Enhancing the Design of Length Measuring Board for Stunting Detection in Posyandu: A Qualitative and Quantitative Study

Stunting remains a critical health challenge in Indonesia, affecting approximately 27.7% of children under five years old. Despite national efforts to combat this issue, accurate detection at the community level remains problematic. There is a clear need for improved tools that can enhance the accuracy, usability, and child-friendliness of length measurements in Posyandu settings. The development of a modified length measuring board that facilitates the immediate detection of stunting is needed, particularly in resource-limited areas where traditional tools may be inadequate to use effectively. This study evaluated the effectiveness of a newly designed length measuring board in improving stunting detection in community health posts. A mixed-methods study was conducted across three locations in North Sumatera, Indonesia, involving 120 mother-child pairs and 60 Posyandu caders. The intervention introduced a new design measuring board with integrated stunting thresholds and child-friendly features. Quantitative data on measurement accuracy, efficiency, and user satisfaction were collected through standardized assessments and surveys. This was complemented by qualitative interviews to understand user experiences and implementation challenges. Stunting detection rates increased significantly, 175% (p<0.001) across all study locations. Measurement time decreased from 95.4 to 62.4 seconds (p<0.001), indicating improved efficiency. High satisfaction scores were reported by mothers (mean 9.25-9.68) and cadres (mean 9.5-9.8). Qualitative data revealed themes of increased confidence among healthcare workers, enhanced satisfaction among mothers, and improved community engagement in growth monitoring activities. The new tool demonstrated particular effectiveness in rural areas where traditional measurement methods had been most challenging. The enhanced measuring board significantly improved stunting detection accuracy, efficiency, and user satisfaction in Posyandu settings, potentially contributing to Indonesia's national stunting reduction efforts. This improved tool could strengthen community-based growth monitoring programs and support early intervention strategies for stunting prevention.