Cultural dynamics, social capital, and clinical challenges in stunting reduction in Indonesia: A qualitative study of pediatric nursing

Abstract

The high incidence of stunting in Indonesia is influenced by cultural dynamics, local social capital, and clinical challenges. Exploring these factors is of paramount importance, yet limited qualitative studies have focused on the population residing in areas within Magelang Regency that are categorized as disaster-prone regions. Therefore, this study aims to examine the experiences of healthcare professionals and community health volunteers in navigating the dynamics of implementing child growth and development monitoring. The study employed a qualitative approach to achieve its objectives. This study was conducted at the Muntilan 2 and Mertoyudan 2 Public Health Centers, which were selected for their extensive experience in supporting families and children with stunting in mountainous areas. Data collection was conducted between September and December 2025. Purposive sampling was employed to select participants based on predefined inclusion and exclusion criteria, resulting in a total of four key informants. Data collection instruments such as interview guides, were developed then validated by experts prior to the study. Data were gathered through in-depth interviews with key informants, including village midwives, nutritionists, community health volunteers, and community health centre nurse. Data analysis was conducted using the Miles and Huberman model, which involves three main stages: data reduction, data display, and drawing conclusions. The study identified five key themes: education and delivery of the 1000 first day of life, challenges of cultural barriers and resistance, multi-sector collaboration and local policies, specific interventions, monitoring and sustainability, and integration of disaster preparedness. The research findings indicate that program acceleration becomes more adaptive through the strategic utilization of social capital, flexibility in village fund allocation, and service innovations within integrated health post (Posyandu in Indonesia term). This study recommends policies that integrate intergenerational health education with community nurses acting as key educators to strengthen health promotion and accelerate stunting reduction.

Keywords: Local wisdom, paediatric nursing, qualitative study, social capital, stunting