Government Strategy in Reducing Stunting Rate for the People of North Labuhanbatu Regency towards Zero Stunting

Abstract

This problem is one of the problems that has an impact on the development and improvement of the younger generation. The absence of energy and protein in a long enough period of time will cause inhibition of growth and development in infants. This research aims to find out the strategies implemented by the North Labuhanbatu Regency government in the process of reducing stunting rates and how to overcome them. This research uses a qualitative approach with descriptive research type. Research data was obtained from interviews and observations. The data analysis carried out was taken from several stunting cases that have occurred and looked at the social situation and conditions in the field. The results of this research show that there are still many cases of stunting occurring in North Labuhanbatu Regency, especially among toddlers, pregnant women, postpartum and breastfeeding mothers, prospective brides, and grooms. The main causes of stunting are nutritional, health and environmental disorders. This has become the concern of the North Labuhanbatu Regency government in the process of targeting a reduction in the stunting rate towards zero stunting by 2024. Apart from that, the government will carry out eight convergence actions to reduce stunting in each district/city.

Full text

Volume 5 Number 1 (2024)
November – April 2024
Page: 75-88
E-ISSN: 2716-0750
P-ISSN: 2715-7997
DOI: 10.37680/amalee.v5i1.4302
Indonesian Journal of Community Research and Engagement
Published by LP2M INSURI Ponorogo; Indonesia
Accredited Sinta 3
Government Strategy in Reducing Stunting Rate for the People of
North Labuhanbatu Regency towards Zero Stunting
Andriansyah Putra1, H.M. Iqbal Abdul Muin2
1,2) State Islamic University of North Sumatra, North Sumatra, Indonesia
Correspondence e-mail: andriansyah0103193067@uinsu.ac.id
Article history
Submitted: 2023/11/16; Revised: 2023/12/14; Accepted: 2024/01/25
Abstract
This problem is one of the problems that has an impact on the development
and improvement of the younger generation. The absence of energy and
protein in a long enough period of time will cause inhibition of growth and
development in infants. This research aims to find out the strategies
implemented by the North Labuhanbatu Regency government in the process
of reducing stunting rates and how to overcome them. This research uses a
qualitative approach with descriptive research type. Research data was
obtained from interviews and observations. The data analysis carried out
was taken from several stunting cases that have occurred and looked at the
social situation and conditions in the field. The results of this research show
that there are still many cases of stunting occurring in North Labuhanbatu
Regency, especially among toddlers, pregnant women, postpartum and
breastfeeding mothers, prospective brides, and grooms. The main causes of
stunting are nutritional, health and environmental disorders. This has
become the concern of the North Labuhanbatu Regency government in the
process of targeting a reduction in the stunting rate towards zero stunting by
2024. Apart from that, the government will carry out eight convergence
actions to reduce stunting in each district/city.
Keywords
Strategy; Stunting; Zero Stunting
©2024 by the authors. Submitted for possible open access publication under the terms
and conditions ofthe Creative Commons Attribution 4.0 International (CCBY SA)
license, https://creativecommons.org/licenses/by-sa/4.0/.

Government Strategy in Reducing Stunting Rate for the People of North Labuhanbatu Regency towards Zero Stunting
Andriansyah Putra, H.M. Iqbal Abdul Muin
76
1. INTRODUCTION
Progress is not just about frameworks, but progress is about how to build
individuals or turn human events. Improvement not only discusses tangible things but
also about individuals, complete human improvement in accordance with the 1945
Constitution, that human progress is to encourage government assistance in general,
to educate the existence of the State, that the improvement of society is carried out
within the structure of the state (Hidayati, 2016; Leonard, 2016). the turn of
humanitarian events, and the intention is to realize a prosperous, just, prosperous, just,
material and profound society based on Pancasila and the 1945 Constitution of the
Republic of Indonesia, that in organizing the turn of events of society, work plays a
significant role and position as a destination for transfer and improvement
(Kurniawan, 2020; Maulana, 2019). Provision prepares a person to become a human
asset, human development is needed which starts from setting an example of raising
children, providing nutritious food, and fulfilling his sustenance (V. Anggraini, 2019;
Haura et al., 2021).
One of the issues needed in implementing progress in Indonesia is accelerating
the reduction of barriers. Barriers are a difficult issue because they have a devastating
impact on victims, both current and long-term influences. Stunting is an increasingly
severe problem in developing countries, such as Indonesia (Hendrika et al., 2022);
(Yuniarti et al., 2019). This is a serious problem because it is related to problems in the
country.
According to UNICEF, 7.8 million children are experiencing barriers, and
Indonesia is one of the five countries with the largest number of children experiencing
barriers. Based on the 2017 report of the Welfare Office of the Republic of Indonesia,
the national prevalence of stunting among children aged two to five years in Indonesia
is 35.6%. Of these, 15.1% were severely stunted and 20% were stunted (S. Z. Anggraini
& Tukiman, 2022). Stunting is an important issue that will affect the social, economic
life of the community and nutrition (Agustina et al., 2020); (Solihin, 2018). Stunting can
also occur when the fetus is still in the womb due to the mother's lack of protein intake
as well as environmental factors that do not support (Mega & Sugiyarti, 2021; Octavia
& Octavia, 2019).
This problem is one of the problems that has an impact on the development and
improvement of the younger generation. The absence of energy and protein in a long
enough period of time will cause inhibition of growth and development in infants
(Mâţă Liliana et al., 2023; Saripudin, 2019). In 2017, UNICEF recorded that the
incidence of barriers in Indonesian infants was the second highest in ASEAN, around

77
150.8 million children under the age of five worldwide experienced barriers or a figure
of around 22.2% (Priyanka & Heryadi, 2020); (World Health Organization, 2011).
According to the World Health Organization (WHO), the prevalence of stunting in
children under five of 20% or more is considered a public health problem (Komalawati,
2020; Yanti & Yulia, 2020). Information on the prevalence of obesity in Indonesian
children based on SSGBI (Review of Indonesian Child Nutritional Status) in 2019 is
27.67%. Based on SSGBI data in 2019, stunting is a public health problem in Indonesia.
The government's RPJMN (National Medium-Term Development Plan) for 2020-
2024 targets a stunting prevalence rate in Indonesia of 14%. This target can be achieved
by incorporating multi-field work and ensuring synchronization of programs from the
community level to the city level (Istiniah et al., 2023); (Sukarma et al., 2023). The step
taken to accelerate this goal is to determine the area of districts / cities and also villages
so that they can be focused. The number of districts/cities will be gradually expanded
to cover the entire district/city area. Efforts to prevent and reduce the number of
barriers in Indonesia are not only a matter for public authorities (Sawir, 2020);
(Komalawati, 2020). All components of the state must be involved and play a role in
overcoming obstacles.
North Labuhanbatu regulations, when viewed from SSGI data in 2022, the
obstacle pervasivity rate is 7.3% or close to 23.6% from 2021 or more than 382 children
under five. This makes the North Labuhanbatu region ranked 4th largest obstacle
reduction in North Sumatra Region and fourth rank of the largest obstacle reduction
overall (AR et al., 2023). Therefore, the goal proclaimed by the Government of the
North Labuhanbatu Regime in 2024 is to determine the remaining 7.3% of dominant
cases and we achieve zero obstacles and we must still guarantee that no new cases or
zero new obstacles arise considering that the Diskominfo Regulation of North
Labuhan Batu is obtained from https://labura.go.id/. To date, the most common way
to reduce the number of barriers in the North Labuhan Batu Regulation has worked
very well (Dwi, 2022). This is because the government is working on this gradual
reduction process and wants to eliminate stunting in North Labuhanbatu Regency by
2024.
This research is in line with research conducted by Kinanti Rahmadhita, Faculty
of Medicine, University of Lampung entitled "Stunting Problems and Prevention"
(Rahmadhita, 2020). This study both aims to eliminate stunting in their respective
zones. The Government of Indonesia focused on addressing and reducing the rampant
barriers reviewed in a limited meeting on obstacle mediation held with Community
Group Administrators to Accelerate the Increase in Poverty Reduction in 2017, in

Government Strategy in Reducing Stunting Rate for the People of North Labuhanbatu Regency towards Zero Stunting
Andriansyah Putra, H.M. Iqbal Abdul Muin
78
which the meeting discussed the need to strengthen coordination and increase the
extent of projects undertaken by relevant Agencies/Agencies (K/L), to seek the nature
of the program to reduce the level of barriers in each space What to remember for cities
in need (Dewi & Auliyyah, 2020); (Widyastuti et al., 2022). The same research was also
conducted by Hayati Sofia Salmon, et al of the Faculty of Social and Political Sciences,
Sam Ratulangi University with the title "Government Strategy in Overcoming Stunting
in Sangihe Islands District” (Salmon et al., 2022). This study also aims to reduce
stunting rates in Sangihe Islands Regency. The local government has also done various
ways in the process of reducing stunting because from health data the stunting rate
here has decreased slowly and is getting better.
This research aims to find out the strategies implemented by the North
Labuhanbatu Regency government in the process of reducing stunting rates and how
to overcome them. It is hoped that this research will bring local government policies
to carry out various ways in the process of reducing stunting so that it will slowly
improve.
2. METHOD
The type of research conducted is qualitative research using descriptive methods.
This kind of research seeks to find systematic, factual, and accurate ways of looking at
social situations and events in the field (Sugiyono, 2019). During June and July 2023,
researchers chose North Labuhanbatu Regency as the research location. The location
was chosen considering the high stunting rate in North Labuhanbatu Regency which
the government is still trying to reduce to zero. The data collection technique carried
out in this study is by conducting field research. Surveys conducted by researchers
with a direct understanding of the scope of data collection: Interviews, observations,
and literature studies. Data analysis techniques use data reduction, data presentation
and conclusions.
3. FINDINGS AND DISCUSSION
3.1 Data Stunting
Stunting occurs in North Labuhanbatu district in almost all villages and sub-
districts. Therefore, accurate data is needed so that stunting can immediately go to
zero stunting. One of the areas located on the East Coast Line of North Sumatra Region
is North Labuhanbatu Regency. Its altitude ranges from 0 to 2,151 meters above sea
level, and is located at 99.25.00o – 100.05.00o East Longitude and 01o58'00'' – 02o50'00''
North Latitude. North Labuhanbatu region has eight sub-districts and 61 village. The
following table of information is based on the application survey as of August 2022.

79
Table 1.
Stunting Data in North Labuhanbatu District
TODDLER MEASUREMENT IN AUGUST 2022 THROUGH
EPPGBM APPLICATION
No
DISTRICTS
PHC
VILLAGE
TODDLERS
STUNTING
1
KUALUH
HULU
AEK KANOPAN
PARPAUDANGAN
6
2
AEK KANOPAN
5
3
P. MAMBANG
MUDA
1
4
LONDUT
KUALA BANYAN
19
5
LONDUT
1
6
PULO DOGOM
2
7
SUKARAME
PER. HANNA
3
8
PER. LABUHAN
HAJI
3
9
NEW DIFFICULT
GAME
3
10
SUKARAME
8
11
SONOMARTANI
SONOMARTANI
27
SUM
78
12
SOUTH QUAIL
GUNTING SAGA
DAMULI PEKAN
1
13
GUNTING SAGA
2
14
MALAY
MOUNTAIN
4
15
HASANG
3
16
LOBU HUALA
2
17
PER. DAMULI
4
18
SIAMPORIK
4
19
Sidua-One
1
20
SIMANGALAM
SIMANGALAM
5
21
SIALANG TAJI
10
22
CAPE PASIR
CAPE PASIR
18
SUM
54
23
AEK NATAS
DURIAN TOWN
PANGKALAN
3
24
UJUNG PADANG
1
25
ADIAN TOROP
1
26
SIMONIS
SIMONIS
8
27
POLDUNG
7
28
ROBISON
5
29
SIBITO
7
SUM
32
30
AEK KUO
AEK KORSIK
AEK KORSIK
9
31
SAFE CITY
5

Government Strategy in Reducing Stunting Rate for the People of North Labuhanbatu Regency towards Zero Stunting
Andriansyah Putra, H.M. Iqbal Abdul Muin
80
TODDLER MEASUREMENT IN AUGUST 2022 THROUGH
EPPGBM APPLICATION
No
DISTRICTS
PHC
VILLAGE
TODDLERS
STUNTING
SUM
14
32
ON IX-X
KMP. TAX
K.TAXES
2
33
MERANTI OMAS
1
34
BANGUN REJO
2
35
PULO JANTAN
2
36
AEK BATU CITY
HATAPANG
2
37
BATU TUNGGAL
BATU TUNGGAL
26
38
PEMATANG
8
SUM
43
39
MARBAU
MARBAU
LOBU RAMPAH
1
40
INTERSECTION
FOUR
1
41
SOUTH MARBAU
1
42
AEK HITETORAS
2
43
AEK TAPA
1
44
BELONGKUT
SIPARE-PARE
HILIR
6
45
TUBIRAN
1
46
BELONGKUT
2
47
PULO BARGOT
1
SUM
16
48
KUALUH
HILIR
KUALA BANGKA
KUALA BANGKA
11
49
SEI APUNG
6
50
TELUK BINJAI
5
51
MESJID VILLAGE
KEL K. MESJID
8
52
SEI SENTANG
9
53
TANJUNG
MANGEDAR
4
TELUK PIAI
5
SUM
48
54
LEIDONG
Quailuh
TANJ LEIDONG
BLACKWATER
18
55
COCONUT STICK
4
56
PANGKALAN
LUNANG
4
57
SIMANDULANG
22
58
TANJUNG
LEIDONG
43
59
GULF PULAI
DALAM
3
60
OUTER PULAI
3

81
Source: Population Control and Family Planning Office of North Labuhanbatu
Regency
The data above explains where toddlers and pregnant women are stunted and
the number affected by stunting. The data is a benchmark for the North Labuhanbatu
Regency government in the process of reducing stunting. From the table above, it is
clear that all sub-districts in North Labuhanbatu Regency have children affected by
stunting. The districts with the most stunting are Kualuh Leidong with 97 people,
Kualuh Hulu with 78 people, Kualuh Selatan with 54 people, KualuhHilir with 48
people, NA-IX-X with 43 people, Aek Natas with 32 people, Marbau with 16 people
and Aek Kuo with 14 people.
3.2 Audit of Stunting Cases
From the stunting cases that occurred in North Labuhanbatu Regency, the North
Labuhanbatu Regency expert team successfully conducted an audit and found the
following results:
Table 2. Stunting Case Audit Results (AKS)
Expert Team of North Labuhan Batu Regency
Target Groups
Identify
Risks/Problems
found
Management Plan/
Expert Team
Recommendation/
Follow-up Plan
Information
Toddler
1. Pregnant
women at the
age of 43 years
2. Not Exclusive
Breastfeeding
3. Not getting
MP-ASI
4. SEZ mothers
during
pregnancy
5. BBLR Children
1. Education to
mothers about
stunting
2. Need help for
nutritional intake
through
intensive PMT
3. Education about
good parenting
(food care,
sanitary hygiene
Conclusion:
Audit Case of
Children
Stunting
1. Need special
attention
from family
and
government
(Sub-
districts and
TODDLER MEASUREMENT IN AUGUST 2022 THROUGH
EPPGBM APPLICATION
No
DISTRICTS
PHC
VILLAGE
TODDLERS
STUNTING
BAY
SUM
97
TOTAL AMOUNT
382

Government Strategy in Reducing Stunting Rate for the People of North Labuhanbatu Regency towards Zero Stunting
Andriansyah Putra, H.M. Iqbal Abdul Muin
82
Target Groups
Identify
Risks/Problems
found
Management Plan/
Expert Team
Recommendation/
Follow-up Plan
Information
6. Incomplete
basic
immunization
7. Short TB
8. Difficult to
meet food
needs
9. Mothers do not
have birth
control
Mothers do not
understand
balanced
nutrition
10. 5th child
11. Usiaibu 43 year
and health care)
4. Education to
families (fathers
and mothers) in
allocating
income to
priority on food
not for cigarettes
5. Need Risk
Education for 4
Too (4T)
health
centers)
2. Priority gets
PMT
assistance.
The table above explains which groups can be affected by stunting, both pregnant
women and malnourished toddlers. As well as the main cause of stunting to them.
Stunting cases like this are vulnerable to often occur due to lack of concern for health
(Nurlila & La Fruit, 2020). Prevention that can be done to overcome stunting cases in
pregnant women by doing the following: (George Wilhelm Bender. 2022.
Communication Strategy for Stunting Awareness Campaign 2021)
1. Regular pregnancy control every month
2. Consumption of nutritious foods and special milk for pregnant women
3. Take Supplements
4. Monitor BB gain once a month
Prevention of stunting in toddlers can be done by:
1. Regularly check the development and progress of the child.
2. Give toddlers additional and nutritious food.
Efforts to prevent and overcome stunting:
1. Behavior changes
2. Mindset improvement
3. Improved parenting
4. Improved health services

83
5. Improved sanitation
6. Improved water access
3.3 Problems with stunted children
Table 3. The Problem of Children Affected by Stunting
Psychomotor for children of their
age is not developed
1. Not yet able to walk
2. Standing still holding on and can't
be long
3. Haven't been able to sit upright for
a long time
Social Interaction
1. No Eye contact with strangers
2. Does not respond when greeted
Cognitive Development – Language
1. The ability to speak is also slow.
2. Limited vocabulary
3. Has not been able to show his
limbs when asked
Indications of Down syndrome,
Autism and Mental Retardation
1. The shape of the face leads to
Mongolian, thick tongue, often
sticking out the tongue, fingers are
large and short
2. No eye contact
3. Not responding well
4. Slow-psychometrics (crawling,
standing, walking)
5. Speech difficulties
From the problem of child stunting above, there are several recommendations
from the audit team of North Labuhanbatu District in order to reduce stunting rates,
namely in the following ways:
• Improving the ability of parents to develop good parenting for children,
especially in training and stimulating psychomotor and language development
• Develop specific tools for monitoring the psychological/mental development
and growth of children
• Improve the skills of cadres to perform simple therapy on psychological and
motor problems of stunted children, detect children with other mental
problems to distinguish stunted children from children with "Down syndrome,
mental retardation or autism"

Government Strategy in Reducing Stunting Rate for the People of North Labuhanbatu Regency towards Zero Stunting
Andriansyah Putra, H.M. Iqbal Abdul Muin
84
• Equipping posyandu facilities with simple game tools to train psychomotor,
cognitive and language development in children.
3.4 Convergence ActionStunting Reduction
By using an evaluation instrument that takes into account certain markers and
time frames, evaluation of the implementation of obstacle reduction is a cycle or series
of exercises carried out by the joint territorial legislature to assess the performance of
the district/city provincial state in carrying out eight (eight) combined stunting
reduction activities. With the aim of:
1. Estimating the level of implementation of district / city performance in carrying
out 8 (eight) conversion activities to reduce stunting.
2. Ensure the responsibility of regional/city governments in carrying out 8 (eight)
conference activities to reduce stunting.
3. Reviewing local / city governments in implementing 8 (eight) convex activities
to reduce stunting.
4. Appreciating the efforts of representatives of district/city DPRD in
implementing 8 (eight) DPRD activities to reduce stunting.
This stunting reduction convergence action is carried out with (8) eight stages as
follows:
1. Masteransit and situation analysis
2. Activity plan
3. Stunting booth
4. Regent / Mayor Regulation accelerates stunting reduction
5. Development of actors and village / village government
6. Stunting data management system
7. Stunting measurement and publication
8. Annual work review
The general government will survey the presentation of local governments in
carrying out 8 (eight) combined obstacle reduction activities in April – May of the
following year. The general assessment activities of local governments on regional/city
exhibitions start from the Regional Consumption Revenue and Expenditure Plan
(APBD) of provincial parliaments, city and regional governments, and other sources
of financial support.
In addition, in accordance with Presidential Regulation Number 72 of 2021, a
Special Team for Steering and Implementing the Acceleration of Stunting Reduction
was formed. The Vice President became the Basic Chair followed by Human and Social
Change Planning Experts. To accelerate the reduction of stunting, teams have also

85
been formed at the provincial, district/city, and village/village levels.
Based on the explanation of North Labuhanbatu Officials who are currently
based on SSGI information in 2022, North Labuhanbatu Regulations are at an
inhibition prevalence rate of 7.3% or a decrease of 23.6% from 2021 or as many as 382
toddlers. This makes the North Labuhanbatu Regime recorded as the area with the
largest decrease in obstacles in the North Sumatra region and the fourth highest
decline area overall.
In terms of reducing barriers, this obstacle acceleration hypothesis makes sense
in one of the areas that direct government aid. Therefore, families in Indonesia highly
value the health of their mothers and children, especially in light of the public debate
surrounding the Increasing Speed of Barriers Reduction, for which guidelines have
been provided. President Number 72 of 2021 is an overview of a system of good
behavior and implementation. according to the findings of research conducted by
Hayati Sofia Salmon et al, who also want to accelerate the process of reducing stunting
rates in Sangihe Islands Regency.
3.5 Stunting Reduction Program
1. Giving pregnant women iron folate tablets
2. Giving Vit A babies and toddlers
3. Infant and child feeding
4. Provision of lactation counseling
5. Monitoring of nutritional status of outpatient children
6. Inpatient nutritional status monitoring
7. pregnant women education
8. Busui Education
4. CONCLUSION
From the results of research that has been conducted in the previous chapter
regarding the strategy carried out by the North Labuhanbatu district government in
reducing stunting rates, several conclusions can be drawn including: stunting cases
that occur in North Labuhanbatu district occur due to nutritional and health factors.
This often occurs on average in toddlers and pregnant women. The lack of intake
obtained by them makes this stunting case increase. But with this, the North
Labuhanbatu district government has taken a policy to reduce this stunting rate
towards zero stunting in 2024. In terms of overcoming stunting cases that have
occurred, the provincial government conducts district and city governments are
obliged to carry out these activities within a predetermined period of time as part of

Government Strategy in Reducing Stunting Rate for the People of North Labuhanbatu Regency towards Zero Stunting
Andriansyah Putra, H.M. Iqbal Abdul Muin
86
convergence actions to reduce stunting. In order to create this zero stunting. The
strategy carried out by the government in reducing the acceleration of stunting in
North Labuhanbatu Regency is by conducting sweeps to all villages in North
Labuhanbatu Regency and conducting socialization on how to prevent stunting. As
well as providing treatment to pregnant women and toddlers who have been affected
by stunting so that they are quickly given the first treatment.
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