Child Stunting Reduction in Aceh Province: Challenges and a Way Ahead.

introductionIndonesia ranks the fifth highest in child stunting among Asian countries. Aceh, a westernmost province in Indonesia recorded the highest prevalence of stunting in children under two years old in the nation. Our study investigated the current government efforts on child stunting reduction activities since the introduction of Governor Regulation No. 14/2019.

methodsThe study investigated the current efforts of Aceh governments and relevant actors on child stunting reduction using in-depth interviews, document reviews and focus group discussions.

resultsThirty-five (35) respondents including policy makers were interviewed, four focus group discussions (15 each group) were conducted, and various official documents were reviewed. Various challenges for reducing child stunting in Aceh were identified: inadequate knowledge and skills of Posyandu cadres on child stunting; reluctance to consume iron and folic acid (IFA), and supplementary foods (PMT Bumil) by many pregnant women due to perceived annoying effects and unappetizing taste; work engagement, insufficient breast milk production and inadequate support from husbands failing to achieve exclusive breastfeeding among nursing women; inadequate provision of complementary fortified foods for children 6-23 months; lack of clean water, waste management and WASH practices.

conclusionThe intervention on both nutrition-specific and nutrition-sensitive factors was found to be insufficient in Aceh. Although WASH (water, sanitation and hygiene) practices are the most important contributors to child stunting, only the health agency plays a singular role in reduction efforts by focussing on specific factors. Coordination between relevant agencies to address both factors is required to achieve the effectiveness of child stunting reduction and prevention in Aceh.