From parallel to partnership governance: Strengthening institutional synergy for stunting reduction in decentralized Indonesia

Stunting is impaired growth and development in children caused by chronic undernutrition, repeated infections, and inadequate psychosocial stimulation. It remains a persistent public health challenge in Indonesia, compounded by fragmented governance and socio-cultural barriers that limited intervention effectiveness. This study aimed to explore the dynamics between formal and informal institutions involved in implementing stunting reduction programs in a decentralized setting. A qualitative case study design was used, with data collected through semi-structured interviews involving 26 participants, including government officials, health practitioners, mothers of stunted or at-risk children, non-governmental organization (NGO) representatives, and religious leaders. The analysis identified four major barriers: institutional fragmentation, cultural misperceptions, regulatory constraints, and weak coordination structures, all of which contributed to overlapping services, resource inefficiencies, and limited community engagement. Participants proposed strategies to address these issues, including establishing multi-level coordination platforms, enhancing community-anchored communication, integrating referral systems, and supporting maternal economic empowerment. Collectively, the study suggested that bridging formal governance structures with informal networks was essential for effective stunting prevention. While findings were context-specific, they offered valuable insights for developing collaborative governance models adaptable to similar settings. Future research should incorporate mixed methods and longitudinal designs to further strengthen evidence and inform policy development.