Optimizing the Role of Primary Health Workers in the Implementation of Stunting Policies at the Village Level

Syaharuddin Syaharuddin; Suprapto Suprapto; Maria Kurni Menga; Yuriatson Yuriatson

doi:10.61099/jpmei.v3i2.378

Authors

Syaharuddin Syaharuddin Department of Nursing, STIKES Bhayangkara Makassar, South Sulawesi, Indonesia https://orcid.org/0009-0007-6629-8515
Suprapto Suprapto Politeknik Sandi Karsa, South Sulawesi, Indonesia https://orcid.org/0000-0003-4294-1469
Maria Kurni Menga Politeknik Sandi Karsa, South Sulawesi, Indonesia https://orcid.org/0000-0001-5679-3001
Yuriatson Yuriatson Politeknik Sandi Karsa, South Sulawesi, Indonesia https://orcid.org/0000-0002-0464-2137

DOI:

https://doi.org/10.61099/jpmei.v3i2.378

Keywords:

Community empowerment, Health workers, Policy implementation, Primary health care, Stunting

Abstract

ntroduction: Stunting remains a persistent public health challenge in Indonesia, affecting child growth, cognitive development, and long-term productivity. Despite national policy efforts, gaps in implementation at the primary health care level continue to limit program effectiveness, particularly in community engagement and service utilization. This community service program aimed to strengthen the implementation of stunting prevention policies through a primary health care approach by enhancing the capacity of health workers and community health cadres, and improving household-level practices.

Methods: A participatory approach was applied involving 50 participants, including health workers, cadres, and mothers of children under five. The program consisted of training sessions, nutrition education, mentoring of at-risk families, and routine growth monitoring over three months. Evaluation was conducted using pre- and post-test assessments, structured observations, and questionnaires.

Results: The intervention resulted in a marked increase in knowledge scores (from 62.4 to 84.7). Appropriate feeding practices improved from 46% to 78%, while attendance at posyandu services increased from 58% to 85%. Early improvements in child growth indicators were observed, with 64% of children showing better weight-related outcomes.

Conclusion: Strengthening primary health care capacity and community engagement effectively supports the implementation of stunting prevention policies. This approach demonstrates potential as a scalable model for accelerating stunting reduction in similar settings.

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References

Alderman, H., Gilligan, D. O., Leight, J., Mamo, T., Mulford, M., & Tambet, H. (2025). Scalable Nutrition Interventions in a Graduation Model Program: Experimental Evidence from Ethiopia. Economic Development and Cultural Change, 73(3), 1559–1604. https://doi.org/10.1086/732179

Anthonj, C., Setty, K., Hoeser, C., Brown, J., Ihnacik, L., & Poague, K. (2025). Assessing water and health insecurity in informal settlements: Bringing Europe’s invisible, marginalized Roma communities into focus. A systematic scoping review. Social Science & Medicine, 384, 118526. https://doi.org/10.1016/j.socscimed.2025.118526

Arqam, M. L., Firdaus, A. A., Atmojo, A. M., Saputri, G. Z., Furizal, Palahuddin, & Sirnopati, R. (2026). Integrating education-based interventions and machine learning for stunting prevention: A case study in East Lombok, Indonesia. Dialogues in Health, 8, 100264. https://doi.org/10.1016/j.dialog.2025.100264

Astuti, S. J. W., Suindyah Dwiningwarni, S., & Atmojo, S. (2025). Modeling environmental interactions and collaborative interventions for childhood stunting: A case from Indonesia. Dialogues in Health, 6, 100206. https://doi.org/10.1016/j.dialog.2025.100206

Ataullahjan, A., Keats, E. C., Habib, M. A., Islam, M., Confreda, E., Somaskandan, A., Charbonneau, K., Cheng, B., Jardine, R., Rizvi, A., Ahmed, I., Soofi, S., Achakzai, B. A., & Bhutta, Z. A. (2025). Social sector drivers and stunting reduction in Pakistan: A subnational analysis. The American Journal of Clinical Nutrition, 121, S78–S85. https://doi.org/10.1016/j.ajcnut.2024.09.025

Bhattacharjee, S., Mishra, T., Kandapan, B., Reja, T., & Pradhan, J. (2026). Reassessing the nutrition policy landscape: Mapping nutrition policies and analysing malnutrition burdens in selected South Asian countries. Nutrition, 146, 113115. https://doi.org/10.1016/j.nut.2026.113115

Bhutta, Z. A., Islam, M., Gaffey, M. F., Victora, C. G., Menon, P., Katz, J., Horton, S. E., Yearwood, J., & Black, R. E. (2025). What works for reducing stunting in low-income and middle-income countries? Cumulative learnings from the Global Stunting Exemplars Project. The American Journal of Clinical Nutrition, 121, S113–S128. https://doi.org/10.1016/j.ajcnut.2025.03.004

Bhutta, Z. A., Keats, E. C., Owais, A., González-Fernández, D., Udomkesmalee, E., Neufeld, L. M., Izadnegahdar, R., Kassebaum, N., Fairweather-Tait, S., Branca, F., Christian, P., & Fawzi, W. (2025). What works for anemia reduction among women of reproductive age? Synthesized findings from the exemplars in anemia project. The American Journal of Clinical Nutrition, 121, S68–S77. https://doi.org/10.1016/j.ajcnut.2024.11.031

Dickson, C. A., Ergun-Longmire, B., Greydanus, D. E., Eke, R., Giedeman, B., Nickson, N. M., Hoang, L.-N., Adabanya, U., Payares, D. V. P., Chahin, S., McCrary, J., White, K., Moon, J. H., Haitova, N., Deleon, J., & Apple, R. W. (2024). Health equity in pediatrics: Current concepts for the care of children in the 21st century (Dis Mon). Disease-a-Month, 70(3), 101631. https://doi.org/10.1016/j.disamonth.2023.101631

Efobi, U., Adejumo, O., Nnadozie, O., Omoju, O., & Ekisola, A. (2024). From subsidies to nutrition: Investigating effects among cohort children from the Subsidy Reinvestment programme in Nigeria. Social Science & Medicine, 362, 117479. https://doi.org/10.1016/j.socscimed.2024.117479

Garina, L. A., Dewi, M. K., Trusda, S. A. D., Purbaningsih, W., Muflihah, H., Tursina, A., Respati, T., & Rahimah, S. B. (2024). Maternal, Child, and Household Risk Factors for Children with Stunting. The Open Public Health Journal, 17(1). https://doi.org/10.2174/0118749445321448240823112908

Golden, C. D., Childs, M. L., Mudele, O. E., Andriamizarasoa, F. A., Bouley, T. A., De Nicola, G., Fontaine, M. A., Huybers, P. J., Mahatante, P. T., Rabemananjara, R., Rakotoarison, N., Ramambason, H. R., Ramihantaniarivo, H., Randriamady, H. J., Randriatsara, H., Ravelomanantsoa, M. A., Razafinimanana, A. K. S., Rigden, A. J., Shumake-Guillemot, J., … Dominici, F. (2025). Climate-smart public health for global health resilience. The Lancet Planetary Health, 9(8), 101293. https://doi.org/10.1016/j.lanplh.2025.101293

Kajjura, R. B., Owais, A., Lee, C., Ahsan, H., Merritt, C. E., Rattan, P., Ataullahjan, A., Waiswa, P., & Bhutta, Z. A. (2025). Drivers of anemia reduction among women of reproductive age in Uganda: a country case study. The American Journal of Clinical Nutrition, 121, S36–S45. https://doi.org/10.1016/j.ajcnut.2024.06.015

Makwela, M. S., Ntimana, C. B., & Mashaba, R. G. (2026). Investigating interventions to mitigate sub-optimal complementary feeding among children aged 6–23 months in Africa: A scoping review. Clinical Nutrition Open Science, 67, 100643. https://doi.org/10.1016/j.nutos.2026.100643

Nyarko, M. J., ten Ham-Baloyi, W., & van Rooyen, D. (R. M. . (2024). Qualitative Exploration of Health Professionals’ Perceptions of Addressing Malnutrition Within the First 1,000 Days. Journal of Nutrition Education and Behavior, 56(7), 442–451. https://doi.org/10.1016/j.jneb.2024.03.010

Orimadegun, A. E., Jegede, A. S., Gaffey, M. F., Olufadewa, I., Confreda, E., Somaskandan, A., Islam, M., Keats, E. C., Ataullahjan, A., Amzat, J., Okonta, P. I., Ezeome, I. V, Farouk, Z., Hamza, A., Adepoju, O. T., Lawanson, A. O., Osungbade, K. O., Akinyemi, J. O., Grange, A., & Bhutta, Z. A. (2025). A mixed-methods study of the drivers of stunting reduction among children under five in Nigeria, 2008–2018. The American Journal of Clinical Nutrition, 121, S86–S94. https://doi.org/10.1016/j.ajcnut.2025.02.022

Otoo, G. E., Gaffey, M. F., Confreda, E., Somaskandan, A., Islam, M., Kyei-Arthur, F., Keats, E. C., Ataullahjan, A., Bhutta, Z. A., & Adu-Afarwuah, S. (2025). A mixed-methods study of the drivers of stunting reduction among children under-5 in Ghana, 2003–2017. The American Journal of Clinical Nutrition, 121, S95–S105. https://doi.org/10.1016/j.ajcnut.2025.02.011

Prayitno, G., Zuhriyah, L., Efendi, A., Arifin, S., Rahmawati, Auliah, A., & Subagiyo, A. (2025). Community-powered environmental pathways to reduce stunting: Food security, social capital, and open innovation in semi-urban Indonesia. Environmental Challenges, 21, 101350. https://doi.org/10.1016/j.envc.2025.101350

Ranganathan, M., Parveen Banu, B., Sekar, D., & Ganesh Kumar, J. (2025). Exploring the education, care, and support of children from fishing communities in India. International Journal of Sociology and Social Policy, 45(11–12), 1086–1101. https://doi.org/10.1108/IJSSP-03-2025-0172

Rosyada, D. F., Sudargo, T., & Murni, I. K. (2026). Altitude of area of residence as a risk factor for stunting in children aged 0–60 months: A systematic review and meta-analysis. Dialogues in Health, 8, 100268. https://doi.org/10.1016/j.dialog.2025.100268

Sentika, R., Setiawan, T., Kusnadi, Rattu, D. J., Yunita, I., Basrowi, R. W., Masita, B. M., & Makrufardi, F. (2024). Expert Consensus on Interprofessional Collaboration (IPC) Guidelines on Stunting Management in Indonesian Primary Healthcare (Puskesmas). The Open Public Health Journal, 17(1). https://doi.org/10.2174/0118749445352608241119164446

Silaen, M., Rahayu, S., Aryanti, I., Prasetyo, A., Wahyuni, S., Wahyono, T. T., Sumarno, Mumfangati, T., Irmawan, Saksono, H., Rachmadhani, A., Nur, Y. H., & Marannu, B. (2025). Health and socio-economic factors as determinants of antenatal care service access in Indonesia. Clinical Epidemiology and Global Health, 33, 102010. https://doi.org/10.1016/j.cegh.2025.102010

Supranoto, Sasmito, L., Indriastuti, S., Prayitno, H., & Sawir, M. (2025). From parallel to partnership governance: Strengthening institutional synergy for stunting reduction in decentralized Indonesia. Social Sciences & Humanities Open, 12, 102051. https://doi.org/10.1016/j.ssaho.2025.102051

Suprapto. (2026). Stunting Policy Implementation in Indonesia: A Primary Health Care Perspective. Jurnal Ilmiah Kesehatan Sandi Husada, 15(1), 347–361. https://doi.org/10.35816/jiksh.v15i1.302

Suprapto, S., Arda, D., & Kurni Menga, M. (2024). Community empowerment in an effort towards quality health. Jurnal Pengabdian Masyarakat Edukasi Indonesia, 1(2), 49–55. https://doi.org/10.61099/jpmei.v1i2.40

Widiastuti, T., Al-shami, S. A., Mawardi, I., Zulaikha, S., Haron, R., Kasri, R. A., Mustofa, M. U. Al, & Dewi, E. P. (2024). Capturing the barriers and strategic solutions for women empowerment: Delphy analytical network process. Journal of Open Innovation: Technology, Market, and Complexity, 10(3), 100345. https://doi.org/10.1016/j.joitmc.2024.100345

Yang, K. P., Bray, T. M., Chaudhuri, A., Syam, S. B., & Khanna, S. K. (2025). Barriers to child nutrition in Bengaluru slums: Caregiver insights from the SCOPE strategy. Evaluation and Program Planning, 111, 102612. https://doi.org/10.1016/j.evalprogplan.2025.102612