Dynamic Governance in Reducing Stunting in Manggarai Regency, East Nusa Tenggara Province, Indonesia ()
1. Introduction
Banul et al. (2022) stated that stunting is “a serious problem that the world, including Indonesia, has to face. Stunting is considered serious due to causing delayed motor development and decreased levels of intelligence in toddlers”. Stunting is a condition in which toddlers have lower height-for-age. Cases of stunting or stunted toddlers are potentially misused as a measure of population health because poor nutrition affects children’s health, growth, and development [1]. Rahmadhita (2020) added that stunting is “a chronic malnutrition problem caused by lack of nutritional intake in a long enough time due to nutritionally insufficient feeding”. Stunting may happen from the prenatal period and begin to manifest in two-year-old children. If not countered with catch-up growth, it results in delayed growth. Stunting is a public health problem associated with increased morbidity and mortality risks and delayed motor and mental development [2]. Kusumawati, Rahardjo, and Permata (2015) suggested that stunting is “a sensitive indicator of poor socio-economic condition. Stunting has a wide range of impacts, from individual to national levels, due to be abling to affect a country’s economy and development. This happens because stunted children are naturally different from healthy children in terms of quality”. Stunted children have a decreased immunity. This condition makes it easier for them to contract infectious diseases [3]. Yuliani (2020) stated that “Early childhood is a period with a high risk of malnutrition because it is in this phase that a child’s body experience relatively rapid growth and development compared to other phases. The growth and development of the body during early childhood dictates the future growth” [4].
According to Sulistyaningsih, Panunggal, and Murbawani (2018), “In general, causes of stunting in children can be divided into two, direct and indirect causes”. Direct causes of stunting include nutrient consumption, genetic factors, and infectious diseases suffered by children. The body needs macro- and micro-nutrients. Indirect causes of stunting include maternal knowledge of nutrients, parenting style, parents’ income level, and utilization of health services [5]. As a commitment to accelerate stunting reduction, the government has issued Presidential Regulation (Perpres) No. 72 of 2021 on Accelerating Stunting Reduction. This Perpres serves as a legal umbrella for the National Strategy (Stranas) for Accelerating the Stunting Reduction launched and implemented in 2018. It also serves to solidify the intervention and institutional frameworks in which acceleration of stunting reduction is implemented. It is also to appoint an Acceleration Team for Stunting Reduction, consisting of Steering and Organizing Committees. The Vice President is the Chair of the Steering Committee, assisted by the Coordinating Minister for Human Development and Cultural Affairs and other ministers. Meanwhile, the Head of the National Population and Family Planning Agency (Badan Kependudukan dan Keluarga Berencana Nasional, or BKKBN for short) was appointed the Chair of the Organizing Committee. Acceleration teams were also formed at the provincial, regency/city, and sub-district/village levels [6].
Apart from that, according to research results from Chaveepojnkamjorn, Songroop, Satitvipawee, Pitikultang and Thiengwiboonwong, efforts to prevent and reduce stunting in children must include a stunting surveillance system and a healthy eating pattern campaign and Basic techniques for healthy lifestyles among risk groups must be established along with knowledge sharing programs about factors associated with stunting among teenage mothers during pregnancy to minimize and reduce the risk of stunting in children [7].
The decision of the Minister of National Development Planning No. Kep. 124/M.Ppn/Hk/10/2021 on the Establishment of the 2021-2024 National Action Plan for Food and Nutrition states that the government targets a 14 percent reduction in stunting prevalence in 2024 and sustainable development targets in 2030 based on achievements in 2024. Based on the Five Acceleration Pillars of Stunting Reduction, a National Action Plan (NAP) will be formulated to encourage and reinforce inter-program convergence through the at-risk-of-stunting family approach. Based on Indonesia’s 2022 National Nutrition Survey (Studi Status Gizi Indonesia, or SSGI for short), East Nusa Tenggara Province still has 3 regencies with “red” status. The assigning of red status is due to the prevalence of stunting above 30 percent. The three regencies are South Central Timor, North Central Timor, and Southwest Sumba. Eight regencies and cities, including West Sumba, Kupang, Belu, Lembata, East Flores, Manggarai, Rote Ndao, and Sabu Raijua, have “yellow” status, with 20 to 30 percent prevalence. Other regions, including East Sumba, Alor, Sikka, Ende, Ngada, West Manggarai, East Manggarai, and Malaka, are assigned “green” status, with 10 to 20 percent prevalence. Meanwhile, Central Sumba and Nagekeo are in the “blue” status, with the lowest prevalence of below 10 percent [8] (see Table 1).
Table 1. Prevalence of stunting in East Nusa Tenggara Province in 2022.
No. |
Regency/City |
Stunted (Children) |
Prevalence
(%) |
Short |
Very Short |
1 |
West Sumba |
1.565 |
522 |
23.7 |
2 |
East Sumba |
2.822 |
1.199 |
17.2 |
3 |
Kupang |
5.351 |
1.856 |
24.1 |
4 |
South Central Timor |
9.131 |
4.002 |
32.0 |
5 |
North Central Timor |
4.262 |
1.262 |
31.2 |
6 |
Belu |
2.236 |
968 |
21.2 |
7 |
Alor |
1.981 |
577 |
13.7 |
8 |
Lembata |
1.511 |
386 |
22.5 |
9 |
East Flores |
3.106 |
590 |
20.9 |
10 |
Sikka |
3.242 |
742 |
16.4 |
11 |
Ende |
2.156 |
619 |
14.3 |
12 |
Ngada |
1.370 |
262 |
15.7 |
13 |
Manggarai |
3.919 |
1.378 |
20.0 |
14 |
Rote Ndao |
2.255 |
848 |
23.5 |
15 |
West Manggarai |
2.666 |
828 |
15.1 |
16 |
Central Sumba |
562 |
133 |
9.4 |
17 |
Southwest Sumba |
8.592 |
4.558 |
44.3 |
18 |
Nagekeo |
783 |
206 |
9.1 |
19 |
East Manggarai |
2.279 |
773 |
13.7 |
20 |
Sabu Raijua |
1.536 |
501 |
25.5 |
21 |
Malaka |
2.219 |
807 |
18.3 |
Total |
63.544 |
23.017 |
22.0 |
Source: SSGI in 2022.
Manggarai Regency has a prevalence of 5297 cases or 20.0%. The measurement indicates that there are about 20 stunted toddlers per 100 toddlers in Manggarai Regency. Based on the results of the 2022 SSGI, three districts in Manggarai Regency are in “red” status, with over 30 percent prevalence of stunting. They are Ruteng (30.1%), Wae Rii (33.6%), and Lelak (37.1%). Cibal and West Cibal are in “yellow” status, with 22.3% and 24.1% prevalence, respectively. Other 7 (seven) districts are in “green” status. They are Satar Mese (16.6%), West Satar Mese (18.7%), North Satar Mese (15.6%), Langke Rembong (6.4%), North Rahong (14.2%), Reok (18.0%) and West Reok (15.5%). This is a good achievement considering that the previous year’s (2021) prevalence of stunting in Manggarai Regency overall was in “red” status at 33% (see Table 2).
Table 2. Prevalence of stunting in Manggarai Regency, 2022.
No. |
District |
Amount |
Stunted (Children) |
Prevalence
(%) |
Short |
Very Short |
1 |
Satar Mese |
3.193 |
394 |
137 |
16.6 |
2 |
West Satar Mese |
1.650 |
199 |
110 |
18.7 |
3 |
North Satar Mese |
1.519 |
177 |
61 |
15.6 |
4 |
Langke
Rembong |
4.443 |
222 |
64 |
6.4 |
5 |
Ruteng |
3470 |
777 |
268 |
30.1 |
6 |
Wae Rii |
2559 |
625 |
236 |
33.6 |
7 |
Lelak |
995 |
274 |
96 |
37.1 |
8 |
North Rahong |
1807 |
211 |
46 |
14.2 |
9 |
Cibal |
2574 |
418 |
158 |
22.3 |
10 |
West Cibal |
1290 |
205 |
106 |
24.1 |
11 |
Reok |
1668 |
234 |
67 |
18.0 |
12 |
West Reok |
1360 |
183 |
29 |
15.5 |
Total |
26.528 |
3.919 |
1.378 |
20.0 |
Source: SSGI in 2022.
Quoted from VoxTimor.com dated September 24, 2022 (https://voxtimor.pikiran-rakyat.com/), “To accelerate the reduction of stunting cases, the Manggarai Regency Government strives to optimize the convergence or integration actions for stunting reduction. Convergence actions for stunting reduction include identifying the distribution of stunting, availability of programs, and obstacles to the implementation of integrated nutritional interventions, making plans to improve the integrated nutritional interventions, organizing Rembuk Stunting (stunting discussion forum) at the regency/city level, and ensuring legal certainty for villages to play their role and exercise their authority in nutritional intervention” [9]. The next actions include ensuring the availability and functions of cadres to assist in integrating nutritional interventions in villages, improving the management of data on stunting and coverage of interventions at the regency/city level, measuring the growth and development of toddlers, and publishing stunting rates at regency/city level, and reviewing the performance of implemented programs and activities related to stunting reduction [10]. In regards to the issues above, the Manggarai Regency Government must work even more intensely and develop more competent governance to achieve better results in stunting reduction. This was confirmed by Manggarai Regent Herybertus Nabit in his remarks, as quoted in the newspaper Regional.Kompas.com on March 10, 2022, “The point is that many of our children are still stunted, indicating that our cooperation and governance are still lacking and below par. It is important to set targets to push us to work harder. Whether or not it will be achieved, we cannot know for sure, as it depends on how well the work and coordination are” [11].
Gabriel Goa, the Head of the Indonesian Society Coalition Against Corruption, and Roy Watu Pati, the Head of the National Civil Society Alliance FLOBAMORA, suspect misuse of the stunting-related budget by the East Nusa Tenggara Provincial Government. Their argument is based on the Audit Report of BPK No. 91.C/LHP/XIX.KUPANG/05/2021, dated May 17, 2021, on the Effectiveness of the Efforts by the NTT Provincial Government to Support the Acceleration of Stunting Prevention for the Fiscal Year 2018-2021. As quoted from the newspaper KatongNTT.com on March 24, 2022 (https://katongntt.com/), “a number of programs are considered ineffective, including supplementary food for maternal and child malnutrition program of IDR 46.5 billion, clean water development of IDR 8.7 billion that was not realized in priority villages for stunting prevention, livestock grants of IDR 18.1 billion, sustainable food-reserved garden program of IDR 9.9 billion, and housing stimulant assistance of IDR 32.2 billion” [12].
A study by Maria Sriana Banul et al. (2022) titled Pemberdayaan Keluarga dalam Pencegahan Stunting di Desa Rai Kabupaten Manggarai, Nusa Tenggara Timur (Family Empowerment for Stunting Prevention in Rai Village, Manggarai Regency, East Nusa Tenggara) states that “the lack of knowledge and awareness of the community in Rai Village on stunting prevention poses a factor in stunting the village. To date, despite the efforts made by the Manggarai Regency Government to accelerate its reduction, the stunting rate in Manggarai Regency is still very high”. Based on the results of Banul et al.’s (2022) interviews with families with stunting in Rai Village, one of the causes of stunting is the lack of family attention and support for their children’s growth and development [1].
In addition to the lack of community knowledge and participation in reducing stunting, the problem of supporting facilities and infrastructures also matters. As quoted from the newspaper RakyatNTT.com, on August 7, 2021 (https://rakyatntt.com/), “We are in serious need of all this. Personally, and also on behalf of my colleagues at community health centers (Puskesmas), auxiliary health posts (Pustu), or village health posts (Poskesdes), allow me to express our gratitude for everything that Mama Yeni, said Ermelinda, Head of Pagal Health Center. In line, Mikael Eduar Kluman, Head of Wae Codi Health Center, explained that the institution he leads lacks a lot of medical equipment. And one of the most urgently needed is a microtoise stature meter. The microtoise at the Wae Codi Health Center is no longer usable” [13].
Ministry of Administrative and Bureaucratic Reform (PANRB) in 2020 mentioned five national development priorities set in President Jokowi’s 2019-2024 administration: construction of infrastructure development, development of human resources, bureaucratic reform, facilitation of investment licensing, effective and efficient management of State Budget. On the priority of bureaucratic reform in this third period, the vision to achieve at the end of the period is to realize a dynamic and world-class Indonesian government. Furthermore, Syafri (2012) explained that to realize dynamic governance, it is necessary to implement adaptive policies by having 3 capabilities, including thinking ahead, thinking again, and thinking across. Thinking ahead is the capability to analyze future, uncertain conditions by looking at new opportunities and potential threats. Thinking again is the capability to evaluate and identify changes to established policies for better results. Thinking across is the capability to think out of the box and adopt ideas and innovations from other parties in policy making” [14]. Boon and Geraldine (2007) in Fernandes and Birokrasi (2020: p. 79) emphasize dynamic governance as “how these chosen paths, policies, institutions, and structures adapt to an uncertain and fast-changing environment so that they remain relevant and effective in achieving the long-term desired outcomes of society” [15]. Huseini (2015: p. 90) states “dynamic regional governments will be able to make changes in their regional development following the implementation of regional autonomy. They leave the old, stiff, spoon-fed, hierarchical, short-term-oriented government. They change the paradigm of government officials from the one being served to the one to serve, with the aim of giving excellent services [16].
In dealing with stunting, the Manggarai Regency Government needs to have appropriate and clear models, policies, or programs. The Manggarai Regency Government needs to open up and adopt the dynamic governance approach in which lies three important elements, thinking ahead, thinking again, and thinking across.
2. Framework
A framework is an outline devised by researchers to design the research process. Based on Figure 1, stunting is a social problem in Manggarai Regency wherein the problems identified by the researchers are as follows:
1) SSGI data shows a fairly high prevalence rate of stunting.
2) The governance model is not yet effective in addressing the stunting problem.
3) Indications of the Government misusing the stunting-related budget.
4) Lack of community awareness and knowledge of stunting prevention.
5) Lack of Government attention to the stunting measurement facilities and infrastructure.
In addressing the problem of stunting, the Manggarai Regency Government is legally responsible for it. The main duties and authorities refer to Presidential Regulation (Perpres) No. 72 of 2021 on Accelerating the Reduction of Stunting, Decision of the Minister of National Development Planning No.
Kep.124/M.Ppn/Hk/10/2021 on the Establishment of National Action Plan for Food and Nutrition 2021-2024, Decision of the Minister of National Development Planning No. Kep.42/M.Ppn/Hk/04/2020 on the Declaration of Additional Regencies/Cities as Focal Locations for the 2021 Integrated Stunting Interventions, and Regional Regulation of East Nusa Tenggara Province No. 2 of 2018 on the Provision of Regional Health Services. To carry out the task of reducing stunting as per the above regulations, the Manggarai Regency Government needs to implement appropriate and on-target programs and policies. In this regard, the policy direction and program innovation of the Manggarai Regency Government in addressing stunting problems will be studied and analyzed using the capability theory of dynamic governance by Neo and Chen (2007) in Syafri (2012: pp. 180-186) which suggests that capabilities consist of three elements:
The first is thinking ahead, the capability to identify environmental factors that may affect future development, to foresee their impacts on socio-economic conditions, and to avoid potential threats that may interfere with the progress of society.
The second is thinking again, the capability to review existing policies, strategies, and programs, whether they have produced results that meet the expectations of many parties or need a redesign for better results.
The third is thinking across, the capability to open up to and adopt views, opinions, and ideas beyond the traditional inherent mindset upon which actions are based [14].
Other than the theory above, we authors are also to look at the supporting and inhibiting factors of dynamic governance in reducing stunting in Manggarai Regency as well as the efforts to overcome the inhibiting factors. The expected result is to overcome the stunting problem in Manggarai Regency. The details regarding the scope of the study to do are in Figure 1.
Figure 1. Framework.
3. Working Hypothesis
According to Fernandes (2017: p. 174), a working hypothesis is the researcher’s basic assumption regarding a problem being studied. With the hypothesis as a guide, it is then proven empirically by testing it using data obtained during research. The hypothesis is a provisional answer to a problem whose truth needs to be verified with more complete, supporting data [17]. This study aims to learn about dynamic governance in reducing stunting in Manggarai Regency. In doing the study, we coordinated with the Health Office and Population Control and Family Planning Office of Manggarai Regency.
Working Hypothesis from Research on Dynamic Governance in Overcoming Stunting in Manggarai Regency, East Nusa Tenggara Province can be carried out if three elements of Dynamic Governance are implemented, namely Thinking ahead Fernandes thinking forward), Thinking Again (thinking Back), and Thinking Across (thinking out) which are sourced from the opinion of Neo and Chen (2007) in Syafri (2012: pp. 180-186).
4. Methodology
Data collection techniques of qualitative research on public administration are basically the same as that of social research. According to Fernandes (2017: p. 215), in qualitative research on public administration, data is collected using interviews, observation, documentation, and focus group discussions, and is improved by triangulation. To collect data in this study, researchers used interviews, a process of direct communication carried out by researchers to informants in a question-and-answer session. Fernandes (2017: p. 215) argues that an interview is a process of communication or interaction to collect information by means of questions and answers between researchers and informants or research subjects. In qualitative research on public administration, there are several steps required to prepare for an interview:
1) Prepare interview guidelines;
2) Prepare tools for the interview;
3) Schedule the time for the interview.
To prepare interview guidelines, according to Fernandes (2017: p. 216), refer to the following example of work order:
1) Identify research informants;
2) Specify the research theme structure;
3) Specify question items based on themes;
4) Arrange classification of questions based on informants;
5) Arrange interview results based on informants [17].
The research theme structure for this study is as follows (see Table 3).
The information in this study is categorized into 2:
A) Key informants, including:
1) Regent of Manggarai as Informant 1;
2) Speaker of the Regional House of Representatives (DPRD) of Manggarai Regency as Informant 2;
3) Regional Secretary of Manggarai Regency as Informant 3;
4) Assistant in Public Administration and Public Welfare Division of Manggarai Regency as Informant 2;
5) Head of the Inspectorate of West Manggarai Regency as Informant 5;
Table 3. The scope of research.
Title |
Theme |
Subtheme |
Sub-Subtheme |
(1) |
(2) |
(3) |
(4) |
Dynamic Government in Reducing Stunting in Manggarai Regency, East Nusa Tenggara Province |
1. Dynamic governance in reducing stunting in Manggarai Regency, East Nusa Tenggara Province (capabilities of dynamic governance according to Neo and Chen (2007) in Syafri (2012: pp. 180-186)) |
1.1 Thinking ahead |
1.1.1 Purpose of policy |
1.1.2 Impact of development |
1.1.3 Threats to new opportunities |
1.1.4 Influence on policymakers |
1.2 Thinking again |
1.2.1 Analyzing performance |
1.2.2 Finding out causes |
1.2.3 Reviewing significant factors |
1.2.4 Redesigning programs |
1.2.5 Implementing new policies |
1.3 Thinking across |
1.3.1 Searching for similar programs |
1.3.2 Reflecting on programs |
1.3.3 Evaluating programs |
1.3.4 Connecting new ideas |
1.3.5 Tailoring to community’s needs |
2. Supporting and inhibiting factors of dynamic governance in reducing stunting in Manggarai Regency, East Nusa Tenggara Province |
2.1 Supporting factors |
2.1.1 Internal supporting factors |
2.1.2 External supporting factors |
2.2 Inhibiting factors |
2.2.1 Internal inhibiting factors |
2.2.2 External inhibiting factors |
3. Efforts to overcome the inhibiting factors of dynamic governance in reducing stunting in Manggarai Regency, East Nusa Tenggara Province |
3.1 Efforts to overcome the inhibiting factors |
3.1.1 Internal direct efforts |
3.1.2 External direct efforts |
3.1.4 Internal indirect efforts |
3.1.5 External indirect efforts |
Source: Processed by authors (2022).
6) Head of the Health Office of Manggarai Regency as Informant 6;
7) Head of the Population Control and Family Planning Office of Manggarai Regency as Informant 7;
8) Head of Family Health and Community Nutrition Section of the Health Office of Manggarai Regency as Informant 8;
9) Head of Children’s Right Fulfillment and Children’s Protection Section of the Population Control and Family Planning Office of Manggarai Regency as Informant 9;
B) Auxiliary informants, consisting of 5 (two) leaders:
1) Community leader as Informant 10;
2) Religious leader as Informant 11;
3) Educational leader as Informant 12;
4) Youth leader as Informant 13;
5) Female figure as Informant 14.
5. Result
Based on the results and discussion on dynamic governance in reducing stunting in Manggarai Regency, we can draw the following conclusions:
A) Dynamic Government in Reducing Stunting in Manggarai Regency, East Nusa Tenggara Province
1) Thinking ahead
a) Purpose of policy
Reducing stunting is not separated from the national goal of reducing stunting. Reducing stunting is carried out to allow children to have healthy and optimal growth and prepare them as the country’s fit (as in healthy) and fine (as in of high quality) next generation.
b) Impact of development
The decline in the level of stunting is evident from the last measurement in August 2022, with 4313 cases of stunting, a decrease from 5320 cases in February 2022. The stunting reduction policy also increases children’s productivity, the fruit of collaboration between sectors tasked with reducing stunting in Manggarai Regency.
c) Threats to new opportunities
Evaluation of previous programs then decides the right direction for policy by considering social and environmental changes and focusing on effective interventions. There needs to be a more humanistic approach, which sees the community more as a subject rather than merely an object.
d) Influence on policymakers
To raise awareness and participate in reducing stunting, the community must have the courage to voice their opinions against stunting to the government through seminars and discussion forums.
2) Thinking again
a) Analyzing performance
Improvement in reducing stunting is evident from the last measurement in August 2022, down to 4313 (16.4%) from 5320 (20.0%) in February 2022. This is the fruit of collaboration and cooperation between related regional government agencies (OPD) and the involvement of private partners such as Bank NTT and NGOs.
b) Finding out causes
There is intimate collaboration and cooperation between components such as government, private partners, and the community. Failure to achieve because there are still ineffective implementation of programs and lack of community participation.
c) Reviewing significant factors
Cooperation between and involvement of components, such as community participation and communication between components, is still lacking.
d) Redesigning programs
Not yet, as the government still focuses on developing and improving existing programs.
e) Implementing new policies
Continuing old programs, such as Lonto Leok, together with community leaders in traditional houses to share knowledge and wisdom, optimizing health services, and implementing seven methods of contraception.
3) Thinking across
a) Searching for similar programs
Collaborating with private partners, Supplementary Food for Maternal and Child Malnutrition (Pemberian Makanan Tambahan, or PMT for short), innovating using information technology to record stunted children, and improving access to health services to ensure community needs are met.
b) Reflecting on programs
The government is directed to be able to make use of information technology in stunting interventions. There is a tendency for the community to be passive, and by building more maternal and child health stations (posyandu) in villages, it is easier for people to seek medical treatment, including routine health examinations for infants and children.
c) Evaluating programs
The government seeks to intensify the campaigns on stunting interventions to the public, improve facilities and infrastructure, and recommend giving PMT to toddlers at risk of stunting to ensure that they are well-nourished.
d) Connecting new ideas
Connecting the idea of applying information and technology to efforts to reduce stunting is by recording the number of stunted children in a more detailed and efficient manner, then introducing health examination services to remote areas and opening classes special for children.
e) Tailoring to community’s needs
Seeing the community’s needs, the government optimizes the use of information technology to be more focused on each stunted toddler and improve the quality of healthcare facilities and education for children in Manggarai Regency.
B) Supporting and Inhibiting Factors of Dynamic Governance in Reducing Stunting in Manggarai Regency, East Nusa Tenggara Province
1) Supporting factors
a) Internal supporting factors
Good planning, control, supervision, evaluation, and lastly, convergence of programs are impossible for the government to do alone. Participation of the community and private sector is necessary to target the same groups.
b) External supporting factors
Good collaboration between the government and the community, as well as the availability of a sufficient budget.
2) Inhibiting Factors
a) Internal inhibiting factors
Budgets for outstation claims, a more comprehensive understanding of stunting on the side of government, and community awareness.
b) External inhibiting factors
Lack of community participation and insufficient resources, such as medical personnel and health facilities.
C) Efforts to Overcome the Inhibiting Factors of Dynamic Governance in Reducing Stunting in Manggarai Regency, East Nusa Tenggara Province
1) Efforts to overcome inhibiting factors
a) Internal direct efforts
Ensure the availability of a sufficient budget and develop human resources through coaching and empowerment.
b) External direct efforts
Conduct campaigns for the community on the importance of stunting reduction.
c) Internal indirect efforts
Control the media, as in spreading news consistent with the actual situation, and build adequate infrastructure and health facilities for the community.
d) External indirect efforts
Involve the private sector in reducing stunting and distributing brochures to the community on the causes and means of handling stunting.
6. Recommendation
Based on the analysis that has been stated above, so that dynamic governance in overcoming stunting in Manggarai Regency can run according to its policy objectives and intentions, the following suggestions can be made:
A) Dynamic Government in Reducing Stunting in Manggarai Regency, East Nusa Tenggara Province
1) Thinking ahead
a) Purpose of policy
Manggarai Regency Government needs to focus on the national goal of reducing stunting to allow children to grow healthy and prepare them as our nation’s fit and fine next generation.
b) Impact of development
Manggarai Regency Government is expected to improve stunting interventions through inter-sectoral cooperation to increase children’s productivity in Manggarai Regency.
c) Threats to new opportunities
It is also suggested that the Manggarai Regency Government set the right direction of policy by considering social and environmental changes and results of the evaluation of previous programs.
d) Influence on policymakers
Manggarai Regency Government needs to look at the stunting phenomenon in the community more specifically and empower the community to participate in reducing stunting.
2) Thinking again
a) Analyzing performance
Manggarai Regency Government is expected to improve collaboration and cooperation between components involved to reduce stunting together.
b) Finding out causes
Manggarai Regency Government is expected to maintain good cooperation with every component and optimally implement every program while empowering community participation.
c) Reviewing significant factors
Manggarai Regency Government should encourage the community to participate more actively in stunting reduction and improve communication between components.
d) Redesigning programs
Manggarai Regency Government is expected to be able to develop and improve existing stunting intervention programs while continuously exploring new things for future programs.
e) Implementing new policies
Manggarai Regency Government needs to provide health services to stunted toddlers optimally and engage the community more intimately in the Lonto Leok program to ensure active participation in reducing stunting.
3) Thinking across
a) Searching for similar programs
Manggarai Regency Government can explore new programs to reduce stunting, such as introducing healthcare to remote areas and PMT while assessing the needs of the community in Manggarai Regency.
b) Reflecting on programs
Manggarai Regency Government needs to promote the use of information technology in stunting reduction programs by continuing to build health infrastructure in remote areas.
c) Evaluating programs
Manggarai Regency Government is expected to more intensely empower the community in reducing stunting, improve health facilities and infrastructures, and deliver PMT to ensure stunted toddlers can get proper nutrition.
d) Connecting new ideas
Manggarai Regency Government needs to deliver information technology-based stunting interventions by collecting more accurate data on stunted toddlers and introducing healthcare in remote areas.
e) Tailoring to community’s needs
Manggarai Regency Government needs to optimize the use of information technology to be more focused on each stunted toddler and improve the quality of healthcare facilities and education for children in Manggarai Regency.
B) Supporting and Inhibiting Factors of Dynamic Governance in Reducing Stunting in Manggarai Regency, East Nusa Tenggara Province
1) Supporting Factors
a) Internal supporting factors
Manggarai Regency Government needs to maintain control, supervision, and collaboration between components to reduce stunting in Manggarai Regency.
b) External supporting factors
Manggarai Regency Government could increase collaboration with the community and provide sufficient funds for stunting intervention programs.
2) Inhibiting Factors
a) Internal inhibiting factors
Manggarai Regency Government should focus more on providing sufficient budgets and empowering each component to have a more comprehensive understanding of stunting and its reduction.
b) External inhibiting factors
Manggarai Regency Government could empower and raise the awareness of the community in reducing stunting and also provide sufficient medical facilities and personnel.
C) Efforts to Overcome the Inhibiting Factors of Dynamic Governance in Reducing Stunting in Manggarai Regency, East Nusa Tenggara Province
1) Direct efforts
a) Internal direct efforts
Manggarai Regency Government needs to ensure the availability of a sufficient budget and develop human resources by coaching and empowering each component to be synergetic in reducing stunting.
b) External direct efforts
Manggarai Regency Government is expected to do campaigns for the community on the importance of stunting reduction.
2) Indirect efforts
a) Internal indirect efforts
Manggarai Regency Government could ensure that the media publishes news that is consistent with the actual situation and builds adequate health infrastructure for the community.
b) External indirect efforts
Manggarai Regency Government could involve the private sector in reducing stunting and distributing brochures to the community on the causes and means of handling stunting.
Conflicts of Interest
The authors declare no conflicts of interest.