Peer-reviewed article

Social Ecological Approach to Combating Stunting in Kintamani, Bali, Indonesia

Made Indra Wijaya · 11 Sept 2024

Abstract

This study, conducted in Kintamani, Bali, Indonesia, addresses the persistent challenge of stunting—a marker of chronic malnutrition and impaired child development. Employing the Social Ecological Model (SEM), this qualitative research explores the complex interplay of individual, interpersonal, community, institutional, and policy factors influencing stunting. Through interviews and focus group discussions with diverse stakeholders including healthcare professionals, parents, and community leaders, the study identifies significant barriers and facilitators at each SEM level. Key barriers include limited nutritional knowledge and traditional feeding practices at the individual and interpersonal levels, accessibility issues at the community level, variability in health service quality at institutional levels, and fragmented policies at the policy level. Conversely, facilitators such as targeted nutrition education, robust community support systems, and integrated health programs emerge as potent tools for combating stunting. The study underscores the necessity of a multi-level, integrated approach that bridges the gaps between understanding and practical intervention, highlighting the role of tailored, culturally sensitive community engagement. Research implications stress the need for comprehensive strategies that transcend traditional focus areas to include economic, social, and policy coherence. Practical implications call for enhancing local health services and ensuring consistent policy implementation across regions. Socially, the study advocates for community-driven, culturally informed initiatives that respect local traditions while promoting scientifically sound health practices. The findings contribute to the field by emphasizing the effectiveness of the SEM in dissecting the complexities of public health challenges like stunting. They also advocate for a shift towards multi-dimensional prevention strategies that address both the symptoms and underlying determinants of stunting. This research not only enriches the academic discourse on child nutrition and public health but also offers a replicable model for similar settings globally, making a case for the critical importance of contextualized health interventions.