Factors driving and inhibiting stunting reduction acceleration programs at district level: A qualitative study in West Sumatra

Syafrawati Syafrawati; Nur Indrawati Lipoeto; Masrul Masrul; Novianti Novianti; Gusnedi Gusnedi; Andi Susilowati; Asrawati Nurdin; Idral Purnakarya; Andrafikar Andrafikar; Hermita Bus Umar

doi:10.1371/journal.pone.0283739

Factors driving and inhibiting stunting reduction acceleration programs at district level: A qualitative study in West Sumatra

PLoS One. 2023 Mar 31;18(3):e0283739. doi: 10.1371/journal.pone.0283739. eCollection 2023.

Affiliations

¹ Department of Public Health, Faculty of Public Health, Andalas University, Padang, Indonesia.
² Department of Nutrition, Faculty of Medicine, Andalas University, Padang, Indonesia.
³ Centre of Global Health and Health Technology Policy, Ministry of Health, Padang, Indonesia.
⁴ Department of Nutrition, Health Ministry Polytechnic of Padang, Padang, Indonesia.
⁵ Department of Paediatrics, Faculty of Medicine Andalas University, Padang, Indonesia.
⁶ Department of Nutrition, Faculty of Public Health, Andalas University, Padang, Indonesia.

Abstract

Stunting prevalence varies significantly across Indonesian provinces and districts/municipalities, including West Sumatra. This research aims to identify the driving and inhibiting factors for implementing the stunting reduction acceleration program at the district level in West Sumatra. The research was conducted in 2022 with a qualitative study design and a case study approach. Data were collected through (i) group interviews with key informants involving policymakers and program managers at the provincial, district, sub-district, and village levels and (ii) in-depth interviews with mothers of stunted children. Two districts were selected as research sites. One district represents an area that has yet to be developed (District A or failed district). The other district has seen a significant reduction in the prevalence of stunting (District B or successful district). We found several driving and inhibiting factors that affect the reduced prevalence of stunting, such as the need for the relevant agency to play a strong role as the leading and responsible sector for stunting convergence actions. Another important factor is paying close attention to improving the quality of stunting data and providing adequate funding support. High commitment from Public Health Centers to maternal health through classes for pregnant women, infants, and children under the age of five can also have an impact. Furthermore, properly performing duties by assigned actors in specific and sensitive programs and integrated monitoring and evaluation of program implementation and outcomes can influence stunting prevalence. Recommendations for accelerating stunting reduction include improving communication and coordination, establishing stunting prevalence reduction as a performance indicator among the related district government and its various agencies, and assisting the village administration with planning and budgeting to support stunting prevention.

Copyright: © 2023 Syafrawati et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Child
Female
Growth Disorders / epidemiology
Growth Disorders / prevention & control
Humans
Indonesia
Infant
Mothers*
Pregnancy
Pregnant Women*
Prevalence

Grants and funding

NIL received Fund by the Asian Development Bank (https://www.adb.org). The Grant numbers is No: 037/MADEPADB/KONTRAK/III/2022. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.