Headnote
ABSTRACT
Objective: The objective of this study is to analyze the role of policy evaluation and stakeholder engagement in improving the effectiveness of stunting prevention programs in Desa Ngino, Tuban Regency. The study aims to identify critical factors influencing program implementation success at the local level.
Theoretical Framework: The study draws on theories of public policy evaluation and multi-stakeholder collaboration, highlighting their role in addressing complex social issues such as stunting. These frameworks emphasize the importance of systematic evaluation and community involvement for policy effectiveness.
Method: This research employs a qualitative descriptive approach, collecting data through interviews with village stakeholders, health workers, and families affected by stunting. Secondary data, including health statistics and government reports, supplement the primary data. Analysis involves data reduction, presentation, and conclusion drawing.
Results and Discussion: The findings reveal that Desa Ngino's "PROACTING" program has implemented innovative strategies like nutrition classes and supplemental feeding programs. However, high stunting prevalence persists due to inadequate program evaluation, limited resources, and coordination challenges among stakeholders. Stakeholder engagement plays a crucial role in addressing these gaps, enabling more effective policy implementation and better outcomes.
Research Implications: The study underscores the need for continuous evaluation and stronger multi-sectoral collaboration to enhance program effectiveness. It provides insights for policymakers to design localized interventions and optimize resource utilization for stunting prevention.
Originality/Value: This research contributes to the literature by focusing on the intersection of policy evaluation and stakeholder engagement in a localized setting, offering a holistic perspective on program implementation challenges and opportunities.
Keywords: Stunting Prevention, Policy Evaluation, Stakeholder Engagement, Local Governance, Program Effectiveness, Desa Ngino.
RESUMO
Objetivo: O objetivo deste estudo é analisar o papel da avaliação de políticas e do envolvimento das partes interessadas na melhoria da eficácia dos programas de prevenção de nanismo na aldeia de Ngino, no município de Tuban. O estudo busca identificar os fatores críticos que influenciam o sucesso da implementação de programas em nível local.
Referencial Teórico: O estudo baseia-se em teorias de avaliação de políticas públicas e colaboração multissetorial, destacando seu papel na abordagem de questões sociais complexas, como o nanismo. Esses marcos teóricos enfatizam a importância de avaliações sistemáticas e do envolvimento comunitário para a eficácia das políticas.
Método: Esta pesquisa adota uma abordagem descritiva qualitativa, coletando dados por meio de entrevistas com partes interessadas locais, profissionais de saúde e famílias afetadas pelo nanismo. Dados secundários, incluindo estatísticas de saúde e relatórios governamentais, complementam os dados primários. A análise inclui redução de dados, apresentação e extração de conclusões.
Resultados e Discussão: Os resultados revelam que o programa "PROACTING" na aldeia de Ngino implementou estratégias inovadoras, como aulas de nutrição e programas de alimentação suplementar. No entanto, a alta prevalência de nanismo persiste devido à falta de avaliação do programa, recursos limitados e desafios de coordenação entre as partes interessadas. O envolvimento dessas partes interessadas desempenha um papel crucial na superação dessas lacunas, permitindo uma implementação mais eficaz das políticas e melhores resultados.
Implicações da Pesquisa: O estudo destaca a necessidade de avaliações contínuas e de uma colaboração multissetorial mais forte para aumentar a eficácia dos programas. Ele oferece insights para formuladores de políticas projetarem intervenções localizadas e otimizarem o uso de recursos para prevenir o nanismo.
Originalidade/Valor: Esta pesquisa contribui para a literatura ao focar na interseção entre a avaliação de políticas e o envolvimento das partes interessadas em um contexto local, oferecendo uma perspectiva holística sobre os desafios e oportunidades na implementação de programas.
Palavras-chave: Prevenção de Nanismo, Avaliação de Políticas, Envolvimento das Partes Interessadas, Governança Local, Eficácia do Programa, Aldeia de Ngino.
RESUMEN
Objetivo: El objetivo de este estudio es analizar el papel de la evaluación de políticas y la participación de los actores clave en la mejora de la efectividad de los programas de prevención del retraso en el crecimiento en la aldea de Ngino, en el municipio de Tuban. El estudio busca identificar factores críticos que influyen en el éxito de la implementación de los programas a nivel local.
Marco Teórico: El estudio se basa en teorías sobre la evaluación de políticas públicas y la colaboración multiactor, destacando su papel en la resolución de problemas sociales complejos como el retraso en el crecimiento. Estos marcos enfatizan la importancia de la evaluación sistemática y la participación comunitaria para la efectividad de las políticas.
Método: Esta investigación utiliza un enfoque descriptivo cualitativo, recopilando datos a través de entrevistas con actores locales, trabajadores de salud y familias afectadas por el retraso en el crecimiento. Los datos secundarios, incluidos las estadísticas de salud y los informes gubernamentales, complementan los datos primarios. El análisis incluye la reducción de datos, la presentación y la extracción de conclusiones.
Resultados y Discusión: Los hallazgos revelan que el programa "PROACTING" en la aldea de Ngino ha implementado estrategias innovadoras como clases de nutrición y programas de alimentación suplementaria. Sin embargo, persiste una alta prevalencia de retraso en el crecimiento debido a la falta de evaluación del programa, recursos limitados y desafíos de coordinación entre los actores clave. La participación de los actores clave desempeña un papel crucial para abordar estas brechas, permitiendo una implementación de políticas más efectiva y mejores resultados.
Implicaciones de la Investigación: El estudio subraya la necesidad de una evaluación continua y de una colaboración multisectorial más sólida para mejorar la efectividad de los programas. Proporciona ideas para que los formuladores de políticas diseñen intervenciones localizadas y optimicen el uso de recursos para la prevención del retraso en el crecimiento.
Originalidad/Valor: Esta investigación contribuye a la literatura al centrarse en la intersección de la evaluación de políticas y la participación de actores clave en un entorno local, ofreciendo una perspectiva holística sobre los desafíos y oportunidades en la implementación de programas.
Palabras clave: Prevención del Retraso en el Crecimiento, Evaluación de Políticas, Participación de Actores Clave, Gobernanza Local, Efectividad del Programa, Aldea de Ngino.
1 INTRODUCTION
Stunting is one of the nutritional problems faced globally, especially in low- and middle-income countries. This issue 1s significant as it is associated with an increased risk of illness and mortality, suboptimal brain development leading to delayed motor development, and impaired mental growth (Wiliyanarti et al., 2022).
Stunting is a chronic nutritional issue caused by prolonged inadequate nutrient intake, particularly during the first 1,000 days of life. The long-term impacts of stunting include growth and development disorders, shorter height or stunted growth compared to age standards, and a decline in the quality of life for children, extending into their future. Indonesia has been under the spotlight of WHO due to its national stunting prevalence, which reached 30.7% in 2021. The handling of stunting worsened in 2021, closely linked to the COVID-19 pandemic, which affected the economy, causing many to lose their jobs, and reducing the community's purchasing power for nutritious food. Stunting itself is an indicator of poverty, making its resolution an urgent priority to break the cycle.
The trend of stunting cases in Indonesia over the past decade has been relatively encouraging. The incidence has been steadily reduced over the years. The 2013 Basic Health Research, reported by the Central Statistics Agency, showed that stunting cases in Indonesia reached 37.8% of children. This figure significantly decreased to 30.8% in a similar survey conducted in 2018 (Tim Redaksi KlikDokter, 2021). However, stunting management began to deteriorate again in 2021, likely linked to the COVID-19 pandemic. Stunting is also an indicator of poverty, and its resolution is urgent to break the cycle. According to June 2021 data from BPS, Tuban Regency ranks among the top five poorest regencies in East Java, with 16.31% of its population living in poverty.
Tuban Regency is one of the regions in East Java with a high prevalence of stunted children. The stunting rate in Tuban Regency, East Java, remains high at 25.1%, above the provincial average of 23% and the national average of 24.4%. This situation is compounded by the fact that Tuban Regency ranks among the five poorest regencies in East Java, with 16.31% of its population living in poverty, particularly in five subdistricts along its northern coastal areas. If left unaddressed, this condition will hinder the future generation of Tuban Regency, not only in terms of nutrition but also in learning development and career prospects.
Policies and interventions have been implemented by the Ngino Village Government in Semanding Subdistrict through the PROACTING (Program to Address and Prevent Stunting) initiative. This innovative policy was launched on Thursday, November 21, 2019, in response to the high stunting rate in Ngino Village. The PROACTING program was initiated earlier than Regent Regulation No. 49 of 2019 on Stunting Reduction Acceleration, signed on December 12, 2019. This regulation integrates preventive and remedial efforts for postnatal stunted children (Peraturan Bupati Nomor 49 Tahun 2019 Tentang Percepatan Penanggulangan Stunting, 2019). A series of activities under the PROACTING program in Ngino Village include:
1) Prenatal classes through KOMPLEK KUDA BIMAS (Puskesmas-Facilitated Group for Chronic Energy Deficiency Pregnant Women),
2) Providing additional food for pregnant women,
3) Supplying nutritious food for underweight toddlers,
4) The "Kotak Pedes" (Healthy Care Box) program to fund nutritional supplements at each Posyandu,
5) The "Sepatu Kaca" (School for Tuban Families Committed to Love and Care for Children) program as a foundation for educating intelligent and responsive mothers, and
6) The Safe Food Village initiative as a model village in Tuban Regency (BKKBN Tuban, n.d.).
To date, the Ngino Village Government has made diligent efforts to implement the planned programs effectively. However, based on interviews with the leader of the Ngino Village PKK Driving Team in Semanding Subdistrict, during the February 2023 weighing month, the stunting rate in Ngino Village remains high, along with a high number of pregnant women with Chronic Energy Deficiency/CED (Musrifah, 2023).
Stunting represents a serious nutritional deficiency problem for children, negatively affecting their growth and development (De Onis & Branca, 2016). The role of the family, particularly mothers, is crucial in driving stunting prevention and reduction in children (Setiani & Sriwiyati, 2022). Low education levels among parents, especially mothers, pose the greatest risk for stunting in children. A study of 30 toddlers in Kediri found that stunted children often come from families where parents have low education and income levels (Prabowo & Wardani, 2024). A meta-analysis also revealed that low maternal education increases the risk of stunting in toddlers by 3.01 times compared to mothers with higher education levels (Azizah et al., 2022). This finding underscores that the higher the maternal education level, the greater the information and knowledge accessible to mothers.
This study aims to explore maternal knowledge about stunting in Ngino Village. Parental knowledge, particularly mothers, about optimal child nutrition can prevent the risk of stunting. This is because parental knowledge about nutrition influences attitudes and behaviors in selecting nutritious foods for their children (Wulandari et al., 2022). However, low maternal knowledge can increase the risk of stunting in children (Nasution et al., 2021).
2 THEORETICAL FRAMEWORK
Public policy refers to a series of actions decided by the government, either at the central or regional levels, or by other public institutions (Job, 2024; Menon & Purohit, 2024). These actions are designed to address social, economic, and political issues faced by society and achieve predetermined goals for the public interest (Bot, 2022; Eyam-Ozung Jr., 2023). Policies can take various forms, including legislation, social programs, budget allocations, and the implementation of specific standards and regulations (Lutfi Ar et al., 2022). These aim to influence public behavior, enhance welfare, ensure order, and achieve sustainable and inclusive development.
Policy evaluation is a systematic process for assessing the effectiveness and efficiency of policy implementation, ensuring accountability and rationality in public administration. Since the 1970s, it has evolved to meet various objectives and address challenges faced by evaluators and researchers (Jacob, 2024). The OECD's recommendations on public policy evaluation identify three critical pillars for effective evaluation: institutionalization, which embeds evaluation practices within government structures; quality, which ensures rigorous methodologies; and utilization, which promotes the application of evaluation findings in decision-making. This framework aims to enhance the impact of policy evaluation across governments, facilitating the development and implementation of better-informed policies (Salama & Picalarga, 2024).
The primary goals of policy evaluation are to measure the extent to which a policy has achieved its objectives and identify supporting and hindering factors in its implementation (Smith et al., 2024). This involves analyzing the outputs (what the policy produces) and outcomes (the changes or impacts on society). If policy objectives are not met, evaluations can pinpoint areas needing improvement. Supporting factors may include adequate funding, workforce, and infrastructure, as well as support from the government, community, and private sector, alongside effective inter-agency coordination. Conversely, hindering factors could be limited resources, stakeholder resistance, coordination problems, and inconsistent regulations. Based on evaluation findings, recommendations can be formulated to improve policy implementation, such as adjusting objectives, implementation strategies, resource allocation, or related regulations. Policy evaluation also ensures accountability and transparency, aligning the use of public resources with established objectives.
Policy evaluation is essential for understanding the effectiveness of policies aimed at accelerating stunting reduction. This process assesses whether policies have met their goals, such as reducing stunting prevalence among targeted groups. By evaluating these elements, stakeholders can improve policy implementation, ensure benefits are more equitably distributed, and ultimately enhance the quality of life for communities (Suri et al., 2024).
In addition to policy evaluation, stakeholder engagement is another critical factor for successful public policy implementation (Kumar & Vinati, 2024). Stakeholders include individuals or groups with personal interests in an organization's operations and outcomes, influencing or being influenced by its objectives (Billiet et al., 2023). Stakeholder engagement ensures diverse perspectives are considered and policies are tailored to meet the needs of all involved parties. However, challenges such as balancing interests and resource limitations must be addressed to optimize stakeholder engagement (Kumar & Vinati, 2024).
In the context of stunting management , program effectiveness can be seen through reduced stunting prevalence, improved community nutrition, and better access to health and nutrition services. Managing stunting requires a multi-sectoral approach involving various stakeholders, with specific nutrition interventions and sensitive nutrition interventions implemented simultaneously. Specific interventions include direct actions such as nutrition supplementation, while sensitive interventions encompass non-health sectors such as education, sanitation, and economic empowerment.
Thus, effective policy evaluation and optimal stakeholder engagement significantly enhance the implementation of stunting management programs. Both factors are crucial in achieving the goal of reducing stunting prevalence in Tuban.
3 METHODOLOGY
In this study, the researcher employed a qualitative descriptive approach, utilizing a qualitative research design. The qualitative descriptive approach was chosen to systematically describe and illustrate how a government program is implemented and realized in accordance with predetermined procedures and goals (Box-Steffensmeier et al., 2009). This type of research involves direct field investigations, analyzing processes, events, and outcomes to portray real-world conditions.
The research location was Ngino Village in Tuban City. Primary data, which is typically specific and tailored to the researcher's needs (Thomas, 2005), was collected from the village government, residents with children affected by stunting, and local health workers. The total population of village residents with children experiencing stunting in this study was 50 respondents. Based on the study results, the distribution is shown mathematically in the table below:
Secondary data, consisting of pre-existing information such as diagrams, charts, or tables obtained from various sources such as books, websites, or government documents (King et al., 1994), was used to support the research findings and address the research questions. These data were collected from public records of Tuban City Government, including sources such as the Health Department, Central Statistics Agency, and Regional Development Agency of Tuban City.
The data analysis techniques used include the steps, first data reduction (Summarizing, selecting key information, focusing on essential aspects, and identifying themes and patterns). Second steps data presentation is Organizing the reduced data into structured information to facilitate the drawing of conclusions and decision-making. Third steps drawing conclusions is Deriving insights and conclusions based on the analysis of the findings and interpretations of the research results. This structured approach ensures that the research data is systematically analyzed, allowing for informed conclusions and actionable recommendations.
4 RESULT
4.1 PREVIOUS STUDIES ON STUNTING POLICY MANAGEMENT
The high prevalence of stunting in Tuban contrasts with the region's industrial capacity, hosting major companies such as PT. Semen Indonesia, PT. Semen Holcim, PLTU Tanjung Awar-Awar, PT. Trans-Pacific Petrochemical Indotama, and PT. Pertamina-Petrochina East Java. Additionally, four of its subdistricts have coastal areas that should allow adequate access to protein-rich animal resources.
Stakeholder engagement is crucial for implementing stunting management programs, involving active participation from the government, NGOs, the private sector, and local communities. The effectiveness of these programs depends on the quality of collaboration among stakeholders, from planning and execution to evaluation. Stakeholders play complementary roles, such as funding, monitoring, educating, and raising community awareness about the importance of fulfilling nutritional needs during the first 1,000 days of life. Without adequate support from all parties, the program risks failing to achieve its targets in terms of reach and intervention quality. Thus, fostering strong stakeholder synergies and meaningful participation is essential to improving program implementation and achieving health and welfare goals for Indonesian children.
Inadequate support and cooperation among stakeholders impede effective implementation, highlighting the need for improved cross-sectoral coordination and active involvement (Robichau & Lynn Jr., 2009). Poor communication channels and lack of preparedness for intersectoral processes further exacerbate these challenges (Tiwary et al., 2019). Addressing these issues requires integrated management strategies to enhance alignment with policies and overcome communication gaps.
Given these challenges, research on the impact of policy evaluation and stakeholder engagement on the implementation of stunting management programs-focusing on program effectiveness in Tuban Regency-is critical. It aims to provide strategic recommendations to sustainably reduce stunting prevalence and achieve the national target of 14% by 2024 (Fuad & Indriyany, 2023).
Most prior studies focus on stunting determinants such as socio-economic conditions, parenting practices, healthcare quality, and nutritional interventions (Mugo et al., 2020). These studies often emphasize the effectiveness of specific nutritional interventions, such as micronutrient supplementation or food fortification, without explicitly evaluating the broader policy context (Titaley et al., 2019).
This research uniquely examines the role of policy evaluation and stakeholder engagement as key variables influencing the overall effectiveness of stunting programs. It shifts the focus to the process of policy implementation and the active roles of local actors, particularly in Tuban Regency. Additionally, it incorporates program implementation effectiveness as an outcome variable, which combines various success aspects.
Previous studies typically use variables like maternal education, household income, maternal health status, and child nutrition status as independent variables, with stunting as the dependent variable (Kemenkes RI, 2021). Interventions often focus on a single aspect, such as specific or sensitive nutritional interventions, rarely combining policy and stakeholder engagement variables. Conversely, this study integrates policy evaluation and stakeholder engagement as primary independent variables, offering a novel perspective on how these factors affect program effectiveness.
Previous studies predominantly address stunting on a national scale or in regions with extremely high prevalence, such as East Nusa Tenggara, Papua, or rural areas in Indonesia (UNICEF, 2019). Some use national survey data that fail to account for specific regional characteristics. This study, however, is focused on Tuban Regency, a region with unique socio-economic and health dynamics. By considering local context, this research provides deeper insights into specific challenges and opportunities in the area.
Previous research often offers recommendations for improving nutrition or healthcare access but seldom addresses policy processes or program implementation in detail (Handayani et al., 2023). This study specifically contributes to policy evaluation and stakeholder engagement strategies, providing actionable recommendations to refine policies at local and national levels. The findings aim to offer practical guidelines for local governments to enhance stunting program effectiveness.
By focusing on policy evaluation and stakeholder roles in local program implementation, this study presents a new perspective, underexplored in previous research, on addressing stunting effectively at the local level.
4.2 LOCAL POLICIES IN RESPONDING TO STUNTING
Stakeholder engagement in policy evaluation is critical as it enhances program implementation effectiveness. By incorporating insights from various stakeholders, including volunteers and community leaders, the evaluation process can identify unique opportunities and challenges that might not be evident from participant feedback alone. This broader perspective leads to more informed policy evaluations and ultimately improves stunting management programs through collaboration and addressing community-specific needs (Hodgkins et al., 2019). Engaging stakeholders fosters collaboration, increases policy relevance, and ensures interventions align with community needs, leading to more effective stunting management through informed policy decisions and sustainable program activities (Nam et al., 2019).
Real-time evaluations can identify drivers and triggers of policy changes, ensuring interventions are contextually adjusted and impactful. Stakeholder engagement promotes collaboration and alignment around shared priorities, enhancing advocacy efforts. The Scaling-Up Nutrition movement illustrates how a multistakeholder approach can improve breastfeeding and nutrition outcomes, emphasizing that strong organizational leadership and strategic alliances are essential for successful program implementation and sustainability (Bégin et al., 2019).
Stakeholder engagement, particularly involving policymakers and practitioners, is crucial for implementing effective health interventions. This collaborative approach improves evaluation processes, ensuring interventions align with local needs and existing healthcare structures. Incorporating feedback from diverse stakeholders optimizes stunting management programs, leading to increased effectiveness and sustainability. Engaging stakeholders throughout the study cycle builds capacity and facilitates the rapid adoption of evidence-based practices in public health initiatives (Mugo et al., 2020). Furthermore, it ensures interventions are tailored to local contexts and needs, overcoming implementation barriers and adapting strategies to real-world conditions, ultimately resulting in more effective stunting reduction efforts for women and children (Amouzou et al., 2022).
Involving stakeholders, including public health workers and families, enhances program relevance and acceptance, leading to better adherence to nutritional interventions. Continuous policy evaluation identifies gaps and enables strategy adjustments based on community feedback and outcomes. This iterative process ensures interventions are tailored to local needs, improving stunting management efforts and fostering sustainable health improvements in communities (Kusumawardani et al., 2020). Such measures are crucial for assessing the effectiveness of interventions aimed at improving nutrition and health during the critical first 1,000 days of life. By engaging stakeholders, programs can better address local needs and enhance community participation, improving childcare practices and nutritional status among children under two. This collaborative approach contributes to successful implementation and the sustainability of stunting reduction efforts (Riwayati et al., 2022).
Studies show that robust network relationships within governance frameworks and active community participation lead to successful outcomes. Stakeholder engagement fosters collaboration in funding and resource allocation, while continuous evaluation enables adaptive strategies to address challenges. Initiatives aimed at capacity building further support effective implementation, highlighting the importance of evaluation and engagement in overcoming barriers and achieving desired health outcomes in stunting reduction efforts (Oktarina et al., 2022).
Leveraging the Analytic Network Process (ANP) emphasizes the importance of integrating multisectoral strategies and involving various stakeholders in decision-making. This collaborative approach ensures interventions are contextually relevant and address the complexities of stunting, ultimately improving outcomes in specific and sensitive nutrition strategies during critical developmental periods (Wardani et al., 2021).
4.3 STUNTING MANAGEMENT POLICIES AT THE VILLAGE AND FAMILY LEVEL
Stunting management efforts in Ngino Village, Semanding Subdistrict, are spearheaded by the PROACTING (Program Atasi dan Cegah Stunting) initiative. This innovative program was launched on November 21, 2019, as a response to the high prevalence of stunting in the village. The program preceded the issuance of Regent Regulation No. 49 of 2019 on Stunting Reduction Acceleration, signed on December 12, 2019. The regulation emphasizes integrated prevention and management of stunting among toddlers post-birth.
The PROACTING program comprises various activities, including first, prenatal classes through Komplek Kuda Bimas is a group initiative for managing and assisting pregnant women with Chronic Energy Deficiency (CED), facilitated by the local health center (Puskesmas). Second, supplementary food for pregnant women providing additional nutrition for expectant mothers. Third, healthy food for undernourished toddlers to addressing nutritional deficiencies in children. Fifth, Kotak Pedes (Healthy Care Box) Program to funding nutritional supplements at local Posyandu (integrated healthcare centers). Sixth, Sepatu Kaca program for establishing schools for women to foster educated and proactive mothers. Last, safe food village initiative is a pilot program making Ngino Village a model for food security in Tuban Regency.
Despite these efforts, a 2023 interview with the leader of the Ngino Village PKK Driving Team revealed that stunting prevalence in the village remains high, alongside a significant number of pregnant women suffering from Chronic Energy Deficiency. Data from 2019 to 2022 indicate that the stunting prevalence in Ngino Village consistently exceeds the district average:
* 2019: 36.56% (village) vs. 27.15%% (district)
* 2020: 24.86% (village) vs. 26.1%% (district)
* 2021: 20% (village) vs. 25.1%% (district)
* 2022: 18.1% (village) vs. 24.9% (district)
* 2023: 29.41% (village) vs. 17.7% (district)
This trend highlights persistent challenges despite a decrease in stunting rates from 2019 to 2021.
Nationally, Indonesia has implemented various strategies to combat stunting, such as exclusive breastfeeding, complementary feeding (MPASI), routine baby weight monitoring, prenatal examinations, iron supplementation for pregnant women, and additional food support for high-risk mothers. Programs like the National Strategy for Stunting Reduction (2018-2024) and the 1,000 Days of Life Initiative form a robust framework for nationwide stunting prevention.
As part of the Village Innovation Program (PID), PROACTING aligns with Law No. 6 of 2014 on Villages, which empowers village governments to innovate and leverage local wisdom. In Ngino, the program integrates village-level planning, budgeting, and development activities to address stunting. Implemented with the support of village midwives, PKK leaders, and cadres, it receives funding from the village budget. An example of PROACTING's initiatives is the Community Feeding Center (CFC) launched in 2020. This program provided educational sessions and nutritious menu preparation for mothers of stunted children, aiming to improve dietary intake and reduce malnutrition.
Unfortunately, PROACTING has not undergone formal evaluations since its inception in 2019. This lack of evaluation has hindered the ability to measure the program's effectiveness comprehensively. Policy evaluation remains critical for providing feedback on program outcomes, identifying areas for improvement, and ensuring alignment with broader stunting reduction goals. By addressing these gaps through systematic evaluation and continuous adaptation, PROACTING can serve as a model for localized, effective stunting management strategies.
5 CONCLUSION
Handling stunting through local policies at the village level has significant importance, especially in the context of Stunting in Ngino Village which is still a serious problem despite various efforts through the PROACTING program (Program to Overcome and Prevent Stunting). The prevalence of stunting in this village remains high, even above the district average, indicating the need for more effective steps.
Local policies such as PROACTING allow for the identification of specific challenges faced by village communities, such as parenting patterns, food availability, or infrastructure problems. The PROACTING program includes various activities, such as prenatal classes, supplementary feeding, and education programs for women. This initiative is designed to encourage community empowerment through a local wisdom-based approach. Obstacles to policy implementation The high number of pregnant women with Chronic Energy Deficiency (KEK), the absence of a systematic evaluation of the PROACTING program, making its effectiveness difficult to measure, and the lack of cross-sector coordination and active involvement of stakeholders.
Implications This study highlights the importance of policy evaluation and cross-sector collaboration to improve the effectiveness of stunting handling programs. This approach can be a model for other regions in reducing stunting prevalence sustainably. Village-based programs often integrate local wisdom, making interventions more relevant and acceptable to communities. Policy implementation at the local level is more flexible, allowing for quick adjustments to changing needs or conditions on the ground. Local policies allow resources to be directed directly to vulnerable groups, such as pregnant women and toddlers. Local policies allow resources to be directed directly to vulnerable groups, such as pregnant women and toddlers. Initiatives such as PROACTING demonstrate that villages can be laboratories for policy innovation, which can then be replicated in other areas.
ACKNOWLEDGEMENTS
The researcher extends heartfelt gratitude to the Ministry of Education, Culture, Research, and Technology (Kemendikbudristek) for funding the 2024 Fundamental Research Grant project. Appreciation is also directed to the entire research team for their dedication and hard work, as well as to all respondents and stakeholders who generously contributed data and support essential to this study.
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