Cultural barriers in stunting prevention policy implementation: an ethnographic study in West Sumatra, Indonesia

Despite national efforts to reduce stunting, West Sumatra, Indonesia, still experiences high rates, indicating problems with policy implementation. This study explores how local cultural beliefs, community attitudes, and organizational challenges impact the effectiveness of stunting prevention efforts in three districts prone to stunting. Researchers interviewed local officials, health workers, and community members, observed community practices, and reviewed relevant documents. The study identifies five main obstacles: focusing more on meeting administrative targets rather than engaging communities, misunderstanding stunting as inherited, community distrust due to poor communication, incomplete integration of multiple sectors, and challenges faced by frontline workers. These issues highlight that current stunting prevention methods overlook essential cultural and organizational factors. The study recommends culturally sensitive programs, stronger community involvement, enhanced support for local health workers, and better cooperation across different sectors. The findings help inform global discussions about effectively implementing health policies by emphasizing the need for culturally and contextually suitable interventions.