawati, D. M. D., & Sunjaya, D. K. (2022). Implementation outcomes of national convergence action policy to accelerate stunting prevention and reduction at the local level in Indonesia: a qualitative study. International Journal of Environmental Research and Public Health, 19(20), 13591. https://doi.org/10.3390/ijerph192013591

Hermanussen, M., & Scheffler, C. (2024). Stop Stunting A Misguided Campaign by Well Meaning Nutritionists. American Journal of Human Biology, 36(8), e24068. https://doi.org/10.1002/ajhb.24068

Indartuti, E. (2022). Utilization of Village Funds in Improving the Economy of Village Communities. International Journal of Social Science and Business, 6(3), 343–349. https://doi.org/10.23887/ijssb.v6i3.49953

Iruhiriye, E., Frongillo, E. A., Olney, D. K., Niyongira, E., Nanama, S., Blake, C. E., Rwibasira, E., & Mbonyi, P. (2024). Understanding Differential Reductions in Undernutrition Among Districts in Rwanda through the Perspectives of Mid Level and Community Actors on Policy Commitment and Policy Coherence. Maternal & Child Nutrition, 20(3), e13640. https://doi.org/10.1111/mcn.13640

Kementerian Kesehatan Republik Indonesia. (2022). Buku Saku Hasil Survei Status Gizi Indonesia (SSGI) 2022. Jakarta: Kementerian Kesehatan Republik Indonesia.

Miranda, A. V., Sirmareza, T., Nugraha, R. R., Rastuti, M., Syahidi, H., Asmara, R., & Petersen, Z. (2023). Towards stunting eradication in Indonesia: Time to invest in community health workers. Public Health Challenges, 2(3), e108. https://doi.org/10.1002/puh2.108

Montenegro, C. R., Gomez, G., Hincapie, O., Dvoretskiy, S., DeWitt, T., Gracia, D., & Misas, J. D. (2022). The Pediatric Global Burden of Stunting: Focus on Latin America. Lifestyle Medicine, 3(3), e67. https://doi.org/10.1002/lim2.67

Mulyani, S., Soetrisno, Andayani, T. R., & Perestroika, G. D. (2023). Factors Affecting Village Apparatus, Integrated Service Post and Early Childhood Education in Stunting Prevention. Ethiopian Journal of Health Sciences, 33(2), 237. https://doi.org/10.4314/ejhs.v33i2.8

Niga, J. D. (2023). Collaborative Governance in an Effort to Reduce Stunting Rate in TTS District, NTT Province. International Journal of Social Service and Research, 3(4), 1060–1067. https://doi.org/10.46799/ijssr.v3i4.355

Palutturi, S., Syam, A., Asnawi, A., & Hamzah. (2020). Stunting in a Political Context: A Systematic Review. Enfermería Clínica, 30, 95–98. https://doi.org/10.1016/j.enfcli.2019.10.049

Prasetyo, A., Noviana, N., Rosdiana, W., Anwar, M. A., Harwijayanti, B. P., & Fahlevi, M. (2023). Stunting convergence management framework through system integration based on regional service governance. Sustainability, 15(3), 1821. https://doi.org/10.3390/su15031821

Rahman, M. A., Halder, H. R., Rahman, M. S., & Parvez, M. (2021). Poverty and childhood malnutrition: Evidence-based on a nationally representative survey of Bangladesh. PLoS One, 16(8), e0256235. https://doi.org/10.1371/journal.pone.0256235

Santinha, G., Fernandes, A., Oliveira, R., & Rocha, N. P. (2023). Designing a health strategy at local level: A conceptual framework for local governments. International Journal of Environmental Research and Public Health, 20(13), 6250. https://doi.org/10.3390/ijerph20136250

Saputri, R. A., & Tumangger, J. (2019). Stunting Management Policy in Indonesia. Journal of Political Issues, 1(1), 1–9. https://doi.org/10.33019/jpi.v1i1.2

Soliman, A., De Sanctis, V., Alaaraj, N., Ahmed, S., Alyafei, F., Hamed, N., & Soliman, N. (2021). Early and Long-term Consequences of Nutritional Stunting: From Childhood to Adulthood. Acta Bio Medica : Atenei Parmensis, 92(1), 2021168. https://doi.org/10.23750/abm.v92i1.11346

Soviyati, E., Sulaeman, E. S., Sugihardjo, I., & Wiboworini, B. (2023). Effect of Applying the Health Promotion Model in Stunting Prevention and Behavior Control in Indonesia. Journal of Education and Health Promotion, 12(1), 227. https://doi.org/10.4103/jehp.jehp_276_23

Syafrawati, S., Lipoeto, N. I., Masrul, M., Novianti, N., Gusnedi, G., Susilowati, A., ... & Umar, H. B. (2023). Factors driving and inhibiting stunting reduction acceleration programs at district level: A qualitative study in West Sumatra. Plos One, 18(3), e0283739. https://doi.org/10.1371/journal.pone.0283739

Trivedi, M., Patel, M., Divya Nair, H., & Sharma, B. (2022). Evaluation of Community Bbased Participatory Governance Interventions to Improve Access to Health Related Public Entitlements in India. International Journal of Health Governance, 27(3), 296–311. https://doi.org/10.1108/ijhg-03-2022-0030

Vaivada, T., Akseer, N., Akseer, S., Somaskandan, A., Stefopulos, M., & Bhutta, Z. A. (2020). Stunting in Childhood: An Overview of Global Burden, Trends, Determinants, and Drivers of Decline. The American Journal of Clinical Nutrition, 112(Suppl 2), 777S. https://doi.org/10.1093/ajcn/nqaa159

Wiliyanarti, P. F., Wulandari, Y., & Nasrullah, D. (2022). Behavior in fulfilling nutritional needs for Indonesian children with stunting: Related culture, family support, and mother’s knowledge. Journal of Public Health Research, 11(4). https://doi.org/10.1177/22799036221139938

World Health Organization. (2020). Joint Child Malnutrition Estimates. World Health Organization. Retrieved from: https://www.who.int/data/gho/data/themes/topics/joint-child-malnutrition-estimates-unicef-who-wb

World Health Organization. (2022). Malnutrition. World Health Organization. Retrieved from: https://www.who.int/health-topics/malnutrition#tab=tab_1

Yani, D. I., Rahayuwati, L., Sari, C. W. M., Komariah, M., & Fauziah, S. R. (2023). Family Household Characteristics and Stunting: An Update Scoping Review. Nutrients, 15(1), 233. https://doi.org/10.3390/NU15010233

Zai, Z., Girsang, E., & Nasution, S. L. R. (2023). The Evaluation of Implementation of the Stunting Reduction Program. AIP Conference Proceedings, 2722(1), 080019. https://doi.org/10.1063/5.0144397

Downloads

Published

2024-12-31

How to Cite

Tage, P. K. S., & Febriyanti, E. (2024). Barrier from the Side of Stunting Management Policy in Rural Areas of Indonesia: A Qualitative Study. JURNAL INFO KESEHATAN, 22(4), 891–905. https://doi.org/10.31965/infokes.Vol22.Iss4.1522

Issue

Section

Original Articles

Similar Articles

1 2 3 4 5 6 7 8 9 10 > >> 

You may also start an advanced similarity search for this article.