JPPIPA 9(12) (2023)

Jurnal Penelitian Pendidikan IPA

Journal of Research in Science Education

http://jppipa.unram.ac.id/index.php/jppipa/index

The Effectiveness of Stunting Prevention Programs in

Indonesia : A Systematic Review
Pingkan Fristiwi1*, Sri Achadi Nugraheni2, Apoina Kartini2
1 Master of Health Promotion, Faculty of Public Health, Diponegoro University, Semarang, Indonesia.
2 Department of Public Health Nutrition, Faculty of Public Health, Diponegoro University, Semarang, Indonesia.

Received: October 27, 2023 Abstract: Stunting remains a major nutritional problem in developing countries, including
Revised: November 29, 2023 Indonesia. This research aims to identify the effectiveness of stunting prevention programs
Accepted: December 20, 2023 in Indonesia. The research method employed in this study is a systematic review based on
Published: December 31, 2023 the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)
guidelines. Article searches were conducted using five database; Scopus, ScienceDirect,
Corresponding Author: ProQuest, Google Scholar, and Portal Garuda. The inclusion criteria for this research are
Pingkan Fristiwi articles published in the last 10 years, from 2014 to 2023, with a population in the
[email protected] Indonesian region. Based on the reviewed articles, it was found that the most effective
stunting prevention measures include providing nutritional education to influential
DOI: 10.29303/jppipa.v9i12.5850 parties such as community health workers, mothers of toddler, and women of childbearing
age or prospective mothers, interprofessional collaboration, and supplementary feeding.
© 2023 The Authors. This open Trained community health workers are capable of reducing the stunting rates. Therefore
access article is distributed under the goverment should stengthen community health worker training to optimize stunting
a (CC-BY License) prevention through nutritional education.

Keywords: Stunting prevention; Stunting prevention program; Systematic review

Introduction adulthood, and decreased productivity (Maulina et al.,

2023).
The nutritional problems in toddlers remain a Stunting is widely recognized for its significant
primary concern in the population structure. Nutritional impact on individuals and communities, including
issues in toddlers include stunting, wasting, and cognitive development delays, poor school
overweight (World Health Organization, 2020). At performance, decreased physical capacity,and when
present, stunting remains a major issue in developing entering adulthood, it hinders economic (Haile et al.,
countries, including Indonesia. Stunting is the failure to 2023). Poor nutrition in early childhood will affect low
reach the linear growth potential as indicated by a height intelligence levels in the future (Rosalina et al., 2023).
for age Z-score (HAZ) of less than -2 standard deviations The problem of stunting in toddlers also has
with reference to the current growth standards due to implications, motor skills, and can lead to mortality.
suboptimal health and nutritional status (World Health Stunting occurs due to multiple factors, with these
Organization, 2013). Stunting is one of the forms of factors interrelated and possibly varying in different
growth failure resulting from the accumulation of regions (Ummah et al., 2023). Several internal and
nutritional deficiencies that occur from pregnancy to 24 external factors can influence the occurrence of stunting,
months of age (Syakur et al., 2023). The consequences of internal factors are directly related to the growth and
malnutrition during the first 1000 days of life are development of infants and include exclusive
permanent and difficult to rectify (Sitompul et al., 2023). breastfeeding, child-rearing practices, complementary
Stunting in children becomes a serious issue because it feeding, mineral and protein intake, infectious diseases,
is associated with several risks of diseases, higher future and genetics. External factors are related to the family’s
mortality, obesity, non- communicable diseases, shorter low economic status, such as maternal empoyment,

___________
How to Cite:
Fristiwi, P., Nugraheni, S. A., & Kartini, A. (2023). The Effectiveness of Stunting Prevention Programs in Indonesia : A Systematic Review . Jurnal
Penelitian Pendidikan IPA, 9(12), 1262–1273. https://doi.org/10.29303/jppipa.v9i12.5850
Jurnal Peneliatian Pendidikan IPA (JPPIPA) Desember 2023, Volume 9 Issue 12, 1262-1273

family income, and maternal intellectual level. In the and children aged 0-2 years, meanwhile, important
study (Amalo et al., 2023). it is also mentioned that targets include children aged 24-59 months, adolescents,
among children aged 24 to 59 months, there is a and women of reproductive age (Satriawan et al., 2018).
significant relationship between economic status and In formulating policies, the goverment cannot rely on a
stunting, indicating that the lower the family’s economic single study. Instead, data from various research sources
status, the higher the prevalence of stunting. Poor are needed as the foundation for policy development.
parenting practices, limited healthcare services such as Therefore, it is essential to conduct comprehensive
Ante Natal Care (ANC), or maternal health services research on the prevention of stunting programs in
during pregnancy, are also factors contributing to the Indonesia, as stunting also has long-term effects on
occurrence of stunting (Yahya et al., 2023). Therefore, human life, and the current stunting rates in Indonesia
addressing stunting not only impacts the health sector are relatively high. Hence, this research is crucial to
but extends to other factors such as social and economic understand the extent to which the existing stunting
aspects, stunting prevention has become a specific focus prevention programs have been succesful in addresing
of both central and local governments in recent years this issue. Through this research, we can also identify the
(Utari et al., 2023). The prevalence of stunting in toddlers most effective strategies to combat stunting and
worldwide according to the World Health Organization pinpoint areas that require improvement, which can be
(WHO) is 21,9%. The majority of toddlers experiencing beneficial for the goverment in crafting more precise and
stunting are from Asia (World Health Organization, efficient policies related to stunting prevention
2020). Based on data from the Indonesian Nutrition programs.
Status Survey (SSGI) in 2022, the prevalence of stunting A systematic review study is a research that
in Indonesia toddlers decreased from 24.4% in 2021 to involves the examination of a specific topic, focusing on
21,6% in 2022 (SSGI, 2023). a predefined question, evaluated, selected, and
In order to expedite the reduction of stunting in line systematically concluded based on pre-established
with the established terget, the Indonesian government criteria, using relevant and high quality research
has formulated 5 pillar national stunting reduction evidence (Adisasmito et al., 2007). This research aims to
strategy set in 2018. National policymakers and the identify the effectiveness of stunting prevention
World Bank have discussed these five pillars, developed programs in Indonesia. The findings of this study can be
based on Indonesian knowledge and global best used by the Indonesian government to formulate
leadership, national media campaigns, integration of policies for stunting prevention.
national programs with regional and community
initiatives, nutrition and food security policies, and Method
monitoring and evaluation. The implementation of
convergent actions to reduce stunting is carried out We conducted this research as a systematic review,
through 8 convergent actions, which include situation following the PRISMA guidelines (Figure 1). We utilized
analysis (business planning), action planning, stunting five database for article searches; Scopus, ScienceDirect,
discussions, village role regulations, human ProQuest, Google Scholar, and Portal Garuda. The
development, staff development, data management keywords for this article search were organized based on
systems, measuring and publishing stunting data, and the PICOS Framework. In this study, we will focus on
evaluating performance annually (Siswati et al., 2022a). several key aspects; Stunting, Stunting programs, and
In an effort to reduce the prevalence of stunting, the Toddlers. This aids us in establishing our criteria when
government has also implemented various program to searching for articles with the predetermined keywords.
achieve this goal. The government’s efforts include both We set the inclusion criteria to be articles published
direct measures (specific nutritional interventions) and within the last 10 years, from 2014 to 2023, with a
indirect measures (sensitive nutritional interventions) to population in the Indonesian region. The exclusion
prevent and reduce disruptions. The priority targets in criteria are as follows; paid articles, textbooks, and
this regard are individuals involved in the first 1000 days articles not written in English or Bahasa Indonesia.
of life, namely pregnant women, breastfeeding mothers,

Table 1. Summary of Journal Literature Search Results

Writer Title Research Purposes Program Study Desain Results
(Maryati et The Effect of Evaluating the impact The interactive Rct There was a substantial effect
al., 2022) Interactive Education of interactive education (Randomized on illness in the last week, and
Program in education programs program controlled with increasing age, children in
Preventing Stunting on stunting includes trial) all categories experienced a
for Mothers with prevention in mothers parenting reduction in stunting rates.
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Writer Title Research Purposes Program Study Desain Results

Children under 5 with children under 5 practices for Dietary pattern diversity
Years of Age in years of age in mother. showed an improvement in the
Indonesia: A Indonesia. intervened caregivers
Randomized compared to the control group.
Controlled Trial This is evidenced by the better
ratings in more varied dietary
practices. The impact size on
food diversity ranged from 0.30
to 0.53.
(Siswati et Impact of an Understanding how Integrative Experimental The impact of Polri intervention
al., 2022) Integrative Nutrition home visits provided nutrition on maternal knowledge and
Package through Polri influence package (Inp) practices in CGM (Child
Home Visit on maternal knowledge Growth Monitoring), CDM
Maternal and and behavior in (Child Development
Children Outcome: monitoring child Monitoring), and PMBA (Infant
Finding from Locus growth and group showed better
Stunting in development, infant improvements and had greater
Yogyakarta, feeding, stunted outcomes for both mothers and
Indonesia child’s weight, height, children compared to the
and child control group.
developmental scores.
(Andriani et The Differences in To determine the Program Pre- There are differences in the
al., 2017) Knowledge, Attitude, differences in Mother Smart Experimental knowledge, attitudes, and
and Motivation of knowledge, attitudes, Grounding motivation of mothers with
Mothers After and motivation of (Msg) toodlers before and after
Receiving the Mother mothers with toodlers receiving the intervention,
Smart Grounding after participating in namely the Mother Smart
(Msg) Program in the the mother smart Grounding (Msg) program.
Prevention of grounding (Msg)
Stunting in the program for stunting
Working Area of the prevention in the
Puuwatu Health Puuwatu Health
Center, Kendari City Center’s working
in 2017. area, Kendari City in
2017
(Astuti et al., The Effectiveness of To ascertain the Interprofession Quasi- There is a difference in
2021) the Interprofessional effectiveness of al eksperimen knowledge before and after the
Collaboration (Ipc) interprofesional Collaboration program is implemented, with
Program on The collaboration on the (Ipc) Program the average results showing
Attitude of Mothers attitudes of mothers that the attitudes of mothers
and Health Cadres on and health cadres and health cadres toward
Stunting at Puskesmas toward stunting. stunting have improved.
Karanganom Klaten Therefore, interprofessional
Central Java Republic collaboration is effective in
of Indonesia. enhanching the attitudes of
mothers and heakth cadres
regarding stunting.
(Effendy et Nutrition education Evaluating the impact Nutrition Rct There was a change in the
al., 2020) in Southeast of nutrition education education Dietary Diversity Score (Dds) in
Sulawesi Province, intervention on infant toddlers after receiving
Indonesia: A cluster feeding practices and nutrition education, increasing
randomized the nutritional status from an average of 2.37 to 3.87.
controlled study of toddlers. However, there was no
significant difference in height
for age (Tb/U) between the
treatment group and the control
group. These result indicate
that nutrition education
delivered through nutrition

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Writer Title Research Purposes Program Study Desain Results

classes combined with regular
home visits by influencers
provides significant benefits
and has the potential to be
adopted to complement other
nutrition program in the
community and healthcare
centers.
(Muthia et Evaluation of Analyzing the Specifik Qualitative The results indicate that
al., 2020) Stunting Prevention evaluation of the Nutritional stunting prevention through
Program implementation of Interventions specific intervention programs
Implementation stunting prevention has been reasonably effective,
From the Perspective programs, with a but it has not yet achieved a
of Specific Nutrition focus on the specific reduction in stunting below
Intervention of the nutritional 20%. This is due to several
1000 Hpk Movement intervention of the constraints, including the lack
at Pegang Baru 1000 days movement. of dedicated budget for the
Health Center, program, limited human
Pasama District. resource to carry out the
intervention, the absence of
standard operating procedures
(Sop), Top-down planning, and
the absence of record keeping
for reports.
(Siswati et Effect of a Short To determine the Short course Single group There was an improvement in
al., 2022) Course on Improving influence of a short for cadres pre-test post- the knowledge of cadres
the Cadres’ course on the test regarding Cgm, Cdm, and
Knowledge in the knowledge of cadres Pmba, and this short course
Context of Reducing increased their self-efficacy,
Stunting through self-confidence, and their ability
Home Visits in to support stunted children
Yogyakarta, through home visits.
Indonesia
(Wicaksono The Laktasi Program Establishing the Laktasi Pre- There was an increase in the
et al., 2021) (Smart Parents Laktasi program as an Program eksperimental weight and height of toddlers.
Indonesia Education effort to enhance child The Laktasi program can
Class) in Reducing nutrition and reduce provide insights to mothers
Stunting. stunting in the dealing with child nutrition and
Sumbersuko village. stunting issues.
(Prastiwi et The Effect of Health Analyzing the impact Stunting Quantitative There is an influence of the
al., 2020) Officer Role to the of healthcare worker prevention basic role of healthcare worker
Program of Stunting implementation on program in the on the occurrence of stunting
Prevention on First the stunting first 1000 days and stunting prevention. The
1000 Days of Life in prevention program of life. result of this study also indicate
Indonesia during the first 1000 that a good specific nutrition
days of life intervention has the highest
probability 0.703 times, of
preventing stunting compared
to poor specific nutrition
intervention.
(Tambuwun The Influence of To determine the Health True- Health promotion, in the form
et al., 2019) Health Promotion on effect of health Promotion Experiment of lectures and leaflet media, is
Pregnant Mothers’ promotion on the (Counseling) effective in providing health
Knowledge knowledge of knowledge that can improve
Regarding the 1000 pregnant mothers the knowledge of pregnant
Hpk in Molas regarding the first mothers because information is
Subdistrict, Bunaken 1000 days of life in the conveyed not only verbally but
District, Manado Molas Village, also in written form.
City.

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Writer Title Research Purposes Program Study Desain Results

Bunaken District,
Manado City.
(Purwanti et The Gastizi 1000 Analyzing the Gastizi 1000 Quasi- There is an increase in the
al., 2019) Program in effectiveness of the Program Experiment knowledge and skills of cadres
Enhancing the prevent stunting regarding stunting and
Capacity of program eith nutrition during the first 1000
Posyandu Cadres. nutritional days of life after participating in
improvement during the Gastizi program.
the first 1000 days of
life (Gastizi 1000) in
enhancing the
capacity of posyandu
cadres.
(Fatmah & Effectiveness of Evaluating the impact Providing non- There was a significant increase
Utomo, orange almond of including almond Supplementary randomized in the mean Z-score for age in
2023) potato cookie vs. potato cakes and Food pre-post the intervention group.
orange potato cookie orange in the food intervention Consumption of almond potato
supplementation on menu on the cake and orange has the
nutritional wellbeing nutritional status of potential to improve the
of the Indonesian preschool children nutritional well-being of
stunted preschool- experiencing stunting. preschool-age children
aged children during experiencing stunting.
Covid-19 pandemic
(Sari et al., Balanced Nutritional Enhancing the Nutrition Community There was an increase in the
2023) Menu for Stunting attitudes and Education Empowerment knowledge of the subjects after
Prevention in Toddlers behaviors of subjects being provided with education.
in the Village of regarding toddler Subjects, particularly the
Kudus District. nutrition and food cadres, are expected to become
types for stunting agents of change in the
prevention. behavior of preventing toddler
stunting. Meanwhile, mothers
with toddlers are expected to
change their behavior in
providing food to their
children.
(Wijayanti The impact of Pmba To determine the Pmba Training Qualitative Pmba training can enhance the
et al., 2019) training for posyandu impact of PMBA for posyandu cadres’ knowledge about how
cadres on improving (Feeding Training for cadres to provide counseling to the
Infants and Children) community, enabling them to
training on posyandu offer effective consultations to
cadres in improving the target population of the
the nutritional status stunting program. It can also
of stunted children in help change parents’
the Sleman District accordance with balanced
Health Center Area nutritional guidelines.
(Muhamma Nutritional Education Analyzing the impact Nutrition Quasi- The results showed that
d et al., for Mothers by of nutritional Education Experiment nutritional education by trained
2020) Trained Cadres education provided to cadres significantly increased
Increase mothers by trained energy and protein intake in
cadres on the intake toddlers, in contrast to the
of protein toddlers in control group that did not
the nutrition recovery receive the intervention.
center in the Sedayu Nutritional education for
District, Bantul mothers involving trained
Regency, Special cadres can be considered as one
Region of Yogyakarta. of the effective and sustainable
alternatives for specific
nutritional interventions.

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programs throught nutrition education. Nutrition

education is a method and effort aimed at enhancing
nutritional knowledge and nutritional behavior to create
optimal nutritional status (Perdana et al., 2017). The
eight reviewed articles indicate that nutrition education
has a positive impact on stunting prevention. Based on
the research conducted by Siswati (2022a) nutrition
education interventions provided to cadres have been
shown to significantly enhance maternal understanding
and communicate behavior changes throught home
visits for CGM, CDM, IYCF, and also help determine
their impact on mothers and children, which is greater
than that observed in the control group not receiving the
Figure 1. Flow process literature search based on prisma intervention. Home visits also provide a broader
guidelin opportunity for interaction between cadres and mothers
with toddlers and can bridge the gap between ignorance
Result and Discussion and mistakes in action. Among the factors mediating the
positive effect are maternal caregiving practices for child
A literature search of articles through 5 databases health and the knowledge and practices conveyed
resulted in 1.959 articles that matched the keywords through interventions by cadres to mother.
used by the researcher. Among them, 258 articles were Simultaneous PMBA instruction with food items enables
found to be duplicates, and 1.606 articles were deemed parent to directly implement proper dietary practices for
irrelevant due to their population being outside of their children. INP intervention significantly increases
Indonesia and not using either English or Indonesian the weight of toddlers compared to the control group
language. Consequently 95 articles were selected for a that did not receive treatment. This is related to the
comprehensive review of their content. After the review extent to which the intervention can influence maternal
process, 15 articles were found to align with the research outcomes compared to the untreated control group.
objectives, inclusion criteria, and exclusion criteria. This is in line with the research by Wijayanti and
These 15 articles were included in this study and will Fauziah (2019) which states that nutrition education
proceed to the quality assessment stage. After provided to cadres through training can enhance the
undergoing various stages in the systematic review, the cadre’s knowledge in providing counseling and
final outcome was 15 articles that will be discussed in delivering information to mothers of toddlers and the
this research. community effectively and accurately. Cadre workers
Based on table 1, it can be observed that the 15 play a crucial role in community development through
reviewed articles consist of two Randomized Control activities in posyandu. Training for these cadres is
Trial (RCT) research articles, one experimental research highly effective in preventing stunting, especially
article, three Quasi-experimental research article, one during the fetal development or pregnancy and the
single group pre-test post-test research article, two growth of children aged 0 to 2 years (1000 HPK).
quantitative research article, one True experiment Furthermore, this training is highly effective in
research article, one non- randomized pre-post improving the nutritional status of toddlers and altering
intervention research article, one community parental caregiving practices because the information
empowerment research article, and one qualitative provided on children’s dietary patterns based on age,
research article. From the results of the reviewed articles, frequency, quantity, texture, and food diversity can
several nutrition interventions or programs for stunting impact nutritional status. Thus by providing nutrition
prevention were identified, including nutrition education such as PMBA, these cadres can help reduce,
education throught training, interactive education and even prevent, stunting rates and improve the
programs, nutrition intervention packages (INP), nutritional status of children under five years old
Mother Smart Grounding (MSG) program, through family nutrition awareness support. This
Interprofesional collaboration program, program research is further supported by Purwanti’s (2019)
evaluation, Short course for cadres, LAKTASI program, study, which states that the GASTIZI 1000 program in
GASTIZI 1000 days of life program (HPK), this study, when provided to cadres, has an impact on
Supplementary feeding, and PMBA training for improving the knowledge and skills of posyandu cadres
posyandu cadres. in stunting prevention through nutritional improvement
Based on the results of the article review, eight during the 1000 day life period. This is evident from the
articles were found that discuss stunting prevention
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results of statistical tests showing an increase in study also indicates that health education through
knowledge about exclusive breastfeeding, health promotion using lecture based methods and
complementary feeding, recognition of various types of leaflets has proven to be effective in enhancing maternal
complementary foods, the causes and consequences of knowledge because information is conveyed through
stunting. The measurement of body length or height as spoken and written means. The mother’s attitude will
an indicator of stunting, and the first 1000 days of life determine her dietary consumption behavior during
(HPK). The study by (Varakina et al., 2020) also indicates pregnancy, thereby impacting the birth weight of the
that the most effective prevention is carried out during baby. Low birth weight is a risk factor for stunting
the first 1000 days of life and delayed growth in the first (Tambuwun et al., 2019). Because of the mother’s lack of
second 1000 days. knowledge regarding the importance of nutrition and
Cadres trained to provide nutrition education to health for pregnant mothers, it is one of the factors that
mothers with toddlers can enhance maternal knowledge can lead to stunting in infants (Darus et al., 2023).
about nutrition, which will subsequently be put intro Nutritional education is not only provided to
practice by mothers to meet their child’s energy and trained cadres but also directly to mothers of toddlers by
protein requirements. Therefore, this nutrition healthcare personnel through innovative programs. This
education can enhance the fuilfillment of energy and education has the potential to enhance maternal self
protein needs in toddlers and effectively prevent sufficiency in preventing stunting. Nutritional
stunting (Abdillah et al., 2020). This is in line with the education, through lecture methods, the provision of
research by Martha et al. (2020) which suggests that the printed booklets, and demonstrations of how to prepare
empowerment of cadres and doctors through early healthy snacks using local products, are bundled
detection and prevention education of stunting is together in the Mother Smart Grounding (MSG)
considered quite effective. In the study (Muhamad et al., program. The result indicate a significant difference in
2023) it was found that there was a significant difference the knowledge, attitudes, and motivation of mothers
in the behavior of pregnant women before and after before and after the intervention (Andriani et al., 2017).
receiving intervention through the guidance of health This is consistent with the research conducted by
cadres for prenatal check-ups. This is because the better Maryati (2022) which states that interactive education
the knowledge, the better the attitude. This positive programs provided to mothers have proven to be
attitude is then put into practice by individuals in their effective in preventing stunting in Indonesia. Family
daily lives. This study is also consistent with research support is also crucial for the success of stunting
conducted by Sari (2023), which demonstrates that prevention programs. Education delivered in the form
nutritional counseling sctivities and cooking of community empowerment encourages self sufficiency
demonstration for meal preparation have been in improving health, particularly nutrition, among
successful in preventing stunting. These activities aim to toddlers. Empowerment activities are one of the
enhance the knowledge and behaviors of mothers with community nursing interventions, such as the LAKTASI
toddlers. The educational intervention involving the program (Smart Parent Education Class Indonesia)
enhancement of maternal knowledge about nutrition using the Focus Group Discussion (FGD) method in
and cognitive stimulation is known to be associated with which parents actively participate. This provides insight
improvements in child health, survival, and to mothers and results in changes in maternal
development (Ahmed et al., 2023). perceptions of balanced nutrition, improved child
In a study conducted in India, it was found that caregiving practices to ensure balanced nutrition, and an
nutritional education provided by cadres or community increase in the weight and height of toddlers (Wicaksono
health workers (CHW) through home visits allowed et al., 2021).
mothers of toddlers to consult and receive advice from Nutritional education on stunting is one of the
CHW. This has been significantly proven to be a key goverment’s programs aimed at reducing stunting rates,
factor in achieving nutritional improvement and particularly in Indonesia. This nutritional education is
enhancing complementary feeding practice alongside also a part of specific nutritional interventions targeting
breastfeeding (Garg et al., 2023). Maternal nutritional pregnant women, breastfeeding mothers, adolescents or
knowledge is a critical factor that that influences a prospective mothers, and women of childbearing age.
mother’s ability to select nutritious food for her child. However, there is currently no program for
Maternal education through nutrition education has strengthening educators, namely cadres. Based on the
been proven effective in addressing poor feeding findings of the articles reviewed above, it can be
practices and is carried out through home visits observed that trained cadres can reduce stunting rates.
conducted by cadres as agents to deliver accurate Therefore, the gevernment should strengthen cadres
nutritional education (Effendy et al., 2020). The same through training to optimized stunting prevention

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through nutritional education. With the target of likely to experience nutritional deficiencies compared to
education being mothers, expectant mother, and children with less varied dietary patterns. In the study
families through promotive and preventive efforts to (Agustin et al., 2021) it is also mentioned that there is a
enhance the family’s ability to support their health, as significant relationship between the diversity of family
the family plays a crucial role in influencing an foof consumption and the occurrence of stunting in
individual’s health status (Oktaviana et al., 2022). The toddlers. Research conducted in Africa also indicates
study by Sukmawati et al. (2021) states that continuous that poor infant and young child feeding (IYCF)
education and monitoring of the dietary patterns of practices have been identified as one of the main causes
pregnant mothers are highly necessary to prevent of stunting (Gassara et al., 2023).
stunting in children. The provision of supplementary foods, such as
Stunting prevention can also be achieved through cookies or specific nutritional additives, can be part of a
interprofessional collaboration (IPC) programs strategy to assist in reducing stunting in children.
involving professionals such as doctors, nurses, Cookies are a popular snack among children due to their
midwives, nutritionists, and sanitarian personnel. In crispness and consistency. Supplementary foods have
essence, IPC aims to enhance collaboration among the advantage of their limited ability to create a long
healthcare sectors so that all healthcare workers have the lasting feeling of fullness and have a minor impact on
same awareness and concern regarding stunting. This the consumption of primary meals. Potato almond
shared understanding and concern can help the orange cookies indicate that each 50 gram portion of
community evaluated and provide input on stunting to these cookies contains 254 calories, 27,7 grams of
change public perceptions or attitudes. The research carbohydrates, 3,25 grams of protein, 14,4 grams of fat,
results indicate that IPC programs effectively influence 0,425 mg of zinc, 32,75 mg of calcium, and 2,84 mg of
the thinking and actions of mothers. This is marked by a vitamin E. The research result indicate a significant
significant difference in the actions and attitudes of improvement in the HAZ scores of the intervention
mothers and healthcare cadres before and after IPC. group (Fatmah et al., 2023).
With these changes in thinking and actions, mothers The stunting prevention program implemented in
with toddlers will pay greater attention to their child’s Indonesia has not been able to achieve optimal results in
health (Astuti et al., 2021). A study conducted in reducing stunting prevalence. This is due to verious
Lebanon reported that IPC collaboration has a positive challenges encoutered in the field. Research conducted
impact, improving patient outcomes. The feedback from by Mutia (2020) states that the stunting prevention
the experience of IPC collaboration practice is very program has not been successful in reducing stunting
positive and enhances healthcare service outcomes rates due to the lack of specifik funding for nutritional
(Habre et al., 2023). This interprofessional collaboration interventions, a shortage of nutrition professionals, the
program is comprehensive as it involves various absence of guidelines or standard operating procedures
stakeholders, professions, and different sectors working (SOP) for addressing stunting, top-down planning, and
together to create a more holistic and effective program the lack of recording and reporting for program
for addressing stunting in Indonesia. Therefore, the interventions. This study aligns with the research
government may consider strengthening this conducted by Rahayu et al. (2023) which mentions that
interprofessional collaboration program acress all the field constraints are in the input aspect, namely the
sectors to prevent stunting, with qualified facilitators lack of human resources (HR) for support and
capable of supporting mothers with toddlers. insufficient budgetary support for program
In research Suryawan et al. (2022) it is stated that implementation. These challenges hinder the
there is a correlation between food diversity scores and achievement of the program’s objectives in stunting
the occurrence of stunting. A less diverse dietary pattern prevention (Syafrawati et al., 2023) the factors hindering
indicates poor food quality, leading to suboptimal the implementation of the stunting prevention program
growth in stunted children due to deficiencies in in Indonesia are limited funding, inadequate roles and
individual nutrients or a combination of several responsibilities of stakeholders, weak oversight
nutrients. This is consistent with research conducted in functions, and a lack of program innovation to support
India by Saha et al. (2023) it is reported that a the implementation of stunting prevention programs.
significantly varied dietary pattern is associated with a And the study conducted by Ginting et al. (2023)
decrease in stunting, and the risk of stunting decreases mentions that the barriers that occur include limited
significantly as the number of food groups consumed human resources and dual roles, availability and
increases. Therefore, the analysis of food diversity score adequacy of anthropometric equipment, lack of
and minimum dietary diversity (MMD) indicates that coordination in activity planning between program
children who consume a varied or diverse diet are less managers and leaders, families’ fear of negative

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stigmatization related to stunting and low community health workers can effectively reduce stunting rates.
participation levels. This is consistent with the study Therefore, the government needs to strengthen
(Herawati et al., 2022) which suggests that the challenges community health worker capacity through training to
at the district and village levels involve issues of optimize stunting prevention
commitment, staff capacity, and weak coordination.
Stunting prevention can be achieved thriugh Acknowledgments
various efforts, including education for those involved We are grateful to everyone who helped us implement this
research. I’m hoping this study will be helpful.
in stunting prevention, such as cadres, mothers with
toddlers, pregnant women, and women of childbearing Author Contributions
age who are prospective mothers. Education can also be Conceptualization, Pingkan Fristiwi; methodology, Pingkan
delivered through various methods such as counseling, Fristiwi; validation, Sri Achadi Nugraheni, Apoina Kartini. All
training, lectures, short courses, and community authors have read and agreed to the published version of the
empowerment. To empower mothers with toddlers, manuscript.
stunting can also be prevented through the
interprofessional collaboration (IPC) program that Funding
This research was independently funded by researchers.
involves all professions indluential in stunting
prevention, such as doctors, nurses, midwives,
nutritionists, and sanitarian workers. Through this
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