Effectiveness of the Role of Posyandu (Community Integrated Health Services) in Reducing Stunting in Srikamulyan Village, Karawang District, Indonesia: A Qualitative Study

Abstract

Background and Objective. Stunting affected 30.8 percent of children under the age of five in Indonesia in 2018, amounting to nearly eight million children. As a result, it is a very troubling issue. To combat stunting, the government has developed a variety of central and local government program interventions. Community integrated health services called Posyandu is the frontline for public health services. Volunteer staff called cadres, are the main actors, health information providers, and models of changes in healthy living behavior. Posyandu holds a strategic position to assess the magnitude of stunting problems in the community, including early detection of the most important determinants of stunting, such as nutritional intake of mothers and children, parenting style, hygiene, and sanitation. This study aimed to determine the effectiveness of Posyandu in reducing the incidence of stunting.

Methods. This study used a qualitative research design with a phenomenological approach which aimed to describe the meaning of life experiences by several individuals, about certain concepts or phenomena, by exploring the structure of human consciousness. The researcher wants to know the meaning of these experiences by Posyandu visitors, cadres, and community leaders regarding the role of Posyandu in Srikamulyan Village in Karawang. Key informants consisted of five cadres who were active in Posyandu activities. Ordinary informants were people directly involved in the social interactions studied. Additional informants were community leaders.

Results. Almost all of the informants who visited the Posyandu recognized the Posyandu's role in improving health in their own communities. Cadres who were involved in Posyandu activities have a good understanding of Posyandu. All Posyandu cadres understood what stunting was and what caused it as a result of group discussions. There were still some parents who did not want to take their children to the Posyandu because their children cried and were afraid if they were brought to the Posyandu. One of the factors that hindered the implementation of Posyandu activities in Srikamulyan Village which made the four Posyandu less effective in reducing stunting was incomplete anthropometric measuring instruments, such as body length board which was only available at the puskesmas (Public Health Center) so that only the child's weight was measured.

Conclusion. All cadres had high motivation in their respective Posyandu. As for cadre knowledge, it can be categorised as good based on the results of questionnaires and group discussions. It can be concluded that the cause of stunting was the lifestyle in the community of Srikamulyan Village which has not implemented clean and healthy living behaviours such as the practice of open defecation, non-compliance of hand washing with soap, and lack of parental knowledge about exclusive breastfeeding and complementary feeding. The role of community leaders in Posyandu activities is still less active due to the busyness of community leaders who work as farmers.